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 county decisions on money allocation.
County Commissioner Mark Richard, chairman of 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 for their care.
When too many patients are treated, the county picks up the bill at a time when money is tight.
Richard said the high number of 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 budgets meant little to patients. A dose of methadone a day is the difference between stable, even productive lives, and lives of drug addiction, said Martin Branham, 44, a Medicaid patient who was at the methadone clinic Monday. He has reconnected with family members since starting 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. 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 last resort. They have often failed to kick their drug habits through 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.
The clinic now has 358 patients. Many, including those being removed from the list, must arrive there every morning between 5:30 and 9 for their dosage. They must submit to random drug tests 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 their own pockets.
The clinic’s number of Medicaid patients will fall 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 in the context of 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. Pregnant addicts can be forced to take methadone to protect the fetus.
Staying on methadone allows them to breastfeed and remain stable during the 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.