Aftershock Looms For Substance Abuse in Gulf Coast

As the focus of relief efforts of Hurricane Katrina shifts from crisis mode to examining short-term stability and rebuilding, substance abuse has fallen under the radar, making thousands of residents uneasy about the future of a now exacerbated addiction problem. Inadequate funding and scarce resources are at the top of the list of obstacles for addiction-focused health care professionals, counselors, and those providing substance abuse services. The most alarming realization is that the worst is yet to come.

Prior to the storms, “Louisiana had 32 medical detox beds, 20 of which were in Charity Hospital (which is now gone) and 416 beds statewide,” said Michael Duffy, director of the Louisiana Office for Addictive Disorders (http://www.dhh.state.la.us/offices/?ID=23). These services provided care for 4.4 million residents. On any given day, “1,186 people waited to access 24-hour care.” Now, those resources have vanished.

“One third of our capacity has been destroyed during hurricanes Katrina and Rita. We hope to be able to get things up and running in phases,” Duffy said. “Eighty-eight percent of the addiction population in treatment is unaccounted for.” The remaining 12 percent continue to be displaced, according to Duffy.

Concern is also growing for those not in recovery programs who are turning to alcohol and other drugs to deal with the devastation, homelessness, and personal tragedy as a result of the storm.

“Trudging” is how Samantha-Hope Atkins, founder and executive director of Hope Networks (www.hopenetworks.org), a treatment and prevention advocacy organization based in Baton Rouge, Louisiana, describes the addiction recovery situation in Louisiana. “We’ve had a real challenge. There are no resources and the need is extensive.”

With resources strained for substance abuse treatment before the storm, the problem has now escalated. In Louisiana, where Katrina ravaged the majority of the state, functioning substance abuse treatment facilities are scarce. “We have lost 19 outpatient treatment programs and 25 prevention programs statewide,” said Duffy.

Louisiana is looking at a $1.5 billion deficit due to hurricanes Katrina and Rita, severely impacting the ability to provide services such as substance abuse treatment.

When asked how much money the state of Louisiana has received for substance abuse treatment, Duffy said, “Not one single penny.” Although grant money has been requested for substance abuse treatment, nothing has been received.

“I’m hopeful that the federal government can assist us in restoring our capacity,” Duffy said.

Citizens Take Action

The government was not the only ones to take action. The National Association of Addiction Treatment Providers (NAATP) (www.naatp.org), an organization representing treatment facilities, coordinated efforts with Hope Networks to provide over $5 million for primary inpatient treatment beds and addiction treatment for victims of Katrina. Treatment centers, such as the Caron Foundation, Betty Ford Center, and others, stepped up and donated over 100 treatment beds and several million dollars in airfare to help victims of the storm receive proper treatment care.

Atkins and other volunteers passed out over 1,600 Alcoholics Anonymous Big Books (which has the principles of AA), flyers in emergency rooms and shelters, set up a 1-800 number for those seeking treatment, and coordinated efforts to establish detox facilities.

Over 100 counselors affiliated with NAADAC, The Association for Addiction Professionals (www.naadac.org), are en route or have returned from the Gulf Coast region to aid in counseling victims of the storms. SAMHSA provided funding to NAADAC to help with this effort. The counselors are aiding with everything from addiction to post traumatic stress disorder (PTSD).

“We are so proud to have our members give their dedication, passion, and knowledge to the Hurricane Katrina relief efforts. When so many feel helpless in a time of crisis, NAADAC’s members are answering the call and helping those who are battling their addictions while facing difficult circumstances,” said Cynthia Moreno Tuohy, NAADAC’s acting executive director.

Now that the immediate crisis response has subsided, many are looking towards long-term stability. The picture is not promising.

“In Louisiana, 99 percent of all treatment services are federally or state-funded and given the magnitude of the Katrina crisis there is a need for new funding help as federal resources are stretched,” said Atkins.

Without government support for substance abuse treatment, Louisiana is in a bind.

“In the next six months to a year, we will have very difficult days ahead of us. It’ll be very important for us to be as creative as we can to have a fluid and dynamic system,” Duffy said.

Mississippi faces similar challenges

“We are still trying to digest everything. It’s like being in limbo. Sometimes you can’t count your problems because you don’t know all of them,” said Herbert Loving, director of the Division of Alcohol and Drug Abuse of the Mississippi Department of Mental Health (http://www.dmh.state.ms.us/substance_abuse_services.html) in Jackson, MS.

Mississippi’s substance abuse program had a financial reserve prior to the storm, fueled by casino liquor and wine tax revenue, which provided 41 percent of the funding for substance abuse treatment. Those casinos are now gone. Now, the Division is waiting for the day the money runs out.

In Mississippi, Katrina did not ravage the entire state. The Gulfport area was hit the hardest, leaving nowhere to provide treatment services in that area. On the Gulf Coast, in Pascagoula, MS, a mental health facility was destroyed as well.

Thankfully, Loving noted, “they have not had to turn anyone away in the methadone treatment program.” Service is being provided to everyone, and some are being sent to northern Mississippi to receive treatment in areas unaffected by the storm.

“The process hasn’t caught up with us,” said Loving. “When this funding runs out, there will not be any more money to pay counselors or help out the situation. In the meantime, we are going to make all the adjustments we can make.”

What happens next?

A first step is to ensure that funding and support for substance abuse recovery services are included and acknowledged as the Gulf Coast rebuilds. Loving met with SAMHSA Administrator, Charles Curie, to discuss the importance of including substance abuse along with mental health on grant requests to ensure substance abuse program funding.

Crisis oriented counselors are also needed to help with the addiction recovery situation. According to Barbara Harrison, director of the Mississippi Association of Addiction Professional (MAAP) (www.msaap.net), “the state is supposed to receive 600 to 700 mental health counselors to help with the situation. My only concern is if they are also certified in addiction counseling.” In the United States, certification for substance abuse and mental health counseling are separate.

A request for 100 addiction counselors from the Federal Emergency Management Agency (FEMA) has been granted to the state of Louisiana, a request made by Duffy. His only concern is that if counselors in Louisiana are not employed soon, they will leave the state to look for jobs elsewhere, creating an even bigger obstacle.

In the meantime, Louisiana is making efforts to redirect funds to help the addiction population (both substance abuse and mental health persons) where buildings have been destroyed, are inhabitable, or the population has left. They are mapping out areas where the greatest population shifts exist to identify expanded capacity needs.

Overall, people are trying to find hope of some kind.

“We will recover together,” said Duffy. This disaster provides the opportunity to put a “new face on addiction” and change the discrimination surrounding the public’s perception of addiction.

In her fight to stay positive Atkins said, “When I look for one door and that one closes, I look for another one, and when that closes, I keep looking for another one.”

Loving noted that, “This will be a long process. It may take over a year.” In the meantime, there is a crisis looming over Mississippi.

“We are taking this one day at a time,” Duffy said. “The real impact is yet to come for the addiction world.”

For more information on how you can help the substance abuse situation in the Gulf Coast, go to www.naadac.org or call your local government representative to voice your support of substance abuse treatment.