WASHINGTON – Maryland is better than the national average at providing addiction services, according to a new report, but state health officials said they still have a long way to go.
A study released Friday by the Robert Wood Foundation found that addiction services reach fewer than one-quarter of the 18 million Americans who need alcohol abuse treatment and the almost 5 million who need drug treatment. It faulted inadequate funding and treatment facilities for the gap.
Maryland, by contrast, serves about 30 percent of the 232,807 state residents in need of drug and alcohol treatment received it, according to a February report by the State Drug Treatment Task Force.
“Maryland is doing quite well,” said Jenny Collier, executive director of the task force. “Maryland is truly a leader in getting organized and focusing on this serious health problem.”
But treatment varies widely across the state. Washington County tries to provide service on demand, for example, even though there are no in-patient treatment facilities in the county. Baltimore City has 93 treatment programs alone, but waiting lists that can stretch to more than two weeks for some services.
“Until the nation realizes this is a health problem, it’s not going to get the attention it needs,” said Anna Guard, a spokeswoman for Join Together, a national organization promoting drug treatment coverage. The organization took part in the release of Friday’s study.
Guard said Maryland is one of only five states that requires insurance coverage for substance abuse treatment equal to coverage for other diseases. The state is also in the process of developing a statewide performance measurement system to monitor the effectiveness of drug treatment programs. Collier said it would be the first program of its type in the country, and should be in place by 2004.
Maryland is spending $123 million on treatment in fiscal 2001. The federal government spent, by comparison, spent $670 million on prevention research and drug treatment in 2000. Seventy percent of Marylanders receiving treatment got state support.
There are a total of 329 treatment programs scattered throughout the state, including four residential facilities and one group home.
The biggest challenges are in Baltimore, where there were more overdose deaths than homicides last year. The city has quadrupled treatment funding in recent years, said Dr. Peter Beilenson, the city’s health commissioner.
“We’ve done more than any other area in the country,” Beilenson said. He touted Baltimore’s enhanced services that provide education, daycare and other training along with the addiction programs.
But Jim Graham of Baltimore Substance Abuse Systems Inc., the company that helps the city coordinate and monitor the treatment funding, said a lot of work remains to be done.
“There is a dire need for residential beds right now,” Graham said.
He said the wait in Baltimore for inpatient detox can be two weeks or longer. The wait for outpatient services was three to four days and the wait for methadone treatment was at least 18 days.
Graham said the delays are not simply an inconvenience. He said addicts often will not seek treatment if they know there is going to be a long wait.
“The demand has always been there,” he said. “The problem is if the supply isn’t there, the demand is decreased.”
Other counties grapple with the problem as best they can. Montgomery County, which has 33 treatment programs, has some of the best services in the state, said clinical supervisor Don Martin.
“Sometimes there’s a delay of two to three days, but the philosophy in this county is treatment on demand,” Martin said.
While some contract out treatment services, Washington County provides its 11 programs on its own.
“We are in the business of providing the direct services ourselves,” said Judy Brown, clinical coordinator for Washington County’s health department.
She said her county also aims to provide treatment on demand, but acknowledged waiting lists for treatment in jails in the county.
The state task force in February recommended additional funding, to increase the number of beds and treatment facilities, and to increase salaries. Staff turnover is huge in drug treatment programs, with more than a 20 percent job vacancy rate in Maryland.
The task force said a $25 million increase in fiscal 2001 and a proposed $22.2 million increase for fiscal 2002 were “a good start,” but that Maryland needs to spend an additional $300 million over the next 10 years.
Local officials agree that funding needs to increase.
“We were very pleased that the governor and lieutenant governor called for the funding to be increased,” in the task force report, Beilenson said.