Detox bed shortage complicates fight against opioid epidemic

Feb 21, 2018


A WXXI News investigation has found that there are 25 medically licensed detox beds in all of Monroe County, even though addiction specialists say that the need is at least four to five times that number. Doctors and addiction specialists describe the situation as a shortage that is making the fight against the opioid epidemic more difficult.

“I wanna get high, but I wanna get clean,” said Josh, a man from Rochester who has been addicted to heroin for several years. “I don’t wanna keep doing this anymore. It’s stressful, going out every day trying to come up with money to get high. I don’t wanna keep doing it.”

We met Josh in early February on the day he decided to stop using drugs. It’s a critical moment for anyone who is addicted because the withdrawal symptoms can be overwhelming, and the urge to get clean can be replaced by a desperation to get high. But Josh says he was told there were no detox beds in Monroe County available; he would have to wait two weeks.

"By then, you can either end up dead or like, if you need to detox, you need to detox when you need to detox,” Josh said. “Not in two weeks. And by the time you got a bed, you might change your mind, you know? I don’t want to go anymore; I want to keep getting high."

Less than 24 hours after we met him, Josh was already hurting from withdrawal symptoms.

“I used heroin last night around midnight,” he said. “That was my last use. I haven’t used yet today, so I’m gonna have to figure out how to get something to get off sick because I’m dope sick right now.”

Providers understand how important it is to get people like Josh into detox treatment right away. All of the 25 local detox beds are offered through Syracuse Behavioral Health on University Avenue. 

"SBH has been and continues to search for a location to accommodate an expansion of our existing beds in Rochester," said Jeremy Klemanski, CEO of Syracuse Behavioral Healthcare, in a statement to WXXI News. 

“This is a problem that needs many, many different solutions, but getting people into treatment should be number one,” said David Attridge, executive director of Recovery Now NY. Attridge has driven patients to other towns and counties that have more available detox beds, including in Utica and Schenectady. “These are lives we need to save. When you get that window of opportunity, it’s very small, because obviously the disease, the heroin – it’s calling you back.”

A detox bed is a licensed medical location in which patients have drugs leave their body. Here’s what the experts tell us: there are several ways to accomplish detox, and the process can take anywhere from half a day to four days. Detoxing at home can be dangerous because patients can experience intense withdrawal symptoms, including vomiting, headaches, diarrhea, and more. The rate of relapse is high.

“It’s an issue because our detox center, it runs with a waiting list,” said Patrick Seche, director of Strong Recovery, part of the Addiction Psychiatry Division at Strong Memorial Hospital. “So whenever you have a detox center with a waiting list, it’s a major issue because whenever someone needs detox, that should be readily available.”

Some local providers don’t have licensed detox beds but can offer outpatient detox services. That’s the case at Rochester Regional Health, as well as several others.

“Not everyone who’s in need of help needs to go to an inpatient detox program,” Seche said. “The most important thing is to make assessments more readily available because the person may not need a bed.”

Monroe County is one of many places dealing with a shortage in detox beds. In July of 2017, Senator Bernie Sanders traveled to West Virginia to highlight the problems in the American healthcare system. “In a time when this state is estimating that it has 150,000 residents with an opioid disorder, and only 156 detox beds to serve them, clearly the resources available for treatment and prevention today are totally inadequate,” Sanders said, to a large ovation. “And that is true for the nation as well.” Alaska Public Media reported in 2016 that Anchorage is dealing with a shortage of detox beds for opioid addictions, with 60 people needing a bed on a daily basis, and only 14 available. 

But Monroe County Public Health Commissioner Dr. Michael Mendoza cautions against fixating on any single issue in the fight against opioids – including detox beds.

“There’s definitely a bed shortage,” Dr. Mendoza said. “There’s a shortage in virtually every component of addiction management. So that’s the issue. And the question is, where is the bottleneck? Because if we add more detox beds, but we don’t address the next step, well then we’ve not done anything – we’ve only made the wait longer for whatever the next step might be.”

New York State’s Office of Alcohol and Substance Abuse Services (OASAS) is central to funding and planning for opioid detox. OASAS declined to be interviewed about the situation. When asked if OASAS agrees that there is a shortage of detox beds in Monroe County, the organization did not answer directly, and instead released this statement:

“Under the leadership of Governor Cuomo, OASAS has worked to expand our detox services throughout New York State, including in Monroe County. In addition to dedicated detox programs, detox services are available in some OASAS-certified residential programs, as well as in hospitals. These services are an important way to help prepare people for treatment, and get them on the path to recovery.”

In October, OASAS announced $10 million in available funding to establish 75 new detox beds in “underserved communities in New York State.”

“If all we can get is 75 right now, let’s take the 75,” Attridge said. “Really, we need to come together and demand these beds, no matter what we have to do.” OASAS has not yet announced where the funding and the beds will go. 

Establishing more beds is “something that could happen as quickly as within six months or it could take a couple years,” Seche explained. “It all depends on the level of support for it.”

WXXI News asked Mendoza if adding more detox beds would make a clear difference.

“I don’t know,” he said. “I don’t think anybody knows the answer to that. I mean, certainly, more wouldn’t hurt. I’m trying to understand from the emergency departments, ‘What do you need to help the people that you see who come in for nonfatal overdose or other opioid complications?’ And what I’m hearing from them isn’t that we need more detox beds. I’m hearing from them that they want a bridge to services that can get people started on the path.”

Josh’s path to treatment took him far from home. When we last heard from Josh, he had finally found a detox bed – in Buffalo.

“It’s always that one more, one more, one more,” he said. “I’m sick of the chase. I don’t want one more anymore. I just want it to be over.”

This story includes reporting from Megan Mack and Karen Shakerdge, as well as Fiona Willis and Dave Marshall. They are producing a documentary for WXXI about the effects of the epidemic on the local area. The documentary will air on WXXI in April.

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