HARRISBURG (AP) - 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 last week.

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.Individual counties, individual needsWhile Carbon Monroe Pike Drug and Alcohol Commission does conduct follow-up appointments to evaluate treatment, case management supervisor Chris Sorrentino said that a one-size-fits-all method to monitor program effectiveness may not be the best option."Having some wiggle room helps. I can see where you would want a more standardized way of reporting, so that you know you're hitting the benchmarks," Sorrentino said."But, each individual county has its individual needs. If these benchmarks are being made at a state level, they may work there, but they may not address things as specifically as we need here. I think if they want to implement that standard statewide, they should get some input from local providers and SCAs (Single County Authorities)."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."There's always concern when it comes to available funds to get people into treatment, and the ability to hire the amount of people needed to address the demand," Sorrentino said."There never seems to be enough, especially with the way the opioid epidemic has increased over the years. It's forced the agencies to become more creative with how they meet the demand. People carry full caseloads. There are times when places have waiting lists because they're at capacity. There are times when people are doing jobs that two people used to do."Pieces of the puzzleThe 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.Carbon County Correctional Facility warden Timothy Fritz said that while recidivism is an important element in treatment, it is also one of many pieces of the puzzle."It's a major factor, and obviously you want to get these people off the drugs and alcohol they're using. They may come in the first time, and get out, then they're in again for retail theft, breaking and entering, because they've graduated to stealing to support their addiction," Fritz said.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.Fritz said that Carbon is focused on internal analysis, and that they bring together medical and psychiatric doctors, along with counselors and other Carbon Monroe Pike Drug and Alcohol personnel to evaluate treatment on a personal level."Maybe there are individuals with a dual diagnosis, with mental health and drug issues. Everyone at the table can understand what's going on and what steps can be taken to ensure that these folks are getting the best treatment possible," he said.Continuing treatmentAnd with CMPDA counselors at the prison three to four days a week, inmates with addiction issues that are released may have an easier time continuing treatment, as they can continue with CMPDA on the outside, making for a smooth transition.Fritz said the key to effectiveness in addiction treatment programs is rooted in the motivations of the addict."That's the biggest obstacle that the counselors are facing. Maybe if it's a person who is just going through the motions because the courts said they had to, they don't want to get clean and stay clean, they just want to get out," Fritz said."We've had some success stories over the years. I had one individual complete a program about eight or nine years ago, and he went on to become a counselor himself. I believe that if one person changes their ways, we've done something right. Now that we've started this, I don't see us not having these programs in place. We're constantly looking at things to do to help these folks."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.Brian Myszkowski contributed to this report.