by Justin Mckibben | Apr 26, 2018 | Addiction Treatment, Detox, Harm Reduction, Heroin, Inpatient Treatment, Needle Exchange Programs, News, Opioids, Outpatient Treatment, Professionals, Recovery, Safe Injection Sites, Sober Home
8 months ago, Florida was home to 953 licensed drug treatment centers, and 207 were in Palm Beach County. As of April 1, there are now 185 in Palm Beach, with 771 in the whole state. This decrease is due to the crackdown on fraud by Palm Beach State Attorney’s Office, which has led to 45 arrests in the last year and a half. So far, those arrests have led to 16 convictions. For State Attorney Dave Aronberg there is no sign of slowing down.
Recently, Dave Aronberg spoke with Opioid Watch to talk about the work his office has been doing to try and strengthen the addiction treatment industry. Chief Assistant State Attorney Alan Johnson also sat down to talk about how Palm Beach County is fighting to protect those who are coming to Florida for help. Johnson heads the office’s Sober Homes Task Force.
Dave Aronberg VS Purdue Pharma
According to Aronberg, he got involved with opioid-related issues back in 2001, when he was an assistant attorney general. Aronberg says he was asked by his boss, Bob Butterworth, to investigate Purdue Pharma. This Big Pharma giant is the producer of OxyContin. This powerful prescription opioid has been credited with making a heavy contribution to the opioid crisis. Dave Aronberg was to examine the marketing practices of Purdue Pharma, and is quoted in the interview transcript stating:
“I believe we were one of the first in the country.”
Of course, now Purdue Pharma is one of many big name pharmaceutical companies being accused in lawsuits across America. In fact, Delray Beach, Florida recently filed its own case against the company.
When asked about what he found, Aronberg said that Purdue was marketing the product like it was Advil. Purdue has been repeatedly accused of pushing this product as if it was far less dangerous than it actually was. In 2002, Dave Aronberg was elected to state senate, and shortly afterward the case against Purdue was settled. In the edited interview transcript, Aronberg is quoted:
“Purdue also offered $2 million to the state to establish its first prescription drug monitoring program. I worked in the state senate to get the PDMP enacted into law. But some conservatives refused to go along. They thought it was Big Government. So Purdue’s $2 million went away, because the offer expired. We didn’t get the PDMP till 2011. By then the carnage was horrific.”
Furthermore, Opioid Watch notes that a Purdue spokesperson confirmed that the state failed to implement a PDMP by July 1, 2004, which was the expiration of the companies offer.
Dave Aronberg Goes to Congress
In December of 2017, Aronberg went in front of Congress to testify concerning fraud and abuse in the addiction treatment industry. In this meeting, they discussed various issues with shady facility operators in Florida and made suggestions on how the law could step in to change it and protect patients. The interview transcript quotes Aronberg:
“In recent years, we’ve had an influx of unscrupulous operators who enrich themselves by exploiting those in recovery. As a consequence, we’re attracting thousands of young people from throughout the country into fraudulent rehab centers. (We’re talking about some, not all. There are good rehab centers, too.)”
Again, Aronberg found himself at battle with shady marketing practices. While investigating the treatment industry, Aronberg’s office discovered illegal operations that not only manipulated insurance providers but put patients at extreme risk.
From patient brokering, where illicit actors would sell patients with insurance to the highest bidders, to illegal kickback schemes being run by sober homes to outpatient treatment programs. Chief Assistant State Attorney Alan Johnson added information about the exploitation of urine analysis costs, and even some programs that began billing insurers for allergy and DNA testing. Aronberg states:
“We have a doctor who billed $7 million in nine months for allergy tests.”
Needless to say, the task force and state officials had their work cut out for them.
The ACA, ADA, and FHA
When talking about the many scams being run by various illegitimate businesses, the conversation came back to insurance and how these cons run. Here Dave Aronberg talks about his beliefs on how the law should step in and help restructure the current system.
