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.
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MAP posted-by: Richard Lake