Opioids crisis: Medical Examiner loses key doctor as caseload keeps rising

Palm Beach County commissioners could be asked again this year to add more positions to help the Medical Examiner’s Office keep pace with a rising caseload driven by the opioid epidemic.

A new associate medical examiner and a new technician will start July 3, roughly three months after county commissioners approved the addition of those two positions.

>> HEROIN: Killer of a generation

>> Palm Beach County takes steps to attack heroin epidemic

But the office recently lost a key position when one of its doctors left to take a job with the Broward County Medical Examiner’s Office. That means the new doctor that starts on July 3 will essentially replace the doctor who left, keeping the Palm Beach County’s Medical Examiner’s Office at five doctors instead of six.

“It will be some time before the newly added position will help reduce the examiner workload,’’ deputy county administrator Jon Van Arnam said Thursday in an email to commissioners.

“The number of new cases continues to increase at an unprecedented rate, stressing staff and the system. If this trend continues, it could necessitate us returning to the (County Commission) for additional positions later this year or early next year.’’

Dr. Michael Bell, Palm Beach County medical examiner.

To help reduce the possibility of losing more doctors, Van Arnam has suggested the county’s Medical Examiner, Dr. Michael Bell, conduct a salary and benefits survey.

“Pay and benefits are key factors in our ability to attract and retain qualified medical staff and investigators,’’ Van Arnam said in the email.

At the meeting in April about the opioid epidemic, county commissioners also approved a third position – an executive level drug czar – to oversee the county’s response to the drug crisis. That position could be filled later this year.

“This position is still being developed,’’ Van Arnam said.

“We are determining how to best (use) this position in coordination with key partners including the Health Care District, Southeast Florida Behavioral Health Network, Palm Beach County Fire Rescue and PBSO. We understand the urgency of this situation and will keep you informed of our progress.’’

Last year, the caseload for the Medical Examiner’s Office topped 2,000 for the first time.

“That’s a 60 percent increase in the last two years, which is almost exclusively due to these opioid overdoses,’’ Bell told county commissioners in April.

“It’s not like we’re getting more homicides. We’re not getting more heart attacks, more elder falls and head trauma. This is all due to opioid fatalities.”

MORE: Opioid overdose deaths double to nearly 600: ‘I don’t see any stop’

Got milk? DEA releases drug slang code words

The DEA has released its 2017 list of drug slang code words – the lingo used by dealers and addicts to refer to specific illicit and pharmaceutical drugs of abuse.

According to the DEA, the list “is designed as a ready reference for law enforcement personnel who are confronted by many of the hundreds of slang terms used to identify a wide variety of controlled substances, designer drugs, and synthetic compounds.”

How accurate are the terms? The DEA says it tries its best to keep up with the “ever-changing drug scene” but “subsequent additions, deletions and corrections are inevitable

The list provides slang terms for 24 drugs – some illicit, such as crack cocaine, and some pharmaceutical, such as Klonopin and Xanax.

Marijuana leads the group with the most monikers, including the classics – weed, kush and herb – and some lesser known – Gorilla glue, Green Mercedes Benz and Hairy ones. Fentanyl, a deadly drug rarely seen on the street 20 years ago, now has its own vernacular: Apache; Birria (mixed with heroin); Butter; China Girl; China White; Dragon’s Breath; Fent; Lollipop; Tango & Cash; Toe Tag Dope and White Girl.

As for “milk,” it is slang for cocaine.

Sober Home Task Force raids West Palm Beach treatment center

Wellness Center of Palm Beach is the latest drug treatment center to be raided by the Palm Beach County Sober Home Task Force. 

Delray Beach Police Det. Nicole Lucas, a member of the task force, reported the May 30 raid on her Facebook page and asked patients who want to give a statement to send her a private message on Facebook.  No arrests have been made as a result of the raid.

READ MORE OF THE POST’S INVESTIGATION: Inside the Gold Rush

The center is located at 2724 Australian Ave. in West Palm Beach.  According to Florida corporate records, the center was founded in 2014 by Jayeshkumar Dave of Parkland. Dave could not be reached for comment.  A voice message left on an answering machine at the center was not returned.

