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Feature: Schwarzenegger Trying to Gut California Methadone Funding in Budget Move

With California facing a $19 billion budget deficit, Gov. Arnold Schwarzenegger (R) last month proposed saving the state $53 million by cutting off Medi-Cal funding for methadone maintenance for most heroin addicts. That would cause the loss of more than $60 million in matching federal funds. The move was fiercely resisted by methadone advocates -- including a former drug czar -- and public policy analysts, and the proposal was defeated last week in committee votes in the state Senate and Assembly.

But California gives the governor the power to veto individual budget items, so advocates are not resting yet. Instead they are reaching out to the administration in hopes they can enlighten it and persuade the budget axe-wielding Schwarzenegger to aim elsewhere.

Schwarzenegger isn't the first top-tier elected official to go after methadone maintenance. Back in 1999, then New York City Mayor Rudy Giuliani vowed to wean all of the city's methadone patients off it in three months. While Giuliani acted for ideological rather than budgetary reasons -- he said he wanted "drug freedom," not drug dependence -- the pugnacious mayor later changed his tune, admitting the idea was "maybe somewhat unrealistic."

http://www.stopthedrugwar.org/files/harm-reduction-superheroes-vancouver.jpg
superheroes for harm reduction: ''Methadone Man'' public awareness campaign during last February's Olympics in Vancouver. You're needed everywhere, Methadone Man.
Currently, nearly 150 methadone clinics provide the heroin substitute to some 35,000 addicts, 55% of whom are on Medi-Cal. Advocates and treatment providers said that clinics would be forced to close if the proposal passed, affecting not only the Medi-Cal patients, but also patients who paid out of their own pockets or through private insurance to be able to get maintenance methadone.

"Methadone isn't a cure," said Roxanne Baker, president of the National Alliance of Methadone Advocates (NAMA), "but much like thyroid medication, as long as you keep taking it, it keeps your disease in check, and opiate addiction is a disease. When you mess with your brain with painkillers, it then doesn't produce the endorphins it should. It's not a matter of will power, it's a disease. You need something to replace those endorphins, whether its methadone, suboxone, or even prescription heroin, although I doubt we'll ever see that here."

Enacting the proposed cuts would be "a disaster," said Baker. "There would be no methadone programs left. More than half the patients statewide are on drug MediCal, and they wouldn't even have a place to go. A lot of these people have their lives in order. This is somebody's brother, somebody's aunt, somebody's mom. Please don't take this from us."

Last week, Clinton-era drug czar Gen. Barry McCaffrey flew into the state to hold a press conference denouncing the cut. "Dumping tens of thousands of opiate addicts back on the street would be an immediate disaster to law enforcement, and to the families of people who have become stable, functioning adults" thanks to methadone, said McCaffrey, who has a consulting firm and serves on the board of directors of an organization that treats chemical dependency.

Legislators were listening, not only to McCaffrey, but to the methadone treatment community. A Senate Budget Committee hearing last week proved tough going for Schwarzenegger's representatives.

"This measure would eliminate the drug MediCal program with the exception of the perinatal and youth funding," said John Wardlaw from the state Department of Finance. "This is not an easy reduction in any way. We are at the point where we are making very difficult reductions."

Committee Chair Denise Moreno Ducheny (D-San Diego) wasn't buying it. "How much federal funding are you giving up?" she asked.

"Sixty-six million dollars," Wardlaw said.

"We save $53 million and lose $66 million?" asked Ducheny.

"That is correct, ma'am."

Ducheny just stared at him for a few uncomfortable moments before moving on to the next witness.

"There would be cost shifts in the area of corrections and child welfare services," Greg Tallivant of the legislative analysts' office told the solons. "The day the clinic closes, those people have to do something. If they can't make it to the next methadone clinic, heroin would be the next choice. You would see people arrested. You would see prison costs and child welfare costs go up."

Assemblyman Mark Leno (D-San Francisco) was visibly irritated by the proposal. "There is a complete lack of interest in any cost-benefit analysis here," he said. "This is reckless and cavalier. It doesn't really make much sense. We have 171,000 people addicted to drugs. This will increase our crime rate; it's a recipe for disaster on our streets. Does the governor have no interest in this or does he not believe that this will impact the safety of our children and communities? We've already zero-funded the base Proposition 36 program. The outcome of this is to have drug offenders with no jail and no treatment."

