ALBANY - Lourdes Santana went through state-funded detoxification programs for heroin addiction five times in 10 years. The first four times she left her three-to-four day stays and relapsed within 90 days.

Then she was able to follow up her treatment with a community-based inpatient program and she stayed sober for a year - until state and charity funds ran out and she again relapsed.

Now officials hope long-sought changes in the state's health budget will help addicts like Santana transition gradually into a sober life by spending less on intensive hospital detox treatment and more on community care.

The goal is to stop the “revolving door” of abusing drugs, detoxing and abusing again, said Karen Carpenter-Palumbo, commissioner of the state Office of Alcoholism and Substance Abuse Services.

In 2006, just 25 individuals cost the system about $5 million in substance abuse detox because they were unsuccessful making it to the next level of recovery and staying sober, Carpenter-Palumbo said.

The potential for savings is enormous, with community drug treatment costing the state just $214 a day on average, compared to $900 a day in a hospital, she said.

“One person spent over 200 days in a year's period in detox,” she said. “Obviously the governor sees things like that and says, `Let's respond.”'

Santana, 47, said she has been successful through a community-based system that she had access to through the federal Department of Veterans Affairs. She is currently two months into a five month inpatient program and has plans to transfer to another one to continue her recovery. She said she hadn't previously felt a sense of support in detox centers, and while the information about further treatment was available, the encouragement wasn't always there.

“There were further options, but I didn't receive that extended feeling like 'We really do want to help you,”' Santana said of her times leaving detox. “It was a choice I had to make on my own and a lot of times I wasn't in the healthy frame of mind to make those decisions for myself ... You feel like 'OK, we've detoxed you, now you've got to move on.”'

The state's plan is to spend less money reimbursing hospitals for four- to six-day detox programs and to ensure that OASAS redirects funding so more people get help through halfway houses, outpatient therapy, or other sober community settings.

Nationwide, approximately 73 percent of detox admissions are to freestanding - non-hospital - services and only 21 percent are to more expensive hospital inpatient programs, according to the federal Substance Abuse and Mental Health Systems Administration.

New York state does essentially the opposite, with 71 percent of addicts going into hospital-based detox and 28 percent going into community-based medically supervised withdrawal, OASAS officials said.

In 2006, New York admitted 43,000 people into state-funded detox at a cost of $310 million. Carpenter-Palumbo said half of those people could have been served in a less expensive community setting.

Revisiting detox centers can “turn out to be largely ineffective because the real issue is not what you can accomplish in four or five days in the hospital, but getting people into long-term help,” said state Health Commissioner Dr. Richard Daines.

Most states have moved away from the repeat hospital detox treatments, Daines said. While some “medically fragile or complex cases” will need to be under medical evaluation, many can benefit from less expensive treatment.

Any savings from the change will allow OASAS to help more people over time rather than reducing the program's budget. Officials couldn't estimate how many people.

“We can't predict it day by day,” Carpenter-Palumbo said. “It's not turning a switch and saying, `Now we're ready to help you.”'

While Santana was grateful for the community-based care that has given her hope she could get back to work at some point, or even pursue school, she said addicts have to want to make a change for themselves.

“There isn't some mystical something that's going to happen to you,” she said. “You have to be ready to change and say, 'I'm tired, I don't want to do this anymore.' This disease is so cunning and baffling. Unless you are tired of the pain, I don't care what program you're going through or how you do it ... you may go through years of being clean and still (relapse).”