In 2016 alone, Florida saw 2,798 opioid-related overdose deaths at a rate of 14.4 deaths per 100,000 people. When compared to the national rate of 13.3 per 100,000 persons, it starts to put the topic into perspective. Florida has been hit particularly hard by deaths that involved synthetic opioids. The figure in 2016 has increased exponentially since 2013 where that number was a mere 200. While one death is too many, the influx of substance use is enough to feel worried.
In 2013, Florida providers had written 69.6 opioid prescriptions per 100 persons, but that number had decreased by 7.3 in 2015. Although there has been a decrease in the number of prescriptions written, it seems as though the damage has already been done; too little too late. All this does is push users who can’t obtain a prescription to the streets to purchase illicit drugs if they’re not ready to seek treatment. Solutions to these problems are needed, but Florida has been experimenting with new and existing rules and regulations that are designed to bring some relief.
Drug overdoses have gone up in Broward County, which shows that 10 people a week are dying. The problem is that we don’t even know what’s in the drugs anymore. There has been a rise in synthetic opioids due to their low cost and easy accessibility, and when someone purchases what they think is a bag of heroin, it could actually be a bag mixed with fentanyl. With that, Medical Examiner Dr. Craig Mallak from Broward County is on record saying, “There are no [normal] drugs anymore, everything’s a combination.”
The high volume of overdoses and deaths have completely overwhelmed first responders like police officers, firefighters, hospitals, and even the morgues.
Due to this crisis, there has been a sharp increase in the production of a drug called naloxone, or it’s more common name Narcan. The unfortunate reality of economics is that when something is in demand, the price rises. Narcan is often mentioned to be the miracle drug because of its instant reaction to someone overdosing, but the price has risen dramatically with an increase in its demand. However, counties are willing to pay the price if it means giving someone a second chance at life.
The implementation around the country of training courses for first responders on how to recognize when someone has overdosed on opioids, and how to properly administer the drug has been the only reason why numbers have not inflated anymore when it comes to deaths. Narcan works by completely blocking opioid receptors in the brain; it works immediately after it has been administered. It is truly the difference between life and death, and many survivors can attest to its effectiveness.
Florida has been aggressive in creating policies and devising plans to help combat the issues facing it. While the statistics paint a picture that seems dark, and rightfully so, solution-oriented initiatives are in the works. It’s wise to mention that no one solution will cure this devastating disease, but once it gains the recognition it deserves, there will be more and more support behind stopping this in its tracks.
One strategy that has been put in place is to charge drug dealers in deaths by overdose, and not just charge them with murder, but to potentially have them face the death penalty. It may seem steep, but with addiction overwhelming the state, no half measures are being considered at this point. “If our agents can show the nexus between you—the pusher of poison—and the person that overdoses and die, we will charge you with murder. We are coming for you. Run.” Strong words coming from the Lake County Sheriff’s Department Peyton Grinnell.
Another possible solution that has been put in place is Fla. Gov. Rick Scott signing a bill to try and cap the opioid crisis. The bill was introduced as a means to prevent people from getting hooked on pain medication before they ultimately would turn to street drugs such as heroin or Fentanyl. Once introduced to lawmakers, HB-21 was immediately passed to start putting limits on prescriptions that doctors put out for acute pain.
It serves its purpose by limiting prescriptions of narcotic pain medications like Percocet or Oxycontin to three-day doses but could be prescribed for up to seven days depending on the situation. This is all case based, but the patient is required to return once every three to seven days to check in with the doctor about the pain. There is an exception to this law—those who suffer from a major trauma or terminal illness will be exempt from this.
This law has prompted doctors to be more selective about who they prescribe opioids to in hopes of curbing the crisis. While the damage has been done, it’s important to discontinue the cycle and start making a change for the future. Doctors who have the authority to prescribe opioid medications are now required to take courses geared toward seeking out the warning signs of opioid abuse.