"This is really a short-sighted proposal that shifts costs from funding treatment to funding law enforcement, jails, and prisons," said Jason Kletter, a member of the Bay Area Addiction Research Team (BAART), which is in turn a member of California Opioid Maintenance Providers (COMP), a nonprofit organization representing opioid maintenance treatment centers. "It is a public safety issue, to say nothing of the humanitarian crisis it would provoke," he said.

"We think if this happened many clinics would close, and the folks who lose access to care would likely relapse and cost the system much, much more in a short time," said Kletter. "We see relapse rates of 80% within a year when clinics close, so it wouldn't even be like we'd be kicking the can three or four years down the road."

"This would have the biggest impact on programs that have a high percentage of Medi-Cal beneficiaries in treatment and would be unable to stay open because more than half their patients, and thus, their revenues, are gone," said Kletter. "You would have a fundamental dismantling of the system."

The cost incurred would be staggering, Kletter said."If 80% relapse in same year, we know that the state will incur $700 million to $1 billion in new costs in the criminal justice system," he said, citing a study from the 1990s that found each dollar invested in treatment produced a seven-dollar return. "The state wants to save $53 million by eliminating drug Medi-Cal and will also turn away more than $60 million in matching funds. That's $115 total program cost. A seven-to-one return on that is close to a billion dollars. "With 80% relapse, we could end up seeing $700 million in new criminal justice and prison costs."

"It's a terrible proposal," said Glenn Backes, a Sacramento-based public policy analyst who works with the Drug Policy Alliance at the Capitol. "California Democrats in both houses have said so. The Senate Republicans didn't do a cost-benefit analysis; they just said we can't afford to give out subsidized health care."

But in reality, the situation is even worse, said Backes. "They've killed Proposition 36 funding, drug courts are being slashed. According to the governor's finance director, that's 171,000 patients. The cost-benefit for this is worse than nil. If only one out of a thousand relapses and goes to prison, you've already lost money because prison is so much more expensive than treatment. If only one out of a thousand gets Hep C, the taxpayer loses. If only one out of a thousand gets HIV, the taxpayer loses."

It's easy to lose the human side in all the numbers, Backes said. "If only one out of a thousand ODs and dies, that's 170 California families who have lost a loved one."

And the battle continues. "While both the Senate and the Assembly budget committees have rejected the governor's proposal, in California, the governor has a line item veto," said Kletter. "We are continuing to try to work with the administration to explain the impact of this kind of proposal and get them to understand it is a public safety and cost-shifting issue. We haven't had any direct meeting with them yet, but that's next on our agenda. We want to educate them about them dire consequences of this sort of action."

Even if advocates many to salvage the drug Medi-Cal program, they would be well-advised to be searching for alternative funding sources, and how better than to take money from the drug war? Tough times call for creative solutions, and Backes has one: Use federal Byrne Justice Assistance Grants to fund treatment instead of drug task forces. Every dollar funding more drug war arrests costs $10 additional in spending for courts and prisons, he said.

"Historically, Byrne grant funds have been given to task forces to increase arrests," Backes noted. "The Drug Policy Alliance position is that Byrne funds would be better spent on almost anything other than doing low-level drug sweeps. We would rather see that money go into treatment for people in the system."

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medi-cal funding for methadone clinics

I do not live in california. But, I am a chronic pain patient due to 2 failed spinal fusions and all that comes with it.
If I were to stop my pain meds and had to go to a methadone clinic I would certainly hope this alternative would be available to me;
It is CRITICAL that these clinics remain open and that persons on Medi-cal
have the open option of receiving care for their addiction!!!
If this funding is cut, then the state of Calif. will have some very, very, sick people that will be UNABLE to work, and be good citizens.
The consequences of cutting this funding will result in more crime!!!

'To the governor of Calif.:
Please do not do this.

A concerned citizen from another state.

California Medi-Cal Methadone funding

I was injured in 1986 and my back was broken. I was working at the time as a printer, but I was working in small shops that didn't carry their own insurance, so I found myself in the "Los Angeles County Hospital".

From there they sent me "a white man", to a Convelesent Hospital in Watts. There was no problem with the race relationship, but I needed a friend to pick me up and take me back to my home city to recover, and she did.