“Number one: Change the Affordable Care Act’s fee reimbursement model to an outcome-based reimbursement model. Where the good providers are rewarded and the bad ones are paid less. Right now, the opposite occurs, so the more times you fail, the more money you get. There’s an incentive for more services and for more relapse. That shouldn’t be.”
After talking about the issues with the ACA, he talked about the ADA and FHA.
“The second change we need is this: the Americans with Disabilities Act and Federal Housing Act have been misused and exploited by bad actors who own flophouses.”
He went on to say,
“Local governments are largely prohibited from overseeing the sober home industry. If they want to require mandatory inspections, certifications, and registrations, they’re likely prohibited under federal law.”
In essence, Aronberg believes the law should allow local governments to create their own guidelines for health, safety and the general welfare of the patients. None of these demands seems outlandish, and with reasonable regulation, the reputable and effective providers in this industry can continue to best serve the South Florida recovery community.
Aronberg also points out that the problem is not only in Florida. Recently, he went to Orange County, California to meet with officials dealing with the same situation. Next for Dave Aronberg is leading the national task force of 34 prosecutors in 30 states. Their goal is to produce a working paper for setting best practices for prosecutors all over America concerning these issues. The task force also intends to make suggestions for changes to federal and state laws.
What might be most surprising though is the mention of harm reduction strategies?
“It’s about prevention, drug treatment, and innovative strategies. I think it will be powerful because it’s going to be prosecutors talking about needle exchanges and disposal and safe injection sites. People assume prosecutors are going to be focusing only on mandatory minimums and longer sentences. That’s not what this is about. I think it’s going to surprise people.”
While needle exchanges and safe injection sites have been proposed in numerous states, it is not the most popular idea. San Francisco is actually on track to open the first safe injection site in America, with Philadelphia not far behind, and Seattle and Baltimore in the conversation as well.
With Aronberg and the task force working to make a difference, hopefully, we will see the right change soon. We hope it will make the recovery community stronger as a whole. Reputable and respected providers are also doing their part to refine their practices while implementing innovative and effective resources to ensure that those who with drug or alcohol addiction always have a safe place in Palm Beach County to get the help they need. With the opioid crisis ongoing, having real resources for opioid treatment is still an essential part of overcoming the problem.
Palm Healthcare Company is a leader in holistic addiction treatment with over 20 years of helping people from all over the country heal mind, body and spirit. Providing safe and comprehensive care should always be a focus in the effort to overcome the drug problem, and preservation of life should always be a priority. If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-888-922-5398
by Justin Mckibben | Feb 20, 2018 | Drug Abuse, Drug Policy, Harm Reduction, Needle Exchange Programs, News, Safe Injection Sites
Right now a few American cities are aiming to establish active safe injection sites, with most recent reports indicating the first will probably be San Francisco. Currently, the Golden Gate City is on track to open two of these facilities in July. Meanwhile, Philadelphia is not far behind as city officials are pushing forward with a proposition from January. Other areas fighting for the controversial programs include Seattle and Baltimore.
Now it seems this fight for safe injection sites may soon pit state governments against the federal government, as the DEA under the Trump administration vows to take action against these facilities.
Safe Injection Sites for San Francisco
The city of San Francisco has an estimated 22,000 intravenous drug users. As of now, it has become the norm to see people injecting drugs in broad daylight on a park bench, public transit, or any sidewalk. As a consequence, dirty needles get left out in the open. So the decision by San Francisco officials to establish safe injection sites isn’t all that alarming.
Safe injection sites mean fewer needles on the streets. Reports from public health officials expect that 85% of the intravenous drug users in the city would use these sites, and the city could potentially save $3.5 million a year in medical costs. According to the director of San Francisco’s Department of Public Health, Barbara Garcia, officials are already working out the details. Garcia is currently working with six to eight nonprofits that already provide needle exchange programs and other addiction services. Two of them will soon be operating as safe injection sites.
