Report: Many addicts not getting help

Fewer than one out of 10 North Carolinians who use illegal drugs -- and only one of 20 with alcohol problems -- get state-funded help, and the treatment they do receive is out-of-date and inadequate.

That's the news legislators will hear today when a General Assembly committee gets a preview of a new N.C. Institute of Medicine report on the state of substance abuse services.

Despite a moribund economy and projected shortfalls in state revenue, the report recommends that North Carolina spend an additional $94 million on substance abuse services during the next two years, said Pam Silberman, president of the N.C. Institute of Medicine.

However, Silberman said, the recommended increases in tobacco and alcohol taxes would raise more than the amounts requested. Sen. Martin Nesbitt, the Asheville Democrat who helped lead the task force that wrote the report, thinks legislators will take the need for new substance abuse approaches seriously when faced with the larger costs of addiction.

North Carolina can't afford not to spend more money on substance abuse programs, Nesbitt and other proponents say. The state's economy loses more than $12 billion annually in direct and indirect costs from substance abuse because of premature deaths, crime, traffic accidents, lowered productivity, unemployment and other social ills, the report says.

"You can cut back on treatment, but you end up paying in cops, hospitals and broken families later on," said Wake Forest University addiction expert David Friedman, who studies the brain chemistry of addiction.

But House Speaker Joe Hackney, an Orange County Democrat, said it's too early to make budget determinations.

"Of course, it's a tough year for expansion of any existing program or any new programs," Hackney said Tuesday.

"The committees of the House and Senate are expert at looking at things like this and judging them, and I think that's what they'll do," he said.

More than 60 scientists, doctors, legislators, substance abuse program managers, people dealing with addiction and others spent 14 months putting together the mostly critical report, which still requires approval by the institute's board.

Friedman, of Wake Forest University, said revamping the system will require overcoming a bias among legislators that addiction is a self-inflicted injury.

"If we allowed this to happen in any other kind of treatment program for any other disease, it'd be a scandal," he said.

A key recommendation is that the system should be revamped to reflect up-to-date medical knowledge: that addicts have a brain disorder requiring ongoing treatment and follow-up.

"Addiction is a chronic disease no different than sugar diabetes or heart disease. It is something that you must live with all your life," Nesbitt said

The scientists and doctors who spoke to the task force emphasized that addicts can't be "fixed" the way a patient with a broken leg is healed.

"Instead, the goal of treatment is to manage them so that the burden on the individual -- and to the health care system, the workplace and society in general -- is minimized as much as possible," the report says.

'Give people time'

Robyn Duff, 33, is a recovering addict and a staff member in training at the nonprofit agency Triangle Residential Options for Substance Abusers, or TROSA, in Durham. She experienced firsthand the value of one recommendation: that treatment has to last long enough to head users toward long-term recovery.

Duff said she came to TROSA in 2006 when she was trying to kick 13 years of alcohol abuse, paired with crack and powder cocaine use for the last three of those years.