Treatment options for drug use severely lacking in Texas, experts say


Criminal justice and child care experts say treatment options for substance abuse are lacking in Texas.

Professionals testified before a Texas House select committee Tuesday about their struggles.

The committee will use their testimony to write a report on opioid and substance abuse to help craft new laws.

The consensus was clear at the state Capitol among criminal justice and Child Protective Services professionals facing the nation’s opioid crisis: Texas needs more treatment options.

Experts who work in courts, probation and the foster care system say people with substance use problems often suffer devastating consequences while trying to get into rehabilitation centers, including overdoses and arrests.

“We have quite a waiting list for services,” Doug Smith, a policy analyst for the Texas Criminal Justice Coalition, told legislators. “In a lot of places, people are more likely to access services if they wear handcuffs first.”

Smith represented one of several groups and agencies — including the Department of Family and Protective Services, the Health and Human Services Commission and the Texas Department of Criminal Justice — testifying Tuesday before a Texas House panel on opioids and substance abuse.

He and other experts described the barriers in the criminal justice system and within CPS to helping people with substance abuse problems. These include inadequate staffing, poor access to treatment and few follow-up services.

It was the 13-member committee’s last meeting before public testimony Wednesday. The House members then will compile a report on their findings, which could help craft legislation in the upcoming legislative session in January.

The committee previously heard testimony on drug use among pregnant women, veterans, homeless people and those with mental illness, as well as how law enforcement and first responders’ jobs are changing in the face of the opioid crisis.

Professionals in the criminal justice system and CPS also reported seeing an increasing number of children being removed from homes for negligent supervision related to substance abuse.

So far this fiscal year, 11,366 children in Texas have been removed from homes because of substance use. That’s nearly as many as the 13,464 who were removed in all fiscal 2017, CPS data show.

About 70 percent of all child removals are related to substance use, along with 52 percent of fatalities caused by abuse and neglect, the state agency said. The bulk of cases involve marijuana, followed by methamphetamine.

Although CPS Commissioner Hank Whitman said Texas is not seeing problems with opioids as severe as in other states, “we do believe that opioid abuse can spread further into Texas from other states and that is greatly concerning for all of us.”

“Some states have seen their removal numbers triple because of the tragic toll of substance abuse,” he said.

READ MORE: ‘We are not immune’: How the opioid crisis is hitting Central Texas

Texas in 2016 saw a 7.4 percent increase in fatal opioid overdoses, which is minimal compared with the 44.1 percent increase in places like Pennsylvania, U.S. Centers for Disease Control and Prevention data shows.

However, experts debate the accuracy of those numbers, including many on Tuesday who repeated complaints about how the state gathers data, which might lead to undercounting opioid overdoses.

Williamson County Justice of the Peace Bill Gravell testified that in the past three years he has signed an increasing number of death certificates where opioids were a factor. But nowhere in the Texas electronic registry is a place to record that. The system only asks for a cause of death such as suicide, homicide, accident or undetermined — not for toxicology results.

“I do see an uptick,” Gravell said. “I just don’t know how I am going to support that statistically.”

Gravell said opioid problems have extended into his courtroom, where he is seeing more kids admit to using prescription drugs like Oxycontin and fentanyl. Twenty-five percent of the children in the state’s juvenile justice system have substance abuse problems, the Texas Juvenile Justice Department said.

Officials also see a huge gap in the state’s need and its ability to serve, with many people in rural areas having to drive far distances to get treatment.

Parents say they can’t leave work and their families to get the help they need.Waiting lists are long and departments desperately need more highly trained staffers who can provide integrated services to handle trauma and co-occurring mental health disorders, as well as provide after-care support.

The Texas Health and Human Services Commission is continuing to push for more medication-assisted treatment options like methadone to treat opioid addiction. Director Lisa Ramirez said these services are particularly important for people getting out of jail because they are more likely to die from an overdose within the first week of release.

The Texas Criminal Justice Coalition and other nonprofits testified on the importance of getting people linked to community-based services, instead of funneling them through the criminal justice system. They suggested looking at best practices in other communities and increasing treatment funding.

“We do not have sufficient funding to support those who have substance abuse and opioid use disorders here in Texas,” said Elizabeth Henneke of the nonprofit Lone Star Justice Alliance. “I want to applaud this body for taking extreme steps to help that. I think you are doing a really good job, but we have further to go.”

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