DAYTONA BEACH, Fla. – The opioid crisis continues to worsen across the U.S., but in Volusia and Flagler counties the situation is dire where recent state funding cuts have left only 19 detox beds across two counties to treat opioid addicts.
When a person suffering from mental illness is "Baker Acted," they are involuntarily committed to a health care facility. Similarly, the Marchman Act allows law enforcement to commit those suffering from addiction.
In both Volusia and Flagler Counties, law enforcement officers have only one option for addicts who have overdosed or are close to overdosing.
The Stewart-Marchman-Act Behavioral Health facility (no relation to the Marchman Act) in Daytona Beach, also known as SMA, is the only facility in the Volusia and Flagler areas licensed by the state to receive addicts committed by law enforcement under the Marchman Act.
SMA's detox unit has staff, resources, and support for 19 beds and those 19 beds are almost always full.
This year alone, 29 people have died from overdoses in incorporated Volusia County, which does not including cities like Deltona or Daytona Beach, according to Volusia County Sheriff Mike Chitwood.
News 6 asked how local authorities can care for a community in crisis with online 19 beds.
"You do the best you can,” said Nicole Sharbano, SMA's vice president of services. "Nineteen beds is not enough to take care of Volusia County, it's not enough to take care of Flagler County."
Funding cuts preventing treatment for people in need
Sharbano explained that the part of the problem is that the Florida legislature cut 40 percent of SMA's funding for patient detox beds. SMA relies heavily on state funding because few patients have insurance.
SMA was in the middle of renovating a new wing that would have housed an additional 14 beds but halted construction when the funding was cut.
Sharbano said the timing could not have been worse to eliminate this funding. Opioid deaths are on the rise and addicts are flooding to clinics like SMA in desperate need of treatment.
"They're coming in a situation that is much worse than we ever saw before," she said. "You're talking people who their addiction has progressed incredibly quickly and they're very young, they've lost everything a lot of times."
About 40 percent of patients at SMA come in voluntarily, the rest are brought in by police under the Marchman Act.
Last year, SMA's detox unit turned away 1,200 people.
"It can be very disheartening when people come in voluntarily and we don't have a bed," said Salvatore Gintoli, senior director of crisis services at SMA. "This happened about 1,200 times last calendar year. It's incredibly, incredibly difficult to serve the community with that few beds."
Despite the lack of funding SMA did the best it could, treating nearly 1,600 patients last year in the detox unit. The average stay in detox is four to six days.
SMA is open 24 hours a day, seven days a week, even during Hurricane Irma, and keeps doctors, nurses and counselors on staff because addicts come at all hours.
Detox medications costly, but 'effective'
Adding to the operational costs, SMA is purchasing more detox medication than ever before, drugs like opioid-blockers Vivitrol and Suboxone, which curb cravings.
One shot of Vivtrol, administered monthly, costs $1,200.
Earlier this year, SMA donated enough of the overdose-reversing drug Narcan to equip every deputy in Volusia County with Narcan.
"They supplied us, 240 deputies, with Narcan,” Chitwood said. "They [SMA] did that, the county couldn't afford to do that. SMA did that."
Sharbano said medication has become a key component of addiction treatment.
"The old way of thinking for treating addiction was abstinence only," he said. "Now we know medication-assisted treatment is effective, evidence based, that's one of the ways we're getting results."
SMA also provides long-term residential substance treatment for 54 men and 80 women to teach them how to stay sober. Those beds, however, are also almost always full.
Gintoli said roughly one in three addicts who go through the week-long detox and are turned away from the long-term 6-month residential substance treatment program will relapse.
"So often times people will have to go home and wait until a bed opens up and that's when we see relapse," Gintoli said.
Sharbano is hopeful the Legislature will restore funding so SMA can continue renovating and add the additional 14 beds it had planned.
Chitwood said the opioid epidemic in Volusia County is dire.
If the trend continues for the rest of this year his deputies will likely save nearly 1,000 people from overdosing using Narcan to bring them back from death.
"The federal government wiped their hands clean, the state has wiped themselves clean, and now it has fallen down to the lowest level, it's the counties and cities that are dealing with this crisis," Chitwood said.