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NCSL Substance Abuse Snapshot

Matthew Gever, Staff Writer
Allison Colker, Editor

March 31, 2008

Emerging Issues

Banning Random Tests
The Washington State Supreme Court ruled that randomly testing student athletes for drugs violates the state’s constitution, the Seattle Times reports. The case resulted from two families with high school athletes who sued the Wahkiakum School District claiming a violation of privacy. “If we were to allow random drug testing here, what prevents school districts from either later drug testing students participating in any extracurricular activities, as federal courts now allow, or testing the entire student population?” wrote Justice Richard Sanders in delivering the Court’s opinion. The district starting random testing in 1999, instituting suspensions for students who tested positive.

Treatment Services

Performance Contracting and Treatment Outcomes
Paying treatment providers based on results rather than services may lead to better care and outcomes, according to a new study to be published in the journal Health Policy. In the study, investigators from the Treatment Research Institute examined the pay-for-performance system instituted in Delaware in 2002. Rather than reimburse providers on a fixed basis or for number of services rendered, the state instead based financial incentives on providers being able to reach certain incentive targets. The study found higher capacity utilization rates and a greater proportion of patients who were actively engaged in more than thirty days of treatment in the years after the new contracting system was implemented. This happened while providers were admitting patients with more severe problems than in previous years. The study sites several factors which may have contributed to improved performance, such as providers using evidence-based practices, longer clinic hours, refurbished facilities and better proximity to populations being served. One caveat in the study is that no control group is available since all providers in the state participated, with the authors acknowledging that improved outcomes can not be exclusively attributed to contracting changes.

Maryland County Launches Acupuncture Treatment Program
Montgomery County, Maryland has launched a pilot project to incorporate acupuncture into the county’s substance abuse treatment programs, the Washington Post reports. The Montgomery County Council appropriated $20,000 for the project which seeks to use the needle-based therapy to calm and relax patients before they take part in other treatments.

Currently, only anecdotal evidence exists to support acupuncture’s success, though the practice is gaining popularity across the country as part of addiction treatment. For example, the Post reported that 85 percent of treatment patients in Miami-Dade County, Florida, use acupuncture as part of their treatment regimen. “Medicine has really changed in this county, and many people really are much more comfortable with an integrated approach to care,” Montgomery Council member Duchy Trachtenberg told the Post. “More and more Americans are using alternative therapies.”

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