Cape Coral's Poisoned Oasis
Cape Coral, Florida, population 169,854 is the largest city between Tampa and Miami. With over 400 miles of mostly navigable canals — more miles of canals than any other city in the world — Cape Coral is a beautiful landscape with a dark side.
In 2017 Forbes named Cape Coral #1 out of 25 in “America’s Fastest Growing Cities of 2017”. A hotspot for retirees and young adults alike, Southwest Florida is growing at a faster rate than the state of Florida, and the US as a whole, especially with the 18-24 year old demographic.
Cape Coral, or “The Cape” as it’s referred to by locals, is a diverse area of Florida, with a demographic of 19.5% Hispanic, 73.5% White, 4.3% Black, 1.5% Asian, and 3.3% other ethnicity, as of last census. The Cape is just 14 miles away from the Southwest Florida International Airport, which serves approximately eight million passengers yearly. Due to its vast network of functional canals, many residents live on waterfront property with access to the Gulf of Mexico, via the Matlacha Pass and Caloosahatchee River. Cape Coral’s effortless access to the Gulf of Mexico and proximity to a major international airport, as well as the burgeoning population have made The Cape a hotspot for drug trafficking and distribution. The unemployment rate in Lee County is just 3.3%, lower than the national average.
While unemployment is at an all-time low in Lee County, this does not leave it untouched by the national opioid epidemic. In fact, opioid addicts can be found anywhere on the socioeconomic spectrum. Men and women from urban, suburban and rural communities are affected, whether they are educated and not, wealthy or poor, young or old. With pain killers becoming increasingly difficult to obtain, more and more people are turning to opiates such as black market morphine and heroin to feel the same, and often intensified effects. Fentanyl is also a growing problem in southwestern Florida, as it is becoming increasingly available. Fentanyl is an extremely potent opiate, 20 times more potent than heroin, and can be deadly even on first use whether the user has an opiate tolerance built up or not. While Cape Coral has seen increases in overall overdose rates and drug-related deaths, the biggest uptick in drug-related deaths was due to Fentanyl, according to a 2016 annual report.
Cape Coral's Cravings
The five substances that were the most frequent causes of death in Florida in 2016 were:
- Prescription Benzodiazepines including Alprazolam and Diazepam
- Fentanyl and Fentanyl Analogs
While Cocaine is a major problem in greater Florida, it’s opiates that are truly making their mark in Southwestern Florida areas such as Cape Coral. Lee County has experienced twice as many opioid-related deaths than Collier County to the South and four times as many as Charlotte County to the North. This uptick in overdoses and accidental drug-related deaths has marked Lee County as the epicenter of the opioid epidemic in Southwest Florida.
In Lee County, the majority of illicit substance users are between the ages of 26-50 years of age. According to a 2016 annual report, there were 5,725 opioid-related deaths in Lee County and the surrounding area in 2016 alone. That represents a 35 percent increase from the previous year. The opioids were identified as either the cause of death, or were present in the deceased person. Of the 55 Morphine related deaths reported, 21 were in users between the ages of 35-50. There were also 47 Fentanyl related deaths reported, which represents an increase of 97% from the previous year. Of those 47 Fentanyl deaths, 33 occured in people between the ages of 26-50. Cocaine use also caused a substantial number of deaths in the area, claiming the lives of 99 people in 2016, 68 of whom were between 26-50 years old.
Methadone, Morphine, and Oxycodone were the cause of over 50% of deaths in which they were present in the system, proving these prescriptions to be deadly. In fact, this marked a 24% rise in accidental death due to prescription drugs between 2015-2016.
In addition to Opioid related deaths, non-fatal overdoses have risen 800 percent in the past four years in Lee County. The dramatic increase went from 171 in 2013 to 955 in 2017 according to the largest medical provider in the county, Lee Health.
Years ago, it wasn’t uncommon in southwestern Florida to go “doctor shopping”, to get multiple concurrent prescriptions written for pain killers. Two years ago, lawmakers cracked down on these practices in an attempt at curbing the widespread writing of opioid prescriptions. With legal prescription opioids harder to obtain, addicts turned to illegal and illicit street drugs, such as heroin, black market morphine and the deadly and potent fentanyl as means to get their fix.
Those who had become addicted to pain killers when they were legally and freely prescribed in years past, struggled with ways to come off the drugs. Opiate withdrawals are notoriously painful, difficult and dangerous, so turning to street drugs may have felt like the only option. If you or someone you know is struggling with addiction to prescription painkillers or street opiates, you don’t have to do it alone. There are many options for recovery and addiction assistance. Call us today, and we can help get you started on your road to recovery.