The Florida legislature tasked Palm Beach County State Attorney Dave Aronberg with investigating corruption in South Florida’s drug treatment industry after numerous news reports about insurance fraud, patient brokering and kickbacks.

Since October, the task force has made 24 arrests and raided treatment centers and sober homes throughout the county.

We first exposed Kenny Chatman. He tried to sue us for it.

When The Palm Beach Post first wrote about corrupt drug treatment center owner Kenny Chatman – a year before his arrest – the story exposed Chatman as a liar, fraud and potential sex trafficker.

Apparently, Chatman didn’t like it.

Kenneth Chatman walks into Reflections, his treatment center in Margate, in 2015.

Court files show that he had lawyer Jeffrey Cohen, of the Florida Healthcare Law Firm, run up $5,000 in billings investigating whether to sue The Palm Beach Post for defamation.

Cohen had a fellow lawyer pull the police records The Post cited in its story. He also called four different South Florida lawyers who specialize in defamation cases to try to get them on board.

“Teleconference with Benny Lebdecker (sic) re meeting to discuss possible lawsuit against Palm Beach Post,” reads one entry in Cohen’s list of billable hours.

“Discussions with Attorney Bruce Rogow re Palm Beach Post article and retention of his services,” reads another.

Chatman and his treatment center’s medical director, Barry Gregory, teleconferenced with Cohen multiple times between December 2015, when The Post’s article ran, and January 2016, the records show.

Ultimately, Chatman never pursued a lawsuit against The Post, and in December, he was arrested by the FBI. He pleaded guilty to conspiracies to commit sex trafficking, money laundering and health care fraud, and last week was given a 27-year sentence in federal prison.

RELATED: ‘Kenny Chatman kidnapped me:’ Read one woman’s human trafficking story

Gregory pleaded guilty to conspiracy to commit mail fraud and false statements regarding health care matters, and he was sentenced to five years in prison.

Normally, such billable hours are rarely made public, especially if a case doesn’t go to trial. So how did The Post find out about it?

Chatman racked up more than $5,000 in legal fees with Cohen – a relative pittance considering Chatman built his fraudulent treatment centers into multimillion-dollar operations.

But Chatman never paid the bills, and last year, Cohen sued him over it. The billable hours were included in the lawsuit. Chatman quickly paid up. (Read the bills here.)

When asked about it in March, after Chatman pleaded guilty, Cohen said he couldn’t talk about it, since Chatman was a former client.

Cohen has taken a contrarian view on some of the issues surrounding the addiction treatment industry. He’s been one of the few people to publicly criticize the efforts of the Palm Beach County Sober Home Task Force, which has arrested more than a dozen people in the industry for fraud and recommended widespread legislative reforms.

“They’re trying to kill cockroaches with shotguns,” he told The Post in March. “The way in which they’re going about it, sometimes, is eyebrow-raising.”

(He’s also been critical of The Post’s extensive coverage of South Florida’s drug treatment industry, calling it “a story in search of a villain.”)

Whether or not a lawsuit against The Post would have been successful is obviously unknown. But the Chatman story, like all the big stories by the paper’s investigative team, are thoroughly reviewed for potential libel issues by The Post’s lawyers.

‘Kenny Chatman kidnapped me’: Read one woman’s human trafficking story

Corrupt drug treatment operator Kenny Chatman will be sentenced Wednesday, and for the past few weeks, parents and victims have been writing letters to U.S. District Judge Donald Middlebrooks, telling him that they believe Chatman killed their children or furthered their addictions.

But perhaps none of the letters is as chilling as one filed with the court Monday, from a woman who says Chatman kidnapped her and forced her into prostitution. Then, after she escaped and told police, she says Chatman confronted her again and forced her to sign a sworn statement recanting.

Chatman has admitted to many of the details mentioned in the letter, and he pleaded guilty to conspiracy to commit sex trafficking, along with conspiracies to commit money laundering and health care fraud. He faces up to life in prison.

The woman’s letter is so chilling that The Palm Beach Post is choosing to publish it in its entirety:

My name is (redacted)

I’m 22 years old. I came down to Florida in 2013 for substance abuse treatment. I’ve been struggling with addiction since I was 11 years old.

