Baker Institute paper: Harris County lacks reliable data on drug treatment services

Harris County lacks reliable data on the number and quality of drug treatment services in the county — data that is needed to improve local efforts to combat substance use disorders in the community, according to a working paper by drug policy experts at Rice University’s Baker Institute for Public Policy and the Texas Criminal Justice Coalition.

Credit: 123RF.com/Rice University

“Gaps in Drug Treatment Data and Availability: Lessons from Harris County, Texas” was co-authored by Katharine Neill Harris, the Alfred C. Glassell III Fellow in Drug Policy at the institute, and Jay Jenkins, the coalition’s Harris County project attorney, who surveyed drug treatment providers that serve criminal justice populations in Harris County.

“The limited data that are available on drug treatment providers in Harris County suggest that the area lacks access to medication-assisted treatment for opioid and alcohol use disorders and to comprehensive care options that address problems closely tied with substance use disorders, such as mental illness, unemployment and housing insecurity,” the authors wrote. “For people on Medicaid or without insurance, treatment options are more limited, especially in these specific areas.”

The drug overdose rate in Harris County was 11.4 per 100,000 people in 2016, above the statewide rate of 10.2 but significantly below the national average of 19.7, although it is likely that deaths from overdose are undercounted, the authors said. “Opioid use is a concern for the area, and law enforcement officials predict that overdose deaths from opioids may increase due to the increasing frequency with which counterfeit prescription pills containing the powerful synthetic opioid fentanyl are found on the streets,” the authors wrote. “But law enforcement officials also report that cocaine and methamphetamine use is more problematic for Harris County, with meth rated as the greatest drug threat for the area.”

Forty-nine percent of all drugs identified and tested by the Houston Forensics Science Laboratory in fiscal year 2017 were cocaine or methamphetamine, compared to 10 percent that were heroin or pharmaceuticals, according to the paper. “While heroin and prescription opioids are implicated in more overdoses than methamphetamine or cocaine, deaths involving these drugs are also increasing, as is the tendency to find overdose deaths caused from the use of multiple drugs,” the authors wrote.

“It is possible that the treatment options in Harris County are superior to what is characterized here,” the authors wrote. “But it is impossible to know, given the current lack of data. There are more than 200 providers that claim to offer substance use treatment in Harris County, but little is known about the services they offer. Until there is a better inventory of what already exists, it is hard to devote resources to fill the gaps in care. The information available suggests that some of the gaps in care that need to be addressed include medication-assisted treatment for opioid and alcohol use disorders, treatment that addresses co-occurring issues with substance use, and expanding access to these services for low-income and Medicaid populations.”

The authors said state and local governments should also work together to improve data collection on drug treatment services in communities around Texas, to expand access to low-cost treatment options and to better integrate drug treatment with other areas of medical care and social service needs, particularly mental health, employment and housing. “And while the opioid epidemic is deserving of the attention it is receiving, opioids are not the most problematic drug for all communities,” the authors wrote. “It is absolutely necessary to expand access to medication-assisted treatment for opioid use, but it is also important that efforts to expand access to treatment account for other trends in drug use, particularly the rise in methamphetamine use that is happening in Harris County and in other communities across Texas and the U.S.”