The state government isn't doing enough to measure the effectiveness of its addiction treatment programs that can be helpful in the fight against the epidemic of heroin and prescription drug overdoses, auditors said Thursday.
The audit launched last year by Auditor General Eugene DePasquale produced recommendations that three state agencies — the departments of Human Services, Corrections, and Drug and Alcohol Programs — do more to assess whether their addiction treatment programs are successful in curing people. It also warns that more money is needed to fund the effort.
The agencies, all under Democratic Gov. Tom Wolf, largely agreed with the findings and said they were working toward establishing the evaluation processes recommended in the audit.
The audit noted that the agencies have different ways of defining a program's effectiveness. It also said that the success of addiction treatment is greatly influenced by someone's desire to be treated and that tracking the effect of treatment on people with an addiction is very difficult.
The Wolf administration's creation of 51 locations in a "Centers of Excellence" network designed to connect people with addictions to services is perhaps Pennsylvania's most aggressive step to fight opioid addiction, and the Department of Human Services is gathering data to evaluate the effectiveness of the centers. But DePasquale said the agency does not have procedures to ensure the accuracy and completeness of the data collected, something the department said it is working to create.
"This is crucial," DePasquale said at a news conference in the Capitol. "Complete and accurate information is vital for the Department of Human Services. They must add a step to verify that accuracy in all the data it collects because that is the best way to find out what works and what doesn't."
The Department of Drug and Alcohol Programs must develop a method to monitor the effectiveness of the programs on a regular basis and share that information in a way that is easily accessible to the public, the audit says. That method should include periods after a person leaves drug treatment, it says.
Chronic understaffing and underfunding at the Department of Drug and Alcohol Programs is hurting the state's ability to fight the opioid epidemic, the audit says. Imposing a licensing fee on drug treatment centers would help bring money into the agency, the report says.
The Department of Corrections monitors just one of its seven addiction treatment program for effectiveness, and that work is limited to recidivism, auditors said. The department should evaluate all the programs for effectiveness, the report says. Also, the prison agency's medication-assisted treatment program, which is based on Vivitrol, should target the effectiveness of the drug beyond recidivism rates, auditors said.
The department pointed out that it has had its treatment programs studied at various times, including by university researchers, but also agreed that it should establish a routine program evaluation.
Meanwhile, the Department of Health should write regulations to ensure Pennsylvania physicians are safely prescribing buprenorphine-related medications, the audit said. Buprenorphine is designed to block the effects of opioids and help reduce cravings for opioids.
The U.S. Drug Enforcement Administration reported last month that there were 4,642 drug fatalities in Pennsylvania in 2016, a 37 percent increase from the year before. Prescription or illegal opioids such as heroin were implicated in 85 percent of the deaths, it said.
Pennsylvania was slightly above the national average in 2015 in opioid overdose death rates, according to information from the Kaiser Family Foundation.