While addicts are often good at hiding their behavior from those closest to them, there are certain tell-tale signs to look for if you believe someone you know may be abusing prescription drugs or other opiates such as heroin. Some of the physical and behavioral red flags to look for include:
- Drowsiness or an inability to maintain consciousness, “nodding”
- A sense of confusion, lack of focus
- Slowed breathing
- Slurred Speech
- Poor judgement
- Lowered inhibitions
- Loss of appetite
- Disinterest in things they used to enjoy
- Irritability and aggression
- Secrecy and lying
Opiate abuser also often engage in risky behavior as their addiction progresses. Addicts will often do anything they can to get their next fix, as it’s incredibly uncomfortable to come down from these substances. These risky behaviors can include theft, trading sex for drugs or money, physical violence and assault, property damage, sharing needles, and more. Most of these risky behaviors can lead to ongoing legal complications, further complicating the addicts life, sometimes long after they choose to get sober. Some of these behaviors such as prostitution and needle sharing also prove to be health risks, as they may lead to life-long issues such as HIV and Hepatitis.
The best thing you can do if you believe you or someone else is addicted to prescription pain killers or opiates of any kind is to seek professional help. Call us today, and we can help you find a program that fits your needs.
Types of Treatment
While Lee County is at the center of opioid addiction, southwestern Florida is also a haven for many who are seeking help. It’s beautiful landscape, year-round pleasant weather, and variety of treatment options has earned Florida the nickname of “The Recovery State”.
Under the Florida Mental Health Act of 1971, also known as the “Baker Act”, individuals may be involuntarily institutionalized if it is found that they may have a mental illness, are in danger of becoming a harm to their self or others, or are self-neglectful. The Baker Act can be initiated by law enforcement officials, judges, physicians or other mental health care professionals. These examinations may last up to 72 hours, and take place in one of the Florida Department of Children and Family receiving facilities. Possible outcomes following “being Bakered” may include a release of the individual, petition for involuntary inpatient commitment, involuntary outpatient commitment, or voluntary treatment. Very specific criteria must be met before involuntary examination is considered.
The first step to every treatment program is to undergo an assessment or evaluation to determine if physical or psychological dependance or addiction is present. Assessments can be valuable in determining if treatment is needed, and if so, what type of treatment is most appropriate. Self-assessments are available online, but many programs also perform assessments on site. Seeing a treatment professional in person can provide you with insights online assessments cannot.
Pre - Intake
Pre-Intake involves a deeper assessment into the individuals lifestyle, and how addiction is affecting them. Pre-intake evaluations can include questions that probe deeper into:
- Types of substances being used
- Length and frequency of use
- Past treatment and recovery attempts
- Areas of notable stress
- Employment and living situation
- Close relationships and family
- Medical conditions and co-occuring disorders (such as depression, anxiety, OCD, ADHD, post traumatic stress, etc)
Some facilities conduct pre-intake interviews over the phone, while others perform them in person. It is critically important to answer the questions asked during pre-intake honestly, as they will help healthcare professionals determine the best method of treatment for you as an individual. Research has shown that those who have a treatment program that is tailored to their needs are more likely to stick with it, improving chances of maintaining sobriety long-term.
During this time, it’s a good idea to ask any questions you may have regarding treatment costs and insurance coverage. It is also the time to ask what is allowed to bring with you to the facility, what the typical duration of treatment is, and to make travel arrangements to the facility if necessary.
In the intake process, you’ll meet with healthcare professionals such as a doctor, psychologist or psychiatrist, and/or a counselor or therapist. Sometimes a physical exam will be done at this time to determine if and how addiction has impaired your physical health. A mental health screening may also be performed at this time, in order to diagnose or review any co-occuring disorders that may contribute to the addiction. It is during the intake process that you’ll be admitted to the substance abuse treatment program. This is a great time to ask and remaining questions you have about the treatment facility, your addiction, and what will be expected of you.
Detoxification is the first major step to recovery. This is the process of ridding and cleansing the body of all illicit substances. Your treatment plan may involve detoxing in a detox facility, a hospital, or a home detox. Depending on the substances involved, it is typically a good idea to detox under the supervision and care of medical or detox professionals. Most addicts experience withdrawal symptoms during detox that are moderate to severe. Withdrawal occurs when the drug or drugs are leaving the system, and the body starts craving more. Withdrawal is often what leads addicts to relapse and begin using again, as it can be incredibly uncomfortable, and present unpleasant physical and psychological symptoms. While detox is different for every person and every substance, there are certain symptoms that are commonly experienced, depending on the drug, length and frequency of use.
Withdrawal symptoms are usually the opposite of what one experiences while using their drug of choice. For example, individuals withdrawing from prescription pain killers may experience pain for the first time since they started using.
Detoxing from opiates such as heroin and fentanyl can be especially painful, due to the potency of the drug. Some detox facilities may provide medication such as Buprenorphine to ease the pain make the process more bearable.
Opiate withdrawal symptoms may include:
- Pain in the bones and muscles
- Irritability and agitation
- Loss of Appetite
- Extreme craving for the drug
While detox can be an incredibly uncomfortable process, The symptoms will eventually subside. Opiate withdrawal symptoms typically begin within 6-12 hours of using the last dose and last 5-10 days, peaking at the 2-3 day mark.
