Thursday, July 24, 2008

NY prohibits smoking in addiction recovery centers

ALBANY, N.Y. (AP) — Many drug addicts, problem gamblers and alcoholics may find it harder to kick their habits in New York now that the state has become the first in the country to ban smoking at all recovery centers.

Some addicts say losing the tobacco crutch could keep them from getting clean and sober, or from trying at all.

New York's 13 state-run addiction treatment centers have been tobacco free for more than 10 years. New regulations that take effect Thursday will also apply to private treatment centers. Some are worried that people who need help for drugs and alcohol won't pursue it because they aren't ready to quit smoking.

Bryan Lapsker, a 21-year-old PCP addict from Brooklyn who has been getting help for his addiction at a treatment center in Queens for nearly nine months, has been dreading the change every day.

"Nicotine helps (addicts) get through the day," he said. "Now you take the nicotine away from us, it's almost impossible to get through the day ... addiction is addiction, I understand that, but nicotine is a legal substance."

Legal or not, state officials behind the new rules believe banning tobacco is critical to successful treatment programs.

"Often times smoking was given as a reward in the day-to-day treatment programs, and we need to make sure that we're changing the culture to really promote an overall recovery plan that involves health and wellness for the optimal chance for recovery," said Karen Carpenter-Palumbo, the commissioner of the New York Office of Alcoholism and Substance Abuse Services.

About one in five New Yorkers smoke, compared to nine in 10 chemically dependent New Yorkers, she said.

Addicts are more likely to have long-term success if they quit smoking at the same time they enter treatment, Carpenter-Palumbo said.

A 2004 study in the Journal of Consulting and Clinical Psychology found that smoking cessation intervention provided during addiction treatment was associated with a 25 percent better chance of maintaining long term abstinence from alcohol and drugs.

Thomas Carr, the manager of national policy at the American Lung Association, said he's not aware of any other states that have taken this kind of action — although individual facilities around the country have eliminated smoking and offered cessation help.

An $8 million grant from the New York Department of Health will help train employees to deal with treating nicotine dependence and provide free nicotine replacements.

Providers say that's a start, but it won't pay for everything the mandate requires.

If people leave treatment because of the new rules it could create "an economic crisis for the field," said John Coppola, executive director of Alcoholism and Substance Abuse Providers.

Treatment facilities will have a six-month grace period in which tobacco use won't be a factor in whether their certification is renewed. They will also be able to develop their own plans to become tobacco-free and decide at what point an addict would have to leave for violating the rules.

Robert Doherty, the executive director at St. Peter's Addiction Recovery Center in Albany, said the new regulations are more fair to facilities that have already prohibited smoking in the interest of their patients.

Doherty said St. Peters has had few problems since banning smoking in May 2006.

"I think it's a more healthy approach to providing care, it's a more useful approach to treating addiction ... it just seems to be a responsible thing to do," he said.

OASAS estimates that 250,000 addicts in New York are in non-state-run addiction treatment centers and could be affected by the change. Some of those facilities already have nonsmoking policies.

Roy Kearse is the vice president of residential services at Samaritan Village, the Queens-based long-term treatment facility where Lapsker and other addicts get treatment at multiple locations.

While Kearse supports eliminating tobacco use among addicts, he is concerned the zero-tolerance policy could discourage some from seeking help.

"We don't know how many people will leave, if any at all will leave," Kearse said. "But we did have patients who said 'I didn't come in here to deal with my smoking addiction, I came in here for my heroin addiction, or my addiction to crack.'"

Lapsker, getting treatment through a court-ordered mandate, says he is grateful for his time at Samaritan. But he said if he faces a potential relapse after leaving the facility he will "definitely not" go seek help because he doesn't want to quit smoking.

"I look forward to my every cigarette that I smoke," Lapsker said. "That's what gets me through the day, through the stress, through the pressure."
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source: Associated Press

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