Sun doesn’t shine on HUD’s closed-door sober homes meeting with local leaders

At least 15 elected officials were among a roster of more than 50 government leaders from Palm Beach and Broward counties who met behind closed doors Monday in Delray Beach.

The purpose of their meeting: To discuss with the U.S. Department of Housing and Urban Development possible strategies for how towns and cities can draft local laws aimed at stemming the influx of sober homes.

U.S. Department of Housing and Urban Development Assistant Secretary Gustavo Velasquez (center) and Congresswoman Lois Frankel (center right) speak with local leaders about sober homes at the Crest Theatre in Delray Beach's Old School Square Monday, May 2, 2016. (Bruce R. Bennett / The Palm Beach Post)
U.S. Department of Housing and Urban Development Assistant Secretary Gustavo Velasquez (center) and Congresswoman Lois Frankel (center right) speak with local leaders about sober homes at the Crest Theatre in Delray Beach’s Old School Square Monday, May 2, 2016. (Bruce R. Bennett / The Palm Beach Post)

Some of those elected officials serve on the same board.

Among the attendees: West Palm Beach mayor Jeri Muoio and city commissioner Shanon Materio; Boynton Beach mayor Steven Grant and city commissioners Christina Romelus and Joe Casello; and Boca Raton mayor Susan Haynie and councilman Robert Weinroth.

But the public and media were not allowed to attend.

Florida’s Government-in-the-Sunshine law contains open meetings requirements that apply to almost all state and local public bodies with the exception of the courts and the state Legislature, which have their own constitutional provisions.

The law says meetings at which public business is to be transacted or discussed must be opened and noticed to the public. The courts have interpreted that to mean that “any discussion by two or more members of the same board or commission in which foreseeable action will be taken,” Barbara Petersen, president of the First Amendment Foundation, a Tallahassee nonprofit focused on open government, has said.

An agenda for the meeting refered to the gathering as a “Sober Home Listening Session.” The meeting included discussions on how local governments might be able to eventually draft laws regulating sober homes.AGENDA

Congresswoman Lois Frankel, who hosted the meeting, said the gathering was closed to the media at the request of HUD officials.

“They wanted to have a frank and open discussion,’’ Frankel said at a post-meeting press conference.

She said there was “a concern’’ by HUD that “everything they say comes back in litigation. Instead of us sitting there all day with everybody being exact and not being able to explain what the issues were, that’s the reason. It was really for legal reasons that they didn’t want it (open to the press).’’

Photographers were allowed in to take still shots, but only after being told not to record any of the meeting with audio or video devices.

One Delray Beach resident said she tried to attend but was not allowed.

The meeting was encouraging for government leaders who attended. They are optimistic HUD officials will work with the Department of Justice on “a joint statement” clarifying federal laws that protect recovering drug addicts and alcoholics.

The joint statement could help local towns and cities in their efforts to draft laws regulating sober homes.

Feds charge Lake Worth man in overdose death

Federal authorities on Friday charged a Lake Worth man for selling a powerful painkiller that led to another man’s overdose death, the first case of its kind in Palm Beach County despite hundreds of recent overdose deaths.

Christopher Massena (Florida Department of Corrections)
Christopher Massena (Florida Department of Corrections)

Christopher Sharod Massena, 24, was indicted for distribution of fentanyl resulting in death, a charge that carries a 20-year minimum mandatory prison sentence. He was also charged with multiple counts of distributing heroin and heroin laced with fentanyl.

At roughly 100 times more powerful than morphine, fentanyl, a synthetic drug, can be deadly even in small doses, and it’s become common for drug dealers to combine it with heroin.

The effects have been lethal: roughly 200 people died in opioid-related overdoses in Palm Beach County last year, according to Palm Beach Post data. Many of those also had fentanyl in their system.

But while some local police have made a point of arresting dealers for selling heroin, Massena’s is the first case of a dealer being held responsible for an overdose death.

A Friday Justice Department press release hinted that the charge could be a new strategy to stem the growing number of overdose deaths. The FBI is already close to wrapping up a 2-year investigation of some drug treatment centers.

“The DEA is working very closely with our law enforcement partners in Palm Beach County and the United States Attorney’s Office to fully investigate and prosecute illicit drug trafficking activities to ensure that those responsible are held accountable for the consequences of their actions, especially when the sales result in the tragic death of another individual,” DEA Special Agent in Charge A.D. Wright said in a press release.

The press release said that on Feb. 18, Massena distributed fentanyl to a 23-year-old man who died after taking the drug. The man was not identified.

Afterward, Massena sold heroin and heroin laced with fentanyl to an undercover officer four times, according to the release. On April 21, Massena possessed heroin with the intent to distribute it, the release said. Those charges carry a maximum of 20 years in prison.

Local court records show Massena has been arrested several times on violence- and drug-related charges, with stints in Florida prisons from 2011-2012 and 2014-2015.

A message sent to Massena’s lawyer was not returned.

What’s a “save shot” and why did Prince reportedly get it?

Prince_at_Coachella_001
Maybe you believe TMZ’s tabloid reports that Prince overdosed on opioids -twice – and had to be given a “save shot” – twice- or maybe you don’t.

Or maybe you want to know what a save shot is.

Short answer: It’s Naloxone, also known by one brand name, Narcan. Naloxone is an antidote to an opioid overdose. That can be from opioids such as Percocet, which Prince’s sister said the singer used, or from heroin.

