Rehab Madness

Addiction treatment in Madison is a patchwork of vanishing resources

In Madison, the problems of alcohol and other drug addiction are increasingly with us, despite the efforts of citizens’ groups, school programs, social service agencies and law enforcement at every level of government. People who need treatment today face waiting lists that stretch for months. And they receive fewer services than ever, largely because of disappearing insurance coverage and
cutbacks in public funding. Providers are sounding the alarm.

“I get, probably, twenty to forty calls a day, seven days a week, from people begging for treatment,” says Michael Florek, founder of the in- and out-patient treatment facility Tellurian. “Right now I have to tell them, ‘We can’t get you in until next year, maybe March.’”

Other providers note that people who do get into treatment here find that their stay, even for the grueling physical withdrawal from their drug of choice, is almost certain to be very short. And not at all like the luxurious “rehab” depicted in celebrity tabloids and advertised on local television.

“It started with thirty days and then it went to twenty-one and there are now some places that really only offer three to seven days of inpatient treatment,” says Michael Gerst, program manager of NewStart treatment center, describing how providers everywhere have scaled back services.

As a result, Florek says, “The biggest withdrawal facility in Dane County is the jail.”

Typically arrested on drug-related charges, many of those people are withdrawing from drugs classified as opiates, such as the prescription drug OxyContin and the street drug heroin. While alcoholism continues its relentless assault on social services, experts now say the epidemic of opiate abuse in the area alarms them the most. Almost nothing, they say, seduces the human brain faster or more lethally than an opiate.

“This drug takes over executive function of the brain,” explains Gerst. “Alcohol eventually does that, but opiates, if used improperly, do that within a week. It is an extremely dangerous drug.”

And nearly impossible to resist because physical withdrawal does nothing to address the rapid changes in the brain that have been caused by even short-term opiate abuse.

The best hope for people addicted to this class of drug, say Gerst and other providers, is supervised, long-term opiate replacement therapy with medications such as Suboxone or methadone. (And, of course, necessary medical treatment, supportive counseling as well as group therapy, and significant lifestyle changes.)

Yet only a handful of doctors in Dane County hold the special license required to prescribe Suboxone—which has, itself, become a valuable street drug in Madison, notes Florek. Sadly, these physicians, too, have waiting lists.

Fair or not, the well-documented rise in opiate abuse among white suburban teenagers and young adults seems to have brought new urgency to the efforts of civic and community leaders. After a local teenager died of an overdose in January, the mayor convened a February mini- summit with city and county officials, service providers and law enforcement. A major initiative has not yet come from the efforts discussed at that meeting or at a subsequent one, although the mayor’s 2011 budget includes funding for more prescription medication drop-off locations. Meanwhile, 2010 ends with twenty opiate overdose deaths in Dane County, over twice the number of deaths in 2009.

Call for Help: Madison-area addiction treatment options

Mary Erpenbach and Catherine Erhard are area freelance writers.

Read more Madison Magazine health features here.

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