Cold turkey for services.

Byline: The Register-Guard

It's hard to comprehend the magnitude of what may happen soon to drug and alcohol treatment programs in Oregon. In large measure, they're about to be destroyed - not just cut, not just scaled back, but dismantled. These programs are the hub of the social services wheel; without them the state can expect more crime, more child abuse, more domestic violence, more hospitalizations, more homelessness. It would be a disaster, and the legislative Emergency Board must prevent it.

The Emergency Board created the crisis at its Nov. 8 meeting, when it confronted another of the budget dilemmas that have become so painfully familiar in Oregon. In a cost-cutting move, the state Department of Human Services had recommended a reduction in payments to hospitals for treating patients on Medicaid, the health care program for low-income people. Representatives of Oregon's hospitals persuaded the board that the reduction would be ruinous. Instead, the board eliminated coverage for outpatient mental health, alcohol and drug treatment from the Oregon Health Plan, effective March 1.

The hospitals had a good argument; they're already losing money on Medicaid patients. But they're not likely to come out ahead as a result of the Emergency Board's action. Many of the 118,000 Oregonians affected by the change in health plan coverage - primarily single men and women - can be expected to show up in hospital emergency rooms in need of expensive and uncompensated medical treatment.

Nor will dropping these services prove to be an efficient means of reducing state spending. For every two dollars the state contributes to drug and mental health treatment services, the federal government contributes three. A $7.2 million reduction in state spending whacks $18 million from Oregon's already badly stretched network of outpatient treatment programs.

It's uncommon for drug addicts and alcoholics to have private health insurance; about 75 percent of them are covered by the Oregon Health Plan. The health plan's payments represent the primary source of income for the private, non-profit agencies that provide the bulk of chemical dependency treatment services in Oregon. Willamette Family Treatment Services in Eugene, for instance, stands to lose 77 percent if its clientele.

The effects on programs that provide methadone treatment to heroin addicts are among the most dramatic, and consequently have been the focus of public attention. In Lane County, 348 addicts will either lose their methadone or will have to find some way to pay for it themselves. Methadone stops addicts' craving for heroin - shortly after people stop taking the substitute, their hunger for the street drug comes roaring back. A month's supply of methadone costs taxpayers about $300. That's cheaper than feeding addicts' $40-a-day heroin habits, a cost society bears in the form of property crimes, violence, degradation and overdose deaths.

Other effects have yet to penetrate the public's consciousness. Mentally ill people who depend on the Oregon Health Plan for their treatment and medication will lose the support that gives them stability and independence; many will end up in emergency rooms or on the streets. The drug courts that deal with people whose crimes stem from drug addiction will lose the ability to mandate the treatment that is the cornerstone of their success. Judges will no longer be able to include diversion to alcohol treatment programs for indigent people convicted of drunken driving.

It's possible that the Emergency Board was not fully aware of these and other effects. It made its decision without hearing public testimony. In the weeks since the Nov. 8 meeting, the board's action has been obscured by the discussion of the financial consequences of Measure 28, the proposed income tax surcharge that will appear on the ballot next month. The Oregon Health Plan reductions bear no direct relation to Measure 28; the cuts will come on March 1 whether the measure is defeated or approved.

They will come, that is, unless the Emergency Board reconsiders. It will meet again Jan. 9, and at that meeting it should reverse its earlier decision. The difficulty of finding $7 million in the state budget for drug, alcohol and mental health treatment can't be discounted. But the cost of leaving addiction and mental illness untreated is much higher, whether measured in dollars or in human lives.