Related story: Chiefs express concern for first responders’ mental health
By Jane Smith
The addiction crisis in Delray Beach has affected every city department within the past year. Police and fire-rescue workers have seen the most direct effect because of their role in responding to overdoses, City Manager Don Cooper says.
To a lesser extent, staffers from community improvement and parks and recreation have to deal with the results of the addiction crisis, he said.
Two drug users overdosed in the Veterans Park bathrooms in the past year. Parks maintenance workers “keep an approved container for sharps/needles in their maintenance trucks,” said Suzanne Fisher, parks and recreation director. Once the container is filled, the employee takes the container to the Fire Department for replacement with an empty one. “Some parks/crews drop off their container more frequently than others,” Fisher said.
Most of the increased costs go to pay for more public safety officers and Narcan, a medication that blocks the high from heroin and other opioids. The police and fire departments account for 61 percent of the city’s budget, leaving other departments with less-immediate needs to wait, the city manager said.
From Jan. 1 through the morning of Sept. 7 this year, the Fire-Rescue Department administered 1,115 doses of Narcan, ranging from a single 0.4 mg dose to multiple doses up to 10 mg, said Fire Chief Neal de Jesus.
The department buys its Narcan through a cooperative arrangement with the Boynton Beach Fire- Rescue Department, de Jesus said.
Through Sept. 7, Delray Beach Fire-Rescue has spent $29,662.50 on Narcan. The department estimated it had $5,000 worth of the medication in stock, he said.
De Jesus said Narcan is not the only expense on the overdose calls. Rescue workers also use breathing masks, IV lines and other disposable items.
He doesn’t know of any rescue personnel who sought assistance in dealing with the stress from the increase in overdoses. The department offers counseling through a paid city benefit, an early assistance program. But the program is confidential and names are not revealed, he said.
The department is taking a proactive approach to dealing with the addiction crisis and working to create critical incident stress debriefing training. The city program would provide the initial counseling and referral, as necessary, de Jesus said. A county program is available on request, he said.
“The addiction crisis has played a role in the call volume increase we are experiencing,” de Jesus said.
The City Commission approved hiring eight new firefighters/paramedics, totaling $697,060, for the new budget year. The extra staff will respond to overdoses and help by adding a third person at the busiest fire stations, he said. That would allow reduced response times, faster turnaround and in-service times at local hospitals, allow the second unit to be kept in the zone and have less wear and tear on the fire apparatus.
The 412 overdose calls as of Sept. 7 tied up fire-rescue staff for more than 309 hours, or nearly 13 days, including hospital wait times, according to the department.
To transport an overdose patient to a hospital, the department charges $12 a mile. “As of this date we have billed $777,703.60 and collected $151,033.60 leaving an unpaid balance of $626,670,” de Jesus said on Sept. 20. The city also will seek legislative approval to allow a lien for the unpaid amount to be placed on the sober home or treatment center.
Ocean-rescue lifeguards, who are part of the Fire-Rescue Department, find syringes and other drug use items on the beach weekly, said Phil Wotton, ocean-rescue supervisor. Those items are not tracked by ocean-rescue.
His lifeguards have never administered Narcan and the division’s auto-injection Narcan supply recently expired. Wotton is waiting for new direction from the Fire Department. His lifeguards may have to use the Narcan in the upcoming budget year, he predicts.
For the Community Improvement Department, staff is restricted in what it can say or do by federal housing and disability laws that protect sober homes, said Assistant Director Janet Meeks.
A part-time rental housing inspector who works 29 hours weekly in the department said earlier this year that he spends most of his time inspecting sober homes. He’s a retired police lieutenant who earns $18.89 per hour.
Police officers used Narcan 65 times from March 1 through Aug. 31, according to department data. The department received that medication from the Delray Beach Drug Task Force and the city’s Fire-Rescue Department with purchases paid for by grants.
As of Aug. 31, 433 drug users overdosed in the city, compared with 93 for the same period in 2015, according to department data. Three hundred sixty overdosed on heroin this year through Aug. 31, resulting in 31 deaths.
Officers who respond to the overdoses are offered counseling through the city’s early assistance program.
“Of course it’s disheartening to see what sometimes seems like a string of unending overdoses, but as always, they are doing everything they can to ensure public safety,” said Chief Jeff Goldman. “The city does offer services and they are spoken about to the officers. We don’t know who has gone or been seen. This is all confidential information.”
City police officers also respond to crimes connected to addiction when a drug user might break into a vehicle or steal a purse for items that can be pawned in order to feed a drug habit. The department has no way of tracking these types of crimes; they are listed under the general categories of vehicle burglary, larceny, etc. “We can’t even run all the calls we’ve responded to at recovery homes because those addresses aren’t technically known to us,” Goldman said.
To help with the addiction crisis, the Police Department has a pilot program using the services of the Guardian Recovery Network to persuade drug users who overdose to go back into treatment or return home. The data collected show a 20 percent success rate, according to Dani Moschella, department spokeswoman.
The department will use that data to justify hiring a licensed clinical social worker to function as the service population advocate to help drug users who overdose, along with homeless people and people with mental health problems.
The city approved hiring four officers in the budget year starting Oct. 1. That hiring is part of the department’s strategic plan to return to 170 sworn officers. “Officers are needed to handle all types of calls, including those related to the recovery community,” Goldman said.
If Delray Beach was not burdened by the addiction crisis, “officers would still be responding to and investigating other crimes,” he said, “but our employees would not be spread so thin.”
High costs of treatment
Delray Beach paramedics responded to 412 overdose calls this year as of Sept. 7. The charts give an approximate breakdown of the costs for each. The amount of Narcan given is an average. One dose or multiple doses up to 10 mg may be used. The costs do not include department personnel or vehicles, which vary from call to call.
Suspected OD with possible respiratory arrest
Item Cost
Narcan (3 doses at $36.50 each) $109.50
Mucosal atomizer device $6.50
IV (catheter, start kit, flush, extension) $115.50
Bag valve mask $16.50
Miscellaneous supplies $30
Total $278
Cardiac arrest in suspected OD with respiratory arrest
Item Cost
Respiratory arrest (all items above) $278
Lucas II suction cup $45
Defib pads $32
Thomas endotracheal tube lock $4
Endotracheal tube $2
Suction catheter $1.50
Suction container $18
Epinephrine (3 doses at $6 each) $18
Total $398.50
Source: Delray Beach Fire Rescue Department
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