West Virginia lawmakers back more addiction treatment

Published: Apr. 11, 2017 at 5:21 PM EDT
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With more than 30,000 West Virginians already in drug treatment, lawmakers struggling with the state's addiction crisis have voted to spend $24 million from recent court settlements with opioid distributors to increase inpatient beds.

The bill passed by the House and Senate and awaiting Gov. Jim Justice's consideration would authorize the Department of Health and Human Resources to ensure that treatment beds are available in the highest priority areas throughout the state.

They would give preference to West Virginians and accept private, insurance or Medicaid payments and work closely with drug courts. West Virginia currently has 314 crisis and detoxification beds and 818 recovery beds, according to the department.

An earlier version of the bill had called for 600 additional beds, a provision removed from the legislation that finally passed. The department has not yet decided how many beds or where they'll be located.

"DHHR plans to evaluate where the greatest need is for these types of services and develop a plan," spokeswoman Allison Adler said. "An application-type process will be used to encourage the private sector to apply to build these facilities."

Last year, 844 people died for drug overdoses in West Virginia, 708 involving at least one opioid, according to updated information from the West Virginia Health Statistics Center. They included heroin, fentanyl and prescription painkillers. Some 101 cases involved methamphetamines and 149 involved cocaine.

The West Virginia Behavioral Health Providers Association's members provide mainly outpatient addiction treatment to about 30,000 people, Executive Director Mark Brennan said. They include the network of nonprofit agencies designated by the state as 13 Comprehensive Behavioral Health Centers with coverage in all 55 counties.

"Most of our members try to have open access at least part of the time," Brennan said. "Just about anywhere today you can be seen officially for a workup and then they can get you in a rotation ... Probably a little bit of wait time for medication-assisted treatment ... As far as outpatient services, usually people can get right in."

For those with opioid addictions, outpatient treatment usually involves prescribing an opioid-uptake inhibitor that prevents patients from being able to get high and calms some withdrawal symptoms, Brennan said. They also receive therapy. Both can begin in a detox, residential or intensive outpatient program.

Data show treatment program outcomes are effective for many people who complete them, though many who aren't ready drop out, Brennan said. "We've done a lot of work to increase the number of recovery beds, and we've got a pretty good handle on the detox units as well. Where the gap is — those 30-, 60-, 90-day programs, and if some of that settlement money could be used to do that, there's certainly a need for that."

The state has also applied for a Medicaid waiver to expand treatment opportunities for people with addictions, Brennan said. A study a few years ago showed 60,000 West Virginians needing treatment, and that's probably increased since, he said.

At WVU Medicine, its outpatient opioid-addiction program has grown to 500 patients, primarily treated with prescription suboxone, available since about 2002, and regular clinic sessions with a physician, group therapy, and 12-step or peer-recovery groups, said Dr. James Barry, director of WVU's Chestnut Ridge Center.

He said there were 600 people recently on its waiting list.