There still remained the problem of my meds, I had injured several organs, but with no insurance, I had no meds for anything, and the most important to me were the pain meds. No-one can describe what you feel when it's phantom pain, just as if you lost a limb. Dr.s can, and did stick a needle into the bottom of my foot, but I couldn't feel anything.

Please Californians, Arnold Schwartzaneggar has already cut life giving medication to people here in this state who suffer from AIDS, HIV, and I don't know what else, but I do know that now he is trying to cut Methadone Maintenance from Medical, and this will cause us to loose aproximately 15 Million from the Federal government in reciprocating funds. What is he doing?

It looks to me like he is saving 55 million, and loosing 65 million from the Federal Government. Did you get that? Trade 55 for 65? Looks to me like a loss of about 10 million dollars, but I might not have read the proposition right, it could be a loss of 10 billion, I'm not sure, and I don't think so, but isn't a loss of 10 million bad enough?
Please don't vote for this man in any other election, and with his wife a Kennedy, he just might be able to ammend the Constitution to qualify for President.
Lord help me and the thousands like me.

SO TRUE

IF The budget is cut there is gonna be alot of angry people and there are going to be way more crimes from angry people in pain.I think It's just a way of sticking more money back into there own pockets the selfish bastards. Arnold needs to go back to being an actor and stay the hell away from the government because he is starting to be a tumor in this country!! trust me IT IS A TUUUMA! LOL

Hmmm

sicntired@mac.com,Vancouver,B.C.CanadaIt's no surprise to me that the methadone community has mounted such a significant defense to this idiotic proposal.While I have personal objections to the whole methadone idea removing it without first putting in place a maintenance program of some kind of opiate would cause a crime wave the likes of which we haven't seen before.I have always maintained that if an addict is to remain an addict it should be on their drug of choice.Methadone has become an accepted way to deal with heroin addiction and is making a lot of money for the people who provide the treatment.Until we develop a sane approach to the whole drug phenomenon,we are stuck with things like methadone maintenance and until things change,it's the best choice addicts have if they are tired of the jail,street,jail roller coaster.

Methadone and Medi-Cal

I heard about this a week ago and I have already Emailed the Govenor.. , If this becomes a reality we will lose friends loved ones and families to relapse, OD's. AIDS, HIV, and we will also have these loved ones for the first time in decades return to a life of crime, and we will once again fill the prison systems with addicts who have been productive members of society because of the backlash this will have. Even though I pay cash for my Methadone, many of my friends and family don't have that option..Where will that leave them? This Gov is trying to cut the budget by taking away the one thing that lets addicts live normal lives. I am scared and I hope you are all scared too because if this happens too many lives will be ruined by the impact of such a loss of funds..I am asking all of you to please email the Gov..Don't say "This can't happen" it has happened before and it can happen again..
I am a heroin addict who is on Methadone Maintence, I am not a criminal, I have a diease..I am scared for all of my fellow addicts who are on methadone maintenance AND on Medi-Cal..PLEASE write TODAY

Patrice N

i am sure you were forced to

i am sure you were forced to do heroin against your will. so i guess what i am saying is you were a criminal, and because of that you are now an addict that the state and federal government must subsidize for your lack of decision making skills. so in reality you and everyone else (heroin addicts) are a huge drain on society and i feel little sympathy for you, however you are all correct that paying for your fix is the lesser of two evils..........

borden's picture

it's the government's fault because of prohibition.

If heroin (and methadone) were legal, it would be affordable and addicts could buy it without needing the taxpayer's help. Even now, methadone wouldn't cost as much, if they'd just let people get it for maintenance purposes from their doctors, although some training might be needed to increase the number of doctors who are qualified.

In the meanwhile, the least the government can do to make up for the mess it's created is to pay for the maintenance programs, which as you pointed out is less costly than the current alternatives.

Also why is there less sympathy for the addict who needs help than the person whose obesity or smoking or lack of exercise led to heart disease or lung cancer? They made choices too. Let he who has perfect living habits cast the first stone at the methadone patients.

