Alcohol Detox

Those who have worked to create Harbor House for alcohol detox gathered Friday at the duplex for a dedication and blessing. Among the people crowded into the house: homeless service providers, representatives from Memorial and Penrose hospitals and employees with drug, alcohol, alcohol detox and mental-health programs.

It's thought that a core group of 40 to 60 people living in Colorado Springs could benefit from Harbor House alcohol detox, which will be staffed with a full-time case manager who will oversee programs and a house manager who will live behind the duplex.

You want to end up like this ?

The estimated program cost for alcohol detox: $271,600, which is being covered by various grants and community organizations. The program is designed to be structured yet therapeutic, said Sherri Smith, the case manager. The men who will be moving in next week for alcohol detox will be required to spend part of their days looking for work, either at the Pikes Peak Workforce Center or Goodwill's Resource Room, Smith said. For the first six weeks, they'll attend an intensive outpatient drug and alcohol detox program at Lighthouse Assessment Center, the community's alcohol and drug detox facility. Smith said weekend activities -- such as ballgames, hockey games and bowling -- are on the agenda, too. "We're going to try to show them that there's a life outside alcoholism after alcohol detox" she said. Among those who will be moving in: George Gardner, whose struggles were featured in two previous Gazette stories. Gardner, a homeless alcoholic who has been in and out of alcohol detox, stayed for 11 days with a Springs couple who took him in their home on a cold night in late January. The couple found Gardner outside Best Buy near The Citadel during a snowstorm. After being accepted to the Harbor House detox program, Gardner moved to Lighthouse to await the opening of his new home for alcohol detox. "He's doing really well," Smith said of Gardner. "He's anxious to get into the home."

Drunk and gone ready for alcohol deto Drunk at Patong Beach Phuket Thailand ready for detox

CONTACT THE WRITER: 636-0236 or cary@gazette.com

Gazette, The (Colorado Springs), by CARY LEIDER VOGRIN THE GAZETTE
Copyright Provided by ProQuest Information and Learning Company. All rights Reserved.

Lighthouse Alcohol Detox center

Rob's breakfast was a fifth of vodka. He downed it after waking up on his cardboard bed south of the railroad tracks downtown.

At 10:50 a.m. on a recent Friday, after hitching a ride from a "beautiful lady," he's standing, just barely, at the entrance of the Lighthouse Assessment Center, the community's only alcohol and drug detox facility.

A tattoo of a winged heart is fading on his right arm. He's 36. He says he's been living on the streets since his divorce seven years ago. He works day labor - but only some days.

Rob said he's been to the alcohol and drug detox center twice. What does he want this time? "Help. That's it." He stumbles toward the front entrance. "I'm sorry about this, sir."

The opening of the Lighthouse alcohol and drug detox center 17 months ago was supposed to herald a new era for helping people like Rob. Run by the nonprofit Pikes Peak Mental Health with public and private money, the Lighthouse provides medical treatment and counseling for alcoholics who want help, a safe place to dry out for those who don't and a locked area for people who may hurt themselves or others.

But the alcohol and drug detox center is in jeopardy. Pikes Peak Mental Health underestimated the cost of running it by more than $1 million and laid most of the blame on a lack of funding from state and local sources. To save money, the agency cut in half the number of beds used at Lighthouse.

The decision has been felt beyond the alcohol and drug detox center. Police and paramedics now take many seriously drunk people not to detox but to hospital emergency rooms where they pose a safety risk and take up beds. Often these people, who the hospitals call "frequent fliers," return two or three times a night.

Pikes Peak Mental Health is seeking a $1.1 million bailout from Memorial Hospital, El Paso County and Penrose-St. Francis Health Systems. But the request has raised a host of questions about why Lighthouse is bleeding money. Talks are continuing.

If help doesn't come, Pikes Peak Mental Health says it will get out of the alcohol and drug detox business by early next year.

The crisis has forced a re-examination of an issue that seems to crop up every few years but continues to grow more complicated and expensive: How should the community deal with people who abuse alcohol and drugs?

Creating more havens

Thirty years ago, Rob probably would have been taken to the drunk tank at the city jail. In 1973, the state Legislature decriminalized drunkenness, creating the need for places like Lighthouse.

In El Paso County, the city and county signed a contract with Pikes Peak Mental Health for alcohol and drug detox care. First there was a 20-bed center, then a 54-bed place next to the Criminal Justice Center.

