A clock is counting the dead from overdoses

6968
6,968

6,986. 

Moments before a cluster of congressmen began their 9:30 a.m. presentation at the 2016 National RX Drug Abuse and Heroin Summit in Atlanta Wednesday, the grim clock above them stood at 6,970: the number of people dead from an opioid or heroin overdose in the roughly 72 hours since the summit began Monday evening.

When the speakers arrived at the dais, it was 6,970.

6971
Minutes later: 6,971

When they sat down, it was 6,971.

The speakers, including long-time prevention and treatment advocate U.S. Rep. Hal Rogers of Kentucky, had some other numbers.

They cited the 23 percent drop in crime in Gloucester, Massachusetts, since the police chief there told addicts who turned themselves in they would not be arrested but would instead get treatment.

There’s the street value of a single bottle of oxycodone: $2,000. And there’s the sevenfold increase in the amount of Mexican heroin coming into the U.S. in just seven years.

When the congressmen began winding up their speeches two hours later, though, the number left behind was this one.

6975

Doctor, you’ve got mail. The Surgeon General would like you to read it.

Surgeon General Vivek H. Murthy
Surgeon General Vivek H. Murthy

Doctor, you’ve got mail.

Not stamped yet, not even in the envelope, but it’s as good as done, said Surgeon General Vivek H. Murthy Tuesday afternoon at the 2016 Summit on RX Drug Abuse and Heroin in Atlanta.

In an echo of former Surgeon General C. Everett Koop’s historic letter to 107 million households regarding the AIDS epidemic, Murthy is drafting letters to more than one million doctors, dentists and other health care providers in a call for action on the opiod epidemic.

It’s particularly targeted move: It’s physicians who have driven the opiod epidemic with massive numbers of narcotics prescriptions, Murthy and others at the Summit have pointed out.

Every year, Murthy said, another 215 million new opiod prescriptions are written, “enough to put a bottle of pills in the hands of every adult American.”

Former Surgeon General C. Everett Koop used his position to influence public discussion of HIV/AIDS.
Former Surgeon General C. Everett Koop used his position to influence public discussion of HIV/AIDS.

But, he said, doctors have gotten bad information, both about the addictive potential of drugs such as oxycodone, and addiction overall. For instance, physicians beginning in about 1996 were being taught that fewer than one percent of all patients treated with narcotics were likely to become addicted. State medical boards warns of sanctions against doctors who failed to aggressively treat pain.

“Far too often, doctors have been in situations with patients who they believed were addicted to opiods,”  said Murthy, but, he said, physicians did not have the education or tools needed to know whether their prescriptions were alleviating pain or feeding an addiction.

Murthy isn’t stopping with a letter.  He’s compiling the first report of any surgeon general addressing substance abuse, addiction and health.

Like the letter, such reports carry clout: Think the tobacco report in 1964 on tobacco and the 1987 report on HIV/AIDS, both of which moved the needle on public discussions of major health issues.

And, like Koop, Murthy intends to use his position as a bully pulpit to educate.

“I want to help the country see that (addiction) is not a moral failing, but a chronic illness that we need to treat with compassion, urgency and skill.”

Will Florida’s prescription monitoring database broaden to share anonymous information?

Deaths linked to prescription oxycodone in Florida plummeted after drug monitoring database was adopted.
Deaths linked to prescription oxycodone in Florida plummeted after drug monitoring database was adopted.

Tallahassee could probably feel the love emanating all the way from the second floor of the Westin Peachtree in downtown Atlanta Tuesday morning: The object of affection at the 2016 Summit on RX Drug Abuse and Heroin is Florida’s Prescription Drug monitoring database, or EForcse.

Fought for since 2001, approved in 2009 and finally operational in October 2011, the database curbs doctor shopping for opioids by tracking prescriptions for the drugs.

It’s been wildly successful at curbing oxycodone-related overdose deaths in Florida, as its latest report shows. In fact, it’s considered a model for other states of just how effective such a database can be.

At a Summit seminar Tuesday morning, there was a discussion by program manager Rebecca Poston of possibly broadening its scope, by linking it to other databases, such as the database of drug-related deaths compiled annually by Florida medical examiners, or the state database on Hepatitis C infections.

The idea is to provide a sweeping look at Florida public health issues, particularly as it involves patterns of drug use.

Nothing on that scale is happening yet. Whether it occurs depends in part on the University of Florida securing a grant which would fund such a program. (EForcse gets no state money for its operations.)

