Pubdate: Mon, 06 Aug 2001 Source: Register-Guard, The (OR) Copyright: 2001 The Register-Guard Contact: http://www.registerguard.com/ Details: http://www.mapinc.org/media/362 Author: Tricia Schwennesen Note: Tricia Schwenneser covers police and public safety. Bookmark: http://www.mapinc.org/rehab.htm (Treatment) DETOX CENTER CUTS BACK, WORRYING OFFICIALS Many heroin addicts, drug abusers and alcoholics may no longer be able to get the help they need when they want it. Buckley House, the county's only public detoxification center, has slashed its number of available treatment beds from 17 to 10 - less than half its capacity of 23 beds, Director Bob Richards said. The detox center provides medication, attention, food and shelter to addicts and alcoholics who are looking for help. "Money is so tight we can't afford to put people in beds that aren't funded beds," said Richards, who said the reduction was made July 1, the beginning of the fiscal year. If this year plays out like last year, the number of people seeking detox will exceed the number of available beds in late fall, Richards said. "I'll have to develop a waiting list." Running the program off a waiting list could be detrimental to the community, according to state officials, law enforcement, substance abuse specialists and the addicts themselves. "The window of opportunity for any given individual could be a couple hours long," said Carla Newbre, a Eugene police commissioner and crisis counselor for the social service agency CAHOOTS. "If a heroin addict wants to get treatment, and then they have to wait a day or two for a bed, that golden opportunity can be lost," Newbre said. "When anybody asks for treatment, they should be able to get it that instant." Even at capacity, Buckley House falls short of meeting the entire needs of the community, Richards said. But it can't even be run at more than half-capacity unless it gets a boost to its budget. The lion's share of the Buckley House's $600,000 annual budget comes from state funding and a smattering of federal dollars, which have remained the same for the past few years, county Health and Human Services program coordinator Peg Jennette said. Extra money allocated by the governor the past two years ran out and was replaced this year with county funds, she said. But while the agency's money hasn't been reduced, its funding does not stretch as far as it has in the past, Jennette said. The costs of medical care, drugs to relieve painful withdrawal symptoms and payroll for experienced staff have skyrocketed. Other counties have detox centers housed in residential treatment facilities, which qualify them for federal matching grants, she said. Buckley House is a free-standing detox center and doesn't qualify for such extra money. In formulating this year's budget, the county divided $369,122 earmarked for Buckley House's detox center by $100, which is the estimated cost of operating a detox bed per day, Jennette said. That would allow 3,691 bed days per year or about 10 slots, she said. "Detox is a very expensive service," Jennette said. "It's the first step toward recovery and it provides a vital service to the community. If we didn't have detox, we'd have people all over needing emergency services and psychiatric help and being a danger to themselves and others." Which is why even a donation of $50 can be helpful, Richards said. "You're buying bed days here and that's helping one person at a time," he said. "If that's the way we've got to do it, that's the way we'll do it." About 5,000 people come through Buckley House each year, with nearly two-thirds seeking treatment in its sobering unit and the other third in the detox center. On Friday, one addict who had been at Buckley House three days said a waiting list would have been disastrous for him. The man said his decision to enter detox wasn't an easy one. "The night before I came in, I went back and forth, back and forth," he said. "I think that's a crucial time, when someone gets to the point where they want to come in." Without that open door, he said, he would have stayed on the streets and continued to feed his heroin habit to feel well. Forcing addicts to wait on the streets encourages them to drink or abuse drugs, and do whatever it takes to support their habit - usually prostitution, stealing or dealing, he said. "The more beds available the less things like that are going to happen," he said. "I've never known of anyone making it without help beyond detox." Buckley House provides that help, he said, through referrals and group meetings. "You never know where you're going to sleep, never know where you're going to get 350 freaking bucks a day," he said. "The desperation. The desperation that goes along with that and the degradation - I'm not willing to do it. I don't want to live that lifestyle." With fewer beds available at Buckley House, the burden of drunks and drug users will fall on area hospital emergency rooms and the jail, law enforcement and hospital officials said. "(Buckley House) has proven to be a very useful resource to the community and law enforcement as a place to take people who are highly intoxicated," Eugene Police Capt. Steve Swenson said. "They provided a service that is not going to be substituted anywhere." He hopes that more funding can be found. "It's unfortunate in a community the size of Eugene-Springfield that we will only have 10 beds left," Swenson said. "Ten beds is pretty small." Newbre agreed and said the loss of beds would have a significant impact on the work of CAHOOTS teams, which intervene in noncriminal situations and provide dispute resolution, medical transportation and often help those who are incapacitated by drugs or alcohol. People who can't get detox may end up in the criminal justice system instead of a treatment program, she said. "It's hard to hold down a job when you have an alcohol or drug addiction. It's hard to maintain a lawful existence," Newbre said. "I don't mean to imply that people with drug and alcohol problems are all criminals. I think this is absolutely the wrong way to go. I think they need to add treatment beds." If people who are turned away at the detox door don't wind up at the jail, they are likely to find themselves in a hospital emergency room where treatment can cost up to $800 per day, county Mental Health Services program manger Al Levine said. "It's a huge problem," he said. "It will be a big problem for police and a big problem for the hospital, and it creates a huge disposition for those in the ER." About 75 percent of patients admitted because of psychiatric problems have a significant substance abuse condition, he said. "Some will end up back on the streets - and may end up in the jail." Dr. Lee Davidson, an emergency room physician at McKenzie-Willamette Hospital, said ERs would anticipate seeing more drug addicts and inebriated clients with a reduction in detox beds. "They're going to show up here much more frequently than they have in the past," he said. The emergency room can't provide the follow-up care that Buckley House has been providing, he said. "It's the difference between acute care as opposed to Buckley's ability to deal with their acute care and their rehabilitative care," Davidson said. For now, county officials are trying to think creatively about where to get more money. Richards is hoping that it won't come to establishing a waiting list and turning clients away - even for a couple days. "I'm going to be sitting here really frustrated this winter when I have a waiting list and 13 beds I can't put people in," he said. - --- MAP posted-by: Richard Lake