Lighthouse, built with $1.5 million from the county government, opened in April 2000 with a 29-bed unit - a place where people can come and go - and 19 beds in a locked area for people considered dangerous.

Besides providing alcohol and drug detox, Lighthouse treats and houses adults with mental health needs and provides a 24-hour crisis center for people who call or come in for help.

About a third of the drug and alcohol abusers who show up at Lighthouse simply want a place to sleep it off, officials say. The rest get group counseling, medication and planning to help them chart a course for staying sober when they get out.

Those services were in place at the old alcohol and drug detox starting in 1997, Pikes Peak Mental Health said. What's new at the Lighthouse is the locked unit, which police wanted because dangerous people who could be legally held were walking away from the old detox.

"People ask why we do so much for these folks," Lighthouse director Sonia Jackson said. "If you just have a B&B for someone in alcohol and drug detox, what you do is set up something that invites people to just keep coming. We want them to feel they need to change something."

According to Pikes Peak Mental Health, the new alcohol and drug detox center was a success on several fronts in its first 10 months. For example, the number of people who returned after a relapse dropped from 55 percent to 33 percent, the agency said. No one from the locked unit has been able to walk away.

But in one crucial area, the Lighthouse was failing: the bottom line.

Struggling to provide help

Police dispatch takes the call at 5:29 p.m. Four men are drinking under the bridge near U.S. Highway 24 and 31st Street. Officers Chris Cherry and Adam Romine respond.

Technically, the drinkers are trespassing. But that alone isn't going to land them in jail on this or any other night.

One of the men under the bridge is in bad shape. A 45-year-old who gives his name as Anthony flops face-first when the two cops try to help him up. Then, walking up an embankment, he falls flat on his back. He tells the cops he had a stroke about a year ago. He yells for his "walking stick," a bent ski pole.

Within a few minutes, no fewer than eight people - police, paramedics and a fire engine crew - are standing over Anthony.

"He likes his potato juice," one of his buddies says. "He likes his vodka."

The decision is made to take Anthony to Memorial Hospital and then maybe to the Lighthouse. But the odds of getting a bed in alcohol and drug detox are slim.

"Some of these guys, they want to get help, but we can't give it to them," officer Felicia Blake said. "There's no place to go."

That's been the story since February, when Pikes Peak Mental Health, citing budget problems, cut the number of beds at Lighthouse to 24. Every morning now, the Lighthouse releases five to seven people who are sober enough to leave and alerts police, paramedics and hospitals that it has openings.

If there are more people waiting than the alcohol and drug detox center can accommodate, it follows state rules for who gets in first, Lighthouse director Jackson said. A pregnant woman or a needle user, for example, gets in before someone who's just drunk. Otherwise, it's first-come, first- served, Jackson said.

By 5 p.m. every day, the 24 beds are usually taken, and Lighthouse goes on what it calls "divert," a technical term for no vacancy.

So for police and paramedics, it's off to Memorial or Penrose. On busy nights, 20 percent of Penrose's 26 emergency room beds are occupied by drunk people.

Paige Humpston, a Penrose counselor, said she never had trouble getting people into the old alcohol and drug detox. In the past two months, she's gotten just two people into the Lighthouse. Memorial Hospital officials report similar difficulties.

Besides the overall cut in beds at Lighthouse, how the remaining ones are used also contributes to the pressure on the ERs.

With alcohol and drug detox dollars in short supply, the Lighthouse now devotes more space to mental health patients, Jackson said. Those people, unlike those in detox, are covered by Medicaid, the government health insurance for the poor. Before the cuts in February, about 33 beds went to detox; now the number is about 12 on most days.

Only alcohol and drug detox, not the mental health or crisis services, is at risk of being eliminated because of funding problems.

Lack of funding

Pikes Peak Mental Health says subsidies for alcohol and drug detox are too low and have been for years, even though demand for treatment has risen along with the population.

The state, for example, gives the agency about $800,000 a year, an amount that's been fairly steady since 1995. Locally, El Paso County and Memorial Hospital contribute 13 percent of the alcohol and drug detox program's budget. In other communities local sources cover up to 60 percent of the cost of alcohol and drug detox, according to the mental health agency. The foundation set up to support Pikes Peak Mental Health also contributes to alcohol and drug detox

Morris Roth, Pikes Peak Mental Health president and chief executive officer, said the agency expected the Lighthouse would have a deficit of between $500,000 and $800,000 in its first year. But he and others hoped much of the red ink would be erased with more money from the state and through grants. That didn't happen.

