Detox, long-term rehab can be hard to find

Recorder/Paul Franz
The Greenfield methadone clinic.

Recorder/Paul Franz The Greenfield methadone clinic.

The county no longer has a detoxification facility for drug addicts.

The then-Franklin Medical Center in 2003 closed the 24-bed Beacon Recovery Center detoxification facility and ended substance-abuse acute care services, among service cuts made in response to Medicaid cuts at the state level beginning even before the recession. There are clinics in the state’s larger cities, including Holyoke, Springfield, Pittsfield and Worcester. These are the closest in-state options for Franklin County residents, with out-of-state services out of reach for those on state insurance.

Now, the Greenfield hospital’s mental health unit has come to serve as a sort of de facto detox for some.

Donna Stern is a nurse on the mental health unit and believes the health services have taken too much of the burden of statewide cuts, even before the recession began.

“Our hospital, we do the very best we can with serving people the way the system is set up right now,” Stern said. “We do everything we can, and I think we do a very good job, but it desperately needs an overhaul. The system is broken, what can I say. We desperately need resources.”

Stern said she works with many people with both mental health and substance abuse and addiction problems.

The mental health unit is equipped to deal with co-occuring mental health and substance abuse disorders by managing symptoms of withdrawal, but exists to treat patients with an “Axis I diagnosis,” acute mental health diagnoses such as a serious episode of depression, schizophrenia or bipolar disorder.

The unit is not meant to serve as a straight detox, but because the nearest detox facilities are outside the county, the hospital ends up absorbing some of the need.

“The service just doesn’t exist,” Stern said. “So, what is happening is that if people come in to the ER and say they have a substance abuse or addiction problem and say they need help, they know they’re not going to be helped specifically for that, by itself. In order for them to come on to our unit they have to meet the mental health criteria for hospitalization, which includes having to say they’re not going to be safe.”

According to a statement through the hospital, attributed to Chief Nursing Officer and Director of Patient Care Deborah Palmeri, budget cuts made by the governor in 2003 lead to the closure of 24 “Acute Treatment Service” beds at Franklin Medical Center.

“This was not a decision we made lightly, as we knew it was an important service to the community. We simply had no funding to support it,” reads the statement.

Funding for addiction treatment continued to decline, and the hospital transferred the remainder of its programs to ServiceNet in 2008.

“Though we no longer provide detox per se, when patients are admitted with acute medical-surgical or psychiatric issues, who also require detoxification, we manage this aspect of their care during their stay at the hospital,” the hospital said.

Maryanne Frangules, executive director of the advocacy group Massachusetts Organization for Addiction Recovery, said that just as heroin was raising its head in Massachusetts a severe budget crunch in the early 2000s closed 60 detox facilities. The whiplash from the people impacted in each district was enough to create legislative support for services and the development of a state strategic plan. The publicly funded system has grown since, Frangules said, although not to where it should be.

Local availability of services is not the only challenge facing addicts seeking help, and state and private insurance continues not to cover treatment in the way they should, Frangules said.

Frangules said detoxification is more or less available, on a statewide average, but there will likely never be enough rehab and longterm residential programs.


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