I first met Kenny Chatman in 2015 at age 19. Kenny Chatman kidnapped me. I was brought to the house by some of the men that worked for him, as well as himself. Upon entering the house I was punched in the face and lost consciousness.

When I woke up at the house, there were restraints on my wrists and ankles attached to a bed post. There were other girls present at the house, severely under the influence, almost to the point of unconsciousness. They took all my belongings, including my clothes. They IV drugged me with an unknown sedative. And from that point on, men came in and paid him money to rape me.

He had me extremely intoxicated on unknown sedatives and substances that I was going in and out of consciousness but was completely aware of myself being raped, molested, emotionally, mentally physically, sexually abused, and verbally demeaned.

I recall close to 150 in total different faces of rapists abusing me daily over a period of 3-4 weeks. I was unrestrained for brief periods, only to be cleaned up of bodily fluids. I thought I was going to die there, in fact, I was convinced after several days.

After roughly 4 weeks of enduring countless abusive and sexual acts being performed against my will, I managed to jump out of a window while unrestrained and escape in solely a tshirt. I flagged down a car, and went home.

I later contacted local authorities and made a full police report naming Kenny Chatman as the perpetrator and captor. I was contacted by the FBI and detectives of the local police force to question me and get information from me about what happened.

This event has completely changed my life in every way. Emotionally, physically, mentally, and even in relationships with others. I’m terrified of men. I can’t have a normal intimate relationship yet. I have constant night terrors and flashbacks to this day of the events that have happened to me because of this man.

I have struggled to stay sober since these events took place in 2015, which is extremely upsetting since I had close to 2 years sober prior to it. After these events I was placed back in treatment and am still to this day receiving countless hours of trauma therapy, as well as addiction counseling. I’ve done over a year of EMDR therapy.

Long after I came forward with these events, I was confronted by Kenny Chatman again and forced into a vehicle and threatened and taken to a notary and forced to sign a document recanting my previous statements against him.

Once again, I was paralyzed with fear. In a place where you are supposed to feel the safest, TREATMENT, I experienced some of the most gruesome acts that I can think of.

Today, my hope is that justice will be served and Kenny Chatman is permanently removed from the streets so not only can he not get me again, but so he can’t do this to other human beings.

Opioid epidemic: Rick Scott declares public health emergency

Gov. Rick Scott has issued a statewide public health emergency over the opioid epidemic, in response to multiple requests for help from local leaders.

Scott’s decision came after the last of four state workshops on the opioid crisis this morning in Duval County. State officials held their first workshop Monday in West Palm Beach followed by two on Tuesday in Manatee and Orange counties.

Many people who attended the workshops called for him to declare a public health emergency.

“Finally,” said Palm Beach County Vice Mayor Melissa McKinlay, who made the first request for a public health emergency back in February.

“Today I feel relief. relief that the voices of so many were finally heard. For the pain of loss so many families have faced, to those struggling to overcome addition,” she said.

“I am hopeful that the governor’s direction to declare a public health crisis in response to the opioid epidemic will open the door to a truly meaningful plan to fight this disease.”

McKinlay’s request, which triggered other leaders to send similar requests, came after The Palm Beach Post published a special section examining the crisis. That section, Heroin: Killer of a generation, was published days after the daughter of McKinlay’s chief aide died of a drug overdose.

“This emergency declaration is important to combat the epidemic in our communities,” said Jupiter Vice Mayor Ilan Kaufer, who helped spearhead a declaration request by the Palm Beach County League of Cities in March.

“I am thankful to all the local leaders and community members who supported efforts to let the Governor know how important this step was in saving lives.”

Check back later for updates on this developing story.

Here is a press release issued minutes ago by Scott’s office:

Following the Centers for Disease Control and Prevention (CDC) declaring a national opioid epidemic, Governor Rick Scott signed Executive Order 17-146 directing a Public Health Emergency across the state. By signing the Emergency Order, it will allow the state to immediately draw down more than $27 million in federal grant funding from the United States Department of Health and Human Services (HHS) Opioid State Targeted Response Grant which was awarded to Florida on April 21 to provide prevention, treatment and recovery support services. Without the order, it would have taken months for the state to distribute these funds to local communities. In addition to declaring a Public Health Emergency, Surgeon General Dr. Celeste Philip will issue a standing order for Naloxen, an emergency treatment for opioid overdose. This will ensure first responders have immediate access to this lifesaving drug to respond to opioid overdoses.