In fact, things got worse. The deficit grew to $2 million because Pikes Peak Mental Health said it underestimated the cost of running the locked unit, which requires round-the-clock nurses and more expensive care.

So, the agency in August asked Memorial, Penrose and the county government for more money. The bailout would allow Pikes Peak Mental Health to open up 42 beds at the Lighthouse by Oct. 1 at the earliest and Nov. 1 at the latest, Roth said.

City-owned Memorial Hospital signaled it would be willing to give Lighthouse $1 million, an increase of $693,000, for a one-year fix if the other parties ante up. The hospital also wants a say in how Lighthouse is run.

Memorial is being asked to contribute the most because about 70 percent of the Lighthouse alcohol and drug detox patients came through the hospital or the Police Department before detox space became scarce, Pikes Peak Mental Health said.

But Memorial CEO Michael Schrader said the hospital doesn't want to shoulder long-term responsibility for keeping the alcohol and drug detox program afloat because the issue is a communitywide problem.

Penrose officials, who have not given money in the past, are now being asked to contribute $250,000. They have yet to meet with Pikes Peak Mental Health.

County Administrator Terry Harris said the community "will have a crisis on its hands" if Lighthouse closes. But county officials want more answers about the operation and finances of Lighthouse before deciding on whether it should double its contribution to $323,000. A work session is tentatively set for Sept. 20. More answers will likely emerge once a city audit of the Lighthouse is completed.

Regardless of what happens, all parties agree the bailout is a Band-Aid and that a broader debate needs to take place about how to care for alcoholics and drug users and alcohol and drug detox.

Roth, the Pikes Peak Mental Health CEO, defends the Lighthouse model as "clearly on target." El Paso County Commissioner Jeri Howells, though, has questioned whether the community can afford a "Cadillac" of detox care.

"The people who are currently debating the issue are the advocates, and they can't agree on how much or what should be provided," Memorial's Schrader said. "This will be an extremely difficult issue to pose to the community in general."

Some Colorado communities use a more traditional "sleep it off" approach and contract with hospitals when medical care is needed. City Councilman Ted Eastburn, a cardiologist who sits on a task force that's been studying detox issues since May, has proposed that Memorial Hospital carve out space for hard-core drunks and use the Lighthouse for people who really want help. Schrader opposes that.

The parties involved have pledged to lobby the state Legislature to free up more detox funding. Yet, there are no guarantees that will happen.

Another possible funding source is liquor itself. At Eastburn's request, the city finance director determined that a 0.1 percent sales tax on liquor sales would raise $242,561 in 2002. Such a tax, however, would likely face opposition from the hotel and restaurant industry.

In a crowded room

It's 10:30 p.m. at the Memorial Hospital emergency room. One room that would normally accommodate six patients is crammed with 13 men in various states of drunkenness.

One is barefoot, passed out and handcuffed to a bed. Another is lying on this back snoring and wearing a neck brace. A handful of men are sitting in chairs, jawing about nothing in particular, watching the clock as security guards watch them.

The familiar words "Lighthouse on divert" are written on an information board in the hallway.

The waiting room, meanwhile, is brimming. Among the people there are a woman with a possible blood clot in her leg, a pregnant woman with belly pain and victims of a traffic accident. Some people have been waiting 21/2 hours.

One of the men in the room set aside for alcohol detox is Anthony, the guy who was passed out four hours earlier on the grass near the westside bridge. The trip to the Lighthouse apparently didn't materialize. He's doing much better now.

"Hi," he says. "How are you doing?"

The drunks ask for orange juice and coffee. One of them tells a joke. The men are starting to get restless, an ER nurse says. The liquor stores close at midnight.

WHAT IS DETOX? Caring for intoxicated people has evolved into much more than providing a place for them to sleep it off. According to Pikes Peak Mental Health, 38 percent of the drug and alcohol abusers it treats experience moderate to severe withdrawal symptoms that require medication. When someone comes into detox, the staff checks blood- alcohol level, blood pressure and other vital signs. They also can treat tuberculosis, HIV and hepatitis, all of which are common among alcohol and drug abusers. Those who want help kicking alcoholism go through a program that includes individual and group therapy and Alcoholics Anonymous meetings. Gazette, The (Colorado Springs) by Eric Gorski Copyright, Provided by ProQuest Information and Learning Company. All rights Reserved.