Substance Use Treatment & Recovery in Florida

Florida’s dreamy, palm tree paradise filled with soft-sand beaches and warm weather has lured many people to the Sunshine State, including people who come here for drug and alcohol addiction treatment.

But, in addition to being a known haven for recovery and dubbed the Rehab Capital of America, Florida continues to battle substance abuse and addiction cases that still contribute to high death rates.

SUBSTANCE ADDICTION IN FLORIDA

Florida is above the national average for drug-induced deaths.

As of late 2017, data from the Florida Medical Examiner’s Office showed that in late 2016, drugs were involved in 11,910 deaths across the state.

Many of them involved prescription drug use.

According to the report, prescription drugs account for 61 percent of all drug occurrences in the report when ethyl alcohol is excluded.

Some of the statistics from the report are:

The report also said the five most frequently occurring drugs found in the deceased in drug-related cases in Florida were ethyl alcohol (5,318), benzodiazepines (5,167, including 1,851 alprazolam or Xanax occurrences), cocaine (2,882), cannabinoids (2,292), and morphine (2,040).

FLORIDA ADDRESSES ITS OPIOID CRISIS

The opioid crisis that has rocked much of the United States has definitely made its impact on Florida and resulted in many deaths in the state. In 2016, data show that fentanyl caused 1,390 deaths, heroin caused 952 deaths, oxycodone caused 723 deaths, and hydrocodone caused 245 deaths.

Just recently, in March 2018, Florida Gov. Rick Scott signed a unanimously passed bill (HB 21), which aims to discourage and prevent patients from getting addicted to prescription pain relievers before turning to street drugs such as heroin and fentanyl.

Perhaps the most important part of the bill is that it would limit the prescriptions that doctors can write for patients who need treatment for acute pain. In many cases, doctors would be limited to writing three-day prescriptions. However, they could prescribe up to seven days’ worth of supplies if it is deemed medically necessary, according to the bill.

The bill also requires physicians or their staff members to check a statewide prescription database before prescribing or dispensing controlled substances.

OTHER FLORIDA SUBSTANCE USE TRENDS

ALCOHOL

Alcohol remains a top drug of abuse in Florida. Under the state’s sunny skies and among its balmy breezes, residents, tourists, and visitors alike will find the alcoholic beverages in full supply at many of the restaurants, clubs, and bars, especially during spring break season and holiday events. But this perhaps relaxed attitude toward drinking comes with a price.

According to the December 2016 Patterns and Trends of Substance Abuse report, alcohol was found to be present in 49 percent of all drug-related deaths in the state in 2015. In addition, it also was determined to be a cause of death for 17 percent of the decedents in which it was detected, said the report, which was put out by the Department of Children and Families Office of Substance Abuse and Mental Health.

There have been some data showing a decline in underage drinking in recent years, but it is still a significant problem in Florida and the rest of the state. According to the report, “The percent of Florida high school students reporting that daily use of alcohol presents a ‘great risk of harm’ remained stable ranging from thirty-eight (38) percent in 2002 to forty-one (41) percent in 2016.”

It goes on to say, “A serious concern is that even with reduced alcohol use about forty (40) percent of Florida school students who report any alcohol use in the past month also report binge drinking in the past two (2) weeks.”

The National Institute on Alcohol Abuse and Alcoholism (NIAAA)defines binge drinking as “a pattern of drinking that brings blood alcohol concentration (BAC) levels to 0.08 g/dL. This typically occurs after four drinks for women and five drinks for men—in about two hours.”

A BAC of .08 g/dL is considered to be impaired in all 50 U.S. states, reports the National Highway Traffic Safety Administration.

Binge drinking can lead to alcohol use disorder or alcoholism. If you or someone you know can’t control your drinking, it may be time to seek professional treatment.

ILLEGAL DRUGS

Illegal drugs are just as much of an issue as legal ones. In addition to prescription medication abuse, illegal drugs are also a problem in Florida, among them cocaine and heroin. The Florida Medical Examiner’s report lists cocaine as the only illegal drug that caused the most deaths in Florida in 2016. Also, according to the report, “Occurrences of heroin increased by 31 percent and deaths caused by heroin increased by 30 percent” in 2016 when compared to 2015.

The state’s location on the water makes it a prime spot for illegal drugs to enter the country as the state and nation’s drug crisis just expands.