But it raises a question of whether Florida’s lawmakers would resurrect the same privacy concerns they raised back in 2009 and later when arguing against establishing the prescription monitoring database at all.

Poston points out that, as envisioned, there would be no way an individual could be identified. You could not, for instance, be able to individually link Adam Smith to his oxycontin prescriptions, then his treatment for Hepatitis C, his medical treatment for addiction or his death from an overdose. The data would have no names attached.

Post reporters Christine Stapleton and Pat Beall are covering the Summit live from Atlanta. Look for continuing updates on The Insider blog.

 

In unexpected moment, Agriculture Secretary Tom Vilsack reveals a life torn by addiction

Secretary of Agriculture Tom Vilsack
Secretary of Agriculture Tom Vilsack

Taking the wraps off a pair of new federal efforts to address addiction in rural America, Tom Vilsack did the expected thing, the sorta-surprising thing and the totally knock them right out of their socks thing.

Left sockless was a group of more than 1,000 people attending the  2016 Summit on RX Drug Abuse and Heroin in Atlanta.  Vilsack, head of the U.S. Dept. of Agriculture, was among the opening speakers at the Summit Monday. Tuesday afternoon, his boss – that would be the President- will show up for what is described as a Town Hall meeting.

But Monday night, it was Vilsack’s turn.

After announcing that his agency would be giving out $1.4 million in grant money to assist in researching opiate addiction in rural America, and that he would take part in a series of town halls in states hard-hit by the drug crisis, Vilsack explained the origins of his concern.

“I started life in an orphanage in Pennsylvania” before being adopted, he said. It was a loving home, but there was a problem tearing it apart: “My mom had a prescription drug addiction and she was violent. She was mean. She tried to commit suicide a couple of times.

“It was  a tough situation. My parents split up for a period of time. I nearly flunked out of high school.”

He said he judged her harshly, something he now regrets.

“I thought all she had to do was stop taking medications. I did not realize that at that point in time, we were dealing with a disease.”

But, Vilsack said, “on December 25, 1963, she realized she hit bottom.”

His mother got sober, said Vilsack. “She could not have done that without a 30-day treatment program. She could not have done it without a supportive community.”

With an estimated 78 Americans a day dying from prescription opioids, Vilsack said, entire communities now need to  step up: Pastors and community leaders as well as doctors and government.

“Person by person, we can do this,” he said. “We must do this.”

 

 

 

 

Fed report: More Medicaid equals fewer addiction troubles in Florida

Hypodermic needles found in the trash at a cottage apartment by Jean Thomas, 83, in West Palm Beach's Prospect Park neighborhood. (Thomas Cordy / The Palm Beach Post)
Hypodermic needles found in the trash at a cottage apartment by Jean Thomas, 83, in West Palm Beach’s Prospect Park neighborhood. (Thomas Cordy / The Palm Beach Post)

Elevator scene from the National RX Drug Abuse and Heroin Summit in Atlanta:

Reporter to woman: Are you here for the conference?

Woman: Yes, I’m from Detroit.

Reporter: We’re from South Florida.

Woman: Oh, South Florida. That’s where you go when you’ve got money for treatment.

Or not.

On Monday, Health and Human Services released a report on just how many Floridians with addiction or mental health issues can’t get adequate help – in some cases, any help – because the state won’t expand Medicaid, a key feature of Obamacare.

(Comes a day before President Obama is slated to speak at the Summit. Coincidence? You decide.)

Anyway: Florida has fought tooth and nail against any such expansion, even though the rolls of Floridians on the health plan for the poor continues to rise.

About three in every ten people living below 138 percent of the poverty level need treatment for drug abuse or mental illness or both, HHS estimates.

From those numbers, the feds put together these numbers in the report:

  • 390,000: Number of uninsured Floridians age with either mental illness or an addiction problem who would qualify for treatment under Medicaid expansion. (For bragging right purposes, that’s second only to Texas among states without Medicaid expansion.)
  • Nine: Percentage of uninsured Floridians getting help for the above, 2010-14.
  • $7 million-$190 million. Budget savings range reported by different states which expanded Medicaid.
  • 17, 18, 33: Percentage drop in arrests among three groups of people frequently in trouble with the law after Washington state began providing them with Medicaid-financed substance abuse treatment.

We already tackled one tricky addiction math question this morning, one raised by this festive magazine cover.

Harpers' controversial piece on legalizing drugs- all drugs.
Harpers’ controversial piece on legalizing drugs- all drugs.

