Pubdate: Sun, 10 Dec 2006 Source: Newsday (NY) Copyright: 2006 Newsday Inc. Contact: http://www.newsday.com/ Details: http://www.mapinc.org/media/308 Author: Andrew Strickler, Newsday Staff Writer OPIATE ADDICTS FIND FEWER HOSPITAL-RUN DETOX BEDS AVAILABLE Addicts who overdose on heroin or other opiates are likely to land first in a hospital emergency room, where doctors can often save them from brain damage or death. For many of those who want to get clean, the next step is a hospital-run drug detoxification program. There, patients are physically and emotionally prepared to move into a long-term recovery program. But with fewer detox beds available, some of Long Island's hardest-core opiate addicts are finding it harder to take that crucial step. St. Catherine of Siena Medical Center in Smithtown shut its 12-bed unit in July 2005, and Southside Hospital in Bay Shore shut its 10-bed unit in April. According to the New York State Office of Alcohol and Substance Abuse Services, these closures followed two others at Long Island hospitals in 2002 and 2003. All told, the number of beds reserved for the sickest addicts has dropped 69 percent in the last four years, from 81 beds in 2002 to just 25 in 2006. Meanwhile, admissions at Long Island's two remaining medically managed detox units, at Nassau University Medical Center in East Meadow and Eastern Long Island Hospital in Greenport, as well as less medically-intensive programs at two other hospitals, have increased an average of 42 percent over the same period. These detox units provide high-level care for addicts who have especially difficult problems and require more intensive treatment. The reasons for the decrease in detox beds is part financial, part philosophical. While hospital administrators say they need the beds for more widely used services, drug addiction specialists see the closures as part of a national movement to put more resources into long-term rehabilitation. Many of them agree that's a positive development. But the shrinking number of detox beds, many in the field say, also means some addicts at the highest risk of disease or death sometimes are sent to distant hospitals and lose the will to enter before they arrive; others go to programs not prepared to treat the toughest cases. "There are just not a lot of other places to refer these people to," said Helen deReeder, director of addiction services at Eastern Long Island Hospital in Greenport. She said the hospital's five-bed detox unit and 20 spots reserved for addicts with less severe addictions are always at or near capacity. Patricia Hinken, director of alcohol and substance abuse services at Long Beach Medical Center, says that when detox beds are full, she often tells addicts to go to an emergency room, where they can be admitted for a secondary medical problem and treated for withdrawals. "At that point it becomes a revolving door. They go ... right back to using, and get sicker and sicker," Hinken said. "If they went straight into detox, you'd have at least three days to motivate them to get into an after-care program." - --- MAP posted-by: Richard Lake