This is a guest post from our guest writer, Bleeding Heart.
Let me start by saying addiction is an insidious disease. It baffles the mind of the average person that someone will keep using drugs despite the multiple consequences. Although current attention is focused on the heroin epidemic, addiction to any number of substances causes death. Thanks to the heroic efforts of advocacy groups such as Attack Addiction, much of the state resources have been directed to preventing overdose deaths. Agencies from law enforcement, the criminal justice system and the Division of Substance Abuse and Mental Health (DSAMH) have focused much of their resources on this scourge. The Division of Prevention and Behavioral Health Services, responsible for funding treatment for uninsured kids or those with Medicaid benefits, basically dismantled an entire system of care for substance abuse over the last three years (which is a whole different post). Although obviously necessary, opiate related deaths are not the whole story in treating addiction.
Over the past two years DSAMH has rallied the resources to greatly expand the array of services offered to addicts in Delaware. As of this writing, DSAMH funds the following services, not including numerous outpatient programs:
32 inpatient detoxification beds
24 – 23 hour observation beds
60 ambulatory detoxification slots
128 residential beds
16 transitional beds
139 sober housing beds
DSAMH sends out almost daily lists of the available beds in all of these programs and I have reviewed the 35 I have covering the past nine weeks. On any given day, on average, there are 10 open inpatient detoxification beds, 18 beds in the 23 hour observation beds are open, 28 slots open for ambulatory detoxification services, 53 beds are open in residential facilities, 5 beds in the transitional program, and 16 open beds in sober living houses. Remember, these are just the state funded treatment slots. Delaware Medicaid also covers treatment in at least one inpatient facility in PA and two in MD. It’s not that treatment is not available, it’s that it is not being utilized.
I spent the afternoon contacting colleagues at all of the residential facilities and gathered information on the lengths of stay that have been approved by DSAMH over the past year. On average, 62 days have been funded per admission. I realize this information is not in keeping with the perception of the public here in Delaware. We have a problem when politicians like Matt Denn start grandstanding with inaccurate information and those with the loudest voices and anecdotal stories, tragic as they may be, become policy setters.
Again, addiction is an insidious disease and its devastation is far reaching. Many addicts have to try multiple times before they get recovery and many addicts die. It is easy to cast blame, it is easy to demand what others should do, but it is hard to find just the right answer for any addict to be able to achieve recovery. As someone in recovery who has crossed paths with thousands of addicts over the years, I know there is no magic bullet to make people get recovery. I know that the large majority of people who work in treatment centers work very hard to give addicts the tools for recovery. I know that most treatment providers work among themselves and cooperatively with each other to find the services that will best help each individual. And, I know that sometimes the addicts do not use the tools we try to give them. Oftentimes they leave treatment against medical advice, they don’t follow through with aftercare plans, they refuse to sign consents to get families involved in treatment, sometimes the families refuse to participate in the process. Providers get beat down too at the enormity of trying to help this population. It is also true that treatment providers sometimes make mistakes or don’t develop the best plan possible or get frustrated seeing the same clients coming through the revolving door of treatment, never having once followed through with doing what they said they would do. Yet, thanks to the pandering of politicians who see a voting block and don’t even consult with treatment providers and the emotion of tragically destroyed families, treatment providers and the State are blamed for the failure of addicts to achieve recovery. There is a fine line between supporting and enabling and at some point the addict has to accept responsibility for treating their disease on a daily basis.