Two weeks ago, a North Shore resident and self-described alcoholic, was forced to lie to doctors to get the help he needed in order to stop drinking. And some alcoholism and drug addiction counselors say that Keith’s problem is typical
Two weeks ago, a North Shore resident and self-described alcoholic, was forced to lie to doctors to get the help he needed in order to stop drinking.
And some alcoholism and drug addiction counselors say that Keith’s problem is typical of many suffering from addiction on Kaua‘i.
Keith, 42, who has been battling an addiction to booze for years, signed up for an off-island treatment center. But the treatment center needed medical clearance prior to his arrival on O‘ahu. So Keith told doctors he wanted to kill himself in order to get detoxification at Mahelona Medical Center.
“I was suicidal,” said Keith last week as he readied him-self for treatment. “I was killing myself slowly with alcohol.”
Keith said he had no other option, that the only beds for detoxification purposes are in Mahelona Medical Center.
Detoxification, according to drug and alcohol abuse experts, is to clear the body from physical dependence on a drug. In some cases, detoxification without medical care has killed people.
Because of the health risks, no one can just walk into the emergency room and be whisked off to a treatment center.
Hospital treatment
“If you went to Wilcox and if your intention is to be detoxed, they can’t help you without proper screening” said Mardi Maione, a certified substance abuse counselor and chair of the treatment committee of Mayor Bryan Baptiste’s Kaua‘i Community Drug Response Task Force.
First, she said, is to head to a treatment facility, such as Hina Mauka or Ke Ala Pono Recovery Center to be screened. Then, if a medical detox is necessary, a drug or alcohol abuser would head to Wilcox Hospital and then to Mahelona.
To get into further treatment both inpatient (which is not yet available on Kaua‘i) and out-patient, detox must be completed, experts said.
“None of the residential treatment centers (in the state) will accept a person without (going through) detox” first, said Dr. Gerald J. McKenna, Director of Ke Ala Pono Recovery Center.
“Most of the (medical) detox goes on at Wilcox Hospital,” said McKenna. “Many get admitted (for another medical problem) and detox while treating the other medical conditions.”
But for those without acute illnesses, Mahelona does take patients strictly in need of detoxification of drugs and alcohol.
“In terms of in-patient hospitalization (for detoxification), we’re the only show in town,” said Chief of the Psychiatric Unit at Mahelona Medical Center, Doctor Harold Goldberg. “We believe people with alcohol and drug problems should get a fair shake.”
Goldberg said Mahelona takes about 30 or 40 people a year to detox people off alcohol and some drugs, like the painkiller Oxycontin and methadone.
Many other drug users, such as those with methamphetamine and cocaine problems, can be detoxified without the expensive hospital.
Meth users
“Meth (users) don’t always need detox,” said Goldberg. “It’s more keeping an eye on them.”
While on the drug, ice users can be unpredictably violent and psychotic, McKenna said in a phone interview yesterday. When they come down and begin to get the drug out of their system, users can become depressed and withdrawn. But psychosis can last for months after a last hit of ice.
“We see victims, people who get pretty psychotic with ice,” Goldberg continued. “Some get better (after detox), some don’t.”
Most of those trying to get help, are stuck somewhere in the middle. They are not in need of direct medical help. Many just need medication to smooth the effects of taking the drug or booze out of their system and some support.
“We need detox for 10-154573010f addicted persons,” said M. P. Andy Anderson, Chief Executive Officer of Hina Mauka, a recovery center that runs an in-patient facility on O‘ahu and an outpatient center on Kaua‘i. “The majority of people (addicted to drugs and alcohol) are working,” and have homes and families. On Kaua‘i, the majority are stuck with living in the same situation, with the same friends, and trying to stay clean, or lying to doctors and going into the psychiatric hospital.
“There is a stigma about being in a locked-down psychiatric ward,” said Maione. “I’ve had people who would rather continue their miserable lives than go to the psych ward for a few days.”
“Other doctors are stymied,” said McKenna. “They don’t know where to go or what to do.”
McKenna believes three to four beds are needed to adequately supply Kaua‘i’s need for medical detoxification. But it’s expensive, can be messy, and sometimes not covered by insurance.
“It’s a very expensive proposition,” said Roy Nishida, the county’s anti-drug planning coordinator. “It’s almost like having (to build) a medical facility.”
Goldberg said an easy way to treat one of the problems would be to help the majority.
What many experts, including Anderson, conclude is that Kaua‘i, with the rest of the state, needs “social detoxes,” where a person gets medication, as well as help and support without the need for the expensive hospital stay.
“It’s the next major need,” said Goldberg.
Like “clean and sober” houses, which, the experts agree are in dire need on Kaua‘i, a social detox allows people going through the same difficulty to get through together in a safe, supportive environment.
While clean and sober houses would help those who’ve already gone to treatment, a social detox would allow those who need to get out of their situation, like Keith, a place to feel safe before going to treatment.
These “drying-out” places are less-expensive, without the need for a critical care staff, and could accommodate the population with the greatest need.
Maione, a champion for clean-and-sober houses, said that Kaua‘i would be well-served to have these houses.
She said the houses, little more than a bunch of room-mates, would have clear rules and regulations. “They are gender-specific and self-sustaining,” Maione said. “I know that if one pops up, they’ll fly.”
People just out of treatment “have taken steps to change their life. They want to go home and need a safe place to be,” she added. “We don’t have that now.”
Tom Finnegan, staff writer, can be reached at 245-3681 (ext. 252)