Colombians’ transnational criminal organizations, or TCOs, specifically target Miami and Orlando as points of arrival for cocaine and heroin that are shipped directly from Colombia, Mexico, Central America, and the Caribbean, according to the 2016 National Drug Threat Assessment Report.

“Illicit drugs shipped by Colombian TCOs directly to South Florida arrive through a variety of methods, including commercial air flights, commercial air cargo, and maritime containerized cargo. Heroin and cocaine are generally shipped separately to U.S. markets by Colombian TCOs,” the report said.

In addition to that, Florida continues to see people dying from prescription drug overdoses.

TYPES OF FLORIDA ADDICTION TREATMENT PROGRAMS

The centers that make up Florida’s $1 billion recovery industry offer a variety of services to help countless people in active addiction turn their lives around. Drug and alcohol treatment programs are designed to help people get back on track after battling substance abuse and addiction. Many people will struggle to overcome their addiction when they try to do it on their own outside of professional help. But the good thing is they don’t have to do it alone. Many treatment programs view addiction as a disease or illness, not a moral failing or a matter of a lack of willpower as so many people believe.

According to the National Institute on Drug Abuse, addiction is a complex but treatable disease that affects brain function and behavior. The disease can change the brain long after substance abuse has stopped, which is why users are vulnerable to relapse. While it is treatable with the appropriate programs, research shows that at least three months (90 days) or more are needed to properly treat a substance addiction.

WHAT IS SUBSTANCE USE TREATMENT?

According to the Substance Abuse and Treatment Health Services Administration (SAMHSA), the treatment system for substance use disorders is made up of multiple services. They include:

• Detox
• Inpatient and residential treatment
• Intensive outpatient treatment
• Partial hospitalization programs
• Individual counseling
• Group counseling
• Case or case management
• Medication management or monitoring
• Aftercare recovery support services
• 12-step fellowship programs
• Peer supports

The National Institute on Drug Abuse (NIDA) says that the complexity of addiction, as well as its pervasive consequences, mean many components must be involved in addiction treatment. “Some of those components focus directly on the individual’s drug use; others, like employment training, focus on restoring the addicted individual to productive membership in the family and society, enabling them to experience the rewards associated with abstinence, it writes.

According to NIDA, there are more than 14,500 specialized drug treatment facilities in the United States.

Treatment is available for :

• Alcohol Use Disorder
• Benzodiazepine Use Disorder (Xanax, Ativan, Klonopin, Valium)
• Stimulant Use Disorder (such as cocaine, methamphetamine)
• Opioid Use Disorder (OxyContin, Heroin)

Substance use treatment is customized according to the needs and preferences of the person receiving treatment. Therefore, a person may not need all of these services, but each serves a specific role. “These systems are embedded in a broader community and the support provided by various parts of that community also play an important role in supporting the recovery of people with substance use disorders,” SAMHSA writes.

WHAT TO LOOK FOR IN A SUBSTANCE USE TREATMENT PROGRAM

Florida has hundreds of addiction treatment centers to choose from, which is good because that means there’s variety. But having so many options to choose from can make the search for the best one for you a challenge. When you have identified one or more centers that appeal to you, it is important that you ask questions that can help you gain insight into the level of care offered at each center as well as each center’s reputation. Asking questions can also help you figure out which high-level facility would be best for you.

While you are encouraged to come up with your own questions, SAMHSA offers a set of questions in five key areas that can give you an idea of the quality of treatment of a treatment provider. They are accreditation, medication, evidence-based practices, families, and supports. It also says, “Good quality programs will have a good inspection record and both the program and the staff should have received training in the treatment of substance use and mental disorders and be licensed or registered in the state.”

When it comes to accreditation, it is advised that you check the facility’s accreditation with the Joint Commission and the Commission on Accreditation of Rehabilitation Facilities.

The Joint Commission (JCAHO) is a nonprofit organization that provides independent accreditation and certification of health organizations. Before organizations can receive accreditation from JCAHO, they must meet criteria pertaining to quality and performance levels. You can search for find accredited organizations on the Joint Commissions’ website.

IN THESE AREAS, SAMHSA ADVISES THAT YOU ASK ABOUT:

ACCREDITATION

Has the program been licensed or certified by the state? Is the program currently in good standing in the state? Are the staff qualified? Does the program conduct satisfaction surveys? Can they show you how people using their services have rated them?