It can be agonizing. But it’s a re-entry to life, and everyone from the Surgeon General to the President of the United States is urging broader access to the drug.

Delray Beach, Sarasota, Stuart: They needed no convincing. Police officers in all three cities are carrying Narcan.  And with good reason. Less than a day after Delray police started carrying it, they had to use it, saving the life of a 20-year-old who relapsed and overdosed on heroin.

Narcan kit used by Delray Beach police.
Narcan kit used by Delray Beach police.

In dozens of other states, you can buy Narcan over the counter, no prescription needed. In one northeast city, a doctor wrote an “open prescription” so that anyone could go into any drugstore and buy the life-saving drug.

But not in Florida, home to unprecedented numbers of heroin overdoses.

Those overdoses reflect the large  numbers of people coming to Palm Beach County to recover from heroin- and the numbers of unscrupulous businesses exploiting them. That includes dumping them into cheap hotels after they relapse- with deadly consequences.

Read more about addiction in our series Addiction Treatment: Inside the Gold Rush.

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: Do no harm with your prescription pad

FILE - In this Oct. 16, 2014 file photo, Centers for Disease Control and Prevention (CDC) Director Dr. Tom Frieden, listens as he testifies on Capitol Hill in Washington. A bold federal effort to curb prescribing of painkillers may be faltering, amid stiff resistance from drugmakers, industry-funded groups and the government’s own top drug regulator. The agency has abandoned the January 2016 target date and opened the recommendations to public comment for 30 days. (AP Photo/J. Scott Applewhite)
Centers for Disease Control and Prevention (CDC) Director Dr. Tom Frieden. (AP Photo/J. Scott Applewhite)

The Director of the Centers for Disease Control this morning joined a growing list of high-ranking government officials pointing fingers at physicians who have prescribed enough opiate painkillers for every American to have their own stash.

Speaking at the National RX Drug Abuse and Heroin Summit in Atlanta, CDC  Director Dr. Tom Frieden said that although drug cartels have improved management of their supply chains and flooded the country with cheaper and more potent heroin, 75 percent of new heroin addicts say they started with prescription drugs.

“What we’ve said to doctors is remember that any single one of those prescriptions could ruin or end a patient’s life,” Frieden told an audience of hundreds of substance abuse stakeholders at the morning’s keynote session. “Prescription drugs are now gateway drugs.”

Although stopping short of blaming doctors and dentists who prescribe addictive painkillers, Frieden said reducing the supply with better prescribing practices coupled with law enforcement efforts would have a significant impact on the supply of drugs available.

“We  know of no other med routinely used that kills patients so frequently and it’s dose related,” Frieden said.”I’m sorry but at the CDC we don’t sugar coat it.”

A survey released by the National Safety Council on Tuesday found 99% of doctors are prescribing opioid medicines for longer than the three-day period recommended by the CDC. Twenty-three percent said they prescribe at least a month’s worth of opioids. Evidence shows that 30-day use causes brain changes, according to the survey.

Continue reading “Doctor: Do no harm with your prescription pad”

At drug summit, Obama arrives bearing gifts

Moderator Sanjay Gupta listens as President Barack Obama speaks during a panel discussion at the National Rx Drug Abuse & Heroin Summit at AmericasMart in Atlanta, Tuesday, March 29, 2016. (AP Photo/Jacquelyn Martin)
Moderator Sanjay Gupta listens as President Barack Obama speaks during a panel discussion at the National Rx Drug Abuse & Heroin Summit in Atlanta. (AP Photo/Jacquelyn Martin)

What’s the use of being the commander in chief unless you can do a little commanding from time to time?

Which is why President Barack Obama didn’t show up empty-handed Tuesday afternoon at the 2016 Summit on RX Drug Abuse and Heroin in Atlanta. He had executive branch agencies arrive bearing gifts. Among them:

  • Health and Human Services (HHS) is issuing a proposed rule to increase the current patient limit for qualified physicians who prescribe buprenorphine to treat opioid use disorders from 100 to 200 patients. HHS had already released $94 million in new funding to 271 community health centers, with a specific focus on expanding medication-assisted treatment of opioid addiction and abuse- it could assist 124,000 new patients.
  • The Substance Abuse and Mental Health Services Administration (SAMHSA) is releasing a $11 million for up to 11 states to expand medication-assisted treatment for addiction.
  • Back to HHS: Information on HHS-funded programs regarding the use of federal dollars to start or expand needle exchanges.  Obama last year reversed the longstanding ban on federal money for such programs.
  • Also from the White House, an announcement that more than 60 medical schools, beginning in fall 2016, will require their students to take some form of prescriber education, the better to curb the kind of prescribing that has resulted in 215 million U.S. prescriptions for narcotics every year. The only Florida school named: University of Central Florida College of Medicine.

“Very rarely is money the answer alone,” said Obama to a crowd of about 2,000. “But it helps.”

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.

 

Obama’s top drug-abuse officials discuss strategy to deal with opioid crisis

Michael Botticelli, Director of the White House Office on Drug Control Policy, will join the heads of the Food and Drug Administration, that National Institutes of Health and the Substance Abuse and Mental Health Services Administration to discuss updates in federal drug control policy and initiatives.

The speakers highlight the morning session at the National RX Drugs & Heroin Summit in Atlanta. President Obama will participate in a panel discussion this afternoon. Other panel members include Justin Luke Riley, president and CEO of Young People in Recovery.

Follow the Post’s live coverage of the summit 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.”