Training also teaches them how to enter information into a statewide database that screens individuals who could be engaged in doctor shopping, the practice of visiting multiple doctors in a short period to get numerous prescriptions for a drug without a legitimate medical reason.
In short, implementing this law and dusting off the law books to prosecute poison pushers at the highest level won’t completely eradicate the problem, but it is progressive thinking by those in charge want to make a difference in this terrible problem facing our communities.
The treatment for substance use disorders is comprised of multiple service components, but a person accessing the treatments may not require all of them for success. With that said, it is necessary to note that each plays an important role in the treatment of addiction.
The first step in the continuum of care is detox, a procedure that should take place in a medical setting where health care professionals and addiction specialists are present. It involves ridding the body of any illicit substances or drugs/alcohol in a carefully supervised process. The recovering individual will deal with withdrawal, but if done in a medically induced detox, the risk factors involved will be mitigated, and discomfort will be minimized as much as possible. It will be an uncomfortable process, but it should never be done cold turkey, or abruptly. This could be done on an outpatient basis depending on the severity of the addiction.
During treatment, a client will begin at the highest and most intensive level of care, whether they are in residential treatment or participating in an outpatient program. They will follow through with a medical plan set in place in detox for the length of stay, and types of therapies used. They will also determine if residential or outpatient treatment will be a better course of action. During the progression of treatment with the aid of the therapy team, the client will gradually decrease the levels of what is required. This will all be predicated on their current needs; all plans are subject to change if the patient is not responding in a fashion as expected. The typical order of operation is:
With the various levels of care comes different therapies geared toward educating the client, and helping better understand the triggers that could pose threats outside the walls of treatment. The client will be given support, guidance, education, and the necessary coping skills to manage this disease. Some of the therapies include:
The search for facility services that are customized for your needs should never be the stressful part of this process. Specific criteria can help you weigh your options. The decision will ultimately decide the outcome of the potential client’s’ future, and choosing the right facility with high standards will give the best outcome.
Treatment is not a one-size-fits-all solution, and to seek out the best choice for either you or a loved one, certain facilities will meet specific needs more than others. However, those facilities should also meet specific criteria as well. A helpful tool to rely on when evaluating your choices for treatment is the criteria set in place by the Substance Abuse and Mental Health Administration (SAMHSA). Its treatment center criteria are:
Along with the rise in addiction comes a surge of fraudulent practices, and unfortunately, the most vulnerable are not exempt from this. There has been an uncharacteristic rise in fraudulent rehab centers across Florida, and it is important to only seek an accredited facility. Accredited facilities operate on the strictest standards and have gone through rigorous training to obtain licenses and certifications.
Look for a treatment center that offers cutting-edge addiction treatment practices to treat the disease. Make sure there is a track record of proven success and effectiveness based on advances in addiction research.
Addiction research has proven a successful link between recovery and family-based therapies. Not all treatment centers offer this type of therapy, but statistics back up the effectiveness of this technique.
Medication-assisted treatment (MAT) can be the difference between prolonged sobriety, or giving in to the withdrawals. Certain substances such as benzodiazepines carry the risk of an extreme withdrawal period with deadly outcomes, and under the supervision of professionals administering medicine will be the best course of action for success.
Not all facilities offer long-term treatment plans such as an alumni program, but it is important to understand that this is a lifelong disease. It will require constant attention for life, and this is a valuable tool that helps recovery users achieve lasting sobriety.
National Institute on Drug Abuse. (2018, February 28). Florida Opioid Summary. from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-summaries-by-state/florida-opioid-summary
Haden, P. (n.d.). New Strategy To Fight Opioids Epidemic: Criminal Charges For Drug Dealers In Deaths By Overdose. from http://www.wlrn.org/post/new-strategy-fight-opioids-epidemic-criminal-charges-drug-dealers-deaths-overdose
C. (2014, October 01). Treatments for Substance Use Disorders. from https://www.samhsa.gov/treatment/substance-use-disorders
A. (2014, June 20). Behavioral Health Treatments and Services. from https://www.samhsa.gov/treatment