There are two major forms of treatment, with other types of facilities falling under those umbrellas. The first and most intensive form is Inpatient Treatment. These facilities provide patients with 24/7 supervision and care. These treatment options may take place in a hospital or a separate facility. Some inpatient treatment programs are located luxury facilities that offer amenities such as state-of-the-art gyms, yoga and spiritual practices, and resort-style sober living. Other inpatient facilities are more straight forward. Whatever form of treatment you decide on will likely involve several hours of group and/or individual therapy per day, and may also encourage physical exercise, spiritual programs, and social or educational programs. Many treatments focus on dual-diagnosis or co-occuring disorders, such as bi-polar, depression, anxiety, and OCD, offering specialized groups for those dealing with those disorders.
Inpatient programs have proven to be the most successful form of treatment due to the immediate immersion one gets into sober living. In an inpatient program, patients are free to focus on their recovery without the distraction and stress of family, relationships, and work, as well as the temptation to use again by those who may encourage that type of behavior.
Residential Treatment Center (RTC)
Residential Treatment Centers, or RTC’s are the most intensive form of treatment, and are often recommended for those addicted to opiates such as heroin and fentanyl. Residential Treatment Centers are live-in facilities which provide safe, supportive, drug-free living environments, which the patient to focus solely on their recovery free of distractions from their home and outside lives.
While involved in an RTC, the patient may be expected to take part in group and individual therapy, including 12 step programs. There may also be specialized therapy for co-occurring illnesses, family or relationship counseling, psychiatric visits, spiritual sessions such as prayer or meditation practices, and physical exercise. Each facility is different, and the length of time one may expect to stayin an RTC varies from 30 days to 12 months. Contact with the outside world including family, friends and significant others is usually limited or prohibited to ensure immersion and focus on recovery, and the removal of temptation and stress that often leads to relapse.
Partial Hospitalization Programs (PHP)
Partial Hospitalization Programs are those in which the patient spends the majority of their time, much like a Residential Treatment Center, but are permitted to go home at night. This type of facility provides a safe, structured environment, but allows the patient to maintain independence in their community. PHP’s are a good option for those who have familial obligations and/or supportive home environments, or are transitioning from a more intensive Residential Treatment
In this type of treatment, you may expect hours of group and individual therapy, cognitive behavioral therapy, family or couples therapy, social skills counseling, as well as encouraged physical exercise and the availability of spiritual or religious practices, depending on the facility.
The second common form of treatment centers are Outpatient Treatments. While this treatment option is still focused on achieving and maintaining sobriety, it’s a less intensive option. Outpatient treatments are appropriate for those who have a strong support system at home, need to maintain employment or education outside of rehab, cannot attend an inpatient program for financial reasons, or are stepping down from a more intense form of inpatient treatment. Because of the personal freedom and lessened supervision of outpatient programs, the patient must have a strong desire for recovery. There is more of an emphasis on personal accountability in outpatient programs, and many opiate addicts find it difficult to maintain sobriety in these types of treatment if it is their first attempt at recovery.
Intensive Outpatient Program (IOP)
Intensive Outpatient Programs are the most involved form of outpatient therapy, typically requiring the patient to be present for individual and/or group therapy for 10-12 hours per week. IOP allows the individual the freedom of participating in their daily activities such as school or work, working their hours of treatment in around their pre-existing daily obligations either in the morning or evening. Typical IOPs encourage actively “working the steps” of 12-step programs, in addition to the involvement of the IOP therapy. Intensive Outpatient Programs can be recommended as an aftercare for those who have already completed a more intensive form of treatment or detox facility as a way to re-integrate as a sober member of their community.
As mentioned above, treatment is just one step on the long road to recovery. Aftercare can be viewed as a kind of continued treatment which follows the period of inpatient or outpatient treatment. Those who have undergone intensive treatments find that having an aftercare program in place helps to prevent relapse and get back to living a normal, healthy life. Aftercare programs may involve less intensive outpatient programs, specialized group or individual therapies, 12-step programs, etc. These options help maintain sobriety even as the temptations to relapse may occur. Research has shown that those who take advantage of aftercare programs have reduced rates of relapse.
Sober living is a recommended and natural step after a patient leaves a treatment facility. Sober living environments are homes or networks of homes that encourage and require it’s residents to remain sober and vigilant on the path to long-term recovery. These homes may or may not be supervised by staff, and often count on their members to hold each other accountable for their sobriety. Sober living homes typically have house rules, such as curfews and buddy systems, to prevent temptation and relapse opportunities.
Unfortunately, there has been a recent rise in illegitimate sober living homes in Southwestern Florida as they are not legally regulated, so it’s important to research these environments. Give us a call if you need help finding a legitimate sober living option.