Editorial: Don’t let site setback derail county’s drug treatment aims

Feb 14, 2018
  • By The Palm Beach Post Editorial Board
Palm Beach County Fire-Rescue paramedics last year tend to Jessica Wilkerson, a Lake Worth woman who was the victim of an apparent drug overdose. She was back on the street hours later after being admitted to JFK Medical Center. (Courtesy Nick Petrino)

The news that a planned emergency room for opioid overdoses has been delayed because of problems with the site is disappointing — but not disheartening.

On the contrary, it tells us Palm Beach County officials are intent on making drug treatment a key element in their fight against the opioid epidemic, the killer that claimed 600 lives here last year. And that’s rare.

How rare? Well, President Donald Trump, three months after declaring the opioid crisis a public health emergency, now says he’s focused on law enforcement (“My take is you have to get really, really tough, really mean with the drug pushers and the drug dealers”).

Local leaders, to their credit, insist that this crisis will never be solved simply by making arrests and sending sellers and abusers to jail. “It is in fact a health care crisis,” then-County Mayor Paulette Burdick said last April as the County Commission voted unanimously to adopt a multipronged action plan.

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And though this county is flooded with for-pay drug-treatment centers — some of them, unfortunately, little more than money-making mills for unscrupulous owners, as The Post has comprehensively reported — there’s a shortage of treatment options for people of low income. Only 5 percent of the substance-abuse treatment providers in the county are publicly funded through state contracts, a county-commissioned report revealed last year. Some 22,320 uninsured people are in need of detoxification and residential treatment, the report calculated.

Last week, the County Commission had been expected to give the go-ahead to a planned Addiction Stabilization Facility, a forward-thinking, one-stop center for detox and rehabilitation services, to be managed by the Palm Beach County Health Care District.

The vote had to be canceled, however, because engineers determined that upgrades to the intended location — the shuttered stockade next to the South Florida Fairgrounds — were too expensive. As they should, officials made clear the project would go on.

“It’s a little bit of a setback,” Deputy County Administrator Jon Van Arnam said, “but certainly the commitment and enthusiasm for the project is not diminished at all and we may end up with a better facility in the long run.”

The concept behind the project had a promising tryout last year at JFK Medical Center in Atlantis, whose Emergency Department has been receiving about 40 heroin-related overdoses per day. Instead of the usual routine of a) revive the person with Narcan, b) send them on their way, only to c) watch them return, overdosed again — often on the same day — the emergency department tried something new.

When you have paramedics making some 5,000 overdose calls in a single year, as they did in Palm Beach County in 2017, you have to try something else.

Thirty patients, upon being revived by Narcan and having agreed to participate, were given Suboxone, a medication to suppress drug cravings, then transferred to an outpatient clinic for behavioral therapy, a psychiatric evaluation and help with other needs, such as attending Alcoholics Anonymous or moving into drug-free housing.

So far, 56 percent of the patients are still in recovery, the Health Care District reports. That compares with zero to 10 percent under the usual revolving door.

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The Addiction Stabilization Facility would scale that up. Fire Rescue crews from around the county would bypass local emergency room and bring overdose patients, revived in the field, directly to the center’s 14-bed “Addiction Emergency Room.” Patients, assisted by peer-group counselors, would get the medical help they need to detox. They’d move on to outpatient services, also located in the facility, which would be staffed by a nurse practitioner, addiction psychiatrist, clinical social workers and include a pharmacy.

The county last week pledged $500,000 toward the program, pulled from a $3 million pot approved last year to fight the epidemic. A bill to add $1 million in state funding has cleared the House Health Care Appropriations Subcommittee.

The Health Care District has come up with a solid plan, one that could move our county from being a poster child for the nation-vexing epidemic to the forefront of medical approaches to fighting it.

Commissioners must not give up on finding a site.