Stay tuned as Post reporters Christine Stapleton and Pat Beall cover the Summit live from Atlanta.  Stapleton and Beall are members of a team of reporters that have been investigating scams in Palm Beach County’s $1 billion drug treatment industry

The 8-month long investigation by the Palm Beach Post uncovered patient brokering, insurance fraud and kickbacks.

 

Four million vs. 24 million: How many addicts are there in the U.S.?

Credit writer Dan Baum points for timing. But math? Maybe not.

Baum authored a recent Harpers magazine article suggesting that legalizing drugs might be the answer to the current fix we are in.

Harpers' controversial piece on legalizing drugs- all drugs.
Harpers’ controversial piece on legalizing drugs- all drugs.

His Sunday  interview on NPR about the legalization idea out there just hours before an estimated 1800 gather in Atlanta for the National Rx Drug Abuse & Heroin Summit. Among the attendees: President Obama, as well as the head of the DEA, the Surgeon General, the head of the National Institute on Drug Abuse, and various and sundry congresspeople.

Monday morning, a Daily Beast columnist weighed in on ending the war on drugs, citing Baum’s article and pointing out that Obama’s talk will take place in a city ravaged by drugs.

Michael Botticelli, director of the White House Office on Drug Control Policy, is among high-level fed officials at Summit.
Michael Botticelli, director of the White House Office on Drug Control Policy, is among high-level fed officials at Summit.

But while the timing is good, a crucial piece of math used in Baum’s interview is probably not only off base but out of the ballpark entirely.

He suggested about 4 million Americans have a drug dependency problem, citing Peter Reuter of the University of Maryland, who Baum said puts the number of people addicted to hard drugs at fewer than 4 million.

What is being defined as a “hard” drug isn’t entirely clear.

But the feds, based on years of national surveys and emergency room data, estimate more than 24 million people are in need of treatment for addiction.

Even if you’re skeptical of figures provided by the federal government’s drug-fighting agencies, consider this: There are an estimated 600,000 or so heroin addicts in the U.S.  Given its lethal dangers, heroin has all the headlines right now, but it is far from the most common drug of abuse.

Think oxycodone, benzodiazepines, Percocet; throw in methamphetamine, and cocaine. For starters.

If even those five drugs generated the same level of addiction as heroin, once you add in the heroin figures you start bumping up against four million number.

Palm Beach Post Reporters Christine Stapleton and Pat Beall  are covering the four-day Summit live from Atlanta.  The two are members of a Post team of reporters investigating scams in Palm Beach County’s $1 billion drug treatment industry.

The 8-month long investigation by the Palm Beach Post uncovered patient brokering, insurance fraud and kickbacks.

Buzzfeed probe of sober homes cites Post investigation

Corruption in South Florida’s drug treatment industry grabbed headlines on the web on Saturday with an in-depth story by Buzzfeed News – the online news and entertainment giant.Spoon sig

The article chronicled recovering addicts victimized in some of the scams uncovered in the Palm Beach Post’s 8-month investigation. By linking to several Post stories, the Buzzfeed article – “Addicts for Sale” – explained how addicts with insurance are bought and sold by “marketers,” “body brokers” and “junkie hunters” who work for sober homes.

The story focused on Delray Beach, where hundreds of sober homes and outpatient treatment program are the focus of a 2-year-investigation by and FBI task force. Investigators raided two sober homes. However, no charges have been filed.

Besides patient brokering, authorities are investigating insurance fraud resulting from unnecessary urine drug tests and kickbacks paid to addicts, sober home operators, outpatient treatment programs and labs – all who need addict’s urine to continue billing insurance companies.

 

UPDATED: 15 questions addicts should ask to find a safe halfway house

These 15 questions will help you avoid being the victim of insurance fraud and patient brokering in a halfway house.

Picking a sober home: What to ask

More than two dozen sober home operators have been arrested since October 2016 and charged with accepting and paying kickbacks to enroll insured addicts living in sober homes to specific treatment centers. Asking these 15 questions will help you determine if a sober home is doing business legally and offers the best accommodations for recovery. 

1. Are you certified by the Florida Association of Recovery Residences? FARR certifies sober homes that meet 38 standards for recovery, housing, administration, training, finance and good-neighbor practices. Certified homes can be found at farronline.org.

2. Is the residence coed? Experts agree that newly recovered addicts, especially women, are vulnerable. Dating and relationships in early sobriety can take the focus off recovery.

3.What will happen if I relapse? FARR recommends that sober homes devise individual relapse protocols that include contacts and alternative housing arrangements.

