Addiction treatment gets renewed attention from state
Bob Beers isn’t your typical small business owner.
He’s one of a handful of counselors in Iowa certified by the U.S. Department of Transportation to evaluate whether airline pilots, truck drivers and others in safety-sensitive positions can return to work after being treated for drug or alcohol use on the job. But he also counsels others on chemical dependency issues, both individually and through contracts he has with corporate employee assistance programs.
Beers started his one-person business, Addiction Technology Services LC, after being downsized from his job as clinical supervisor of the Powell Chemical Dependency Treatment Center a year and a half ago.
“It’s really rewarding to see people turn their lives around,” said Beers, a recovering alcoholic who became a counselor after a career in the Navy. “Am I going to make a million dollars doing this? No way. But I do enjoy it.”
Alcohol remains the primary substance of abuse in Iowa, though it’s slowly losing that status to other drugs. Fifty-eight percent of the adults admitted to substance abuse treatment centers in the state last year went for alcohol abuse treatment. Among illegal drugs, marijuana has long been the predominant drug of choice in Iowa. The number of adults admitted to treatment programs for marijuana use has increased 38 percent since 1996, according to the state’s Substance Abuse Reporting System.
At the same time, national figures indicate that fewer than a quarter of substance abusers receive treatment, and that half of those people leave the programs before receiving the full benefits of treatment. Studies estimate that more than 340,000 Iowans are in need of substance abuse treatment.
Lack of access to chemical dependency treatment programs is a problem that state officials are working to address. Last week, the Iowa Department of Public Health announced that Iowa was among four states selected for a pilot program that will examine ways to remove barriers that prevent people from accessing or completing treatment programs.
While at Powell, Beers worked firsthand with that problem.
“My job was to get the waiting list down from about 300 people to about 30,” he said. “I think the hardest thing in Iowa is an issue called on-demand treatment. … It can really take over a program and result in having all state-funded clients at a treatment center, which is moving some of the insured people away from treatment centers.”
For those who have the $20,000 or more needed to gain admission to private centers, which are typically located outside the state, immediate treatment is readily available, he said. Also, people who don’t have any insurance or funds probably have the best access to treatment through state-funded programs. It’s those in the middle who may have the most difficulty finding treatment, he said.
At the same time, “companies are more willing to work with people nowadays than they ever were before,” Beers said. “They understand what it costs to hire and process a new employee and train them.”
From the perspective of an employee assistance program provider, a relative minority of employee referrals are now made for substance abuse treatment, said Tom Farley, director of employee assistance programs for Employee and Family Resources.
Though EAPs originated in the 1950s and 1960s largely to address alcohol abuse problems, the programs have since evolved to refer employees for help with a wide range of family and mental health issues, Farley said.
Of a sample of 2,656 people who recently used the EAP over a one-year period, 9 percent used it for drug or alcohol treatment or counseling. Of the people who sought treatment, 12 were referred to an intensive outpatient program; another 12 to continuing care followup programs. Eleven were referred to education classes, nine to self-help groups, one checked into a residential treatment program and two entered a medically managed inpatient treatment program.
“I think that this (variety of methods) speaks to the approach that if someone needs a medically managed program, we refer them there,” Farley said. “But we try to use the resources in the community that are the least intensive.”
Using a $15,000 grant from the Robert Wood Johnson Foundation, the state will begin a one-year pilot program in which the Department of Public Health and a selected provider, Iowa City-based Mid Eastern Council for Chemical Abuse, or MECCA, will participate. MECCA provides services at centers in both Central and Eastern Iowa.
“MECCA’s going to be doing it on a program basis to examine its internal procedures,” said Janet Zwick, director of the health department’s Division of Behavioral Health. “We’ll be doing it on a statewide basis to examine regulatory issues.”
Though $15,000 isn’t a lot of money, the value of the grant is magnified by the access it provides to technical assistance to conduct the research, said Kevin Teale, a spokesman for the Iowa Department of Public Health.
For those that complete substance abuse treatment in Iowa, the statistics are somwhat encouraging. According to interviews of former clients conducted by treatment providers in 2003, approximately half were still clean six months after discharge, while a little more than half were employed and nearly 90 percent were arrest-free.
From Beers’ perspective, “one of the biggest problems we’re going to see will occur as the Baby Boomers are now getting into the geriatric population, if you will. We’re not just abusing our prescription drugs and alcohol; we’re bringing our drugs of choice with us. You’re going to see people in their 60s and 70s who are using marijuana and heroin. … So the needs are changing, and we need to look at different ways of doing business.”