MEDICATION

Does the program offer FDA approved medications for recovery from alcohol and opioid use disorders? At this point in time, there are no FDA approved medications to help to prevent relapse from other problem substances.

EVIDENCE‐BASED PRACTICES

Does the program offer treatments that have been proven to be effective in treating substance use disorders including medication management therapies, such as motivational therapy, cognitive behavioral therapy, drug and alcohol counseling, education about the risks of drug and alcohol use, and peer support? Does the program either provide or help to obtain medical care for physical health issues?

FAMILIES

Does the program include family members in the treatment process?  Family members have an important role in understanding the impact of addiction on families and providing support.

SUPPORT

Does the program provide ongoing treatment and support beyond just treating the substance issues? For many people, addiction is a chronic condition and requires ongoing medication and support. Quality programs provide treatment for the long term which may include ongoing counseling or recovery coaching and support and helps in meeting other basic needs like sober housing, employment supports, and continued family involvement.

WILL MY INSURANCE COVER SUBSTANCE USE TREATMENT?

As you consider alcohol and drug rehab programs in Florida, you may need to call your insurer to verify if your plan will cover the programs offered or ones you are interested in. You also are advised to ask if your insurer has a network of preferred providers that you can use. If you don’t have insurance, SAMHSA advises that each state has funding that provides funding for people who don’t have coverage. Find out where to call for information about payment services.

FLORIDA CRACKS DOWN ON SOBER HOMES

Despite the substance abuse issues in Florida, the state is tackling some of its problems with the legislation.  Another area it has taken the lead on is regulating sober homes. In summer 2017, Florida lawmakers passed legislationthat strengthens the state’s role in enforcing stricter regulations for the substance abuse treatment industry and prosecuting treatment providers, and sober-home owners who authorities say are on the wrong side of the law. House Bill 807, also known as the Practices of Substance Abuse Service Providers Act, was sent to Gov. Rick Scott to be signed and took effect on July 1, 2017.

The measure cracks down on common deceptive practices that have been used in the addiction treatment industry, including fraudulent marketing strategies and patient brokering in which client referrals are exchanged for payments of any kind.

Many people from across the U.S. and the world come to South Florida for drug treatment and recovery services, making the area ripe for sober homes to establish themselves and market rentals to people recovering from substance abuse.

Sober homes offer group housing to people in recovery from addiction, most of whom are from the Northeast and Midwest. Time spent in the homes allows residents to adjust to their new life of sobriety in a structured, safe and supportive setting that still allows for some freedom and independence.

The Florida model of recovery has become increasingly popular in recent years and made South Florida, in particular, a popular destination for individuals in need of recovery treatment.

Certain areas in the region, such as Delray Beach, Florida, have exceptionally high concentrations of rehabilitation facilities and sober-living homes, hundreds, according to a recent New York Times article.  

In the past, Florida’s sober homes had gone largely unregulated because they don’t actually offer addiction treatment. This has left room for “scam homes” to take advantage of residents and commit insurance fraud.

Finding a trusted treatment facility in Florida may have gotten a boost from this legislation. The bill also increases penalties for facilities that operate without a license and requires the Florida Department of Children and Families to conduct background screening for owners, directors, CFOs and clinical supervisors of substance abuse service providers among other.

“The new legislation is groundbreaking in its scope,” Palm Beach County State Attorney Dave Aronberg, told the Sun-Sentinel in May. 

Aronberg, who established and headed the task force, added, “It will save lives by enhancing oversight of the recovery industry in Florida, and give prosecutors and law enforcement powerful tools to eliminate the bad actors who take advantage of vulnerable patients.”

Sources

Florida Department of Law Enforcement. (2017, November). Drugs Identified in Deceased Persons by Florida Medical Examiners. from https://www.fdle.state.fl.us/MEC/Publications-and-Forms/Documents/Drugs-in-Deceased-Persons/2016-Annual-Drug-Report.aspx

Saunders, Jim. (2018, March 19). Gov. Rick Scott signs bill targeting opioid addiction in Florida. from https://www.tallahassee.com/story/news/2018/03/19/gov-rick-scott-signs-bill-targeting-opioid-addiction-florida/438455002/

News Service of Florida. (2018, March 2018). Rick Scott signs bill targeting opioid addiction. from https://floridapolitics.com/archives/259262-rick-scott-signs-bill-targeting-opioid-addiction