In its sweeping series “Igniting the Heroin Epidemic,” The Palm Beach Post has told the remarkable story of the state of Florida’s key role in this century’s devastating addiction crisis: actions and inactions by uncomprehending state leaders that led to misery in places like Ohio and West Virginia as much as in Delray Beach.
That tragic mistake is now in danger of repeating itself when it comes to addiction treatment.
The evidence amassed by investigative reporter Pat Beall shows that by letting rogue clinics run unrestrained for years in Palm Beach and Broward counties, the state of Florida opened the floodgates for thousands of people here and – astoundingly — in every other state east of the Mississippi to become dangerously addicted to prescription painkillers like OxyContin, which had been hyper-marketed to doctors by the avaricious Purdue Pharma.
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The state’s passivity was exemplified in 2002, when Marco Rubio, then a state legislator, killed a bill to establish a prescription-monitoring database. Tracking prescriptions would have curbed the orgy of script-writing and doctor-shopping that made the pill mills thrive. The database wouldn’t be approved until 2011 by a slow-to-persuade Gov. Rick Scott. During that lapse, more than 20,800 Floridians died after taking prescription opioids.
And when the state finally did crack down on the pill mills, in 2011, officials failed to anticipate the utterly predictable effect of suddenly cutting off oxycodone to individuals with serious addictions. The habituated turned to the next best thing, heroin – which the notorious Mexican drug kingpin Joaquin “El Chapo” Guzman had the dark foresight to provide.
The heroin was cheap, and it was deadly. Within months of Florida’s clampdown on the pill mills, death rates spiked not just here, but in drug-soaked counties in other states, Beall’s research shows.
Crackdowns aren’t enough
It turns out that you can’t solve a drug crisis simply by unleashing law enforcement. Closing pill mills and jailing the operators and suppliers, as impressive as that is, gets you only so far. You also must address the medical side of things, lest you leave thousands of people stranded, with nowhere to take their cravings but to the next available fix.
The moral of the story: It wasn’t just Big Pharma and a big drug cartel that fueled this crisis. Florida bears a heavy share of the responsibility.
Having done so much to create the mess, Florida now bears an equally heavy responsibility to clean it up. And on this score, the state is negligent.
Drug addiction, as Beall notes, is a physiological disease of the brain. Yet the state pays scant attention to treatment. Its small substance-abuse unit isn’t even in the Department of Health, but in the perennially cash-strapped, overburdened Department of Children and Families.
Dozens of license applications for methadone clinics have been in limbo or denied since 2003, when the state passed a law that bars the creation of new clinics unless their need can be proved. Predictably, “the number of people getting state-financed addiction treatment dropped by 19,500 between 2011 and 2015,” Beall writes, “a time when 19,000 Floridians overdosed and died after using heroin and prescription opioids.”
Just this month, 33 mental health and substance abuse facilities that treat inmates across Florida are closing or scaling back because the new state budget cuts $30 million from Department of Corrections programs that help alcoholics and drug users prepare to move back to communities.
It’s past time to do a 180 on this unconscionable business-as-usual. Floridians must demand that lawmakers put more money into treatment and reverse the impediments to methadone, which the National Institute on Drug Abuse, citing a wealth of studies, calls “an effective treatment for heroin and prescription narcotic addiction.”
Learn from the errors
And now is time for Florida to get ahead of the next heroin-related epidemic. Hepatitis C and HIV are on the rise among users who share needles (and all the contamination that implies). Needle-exchange programs can help.
“Syringe exchange programs connect the population of injection drug users with healthcare, providing HIV screening and treatment and counseling, and, importantly they provide an opportunity for reaching out to people with addictions and encouraging them to engage in substance use disorder treatment,” says the National Institute on Drug Abuse. “Failure to implement programs that will reduce these risks is irresponsible from a public health perspective.”
But there’s only one program in the entire state, at the University of Miami. And a bill that would have allowed more programs to operate statewide died in the legislature this year, even after the bill’s scope was reduced to Broward and Palm Beach counties.
Florida’s negligence helped spark the last epidemic. It’s urgently important to learn from our errors, and get ahead of the next one.
Having done so much to create the mess, Florida now bears an equally heavy responsibility to clean it up.