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Finding a drug rehab: A choice made at random

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Choosing a drug rehab facility for in-patient care is still a shot in the dark, even though the state is now running a website that tries to update bed availability daily.

The state isn’t providing any information that helps patients choose the best fit for them — or the best facility available.

And in-patient rehab for teenagers, especially girls, is extremely limited.

Within a 100-mile radius of Glens Falls, there were only three beds available for adolescent girls on Monday.

The news isn’t much better for teenage boys: there were six beds available.

There were far more for men and women — 84 and 79 beds, respectively.

And while the two inpatient rehabs in Warren County were full, recent efforts from the state have at least made it easier to find a bed. OASAS, the state Office of Alcoholism and Substance Abuse Services, has a link (https://findaddictiontreatment.ny.gov/) that allows the public to search for inpatient and outpatient care.

Thus, patients could quickly find out that the closest bed Monday was at Conifer Park in Glenville, about an hour’s drive away.

What they can’t find out are any other details about the program, such as its success rate or death rate, among other important details.

The state tracks deaths, both at facilities and in the 30 days after a patient is released. But those rates are not published online and are not easy to get. The Post-Star had to file a Freedom of Information Law request to get the rates and, three weeks later, has not gotten a response from the state.

However, OASAS said deaths are rare. In the past 12 months, about 232,000 people were treated at OASAS-certified facilities in New York state. Of them, 134 people died.

State officials acknowledged that the number of deaths is only valuable if the public is told whether some clinics had many deaths. But they said they could not release that information without a Freedom of Information Law request because the information was so “large.”

The state also does not release remission rates for drug addiction, although it does certify each facility and track how well each patient is doing upon discharge. It simply does not make those figures public.

Every patient is tracked on a form that lists their “problem substances,” how often they are still abusing those substances, and even how they view recovery — ranging from ambivalent to “ongoing recovery and relapse prevention.” The form also tracks how far each patient has come toward meeting their goals, not only in drug and alcohol use but also in emotional functioning, family and social life, education and health.

Knowing how well most patients are doing upon discharge could be a critical factor for people as they choose which facility to go to for help. But the online tool that OASAS created to make it easier for people to find a bed does not list those statistics — or even what programs are offered at each site. It only gives the number of beds available for each gender, the address of the facility and a phone number.

Luck of the draw

An Argyle mother took three weeks off work to find a rehab facility for her 17-year-old son. It was hard to find a bed for him in a facility that would take insurance. One facility told her it accepted Medicaid, but no private insurance. Another facility advised her that it would be easier to get him in if he were being discharged from jail through a treatment program like Drug Court.

While she searched for a bed, she didn’t want to simply pick whatever was available. She wanted to choose the best possible place.

“I wanted the program with the best outcomes. I did my best to look for reviews, but that’s very difficult. There’s not a lot online. I really had to cross my fingers and hope,” she said.

She asked that her name not be used so her son would not be identified. He is doing well now and has just started college after spending a year recovering from addiction to heroin and benzos. She wanted to make sure his recovery was not upended by being identified.

She persuaded him to go to rehab, which she said he was pretty willing to do. He had taken drugs at parties, becoming accidentally hooked.

He ended up at a program for adults, listening in group counseling to others describe the travails of years of addiction. He was the youngest one there and, for most of his treatment, the only one there voluntarily. Although he could not relate to stories about crimes committed or living on the street, the treatment worked. He spent 21 days inpatient and six months outpatient.

A friend also sent her son to rehab, but didn’t have the same experience. There were fights and overdoses. The son has now been to four different rehabs, she said.

But with no statistics or other information available, she said both parents ended up choosing facilities at random.

This leaves an open question: are all rehabs effective?

OASAS pointed to two studies that indicate long-term residential care is key to a patient’s success. The federal studies were all based on patients who received treatment in the 1990s and have not been updated in years.

In an overview of five-year follow-up outcomes in the Drug Abuse Treatment Outcome Studies, published in 2003 in the Journal of Substance Abuse Treatment, researchers found that patients did better if they spent at least six months in residential treatment.

That is not generally covered by health insurance.

“Navigating the insurance ... it’s a nightmare,” said South Glens Falls teacher Judy Moffitt, who has started several NarAnon chapters in the area.

“When they do get in, they get just days. One of my friends’ loved ones was supposed to get 20-something days and he got just 14.”

It makes her frustrated that so much focus is put on simply getting someone into rehab.

“Treatment is just the beginning of all this,” she said. “Yet people think, ‘Oh, he had treatment, he’s fine now.’ ”

Inconsistencies in information

Treatment also varies from facility to facility. Some offer medical support during detox, which is recommended for those withdrawing from opiates or benzodiazepines, which include Xanax. Withdrawal can be deadly without medical support in those cases, so some physicians discourage at-home detox from those drugs.

Some facilities are also connected to methadone clinics, where patients can receive a medication that blocks them from feeling the high from opiates and narcotic painkillers.

OASAS attached a document from each facility to their listing on the website, supposedly showing what programs are offered, what insurance is accepted and other important information. But that document was uploaded regardless of its completeness. The Beacon Center Albert O. Nichols House in Herkimer reported on the OASAS site that it had one adult bed available for a man. But the three-page program data document was entirely answered with N/A. Even the client admitting hours were listed as not applicable, as was every single service and program accreditation. Some other facilities offered very detailed information in the same document.

Parents also reported having problems with the OASAS website, saying they often called facilities that were listed as having available beds, only to find out the beds had been taken.

Each facility updates its own information, and some are more diligent about it than others.

“I usually update it every morning. When I’m not in, I do it from my phone,” said Melissa Deyo of Never Alone Inc. in Hurley. It is one of the few rehabs for adolescents in the area. It’s in Ulster County, about two hours from Glens Falls.

Her facility used to take teenage boys and girls. Now it only takes boys.

“Just, the female referrals really dwindled down, and we had an excess of male referrals,” Deyo said. “So when we graduated our last two females, we brought in more boys.”

Others, when called, did not know how many beds they actually had available. One woman said she was sure the HealthAlliance Hospital in Kingston had at least one bed available for medically managed detox, but wasn’t sure if there were three beds as reported on the OASAS site. Others took messages seeking the number of beds available, but no phone calls were returned.

It can become deeply frustrating, particularly because time is of the essence when a patient agrees to go to rehab, Moffitt said.

“When the person is ready, if there isn’t a bed available, he may not want to do it a week later,” she said.

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You can reach Kathleen Moore at 742-3247 or kmoore@poststar.com. Follow her on Twitter @ByKathleenMoore or at her blog on www.poststar.com.

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reporter - Health care, Moreau, Queensbury, South Glens Falls

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