Rays of Hope for Real Drug Treatment Reform in California – Orange County Register

These horrors are happening right under our noses: A drug addict is airlifted to LAX and taken to a park in Santa Ana, where he is injected with meth in his neck and given Xanax (to make sure insurance pays the costly detox treatment).

Dr. Randy Rosen’s life of luxury was built on the backs of vulnerable drug addicts, prosecutors say. (Courtesy of the Orange County District Attorney’s Office)

And: Users who are paid by unscrupulous doctors to undergo unnecessary surgeries where anti-opioid implants are inserted into their bodies – even if they don’t use opioids (these surgeries are quite lucrative).

And: Patients in state-licensed treatment centers who somehow get fentanyl-containing pills and die in their closets shortly after group therapy (and no one feels the need to research precisely how the drugs got into it to begin with).

We’ve been telling you these horror stories for five years now and are heartened by the fact that so many new laws have been passed to make the treatment safer.

On the street, however, much remains tragically the same.

Lawmakers have been banging their heads against the walls for years as they try to push California toward a major overhaul of how drug treatment works here, but have only managed to nibble at the edges.

A new dawn, however, may be at hand.

A high-ranking helper

There’s a new head at the agency regulating drug treatment in California (a state where, right now, you or I can drag our pebbles and start rehab that bills insurance companies for lump sums. )

Michelle Baass (Courtesy of DHCS)
Michelle Baass (Courtesy of DHCS)

Michelle Baass took over the Department of Health Services in September and is working more collaboratively with reformers, lawmakers said. The big gorilla here: Demanding everything drug treatment facilities must be licensed and meet minimum standards.

Amazingly, amazingly, and shamefully, only residential treatment centers (usually in homes) must be state-licensed and meet California’s minimum standards. Ambulatory treatment centers — where patients only go during the day and where the vast majority of drug treatment takes place — have no such requirements.

In 2019, a bill to change that, sponsored by Rep. Cottie Petrie-Norris, D-Laguna Beach, and then Sen. Jerry Hill, D-San Mateo, vetoed Governor Gavin Newsom. The governor said “developing a new licensing scheme is a significant undertaking and would require a significant departure from the bill as it stands.”

Three years have passed. We understand there have been some distractions lately, but it’s time to get back to work professionalizing this life-or-death industry. Governor Newsom vetoed the 2019 bill, and Governor Newsom must take action to ensure that the changes he has demanded materialize.

“Especially with the governor’s vision for care courts, where we will in some cases be forcing people into treatment, we have to make sure that we have real treatment and real solutions,” said Petrie-Norris. “It is more important and more urgent than ever on his agenda.”

Matthew Maniace, 20, Terri Darling, 52, and James Dugas, 25, died while in state-approved rehab in Lake Arrowhead.
Matthew Maniace, 20, Terri Darling, 52, and James Dugas, 25, died while in state-approved rehab in Lake Arrowhead.

Top of my personal list: Provide proper medical oversight for rehab, where a large number of rehab deaths occur. Detox is a medically fragile process and requires real medical care, not random personnel trained in CPR. Other states prohibit the configuration common in California.

All eyes on you, Governor Newsom. Conduct. Talk to parents whose children died in horrific treatment centers. You will find all the inspiration you need.

CO inspectors

The pleas for field inspectors who can quickly respond to problems right here in Orange County – ground zero for Riviera Rehab – are finally being heard.

Traditionally, all rehab inspectors are headquartered in Sacramento, though the majority of treatment centers are here in Southern California (more than 1,000 of some 1,700 statewide). Once, it took about 18 months after a complaint was filed for it to finally be investigated. Useful, right?