David Borden, Executive Director
StoptheDrugWar.org: the Drug Reform Coordination Network
Washington, DC
http://stopthedrugwar.org

i'm sure there are few

i'm sure there are few people that have been forced to do heroin but there are many like me who have had some sort of surgery and were put on extremely powerful opiates for pain and left on them for too long and even in my case had my script filled before it should have been so that I was taking 400mg's of oxycodone before i even started on heroin because the medication wasn't doing anything for me anymore and at that point i was already an addict thanks to the medical system. And like said above if we could just have methadone prescribed to us by our primary physician it would cut the cost down to nil. Methadone is a cheap drug but at my clinic it costs over $400/mo which is the same as my jeep payment, although i have the money to pay out of pocket, but some people do not, more of our tax money will go to locking addicts up than it is to helping with MMT. Have some compassion for mankind, as I hope you never have to feel the pain of any addiction especially not heroin addiction.

Arnold's proposal to cut Medi-Cal and Methadone

Dear Patrice N.
I wish I new how to email the Governor, but I don't. Do you or anyone else know the email address to email the governor?
I would be deeply grateful for the information.
Chuck_les

Addiction Treatment

After all the trials and proven success in achieving very high detox completion rates and longer-term recovery why is this site not talking about naltrexone? The evidence is clear that people who are no longer dependent on opaites do much better than those addicted to methaone. Many people addicted to methadone have achieved some level of stability in their lives and for them it is no longer relevant and it becomes the biggest barrier to leading a normal life. Many on methadone are now sick of the restrictions it places on their lives and naltrexone is a viable option that should be made availble.

Methadone and Medi-Cal

This article is not about your book. Please take it elsewhere.
PatriceN

A reply to your naltrexone

Have you ever been in a situation, for what ever reason, maybe it was cancer, maybe you broke your femor in a motorcycle accident, or car accident. Anything that gave you so much pain that you begged the Dr's to amputate, say your leg, because you just couldn't stand the pain anymore?

I was, and I did!

I was in an accident that paralyzed me from the waist down. I was in so much pain that I didn't sleep for more than one hour a day, if I was lucky. Just the loss of sleep left me feeling like I had taken drugs, because I was so spaced out.

Doctor's refused to amputate my leg at that time, but the pain I was in left me unable to walk without the use of a walker. A walker you may say "so what, lot's of people use walkers", and there comes a point in everyone's life, if they are lucky enough to live that long...they are going to need a walker. But I was only 36 years old.

After being released from the County Hospital, and excaping from the Convelesant Hospital (that had cockroaches crawling down every isle) I was at last free to look for my own treatment, and I found the Methadone Clinic, actually the best alternative.

Doctors thought so too, because my Neurosurgeon gave me a letter to take to the nearest clinic, which was in Glendale.

I took his letter there and after medical examinations, was put on the Methadone Maintenance program, for pain! This is something that most people in the US don't understand, unless you have had a relative or friend who has been critically injured.

Methadone is the preferred treatment for extreme pain. I can't begin to count the number of patients who have come into my clinic with terrible injuries...a leg ripped off in an accident between a car and an 18 wheel truck, or an arm, and leg amputated because of a motorcycle accident. You would have to see it to believe it, and after spending 6 weeks in the California County Hospital I've seen just about everything.

Please help in anyway you can to stop Schwartzanegger from passing this bill. Please.

It doesn't matter if my name is shown, because my heart only works a 50% of what it should, and in the event that this passes I'm sure I will die, because I've seen a man deprived of his methadone die!!, and he was half the age I am.
Charles Barnett

Getting Naltrexone Treatment

You can enquire about naltrexone treamtent by sending an email to ross@addctiontreamtent.com.au

Getting Naltrexone Treatment

Sorry, that should read ross@addictiontreatment.com.au

Naltrexone Book

A new book, The Use of Naltrexone in the Treatment of Opiate Depedence is now available

Methadone cutbacks

I truely think there should be cutbacks for medi-cal paying for methadone treatment. I've work in this field almost three decades in methadone clinic from east coast to westcoast. The clinic are nothning but juice bars. The majority of the patient are still using, The motto of Methadone clinic is "if there not usinhg herion", "we have succeeded". i WILL ADMIT 30 % of the patience are using cocaine, crack cocaine, or methamphetamines. So do you really think that they are not out committing crime? Im sure of it, they are commiting crime at a high rate. The patient also uses herion as well..Tax payers may not be aware or fail to look at the whole picture of waste .All patinet that are on medi-cal, either recieve Tanf, or AFDC, or SSi. So can you see the waste of tax payers dollar Billions. I believe in treatment, but the methadone clinic has fail drastically and cutback should be used at this time till other services can be seek out. Limit time patient can be on methadone and the patient has to quit using illicit drug, every illicit drug, not just opiate. How can treatment be effective when a patient is still using?

borden's picture

science

The science overwhelmingly finds that methadone maintenance is the most effective treatment for heroin addiction. See, for example, the National Institutes of Health Consensus Statement.