4. Have there been any overdoses or deaths? Is staff trained in CPR?

5. How often do you drug test? Are tests random? What kind of tests? How much do they cost?

Here’s how the fraud works

6. Do you bill insurance? Sober homes are not licensed to offer medical care and cannot bill insurance for services, including rent.

7. How much is rent? How is it paid? What is included in rent? What is the refund policy? Are there rules about pocket change and money transfers? Experts warn insured residents to be leery of free rent, gift cards, cellphones, gym memberships and other inducements if linked to attendance at an intensive outpatient program (IOP) or the provision of urine samples.

8. Do you have an ownership interest or receive referral fees from an intensive outpatient program (IOP) or lab? Such kickbacks, often disguised as “case management fees” are illegal under Florida’s patient brokering law. 

9. Have there been any complaints filed against the sober home or its employees, including code violations?

10. How much training, education and clean time do you require of employees, including house managers?

11. Are properties and vehicles that transport clients insured? Are clients allowed to drive vehicles?

12. Are there 12-step meetings on property? Do you provide transportation to meetings? The grocery store? Is there public transportation within walking distance?

13. What are your policies regarding guests and furloughs?

14. What is your cellphone policy?

15. What is the maximum occupancy? How many to a room? How many bathrooms?

Read more of the Post’s coverage of corruption in the drug treatment industry.

Candle light vigil for victims of drug-overdose on Thursday

Sig2Hundreds of people are expected to attend the 9th Annual National Candle Light Vigil – sponsored by West Palm Beach-based Narcotics Overdose Prevention & Education (NOPE) Task Force – on Thursday to honor the estimated 30,000 people who die every year from drug overdoses in the U.S.

According to data gathered as part of the Post’s ongoing series on the substance abuse industry, more than 200 people have died of drug overdoses this year in Palm Beach County.

Michael Botticelli, Director of the White House Office of National Drug Control Policy, will give the keynote address via video to discuss the importance of drug prevention and education. Dave Aronberg, Palm Beach County State Attorney, will speak about local efforts to fight drug abuse.

At the vigils in more than 55 cities in the U.S. participants will light candles, bow their heads in a moment of silence, and view a memorial wall with more than 300 photos, which represent some of the 100 people who die every day of drug overdoses.

The vigil begins at 7 pm at the Gosman Amphitheatre at the Kravis Center, located at 701 Okeechobee Blvd.

Rage-fueled CPA turned sleepy condo complex into sober complex

ken_bailynson_cigarette_02

A year after an FBI raid, Ken Bailynson – a CPA known for explosive outbursts of rage – is continuing his efforts to take over Green Terrace, a shabby condo complex where Bailynson once housed more than 125 recovering addicts in the more than 30 units he owned and called Good Decisions Sober Living.

Bailynson has not been charged with a crime. A multi-agency task force headed by the FBI raided Good Decisions on Sept. 11, 2014 – confiscating files, computers and boxes of evidence from a unit Bailynson converted into an office and the complex’s clubhouse near the pool.

Since early 2014 the task force has been investigating allegations of insurance fraud, patient brokering and kickbacks in the county’s $1 billion substance abuse treatment industry.

Why Bailynson wants to take over Green Terrace, an 84-unit complex in West Palm Beach that was built in the 1970s, isn’t known. When asked about his plans on two occasions, Bailynson launched into profanity-laden verbal attacks on a reporter.

Residents recalled Bailynson was quiet when he began acquiring units in 2011. However, after he created Good Decisions and began moving recovering addicts into the community, he became loud and verbally aggressive. Some residents, worried that Bailynson’s outbursts would turn physically violent, began recording the outbursts on their cellphones.

Several of the remaining unit owners at Green Terrace are now suing Bailynson and the condo association, claiming money was misappropriated and that Bailynson stacked the board of directors with friends to whom he gave condos. The board also took out a $1.5 million loan from a company created by Bailynson. The loan carries a 24 percent interest rate and is secured by units owned by the association.

In September, Bailynson filed to foreclose on 10 units after the association failed to make it’s $30,000 monthly mortgage payment.

The Post published three stories on Sunday Oct. 25, 2015. Read them here:

http://projects.mypalmbeachpost.com/green-terrace/

http://www.mypalmbeachpost.com/news/news/profane-video-shows-sober-home-owner-ripping-into-/nn8LC/

http://www.mypalmbeachpost.com/news/news/residents-fight-big-loan-thousands-in-monthly-fees/nn8LP/