Methadone clinic cutting uninsured patients

A tight budget is prompting Spokane County to cut two dozen uninsured people from its methadone treatment program and will slam shut the possibility that 22 more uninsured drug addicts on the waiting list will get help from the program soon. The program helps heroin addicts and the growing number of patients who are hooked on prescription painkillers maintain some stability in their lives. Going without it, some say, will result in renewed drug addiction and higher crime rates. “We’ll go out and do anything to get what we need. Anything,” said methadone patient Rosie Rousseau, who received a letter Monday from the Spokane Regional Health District informing her that she’d be dropped from the program in 30 days. County Health Officer Dr. Joel McCullough said the cuts are an unfortunate result of tighter budgets and how the county decided to allocate dollars. County Commissioner Mark Richard, who also chairs the health district board, said the methadone program has been treating too many patients on state assistance for several years. The county is reimbursed to treat a set number of patients who rely on Medicaid pay for their care. Having too many of these patients leaves the county picking up the bill at a time when money is tight. Richard said the recurring problem of too many Medicaid patients isn’t necessarily anyone’s fault. He said some patients who enter the clinic with private insurance coverage lose their jobs, and thus their coverage, and become dependent on state assistance. The clinic’s annual budget last year was $1.2 million; of that, about $441,000 came from Medicaid. All the talk of budget problems and dollar allocations mean little to patients. A dose of methadone a day is the difference between them living lives that are stable and even productive enough in some cases to hold jobs, versus lives of drug addiction, said Martin Branham, a Medicaid patient who was at the methadone clinic Monday. Now 44, he has reconnected with family since starting on the methadone program and credits it with salvaging his life. Rousseau said if patients can’t obtain methadone through the clinic, they will be driven back to buying street drugs financed by prostitution, theft and other crimes. “No one here wants that,” Rousseau said, motioning to more than a dozen people gathered at the health district. “But everyone here knows what will happen.” Methadone is not a cure for addiction, and it does not make a user high. Instead it satisfies the body’s demand for opiates including heroin and prescription painkillers such as oxycodone. Many people who take methadone do so as a kind of last resort. They have often failed to kick their drug habits through inpatient or outpatient drug and alcohol dependency centers. “My life was trash before I got on this program,” said a woman who goes by Toney, a heroin addict for 10 years. “I’d be dead.” The program has turned her life around. This year she helped organize a bake sale and other fundraisers that sent five children to summer camp. That’s a long way from her role harboring a criminal in her home years ago that led to a 10-hour standoff with police. The methadone clinic has its critics. People can overdose and die if they combine methadone with other drugs. There are now 358 patients of the clinic. Many, including those being removed from the list, must arrive at the clinic every morning between 5:30 a.m. to 9 a.m. for their dosage. There are random drug tests – a safety measure meant to ensure patients are not abusing other drugs. And they must take a breath test for alcohol. Of the methadone clinic’s 358 patients, 187 are on state medical assistance, meaning that their health care needs – including drug-addiction treatment – are subsidized by taxpayers. The rest have private medical insurance or pay for the methadone out-of-pocket. This year county commissioners made a series of budget decisions that will roll back the number of Medicaid patients to 162. At the same time, the clinic will boost the number of private-pay patients to 238, for a total of 400 people. Julie Albright, the methadone clinic’s program manager, said cutting patients is difficult, especially when viewed in the broader context of the big savings that can be achieved by reducing crime, social services and medical emergencies associated with drug addiction. Among some of the people getting cut from the program are new mothers. Women who are pregnant and drug addicts can be forced to take methadone to protect the fetus. Staying on methadone allows them to breastfeed and remain stable during those difficult first few months of motherhood. Cutting these women off from methadone after their babies are born increases the risk of a drug relapse, Albright said. “This is a program that really saves money and people’s lives,” she said.