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Where Do We Stand on the “Sober Home” Crisis After the 2017 Florida Legislative Session

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at July 3, 2017

Michael Auslen, a reporter for the Tampa Bay Times, wrote an exceptional article entitled “Did crackdown on ‘pill mills’ open the door to a new opioid crisis?,” published last week on June 30, 2017, and picked up by the Miami Herald. The complete article can be read here.

While the article has some excellent graphs, there remains a lot of debate about whether the over-prescribing and otherwise illegal sale and distribution of opioids have led to this present epidemic. But that is like arguing that climate change is not man-made. Whether it is or is not is presently relevant – there is climate change, and who is to blame is not going to fix the problem.

Mr. Auslen’s article also did not necessarily highlight how those entrusted with LEADERSHIP (elected officials) tend to use different words (and take different actions) depending upon the audience they are speaking to.

On one end, they continue to placate parents and citizens fearful that the opioid epidemic is going to wipe out an entire generation.

On the other, they are placating a fearful electorate and local elected officials who use the terms “sober home” and “treatment program” interchangeably, and have never uttered the words “recovery residence” or “substance use disorder,” let alone actually tour a reputable treatment program or recovery home. It’s much easier to demonize an image in your head, as perpetuated by the media, then to gather actual facts and deal with actual problems.

Nonetheless, here are some excellent quotes taken from Mr. Auslen’s article:

  • Based on data released in May by the state’s medical examiners, last year’s fatal overdoses are on track to rise by a record 36 percent.
  • It looks as though Florida may have had more opioid deaths in 2016 than at the height of the pill mill crisis. (Final data from the medical examiners won’t be out until later this year.)
  • By 2013, opioid deaths had dropped more than 20 percent. “Our relentless efforts are finally starting to pay off,” Bondi said at a news conference promoting the 2012 medical examiner report. “We are blessed to finally see a decline in these prescription drug deaths.” But while the source of prescription drugs had been blocked, people were still addicted. Heroin and other illegal opioids flooded the state.
  • In 2014, the death toll started to tick higher, even as overdoses from oxycodone, which was responsible for most of the pill mill deaths, stabilized. The reason? Those deaths associated with heroin, fentanyl and carfentanyl rose fast. Last month, the latest medical examiners’ report showed that more people were killed by fentanyl and heroin in the first half of 2016 than in all of 2015.
  • Bondi speaks often about the dangers of heroin and fentanyl. But unlike those first few years when the medical examiners’ report provided an opportunity for Bondi to tout success, her office has issued nothing official about the most recent report, which was barely publicized.
  • Bondi is also on the executive committee of a multi-state investigation into painkiller manufacturers, her office confirmed for the first time this week, though it would not provide details, citing that the matter is ongoing. And Scott’s office is “reviewing ways to work with the Legislature to continue to fight the opioid crisis,” spokeswoman Kerri Wyland said in a statement.
  • In contrast, when the Zika virus spread last summer in South Florida, it drew quick attention from state leaders and a batch of emergency spending.
  • But it took until May 2017 — three years after opioid deaths started to rise — and with relentless lobbying by Palm Beach Commissioner Melissa McKinlay, for Scott to declare a public health emergency. Meanwhile, “We didn’t lose one life to Zika.”
  • But rather that expand access to treatment or do a broad drug enforcement sweep, Bondi lobbied for legislation meant to shutter fraudulent “sober homes” that chase profits by exploiting those hoping to overcome addiction.
  • Making matters worse, Florida’s already strained mental health care system has a shortage of treatment centers and professionals who can provide care.
  • “We could use more education, more resources, more treatment centers…. There are far more individuals with addiction than there are beds available.”
  • Few Florida counties have a facility that can take patients under the state’s Marchman Act, which allows people to be involuntarily committed for substance abuse treatment.
  • Another route to treatment is being left out of the conversation: Emergency rooms. Hospitals now must come up with a standard for preventing accidental overdoses, but they aren’t required to refer patients to long-term treatment.
  • Other advocates have pushed for broad policies they say will limit addiction in the first place. Activists called on lawmakers to let doctors treat chronic pain with medical marijuana, which they say is less addictive than prescribed pills. A 2014 study by professors at the University of Pennsylvania and Johns Hopkins found that states with medical cannabis laws had an average 25 percent drop in opioid deaths. But Florida lawmakers did not approve marijuana for chronic pain, in part because the constitutional amendment legalizing medical marijuana did not call for it.
  • Mark Fontaine, Executive Director of the Florida Alcohol and Drug Abuse Association – “I’ve been doing this for 40 years and I’ve never seen anything like we’re dealing with now,” he said. “This is a public health crisis, and I think it needs the full response of a public health crisis.”

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