Scott: Public health emergency to fight opioid overdoses is possible

The Palm Beach Post

Gov. Rick Scott on Thursday said he has not ruled out declaring a public health emergency over the opioid epidemic now burning through Florida.

"I'm still reviewing it," said Scott, who has not previously spoken publicly about the mounting number of requests for such a declaration.

The virus can cause serious neurological birth defects and as of this date, more than 2,000 cases in Florida have been recorded.

It has not, however, resulted in fatalities. By contrast, in 2015, the most recent year for which statewide numbers are available, opioid overdoses claimed 3,896 Florida lives.

Hospital charges for heroin-related illnesses topped $1 billion in the first nine months of that year - $4.1 million a day - much of it billed to Florida's cash-strapped Medicaid insurance program, The Palm Beach Post found.

"The potential effects of Zika on pregnant women and newborns is definitely critical and as we come into summertime, we need to be cognizant," said Palm Beach County Commissioner Melissa McKinlay, who made the first formal request for a public health emergency declaration to Scott.

But, she said in a Thursday morning Facebook post, "To come into Palm Beach County on this and not opioids is a slap in the face to those families that have been pleading for help."

Scott is not ignoring the opioid crisis, emphasized Scott spokeswoman Lauren Schenone. "Gov. Scott understands this is an important national issue and has spoken to the Trump Administration about it," she said.

And speaking with reporters Thursday, Scott characterized addiction as "devastating" to families, citing the case of one of his own family members who has struggled with drugs.

Getting a grip on the epidemic will be hard, he said, and while the state has a role, Scott said it was going to take a concerted effort at all levels of government - not just Tallahassee.

However, Tallahassee's efforts with Zika yielded dramatic results.

Money and media

The governor's full-court press on the virus began in February 2016. After nine confirmed cases he directed the state Surgeon General to declare a public health emergency in four counties. He called on the federal Centers for Disease Control for advice and assistance. A Zika hot line was created. Lab testing capacity was expanded.

Information on preventing Zika was included in curriculum from kindergarten through 12th grade. Mailers were sent out in multiple languages.

In December, Scott was able to stand in South Beach, the epicenter of mosquito transmission of the virus, and report that the immediate danger had passed. The Centers for Disease Control lifted an advisory against pregnant women traveling to South Beach.

Thursday's health department meeting was called in part to reinforce the prevention message and identify successes, such as cutting the amount of time it takes a pregnant woman to get test results on whether she carries the virus. Lab testing capacity has been expanded. Grants have been handed out, including money to help create a vaccine.

Broad powers

There's a precedent for the same focused approach targeting an opioid drug. In 2011, when the OxyContin "pill-mill" epidemic was at its peak, Scott declared a public health emergency.

Virginia in 2016 and Massachusetts in 2014 declared public health emergencies after heroin deaths rose sharply in those states. On March 1, Maryland Gov. Larry Hogan also declared a public health emergency.

In Florida as in many other states, the declarations can give governors the ability to tap state revenue for treatment, now seen as crucial.

More than 7,000 beds are available for substance abuse treatment in Florida.

But the number is deceptively large. Many are in for-profit treatment centers, where a 30-day stay can frequently run up a $20,000 bill. For those without insurance or cash, some stretches of the state are treatment deserts.

In Palm Beach County, where it's estimated more than 600 people died from an opioid overdose last year, there are just 24 publicly funded beds where a person without money or insurance can detoxify from the drug. There are waiting lists. And sometimes people die while waiting.

Air conditioning service man Michael Driscoll was waiting for a bed at the publicly funded Palm Beach County Comprehensive Alcoholism Rehabilitation Program, or CARP, in 2015; so was Nicholas Ricciardi, a custom carpenter who had struggled with addiction since his mid-teens. CARP abruptly closed amid financial irregularities. Both men fatally overdosed before they could find another means of treatment.

In a recent study commissioned by Palm Beach County, only about 8 percent of all locals 17 or older who needed substance abuse treatment actually got it in 2015-16. And while more than 24,000 uninsured people in the county would be expected to need detoxification and residential treatment, just 2,206 received such treatment.

It's not a South Florida problem. Manatee County, for instance, has been especially hard hit. Even small Panhandle hospitals are facing a wave of opioid cases.

But the steady stream of requests that the governor act is coming locally. Wednesday, the governing board of the Palm Beach County League of Cities, representing all 39 Palm Beach County towns and cities, unanimously approved a resolution asking Scott to declare a public health emergency. The town of Wellington, the Martin County Commission and the Florida Senate Democratic Caucus have all done the same.

The League's resolution was passed just one day after Palm Beach County Chief Circuit Judge Jeffrey Colbath also called on Scott to declare a public health emergency, writing that, "It's just the right thing to do."