“Our bill makes it clear that any savings the merger creates will be reinvested into the system,” Sen. Harckham said. “But the unions in particular, have had many trophies, and it’s hard to blame them.” Governor Cuomo cut the Office of Addiction Support and Services, or OASAS, to about 150 positions during his tenure. Governor Kathy Hochul has taken steps to reverse that damage – allocate some $402 million in new funding for the agency and appointing a new commissioner to head it. But even this welcome development poses a challenge to the merger movement. “This is the first time in forever that OASAS has been increased rather than reduced,” said Joelle Foskett, legislative director for Senator Harckham. “The instinct would be to hold on to that, not risk a merger.”
There’s also the matter of history: OASAS was founded in 1992, when alcohol and substance abuse services were extracted from another, larger agency and combined into a new entity. . Philip Steck, Chairman of the Subcommittee on Alcohol and Drug Abuse, says the whole point of that reconfiguration is to improve the state’s addiction treatment machine by separating it from everything else. “Substance abuse was overlooked when it was part of a larger agency,” Steck told me. “People who now want to combine addiction and mental health seem to be forgetting that.”
Mr. Steck agrees that the current setup – mental health in one agency, addiction in another – does not meet the needs of people with both conditions. However, he and others say there are faster, more cost-effective ways to fix that than trying to mix two giant companies together. For example, his own suggestion is to simply “infuse” more mental health services into the 12 addiction treatment centers that OASAS has hosted. The move will not only lead to more integrated treatment for people with co-existing disorders, he said, but will also help increase the workforce, as state institutions pay better than nonprofits. . “The idea of a new behavioral health unit sounds very progressive,” said Mr. Steck. “And I’m not saying it’s never going to happen. But to redo such a system could take 10 years, and we have people who are suffering right now. “
Those are fair concerns, but for Ms. Marquesano and the hundreds of supporters and officials who agree with her, the time for partial repairs has long passed. “We have been begging for 21 years for these systems to integrate and coordinate more,” said Paige Pierce, parent advocate and CEO of the nonprofit Family Together. . “The opponents insist that a merger won’t work. But what we have right now really doesn’t work and hasn’t worked for decades.”
The federal government seems willing to admit it, too. This spring, the Office of National Drug Control Policy disclosure a new, “whole government” approach to beat the epidemic of overdose. The National Drug Control Strategy, as its name suggests, includes Billion in new funding for evidence-based treatment initiatives, a new commitment to combat drug traffickers, and a plan to “better use data to guide all efforts.” this”. Those are welcome developments, but for the broader effort to succeed, officials at all levels will face a deeper list of flaws in the nation’s approach to addiction. . The law will have to change: Some laws from the drug war need to be repealed. Others, including those that focus on equal coverage for behavioral health conditions, need better enforcement. Institutions will have to be restructured so that false distinctions between addiction, mental illness, and the remains of drugs are eventually eliminated altogether. And funding streams will have to be reframed so that they support rather than hinder evidence-based practices.
For anything to happen, however, policymakers and advocates will have to overcome the same apathy and inertia that plagued reform efforts decades earlier. And the rest of us will have to confront our long-standing atmosphere of what addiction really is and what people with it need and deserve.
