Prescription drug abuse is a public health crisis in Florida. Every day seven people in this state die from overdoses. State and local authorities have been late to this game, only recently enacting laws and ordinances to crack down on unscrupulous pain clinics that dole out prescription drugs like candy. But for people who are addicted and want to get off painkillers, there is a patchwork safety net with wide gaps in coverage. It is often easier in Florida to get drug treatment as a felon than as a law-abiding resident of modest means struggling with a serious prescription drug problem.
Karen Hanratty and her stepmother, Ann Weeks, lived this nightmare. Weeks' odyssey to find the 27-year-old Hanratty a way off Oxycodone and Xanax was described recently by St. Petersburg Times reporter Leonora LaPeter Anton. A judge had ordered Hanratty to stop taking all drugs if she wanted to get her children back. That meant she couldn't utilize one of the recommended courses of treatment for opiate addicts — a slow detoxification while using prescription drugs like methadone to help the weaning process. Hanratty qualified for Medicaid, which covers this kind of medical service as well as other treatment options on an outpatient basis. It does not cover residential rehabilitation services for drug offenders, which is what Weeks sought.
In June, Weeks drove Hanratty around Pasco County to hospitals and drug treatment facilities, then called 50 to 60 such facilities around the state, yet she couldn't secure a residential treatment bed. The waiting lists at nonprofit centers with publicly funded beds were months long, and private facilities wanted $10,000 or more.
Hanratty's story ends with her tragic death of an overdose in July, soon after emerging from an assisted living facility in Clearwater after a stint in a psychiatric ward — the only place Weeks could get to take her.
The sad story reflects the disconnect between funding and services for residential placements. In some ways access to drug treatment has improved or will soon. A 2008 federal law requires health insurance policies for employers of more than 50 people to equalize medical, mental health and substance abuse benefits when a policy covers those services. And under President Barack Obama's health reform, parity will expand to individual health insurance policies.
Medicaid is another way Floridians access drug treatment, although it is largely for outpatient services. And federal health care reform will soon expand the safety net. In 2014, Medicaid qualifications will loosen, enrolling many more of the state's low-income residents.
People can also get help through the Department of Children and Families. It has a $215 million budget for detoxification, residential or outpatient treatment programs, thorough aftercare and prevention services. In fiscal year 2008-2009, the office provided services to more than 180,000 adults and children. Still, at any given time about 1,300 people are on waiting lists for publicly funded treatment of all types.
For people like Hanratty — who at one point was taking 240 Oxycodone a month — there is often no clear point of entry into a system of help. Even after she landed in the hospital after swallowing 10 Xanax, she was released the next day without being placed in the treatment she needed. If Florida is going to address its prescription drug abuse epidemic, a better coordination of services and funding sources is needed.