Also, although you think you "know" that the patients are out committing crime at high rates, the scientists who wrote and signed the same consensus statement, using science determined the opposite, a large amount of crime is being prevented.

No treatment is perfect, but as Bob Newman likes to say, we should not make the best the enemy of the good. Science has found this treatment to be the best available for this particular condition, and science does not back up the time limits that you've suggested.

David Borden, Executive Director
StoptheDrugWar.org: the Drug Reform Coordination Network
Washington, DC
http://stopthedrugwar.org

Clinics Hire Hateful Harpies? [Reply to "Anonymous"-comment]

While it strains credulity to believe that someone with your limited English skills actually works in the health care field, I will, for the time being, take you at your word. Perhaps the reason that you've worked at so many different clinics "from east coast to westcoast" (sic) rather than remaining gainfully employed at ONE job, stems from your obvious contempt for the client base you ostensibly SERVE. I have come across your kind before, disdain and condescention oozing from every pore as you look down your nose at me; Your type never lasts for long. I could tell you I use no illicit drugs. I could SHOW you my YEARS' worth of clean urine test results from the clinic, and you'd STILL probably think I was using "somehow." While I DO believe there needs to be some point (2 Years, maybe?) past which a patient who is consistently testing dirty should be switched to private-pay or nothing, I believe even more strongly that YOU, my dear, need to look into a different line of work!

Reply to Methadone cutbacks

Whoever it was that said a certain percentage of people on Methadone Maintenance are still out there using drugs and that it should be cut because of it you are highly mistaken. The clinic that I go to do random drug tests. And no, there is no way to fake the drug test by doing all the little tricks people have been using to dilute the urine or drink those 24hour cleanse bla bla bla, because people under suspicion have to take a mouth swab type of test. So that argument can just get flushed down the toilet. Come on now, were way ahead of you pal.I think that it will be a COMPLETE and UTTER disaster if they stop funding. MMT is not only used for people who have opiate addiction, but also for people who are not addicts at all, but need it for pain. There are tons of people who have chronic pain that have such a high tolerance to the pain medication such as Oxycodone or Fentanyl even that they have to use methadone. This is a very bad idea MR GOVENOR!! pff

methadone

Cutting back on methadone treatment would be a disaster to the people who are really wanting to move on and get their lives back. What about ALL the people on meth for pain therapy? Should they just suffer ? It's easier to point fingers at the users. Unless you have a loved one that is caught in addiction ,or you are the one that's the addict, OTHERS HAVE  NO IDEA of what it is really like, to walk in the shoes of the addicted. Yes there are plenty of abusers to the program that is why random urine are given .NOBODY says "When I grow up I want to be a junky!, the best damn addict I can be!" Addiction happens and it is not going away. What about the Rapid detoxification that gets you clean under sedation for 3-4 days ?(Dr monitored) It's like $5000 a shot!

Why is this not offered? Because addiction is a MONEY maker!!!!! Everyone should get ONE free chance at it, if you mess up after, your fault. You pay next time.

Methadone is a multi million $ maker, do you know how much Dr's get for every script the write??? They can sign their names in their sleep and dream of $$$$ signs, The truth is this subject will go on forever, there is no solution......

The point is drugs are here and they aren't going away, face the facts,it's a multi-billion dollar business all over the world, and if you think our government is NOT involved. THINK AGAIN! drugs are here to stay, so are all the clinics and treatment centers and scientific talks on HOW to beat them. It is never ending, get used to it...

That's like saving money by

That's like saving money by cutting the fire department. I know when I was on dope it didn't matter about right or wrong I got my issue. And these guys will get theirs . Millions in copper wire will be scrapped , banks robbed , theft , fraud it adds up to way more than some methadone. 

GOP

dumbass republicans. stay out of our health care. Its seriously time to get rid of this GOP mess and send them to an island or something. Their vendetta against accessible healthcare is despicable and now they want to cut away drug treatment programs too? get rid of his steroid pumping, womanizing, posing for "blueboy" magazine faggot

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