 

Governor Scott said, “Today, I issued an executive order which allows the state to immediately draw down more than $27 million in federal grant funding which will immediately be distributed to communities across the state to deal with the opioid epidemic. HHS Secretary Dr. Tom Price awarded the Opioid State Targeted Response Grant to Florida and I want to thank the Trump Administration for their focus on this national epidemic. I have also directed State Surgeon General Dr. Celeste Philip to declare a Public Health Emergency and issue a standing order for Naloxone in response to the opioid epidemic in Florida.

Gov. Rick Scott

“Last month, I directed the Department of Children and Families (DCF), the Department of Health (DOH) and the Florida Department of Law Enforcement (FDLE) to meet with communities in Palm Beach, Manatee, Duval and Orange Counties to identify additional strategies to fight the rising opioid usage cases in Florida. They have gotten a lot of feedback this week and we will continue to look at additional ways we can fight this national epidemic which has taken the lives of many Floridians.

“I know firsthand how heartbreaking substance abuse can be to a family because it impacted my own family growing up. The individuals struggling with drug use are sons, daughters, mothers, fathers, sisters, brothers and friends and each tragic case leaves loved ones searching for answers and praying for help. Families across our nation are fighting the opioid epidemic and Florida is going to do everything possible to help our communities.”

Attorney General Pam Bondi said, “This declaration will help strengthen our continued efforts to combat the national opioid epidemic claiming lives in Florida by providing additional funding to secure prevention, treatment and recovery support services. I want to thank Governor Rick Scott for his continued partnership in combating drug abuse in our state; from shutting down pill mills to outlawing deadly synthetic drugs, Governor Scott has long supported efforts by my office and law enforcement to raise awareness, stop drug abuse and save lives.”

 

Kenny Chatman allies sentenced to prison

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Kenny Chatman walks to his Reflections Treatment Center in Margate in December 2015. (Richard Graulich / The Palm Beach Post)

More co-defendants of recovery industry pariah Kenny Chatman were sentenced to federal prison on Monday, but Chatman’s lawyer said he’ll need another month to figure out how to defend his client in sentencing.

On Monday, three of Chatman’s team were sentenced to a combined 12-1/2 years in federal prison. They pled guilty in a case in which Chatman is charged with supplying drugs to patients in his treatment program and sober homes and turning some into prostitutes.

Fransesia “Francine” Davis, who acted as a house mother at Chatman’s sober homes, was sentenced to 7 years in federal prison. Michael Bonds, who sent his own patients to Chatman’s corrupt treatment centers in exchange for payments, was given 4.75 years in prison. Stefan Gatt, who processed fraudulent urine samples from Chatman’s patients, was given an 18-month sentence.

Chatman has pleaded guilty in the case, but may not be sentenced until mid-June. His attorney, Saam Zangeneh, said he needs more time to read a sentencing of 300 paragraphs that includes “a slew of (sentencing) enhancements that are outside the scope of the plea agreement,” Zangeneh wrote Monday.

Kenny Chatman faces life in prison. His wife, Laura, faces 10 years in prison.

In a request for a lighter sentence, Bonds said he’d helped lead investigators to several arrests in his federal case and nine people in state court cases. His lawyer said  he expected federal prosecutors agree to a lighter sentence. Instead, they filed paperwork last week calling for a full sentence of 4.75 years in prison – not far above the 48 months he got.

Bonds and Gatt were also sentenced to three years’ probation and Davis to one year probation. Each must also pay an undetermined amount of restitution, federal records show. All three pleaded guilty to a charge of conspiracy to commit health care fraud, while Davis also faced a charge of using a house to distribute drugs.

Chatman defendant: Feds, state target sober homes together

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A recruiter for Kenny Chatman‘s drug treatment centers says his cooperation with state and local investigators led to about a dozen arrests.

A new federal court filing for Michael Bonds shows how defendants in several cases are being used against each other, as well as cooperation between federal and state officials trying to crack down on South Florida’s corruption-plagued sober home industry. Bonds’ attorney, Paul Walsh of West Palm Beach, said in a filing that he expects federal officials will also ask for leniency in the case because of Bonds’ cooperation.

