Friday, May 25, 2018
Public safety

Romano: The "morally irresponsible'' strategy to fight opioids in Florida

The girls knew the rules, and especially the consequences. Their father would never raise a hand to them, but he was an aficionado of understated punishments.

Grab a pen and paper, he would tell his two daughters, and come sit at the kitchen table. Write down what you did wrong, and how you plan on correcting it. Sign it, date it and make sure you spelled everything correctly.

Frank Vazquez fretted enough about Cylea and Leliana that he wouldn't let them spend the night with friends because of all of the things that might go on in other homes. And he was like a doorman at a fancy high-rise when it came to who got past the threshold to visit his girls.

He did all this while addicted to opioids.

A traffic accident years earlier had messed up one leg, and the prescription painkillers messed up everything else. When pharmacies in Gulfport stopped filling his prescriptions, he turned to dealers. And when pills got scarce, he turned to heroin and fentanyl.

A year ago, when the girls were 14 and 15 and their mom was at work, they called their grandmother. Their dad, they said, was slumped on the bed. He didn't seem to be breathing.

• • •

Experts say opioid addiction has reached crisis level, but it seems more accurate to say it's at catastrophe level. We're at a point where overdose deaths are killing more Americans in a single year than the U.S. military had casualties in the Vietnam War. The entire war.

And in Florida, specifically around Tampa Bay, it's about to get worse. A $20.4 million federal block grant funding centers for substance abuse and mental health recently expired, and agencies were caught completely by surprise when word began to spread at the end of July.

The Central Florida Behavioral Health Network, which coordinates services in Tampa Bay, is taking a $5.9 million hit. That means fewer beds in rehab centers. That means less money for mobile crisis and diversion teams. That means less funds for juvenile programs.

And that means county jails and emergency rooms will have to pick up the slack.

"It's going to create big holes in our system,'' said Central Florida CEO Linda McKinnon.

The $20.4 million was always classified as non-recurring funds, so technically it wasn't a surprise when it disappeared. The only problem is a lot of health funds are considered non-recurring and yet get renewed annually. There was no warning that this grant would vanish so quickly.

Few people understand the ins and outs of substance abuse and mental health care in Florida better than state Rep. Kathleen Peters, R-Pasadena, and even she was stunned when budgets were released.

She immediately called Gov. Rick Scott to explain the necessity of these funds and to ask if there was any way the money could be replaced. The governor said he would look into it, but seemed satisfied that Florida was in good shape because of a different $27 million federal grant.

The problem is that the other grant is specifically earmarked to be spent on drugs such as methadone and vivitrol, which are used to wean addicts off opioids. None of that $27 million can be spent on treatment centers or boots-on-the-ground services. So while big pharmaceutical companies just got a windfall, the nonprofit treatment centers are getting whacked.

"It would be morally irresponsible to do nothing in the middle of this crisis,'' Peters said. "And here we are, doing worse than nothing.''

What does all of this mean in real-life terms?

One of the services provided by Operation PAR in Pinellas County is a program for addicted pregnant/postpartum women. The program is being cut by $500,000, which means it will have to reduce beds in PAR Village from 46 to 36.

In other words, the chances of a baby being born addicted to street drugs just substantially increased.

"Just when we thought we were getting a little ahead of the problem,'' PAR chief operating officer Dianne Clarke said, "the rug gets pulled out from the other end.''

At Personal Enrichment Through Mental Health Services (PEMHS) in Pinellas Park, a reduction in 14 beds means patients who might benefit from a 72-hour Baker Act evaluation could be redirected to other community-based centers or even shelters.

"It's really unfortunate we have this plan to get people the right level of care, at the right time and in the right way, and we don't have the funds to implement it,'' said PEMHS CEO Jerry Wennlund.

Making matters even worse?

It's all for naught.

There's no economic savings in exchange for the lives lost and the babies born in the hellfire of addiction. By not adequately funding mental health services and addiction treatment centers on the front end, we end up spending far more money in jails, courthouses, hospitals and foster care.

Peters said the medical bill for treating a baby addicted to opioids is $280,000 just for the first two months of the child's life. And that doesn't count the long-term costs for the babies who are developmentally disabled by a mother's drug use.

"A big part of the problem is that there is a mindset that addiction is a choice. That stigma is the biggest barrier we face,'' Peters said. "So, okay, take out the moral argument. Take out the compassionate argument. What you still end up with is ludicrous fiscally.''

• • •

They were together 20 years, married for 16 and often miserable for the final five.

Brandy Vazquez could see how opioid addiction was tightening its grip on her husband. She watched when Frank tried to go cold turkey, and he was forced to crawl around the house because he was too disoriented to stand. He grew despondent when construction jobs dried up, and the family had to count on Brandy's paycheck as a dental assistant.

She kept waiting for a turning point, but it never arrived.

"Just giving someone methadone doesn't seem like the right answer,'' Brandy said. "We treat them like, 'Oh, you're a junkie, you're an addict, it's your own fault.' And, yeah, maybe it is partly their own fault that they got to that point, but we all screw up, we're all human. And now he's gone, and I've been through months of hell, and my daughters will never be the same.''

 
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