Detox treatment costs to increase in Hubbard County, along with need

In his day, Dick Devine hauled plenty of inebriated people to the drunk tank.

He recounts the story of being out on patrol one night when he encountered a car crawling along the shoulder of the road, following a person staggering alongside.

Devine, a state patrol trooper at the time, pulled the car over. The woman at the wheel said she was following her husband home; they'd been at a party where he'd over-indulged on the liquor and became angry when she took the wheel. He thought she was a lousy driver and didn't want to ride with her.

Devine counseled the couple to ride home together or he'd have to jail the man. The man had to work in the morning, he told Devine. So Devine suggested he get in the car, go home and sleep it off.

The drunken man complied. When Devine asked what the man did for a living, since it seemed urgent that he be at work the following morning, the man replied he was a surgeon.

That was one of Devine's more humorous encounters. Most were just plain sad. Devine, now retired and a Hubbard County commissioner, and fellow commissioner Cal Johannsen, a retired deputy, recounted some sad arrest stories last week when the Hubbard County board learned that detox treatment costs, which the county pays for indigent people, will rise next year, while the need for those services does as well.

Chronic alcoholism is a problem that has bedeviled society for hundreds of years. Hubbard County is no different.

A hard economy hasn't helped. People are drowning their sorrows in alcohol, they're going into detox, and are being taken care of by the county.

"The actual numbers, I can't say are necessarily on the rise," said social services director Daryl Bessler. "Certain times of the year, typically around the holidays, of course we see a greater need but the issue with detox is that there's no state help with that at all."

State law mandates that the cost of detox, from alcohol or chemical dependency, must be shouldered by the county if the person is in need and is indigent.

Most are.

The cost of one day in detox, usually at Pine Manors, has risen from $260 per day to $275. There is a sliding fee schedule depending on the patient's financial status, but most patients are without the means to pay.

And that bothers Bessler. "The state sells the stuff, they allow the license for booze to be sold, they put a tax on it and then they don't assist in the payment of the costs," he said.

"Detox is 100 percent borne by the county."

Most publicity campaigns center around preventing holiday drinking and driving while the issue of chronic alcoholism is largely ignored.

"I took hundreds of them to detox over the years," Devine said. "A lot of them I felt sorry for. They're really sick people that need help."

But because Bessler and his staff are seeing recidivism rates creeping up gradually, they're looking at a better approach.

"We've had people go to detox four, five, six times a month, the frustrated director told the board.

If a chronically drunk person heads to detox more than four times in a calendar year, social services case workers will look toward involuntary commitment procedures to see if they can get the person into longer term rehabilitation. It's a difficult process because they must get medical documentation conclusively proving the person poses a danger to him or herself - and to society - before a judge will sign a commitment order. Some judges are reluctant to do so because it infringes on a person's civil liberties.

"Putting them in jail does nothing," Devine said. "If you can get them to treatment you've got a chance."

Commissioners discussed the case of a man who went to treatment in Fergus Falls 27 times. "You never know when it's gonna work but when it does, it's great," Johannsen said.

Bessler said commitment procedures are drastic, but can make a difference. "Maybe they're going somewhere else," he said of patients forced into treatment. "But it is saving lives.

"With so many people in detox sometimes we have to go the involuntary route," Bessler admitted. But he said treatment can often fail, too, when a patient is in denial. Even family interventions fail, he pointed out.

Because most of the patients going through the revolving detox doors are single individuals, Bessler worries about their well being during a harsh winter. He doesn't want anyone to freeze to death outdoors and not be noticed.

Devine said he has concerns that working people who have chemical dependency issues usually can't afford treatment. Although many health plans do cover chemical dependency treatment stints, the uninsured pay out of pocket, which discourages them from seeking help.

"It's a sore spot with me," Devine said. "They're not bad people; they're just addicted."

Bessler worries that social services cuts have discriminated against classes of disabled people who need help.

"I have to deny day training services to a mentally retarded person who was born that way versus somebody I had to provide services for because the law said I had to," he said.

The frustration comes when the chronically drunk person "would go out and get intoxicated again and end up in detox and we have to pay these bills and continue to pay them... The person going into detox all the time, we ought to give them so many chances and that's all.

"But you know it's a disease and it is an addiction, and like any addiction, it's hard to address."