SJR 77: Joint Subcommittee Studying Strategies and Models for the Prevention and Treatment of Substance Abuse

July 31, 2008

The first meeting of the joint subcommittee was held at the General Assembly Building in Richmond. Senator Emmett W. Hanger, Jr., was elected chair and Delegate John O'Bannon III was elected vice-chair.

Presentations

Nathalie Molliet-Ribet, JLARC
Nathalie Molliet-Ribet presented the Joint Legislative Audit and Review Commission's report, Mitigating the Cost of Substance Abuse in the Commonwealth. Ms. Molliet-Ribet stated that substance abuse cost the Commonwealth approximately $613 million in 2006, with $595 million, or 96% of the total cost, resulting from criminal justice-related expenditures, primarily the costs of housing offenders convicted of drug-related crimes. She noted that during the same period, state and local governments spent $102 million to provide substance abuse treatment and prevention services. She stated that evidence conclusively shows that treatment works, and that the fiscal cost of substance abuse to the Commonwealth and localities can be reduced through treatment and prevention services.

Ms. Molliet-Ribet described a number of recommendations for increasing the effectiveness of substance abuse treatment and prevention services and limiting the costs of substance abuse to the Commonwealth and local governments.

Raymond Ratke, Dept of Mental Health, Mental Retardation & Substance Abuse Services
Raymond Ratke presented the department's response to the Joint Legislative Audit and Review Commission report, highlighting efforts undertaken by the Department to comply with the recommendations contained in the report.

Dr. Mady Chalk, Director, Center for Policy Analysis and Research, Treatment Research Institute
Dr. Chalk discussed elements of successful and cost-effective substance abuse treatment programs, noting that substance abuse is a chronic disease that needs to be managed in a manner similar to management of other chronic diseases. Dr. Chalk reiterated the point made earlier that treatment works to limit the impact of substance abuse, and volunteered to provide information to the joint subcommittee on promising substance abuse treatment models in other states.

Dr. Joel Grube, Director Pacific, Institute for Research & Evaluation
Dr. Grube presented information on substance abuse prevention models specifically targeting adolescent and underaged drinking. He highlighted programs that have proven to be successful in reducing substance abuse among these populations, including increasing alcohol taxes and graduating licensing.

Douglas Meade, Occupational Enterprises, Inc.
Douglas Meade of Occupational Enterprises, Inc. began a series of presentations from speakers representing a coalition of interested stakeholders from Southwest Virginia. Mr. Meade characterized Southwest Virginia as "under attack" by drugs. He stated that the coalition is working to inventory effective substance abuse programs.

Ron Allison, Exec. Director, Cumberland Mountain Community Services Board
Ron Allison expressed concerns regarding the effects of current low Medicaid reimbursement for drug abuse treatment. He explained that in Southwest Virginia, the only consistently available treatment for person suffering from substance abuse problems is a five- to seven-day detoxification program that, absent sufficient support and follow-up services, accomplishes little. Mr. Allison noted a need for data sharing among the agencies and institutions providing treatment and for gender-specific treatment, particularly for pregnant women, and pointed out that prevention programs based on evidence-based practices are successful and should be incorporated into substance abuse treatment programs. Finally, Mr. Allison observed that since the drugs most abused are legally acquired prescription drugs, area physicians need to develop pain management programs.

Tom Casteel, Director, Washington County Department of Social Services
Tom Casteel described the effect of substance abuse on local social services departments, and explained that substance abuse has become the most common reason for a child to enter foster care in Southwest Virginia, resulting in a substantial increase in foster care needs. Mr. Casteel also stated that cases of substance-exposed infants are rising steadily.

Dennis Lee, Commonwealth’s Attorney for Tazewell County
Dennis Lee noted that the county crime rate tripled after the introduction of OxyContin to the region and that as much as 90% of crime in the county was related to substance abuse. Mr. Lee stated that Tazewell County had built a new jail which, due to the sudden and massive increase in substance abuse-related crimes, was full and beyond capacity at the time it opened. He said the county has a fledgling, nonstatutory drug court that has been successful in addressing substance abuse problems in the county, but that the drug court lacks sufficient funding and currently relies on community resources to function. Acknowledging that Tazewell has found some programs that work such as the drug court and day reporting centers, Mr. Lee stated that the programs are woefully underfunded and Tazewell is a community in crisis.

Bruce Kravitz, Southwestern VA Alliance for Manufacturing
Bruce Kravitz spoke about the need for skilled factory labor in Southwest Virginia and the difficulty in finding or keeping good employees. He said that many potential good workers either fail, or refuse to submit to, drug screening and that this has resulted in difficulty in filling open positions.

Mark Larson, Occupational Enterprises, Inc.
Mark Larson stressed the need for a "system of care" approach in treating substance abuse issues, and stated that the following are needed to create a successful program: drug courts, residential treatment centers, an integrated information system, and aftercare including provisions for jobs, housing, daycare, and transportation. He noted that $1 spent on substance abuse treatment could save $4-$7 in other costs.

John Shinholser, President, McShin Foundation
Mr. Shinholser described the goals of the McShin Foundation, a nonprofit substance abuse treatment facility in Richmond, and how the foundation works to achieve these goals. He stressed the importance of including persons who have been through the recovery process in substance abuse treatment programs. By way of conclusion, Mr. Shinholser emphasized the need to think clearly about substance abuse treatment and prevention programming, to ensure that the best and most effective programs are in place.

Next Meeting
The next meeting date will be posted on the committee website and the General Assembly website as soon as information is available.

Chairman:
The Hon. Emmett Hanger, Jr.

For information, contact:
Sarah Stanton, DLS Staff

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