Walsh wrote that in exchange for Bonds’ cooperation, Bonds and his wife have feared for their safety because of implied threats, “including a call from an individual whom Bonds provided information about, telling Bonds that he would ‘get his.'”

Bonds pleaded guilty in February to taking $240,000 from Chatman for referring patients to Chatman’s treatment centers. Chatman, Bonds and four other associates were arrested Dec. 21. The filing says Bonds has been helping investigators since August, and “has continuously provided assistance whenever called upon and as needed by the government.”

How far did that cooperation go? The filing says Bonds has been working with officials, including a Delray Beach Police Department investigator, to yield “results that are useful to the government.” A grammatically troubled sentence says he offered help on people in the recovery industry, and “This information led to prior to the arrest of at least nine individuals in State court and several individuals in this [federal] matter.”

Bonds is scheduled to be sentenced at 10 a.m. Monday in federal district court in West Palm Beach. He had been running Redemption Sober House Inc., and was getting about $500 a week for each patient he supplied to Chatman.

Chatman is scheduled to be sentenced next month. He admitted in federal court that he’d turned patients into prostitutes and, when they were supposed to be recovering from drugs, fueled their addiction.

While immediate associates of Chatman have been prosecuted in federal court, the Palm Beach County Sober Home Task Force has arrested at least 20 people for prosecution in state courts.

Addicts to get needles from vending machines in Las Vegas

In an unprecedented approach to curb the spread of diseases and infections caused by sharing needles, health officials in Las Vegas are using vending machines to dispense clean syringes to addicts.

But unlike vending machines that dispense candy and snacks, no money is needed. Addicts participating in the pilot project scan a card and enter a unique ID number in order to vend one of the colorfully gift-wrapped boxes. Each box contains syringes, alcohol wipes, safe-sex supplies and a sharps disposal box.

Source: Las Vegas Review-Journal

People using the new needle exchange vending machines must register through Trac-B Exchange, a storefront harm reduction program aimed to prevent infectious disease. The machines will be available at three locations by the end of May.

Besides providing intravenous drug users with access to sterile needles and disposal of used ones, the program serves as a gateway to services and care that addicts may not access otherwise.

Justin Kunzelman, CEO and co-founder of Rebel Recovery Florida in West Palm Beach, said vending machine needle exchanges are the “most objective and honest,” harm reduction programs because they are unmanned.

Lawmakers worry that by endorsing needle-exchange programs it will appear that they are helping addicts use drugs, Kunzelman said. To avoid that, they impose conditions on needle exchanges that discourage addicts, such as requiring them to provide personal information, get tested for other diseases and receive counseling.

Vending machines don’t ask questions, he added.

“It’s a machine,” Kunzelman said. “It’s not asking you how many times you have been arrested, what’s your sexual orientation – all of the things that come along inherently when the legislature passes acts.”

Nevada is the first U.S. state to launch a vending machine program for clean syringes, but the vending machine model has been in use for several years in Puerto Rico, Europe, and Australia.

In Indiana, after roughly 200 people contracted HIV from sharing needles, Vice President Mike Pence – then the governor – lifted a ban on needle exchanges in 2015 in affected counties.

Still, many communities and states prohibit needle exchange programs even though they are endorsed by the Centers for Disease Control and Prevention.

In Florida, where Dade and Broward counties led the nation in new HIV cases in 2014, the Legislature allowed last year the University of Miami to establish a pilot needle-exchange program.

But lawmakers refused to pay for it. And everywhere else in the state, including Palm Beach County, supplying addicts with clean syringes is a third-degree felony.

With more addicts dying of overdoses than ever before, some policy makers are warming to the idea of needle exchanges and other harm reduction programs that encourage recovery.

When the Palm Beach County Heroin Task Force began meeting in June 2016, Kunzelman’s efforts to discuss needle exchanges ended when he stopped talking. Today, it is among topics discussed.

At its April 4 special meeting on the opioid epidemic, Palm Beach County Mayor Paulette Burdick suggested the county explore a needle exchange program and how the county might pay for it.

Kunzelman and several other harm-reduction advocates met with Palm Beach County Health Department Director Dr. Alina Alonso last week and intend to bring up a needle exchange during the Governor’s 90-minute workshop on the opioid crisis on May 1.