Garcia says that because the cities fiscal year will begin on July 1, the process of opening these safe injection sites should begin close to that date. She also adds that once officials are able to examine how the first two sites are working, they can decide if and when to open the third and fourth sites.
Because intravenous drug use is still against state and federal law, the city will be avoiding liability by funding these sites through private investments. Garcia did not include where the money would be coming from. Garcia also does not appear to be too concerned about whether opening safe injection sites will draw the ire of the Trump administration, saying,
“That’s to be seen. I’m more worried about people dying in our streets.”
Given the rates of intravenous drug use and overdose death in the area, that sounds like a reasonable reason to worry. Part of operating safe injection sites also means providing a supervising medical staff equipped with overdose antidotes, and offering addiction treatment resources to those willing to seek help.
Hope for Harm Reduction
State Senator Scott Wiener is also working to get state law changed to ensure that anybody associated with safe injection sites won’t face arrest or punishment, including:
- Property owners
- Employees
- Drug users themselves
The bill Wiener is pushing was last year passed in the Assembly, but remains two votes short of confirmation in the Senate.
Part of the reason for so many officials pushing to protect and advance this project seems to come from a fair amount of public support. For the first time, the Chamber of Commerce’s Dignity Health CityBeat Poll included a question about safe injection sites this year. It asked respondents whether they support or oppose-
“drop-in facilities called safe injection sites where intravenous drug users could use their drugs, off the street, and in a place where medical and social services are available.”
Out of all those who answered the survey:
- 67% of respondents said they support the idea
- 45% of those were ‘strongly’ supportive
- 22% of those were ‘somewhat’ supportive
- Only 27% percent opposed it
- 6% didn’t know
The poll found support for the sites regardless of:
The demographics also includes support from:
- Progressives
- Liberals
- Moderates
- Even 42% of self-described Conservatives
Mayor Mark Farrell is another supporter who said,
“I understand the misgivings around it and some of the rhetoric from people who don’t support it, but we absolutely need to give it a try.”
While issues like homelessness, crime and gang violence were all concerns consistent with opening of injection sites, city officials seem to believe the old way isn’t working. The hope is that by providing social services and treatment options, these safe injection sites will not only save lives but help more people get off drugs that otherwise might not have access to these resources.
Trump Says Sites Will Face Legal Action
It still seems these efforts will be met with resistence from the federal government. Last week the Trump administration made it clear they reject any facilities where heroin users can inject drugs under supervision. The president and his Attorney General Jeff Sessions seem to be committed to their ‘law and order’ approach to the drug problem, despite any lessons learned by the failed War on Drugs.
One might note that in general, the U.S. Drug Enforcement Agency views safe-injection sites as facilitation of criminal behavior. Therefore, it’s an absolute possibility the DEA will take some kind of enforcement action against any safe injection sites that pop up in the states. Katherine Pfaff, a DEA spokesperson, argued that these programs remain federally prohibited. She states,
“Supervised injection facilities, or so-called safe injection sites, violate federal law. Any facilitation of illicit drug use is considered in violation of the Controlled Substances Act and, therefore, subject to legal action.”
However, it appears some of the states that have approved safe injection sites are already preparing to do legal battle with Attorney General Jeff Sessions and his Justice Department to convince the courts that this public health emergency is far too critical to pass up any opportunity at harm reduction.
So, what is going to become of this new controversy? More people, including law enforcement officials and conservatives, could be warming up to the idea of cleaning up the streets with safe injection sites in some states. If the DEA make moves to shut them down, what will happen next? Are safe injection sites an acceptable form of harm reduction? If not, what else could help address the opioid crisis?
Let us know in the comments what you think about these programs.
Palm Healthcare Company believes in providing an effective, holistic treatment program to help those suffering who need help. Providing safe and comprehensive care should always be a focus in the effort to overcome the drug problem, and preservation of life should always be a priority. If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-888-922-5398
