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." 
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