“They’re still getting used to the idea that current policies aren’t working,” Kunzelman said. “I think it will take awhile.”

 

 

 

 

 

 

 

 

CDC highlights speed, deadliness of fentanyl

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Hypodermic needles were found at a West Palm Beach rental property. Such needles are often used for illegal drugs. (Thomas Cordy / The Palm Beach Post)

A new report from the Centers for Disease Control emphasizes just how quickly illicit street fentanyl can kill drug users, and the report suggests moves that are politically unpopular — such as illegal drug “shooting galleries” in supervised injection locations — can save lives.

The CDC interviewed 64 people in Massachusetts, nearly all of whom had witnessed an overdose in the previous six months; two-fifths of those people also had overdosed themselves. One person warned about how much worse fentanyl was than heroin:

“A person overdosing on regular dope leans back and drops and then suddenly stops talking in the middle of a conversation and you look over and realize they’re overdosing. Not like with fentanyl. I would say you notice it as soon as they are done [injecting]. They don’t even have time to pull the needle out and they’re on the ground.”

And fentanyl is increasing faster than authorities can deal with it. In six months, fentanyl went from being present in about two-fifths of opioid overdose deaths in Massachusetts to almost four-fifths. And that data is already two years old. The CDC report warns that the report doesn’t include fentanyl analogs, which can be far stronger.

Palm Beach County wasn’t testing for drugs like carfentanil, a horrifically strong elephant tranquilizer, until last year. The drug helped double the number of Palm Beach County opioid overdoses last year, with carfentanil being found in at least 109 bodies. Carfentanil is said to be 10,000 times stronger than morphine.

Overdoses with fentanyl and especially carfentanil are much harder to reverse using drugs like Narcan and its generic, naloxone. The CDC notes that multiple doses of Narcan are often required. One example of a man trying to save a woman’s life:

“So he put half up one [nostril] and half up the other nose, like they trained us to do, and she didn’t come to. So he put water on her face and kind of slapped her, which doesn’t really make you come to. It doesn’t. So he pulled out another thing of Narcan and he put half of it up one nose and then she came to. … She just didn’t remember anything. She said, ‘What happened? I remember washing my hands and, like, what happened?’ We said, ‘You just overdosed in this room!’ So yeah, it was wicked scary.”

How fast? The CDC itself reported that “Rapidity of overdose death was determined from available evidence, including needles inserted in decedents’ bodies, syringes found in hand, tourniquets still in place, and bystander reports of rapid unconsciousness after drug use.” Lips immediately turned blue; people started gurgling or having something like seizures.

The CDC recommended some ways to reduce deaths, including expanding access to evidence-based treatment. Palm Beach County has lost publicly funded beds, and some privately funded treatment centers reportedly provided drugs to their clients, who sometimes were turned into prostitutes.

The CDC report also pointed to high numbers of overdoses away from people who could help sufficiently. Some 18 percent were away from bystanders; 58 percent were in another room of the house; 24 percent didn’t know about the drug use; 12 percent themselves were intoxicated; 11 percent didn’t recognize overdose symptom and 15 percent thought the person had just gone to sleep. All that means high-quality interventions are few and far between:  “Clear evidence that a bystander was unimpaired, witnessed the drug consumption and was present during an overdose (i.e., able to respond immediately) was reported in 1% of the fentanyl overdose decedent charts,” the CDC reported.

The CDC suggested harm reduction services can help. “The high percentage of fatal overdoses occurring at home with no naloxone present, coupled with the rapid onset of overdose symptoms after using fentanyl through injection or insufflation, underscores the the urgent need to expand initiatives to link persons at high risk for overdose (such as persons using heroin, persons with past overdoses, or persons recently released from incarceration) to harm reduction services and evidence-based treatment.”

The CDC then cites a journal article on supervised injection services.

Justin Kunzelman, president of Rebel Recovery Florida, said the thousands of young people dying will only increase the pressure on government to allow, and support, harm reduction strategies.

“I don’t think people are going to give politicians a choice,” he said.

Kunzelman said because of the increasing overdose risk, more people are carrying Narcan, and, often, higher and more doses of the drug.