The third in a series

NewsLanc recently interviewed Rick Kastner, Executive Director of the Lancaster County Drug and Alcohol Commission (LCDAC). The LCDAC exists to “provide high quality prevention/education programs and treatment services for uninsured and low income citizens.” Our discussion with Kastner revealed the many challenges facing both Lancaster’s drug and alcohol addicted residents and the systems that seek to help them.

Surprisingly, the 2006 opening of a Lancaster-based methadone clinic has increased the demand for similar treatment services from the LCDAC.

In the time since the clinic opened, the number of county residents under methadone or Suboxone treatment has increased from mere dozens to nearly 300. Also during this time, the LCDAC has had to carve funding out of its rehab budget to support the rising demand for these treatments among its “working poor” patrons. According to Kastner, this trend is actually a testament to the success of the clinic’s program.

As Kastner explained it, the demand has risen because many individuals enter methadone or Suboxone treatment under public medical assistance. As the treatment settles these individuals into a stable rhythm of life, they often begin working a steady job. This can potentially push them out of medical assistance and into that “working poor” demographic that the LCDAC primarily serves.

Kastner estimates that, out of the 5,000 to 10,000 heroin addicts currently living in Lancaster County, only about 150 of them are under Suboxone treatment. Furthermore, shortfalls in funding are only one reason why this type of addiction management is not helping as many local residents as it could.

Suboxone is an addiction management medication that, unlike methadone, the FDA has approved for at home use under a doctor’s prescription. Because this new and advanced medication remains patented by its manufacturer, there exist no generic alternatives on the market at this time. For this reason, Suboxone is considerably more expensive and thus less accessible than methadone.

Another reason that Kastner cites for why Suboxone is not in greater use is that there are only 15 doctors in Lancaster care to be licensed to prescribe it:

“A lot of physicians really don’t want to be trained in the use of Suboxone and have a caseload of heroin addicts. And you don’t make much money by treating people on suboxone-you’d probably make a lot more money taking care of peoples’ ingrown toenails.”