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Continued: State calls for ideas on reforming detox services

  • Article by: CHRIS SERRES , Star Tribune
  • Last update: December 28, 2013 - 7:12 PM

In other states, addicts can get detox services on an outpatient basis, with withdrawal medication distributed over several days through clinics. Some states, such as California and Connecticut, have experimented with less-intensive forms of treatment, such as drop-in centers and “wet houses” for people who mostly need shelter and food while they sober up.

In August, a consultant issued a sharp critique of Minnesota’s system of public detox services.

“The advances made in the field … have, to a large extent, now passed Minnesota’s public addictions system by,” wrote Peter Rockholz, a behavioral health consultant from Brookfield, Conn., who was hired at the request of DHS.

One major obstacle to the expansion of treatment services is a state licensing regulation (known as “DHS Rule 32”) that requires detox services to be provided in hospitals or a supervised living facility licensed by the state — two of the most costly forms of detoxification. About 40 to 50 percent of detox patients “likely do not require those service intensities,” according to the DHS memo issued last week.

In addition, since the 1980s county governments that are required by law to provide detoxification services have circumvented the mandate by contracting with detox centers in neighboring jurisdictions.

“With regulatory change, it would be possible to lower [detox] services costs by placing clients in appropriate levels of care,” the DHS document says.

‘Sobering center’

Many county and state officials will be watching an experiment in Hennepin County, which has proposed a 30-bed “sobering center” next to the Chicago Avenue detox facility. Patients would get a place to sleep and would be monitored regularly by staff, but they would not receive the sort of acute medical care available at detox centers or emergency rooms.

The county estimates it will cost just $150 on average to treat an intoxicated person at a sobering center, compared with $340 at a detox center and up to $2,500 at an emergency room. Stretched over a year, those savings would total $4 million to public and private payers. Hennepin County is expected to consider the proposal at a County Board hearing in February.

Benson, the director of the Chicago Avenue detox center, said the need is “becoming a life or death situation.” On Dec. 19, she participated in a march and vigil in downtown Minneapolis for 147 homeless people who died last year across the state. Benson recognized 20 of the names because they were regular patients at the facility she oversees.

“There was a vast array of reasons for why they passed away,” Benson said, “but many could have been saved had the right services been in place.”

Chris Serres • 612-673-4308

  • Detox By the Numbers

    30,604: Admissions to Minnesota detox centers in 2012

    14: Detox centers shut down statewide in past decade

    21%: Decline in detox admissions since 2001

    22%: Minnesota adult population who acknowledge binge drinking in past year

    17%: U.S. adult population who acknowledge binge drinking in past year

    Source: Minnesota Department of Human Services and Centers for Disease Control and Prevention

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