Expert: Addiction treatment lacking

BANGOR – In a joint effort to keep more young people away from addictive drugs, juvenile justice officials and substance abuse treatment providers from around the state teamed up Friday for a daylong look at a subject that concerns them all.

“If kids in the criminal justice system aren’t in treatment [for opiate addiction], they’ll continue to use as soon as they get out. They have a brain disorder; it’s sort of like jailing a diabetic for seeking insulin,” said Dr. Mark Publicker, medical director of the Mercy Recovery Center in Westbrook.

Publicker, the keynote speaker, told the audience that Maine communities and state agencies need to develop a new “culture” that recognizes and supports addiction treatment and recovery.

The city of Caribou, Publicker said, is one Maine community that has risen to the challenge. When officials there realized that a number of teens and young adults from northern Aroostook County were traveling all the way to Westbrook for treatment, they took action. A public meeting attracted about 1,500 area residents who were ready to face the problem head-on, and not, Publicker said, to deny it existed.

Within a year, he said, eight area physicians were certified to treat their patients with the opiate replacement drug Suboxone, and the Aroostook Mental Health Center had developed a comprehensive treatment program to address substance abuse and mental illness, conditions that often co-exist.

A community group is exploring the possibility of establishing drug-free housing for individuals in recovery.

Publicker stressed that intensive counseling and behavioral therapies are essential components of addiction treatment and recovery.

Publicker said the corrections world has been slower to respond to the addiction crisis in Maine. While some county jails allow inmates to be treated with Suboxone or methadone to help them endure the pain and sickness of withdrawal, others do not. Publicker called the failure to provide comprehensive treatment “inhumane,” and said corrections officials at both adult and juvenile facilities were missing an important opportunity to initiate effective treatment.

Many of the crimes committed by teens and young adults are related to their drug habits because addicted individuals will “do anything” to avoid the “hell” of withdrawal, Publicker stressed. Because addiction brings about a chemical change in the way the brain works, willpower alone is often not enough to break the drug habit for good.

While incarceration may force individuals to get clean and may even bring about a heartfelt intention of staying clean, the likelihood of their being able to do so without the support of methadone or Suboxone is slim, Publicker said. Use of the replacement drugs should be considered a long-term strategy, he said, though many individuals, especially younger people with less entrenched addictions, are able to discontinue them eventually. Suboxone is easier to discontinue than methadone, but it is not appropriate for everyone, he said.

The conference was sponsored jointly by the state Department of Corrections, the Maine Office of Substance Abuse and the Spurwink Center for Juvenile Justice in Portland.

Barry Stoodley, associate commissioner of the division of juvenile services for the Department of Corrections, said in an interview that the department is open to suggestions for improving its handling of drug-addicted juveniles.

Stoodley said many young people who get in legal trouble come from families and peer groups in which heavy use of drugs and alcohol are accepted behaviors. Without effective intervention while incarcerated and continuing treatment after they’re released, he said, their chances of staying clean and out of trouble are slim.

“It’s clear that persistent, chronic substance abuse [in juveniles] is the greatest predictor of continued criminality and convictions that ultimately get them into the adult corrections system,” he said.

Stoodley characterized current drug treatment at the Mountain View Youth Development Center in Charleston and the Long Creek Youth Development Center in South Portland as “comprehensive,” but acknowledged there’s room for improvement. Possibilities include strengthening existing programs, bringing methadone or Suboxone treatment to the facilities, improving follow-up care after release, and beefing up staff training.

Mike Higgins, president of Spurwink Institute, said the organization seeks to support the corrections department by working with treatment providers, state agencies and the courts to improve detention practices for juvenile offenders in Maine. In addition to improving addiction services, the group seeks to reduce delays in court hearings and sentencing as well as explore alternatives to detention, Higgins said.

About 175 professionals from across the state attended the conference at the Spectacular Event Center in Bangor.

More information: www.spurwinkinstitute.org.