Assemblyman Cottie Petrie-Norris, D-Laguna Beach, center, announced a new bipartisan legislative task force on drug treatment to push for better regulation of California's drug treatment industry addiction on Tuesday, June 4.  Behind her, from left, is activist Wendy McEntyre, Assemblyman Marie Waldron, R-Escondido, Assemblyman Henry Stern, D-Calabasas, Sen.  Jerry Hill, D-San Mateo;  and Assemblyman Bill Brough, R-Dana Point.  (Courtesy of Assembly Member Cottie Petrie-Norris)
Assemblyman Cottie Petrie-Norris, center, announced the creation of a bipartisan drug treatment task force three years ago. (Courtesy of Petrie-Norris)

In 2017, after our first Rehab Riviera series aired, Congresswoman Sharon Quirk-Silva, D-Fullerton, introduced a bill to move an inspector to OC — to be paid for by Costa Mesa and other affected cities, and not by the state.

There was fierce opposition. Enforcement must be uniform across the state, critics argued. What if the detectives started doing something, you know, different here?

“The current system isn’t broken,” Sherry Daley of the California Consortium of Addiction Programs and Professionals said during that hearing, as mouths opened (including mine).

Anyway, at the time, Quirk-Silva’s bill hit the brick wall. But a good idea lives on. In December, shortly after Baass became DHCS director, Petrie-Norris held a hearing to try to figure out why reform is taking so long.

“This industry is learning that it can do whatever it wants and you’ll write it a trouble ticket,” Petrie-Norris said. “At some point, the blood of these children is not only on the hands of these horrible operators, but also on your hands.”

Meetings with the big shots followed that hearing, as did greater collaboration. And now, after all these years, two inspectors should be assigned directly to Orange County by DHCS. They are expected to be based out of a regional office in Santa Ana.

“It’s big. It’s important,” Petrie-Norris said. “It’s really important for us to continue to pressure the department to step up their work and have better accountability and protection for patients. .”

Some sober houses coexist in relative peace with neighbors.  A young man makes his bed before leaving a sober house in Orange in 2017. (Photo by Mindy Schauer, Orange County Register/SCNG)
Some sober houses coexist in relative peace with neighbors. A young man makes his bed in an Orange in 2017. (File photo by Mindy Schauer, Orange County Register/SCNG)

Sober houses

Once people “graduate” from drug treatment — and often while attending outpatient care centers — many live in sober houses.

Technically, these operations are unlicensed and unregulated homes where recovering users live together like any other like-minded family or group of friends. But the reality is quite different: many sober homes are large corporations, with financial ties to treatment centers. They are also places where people come and go quickly, sometimes lose their will, overdose and die.

In Washington, DC, a bill to reauthorize mental health care funding would invest in, among other things, expanded access to drug-assisted addiction treatment (when it comes to mitigating the need opioids, willpower doesn’t work as well buprenorphine and naltrexone, drugs that bind to opioid receptors in the brain) and explore the thorny question that many CO quarters are concerned about: what does a sober living program look like? effective post-processing?

“For too long, many Americans struggling with substance use disorders have sought help in recovery homes that provide substandard care, failing to offer them a real opportunity to recover,” said Rep. Mike Levin, D-San Juan Capistrano, in a statement. “This is unacceptable, and we need to do better.”

List of Sober House Chores (Courtesy of Orange County Superior Court filing of Hurwitz et al v. Scolari)
List of Sober House Chores (Courtesy of Orange County Superior Court filing of Hurwitz et al v. Scolari)

Levin’s push for a federal study to determine how to bolster the quality of salvage housing is included in the bill now heading to the Senate. There would be $1.5 million for the National Academies of Science, Engineering and Medicine to examine the quality and effectiveness of for-profit and non-profit houses as well as public and private houses, while looking at the number of guests served, the number of people per room, staff certification levels, whether residents are present voluntarily or by court order, taking into account fraudulent and abusive practices.

The goal, Levin said, is to better understand how to make recovery housing more effective and identify best practices to help more Americans borrow and stay on the recovery path.

With over 100,000 deaths in a single year from drug poisoning, lives clearly depend on it. Come on, lawmakers. Do something big.

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