Breann Johnson stopped using heroin on Mother’s Day this year, determined to end her 13-year addiction. Days later, she began three months of residential treatment in Riverside, Calif. — all paid for by California’s Medicaid program.
Johnson, who has two young sons, said other inpatient drug rehab programs had refused to accept Medicaid, and she knew outpatient care would not be enough to break her habit.
“I couldn’t stop,” said Johnson, 28. “With my drug, you are either sick all day or you have to do it to make yourself feel better.”
As the opioid epidemic burns a path of devastation through communities across the nation, California is leading the way in revamping treatment for low-income residents like Johnson. Before this year, the state’s Medicaid program, known as Medi-Cal, covered only limited and episodic care. Now, it pays for a much broader range of treatment including expanded access to medications, inpatient beds, individual therapy and case managers.
The five-year pilot project, which gives the state flexibility in its use of federal money, was approved in
ncbi 2015 by the agency that oversees Medicaid. The California project officially started earlier this year. Virginia, Massachusetts and Maryland also have federal permission to expand drug treatment for Medicaid members. Other states, including West Virginia and Michigan, are seeking it.
California’s drug rehab overhaul makes it easier for Medi-Cal members to get care and improves their chances of long-term recovery, state health officials said. It also aims to reduce costs by decreasing use of emergency rooms and hospitals and keeping drug-addicted enrollees out of jail and out of the child welfare system.
“It is such a dramatic change to our substance abuse field,” said Marlies Perez, chief of the substance use disorder compliance division at the state Department of Health Care Services. “We turned off one system one day and turned on a whole new system the next.”
Health officials and service providers say that with the federal waiver they are finally able to address addiction as a chronic disease.
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Home » News & Events » NIDA Notes » Treatment » Crime Does Not Increase Around Methadone Clinics in Baltimore Crime Does Not Increase Around Methadone Clinics in Baltimore Citizens’ concerns that methadone treatment centers (MTCs) might be focal points for serious crime are unwarranted, a recent NIDA-supported study suggests. Dr. Susan Boyd and colleagues at the University of Maryland School of Medicine in Baltimore found that crime rates in the immediate vicinities of that city’s MTCs were level with the rates in the surrounding neighborhoods. The researchers used Baltimore City Police Department records from 1999‒2001 and global positioning data to plot the distribution of FBI Part I crimes (homicide, forcible rape, robbery, aggravated assault, burglary, larceny theft, motor vehicle theft, and arson) within a 100-meter (328-foot) radius of 15 MTCs. A statistical analysis of the plots showed that the crimes were no more frequent within 25 meters of the MTCs than they were 75 to 100 meters away. In contrast to the case with MTCs, the likelihood of Part I crimes rose with closer proximity to convenience stores. The researchers suggest that the high volume of foot traffic around these stores provides opportunities for criminals to find victims. Consistent with this surmise, the frequency of crime declined near mid-block residences, where foot traffic is relatively sparse. The study MTCs included all but one of the 16 centers located in Baltimore. They were situated in diverse communities, including inner-city, working-class, and middle-class neighborhoods, according to Dr. Boyd. The convenience stores and residences were located in neighborhoods that closely resembled those of the MTCs in demographic and social features that influence crime rates. “There’s no evidence from our study of increased reports of crime around the methadone clinics,” says Dr. Boyd. She and colleagues are now analyzing data on actual arrests around the study sites to see whether drug sales and possession increase with proximity to methadone treatment centers. The researchers hope that demonstrating that MTCs are not hot spots for crime will reduce public resistance to the building of new centers, and thus remove an impediment to making methadone treatment more widely available. Crime Rates Around 15 Methadone Treatment Facilities, and Matched Convenience Stores and Residential Neighborhoods in Baltimore, 1999–2001 The annual rate of FBI Part I crimes* per unit area (1692 m2) was not significantly associated with proximity to methadone clinics. In contrast, crime increased with proximity to convenience stores and decreased with proximity to points within residential neighborhoods. *Homicide, forcible rape, robbery, aggravated assault, burglary, larceny theft, motor vehicle theft, and arson.
The power of the poison twists my arms and legs, cripples me, and drives me to the ground. I die of thirst, I suffocate, I cannot cry.” Other notable poets that struggled with addiction include Romantic poet Percy Bysshe Shelley who was addicted to the liquid opium of the time laudanum, a struggle shared by Charles Baudelaire, who once wrote, “You have to be always drunk. That’s all there is to it—it’s the only way. So as not to feel the horrible burden of time that breaks your back and bends you to the earth, you have to be continually drunk. But on what? Wine, poetry or virtue, as you wish.” More on Baudelaire and his mood and mind altering preferences below. The Beat Generation openly cited drug use as and to aid in composition and legitimized the practice in that they produced great works. The Poetry Foundation writes that “Allen Ginsberg stated “that some of his best poetry was written under the influence of drugs: the second part of Howl with peyote, Kaddish with amphetamines, and Wales—A Visitation with LSD. While I wouldn’t recommend his methods, it’s hard to argue with Ginsberg’s results: his “angelheaded hipsters burning for the ancient heavenly connection to the starry dynamo in the machinery of night” are a part of the American literary canon.” The Romantic poet composed the hypnotic ‘Kubla Khan’ one of his most famous pieces after waking from an opium induced stupor in which he’d dreamed of the stately pleasure-domes of a Chinese emperor, Coleridge’s addiction finally killed him in 1834. The autobiographical account of his addiction ‘Confessions of an English Opium Eater’, published in 1821, brought De Quincey fame, Baudelaire widened the readership in 1860 when he published a French translation ‘Les paradis artificiels’. Baudelaire was an established member of the Club de Hachichins (Hashish Club), which met between 1844 and 1849 and counted Alexandre Dumas and Eugène Delacroix among its numbers. Baudelaire wrote on hash, ‘among the drugs most efficient in creating what I call the artificial ideal… the most convenient and the most handy are hashish and opium.’ Robert Louis Stevenson, suffering from the effects of tuberculosis and medical cocaine wrote ‘The Strange Case of Dr. Jekyll and Mr. Hyde’ (1886). As his wife, who hated the book and tried to destroy it, noted, ‘That an invalid in my husband’s condition of health should have been able to perform the manual labour alone of putting 60,000 words on paper in six days, seems almost incredible.’ In ‘The Doors of Perception’, (1954), Huxley recounts at length his experience on the hallucinogenic mescaline which is to be found in the Peyote cactus. The book is the inspiration behind Jim Morrison’s band name ‘The Doors’. Burroughs used his experience of addiction as inspiration throughout his writing, most notably in Junkie (1953) and Naked Lunch (1959). http://drug.addictionblog.org/writers-and-their-drugs-of-choice/