Politics threaten to delay Taos detox unit

By John Miller
jmiller@taosnews.com
Posted 7/19/19

A 66-year-old Taos man entered an empty, all but silent Our Lady of Guadalupe Church in Taos on Tuesday (July 16).

Agreeing to be interviewed on the condition of anonymity under the pseudonym, …

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Politics threaten to delay Taos detox unit

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A 66-year-old Taos man entered an empty, all but silent Our Lady of Guadalupe Church in Taos on Tuesday (July 16).

Agreeing to be interviewed on the condition of anonymity under the pseudonym, “Anthony,” he said the church is a place that reminds him of how important it is to keep his lifelong addiction to alcohol at bay.

Before Anthony achieved sobriety four and a half years ago, he experienced a similar feeling of asylum when he stayed at the detox center once run by the now-defunct Tri-County Community Services on Weimer Road. The center closed in 2015.

Now, Taos County and town of Taos officials are working out a way to reopen a detox center, but after gaining some momentum this year, those efforts have become mired in a disagreement over how exactly that should be done.

“It’s a really, really, terribly unfortunate circumstance,” Anthony said. “They need a dedicated facility that can start them out on a different path than they’ve been on.”

He had checked himself into the nine-bed facility in 2000. Others had been brought there by court order. Some had been picked up by police off the sidewalk, or at the bus stop or outside the grocery store, where they had passed out.

Today, Anthony barely remembers the hot coffee in the mornings, the three square meals served to him each day. Sympathetic staff members who ran the detox center made themselves available to talk. Pamphlets on Alcoholics Anonymous were stacked on tables throughout the center.

Many years before that, in the early ‘90s, Anthony had been to another detox center that was located off Kit Carson Road, which later became Casa Benavides. That detox center eventually closed as well. So had another that once was operated out of a house in Ranchos de Taos in the 1970s.

He only went to detox twice in his life, but he remembers that each time “a seed was planted,” offering a small window that allowed him to look inward, allowing a moment to consider what his life would be like sober, before he took another drink.

“I just remember that I would always get these thoughts,” he recalls. “ ‘Why am I doing what I’m doing? Why am I drinking so much?’”

Detox didn’t cure his addiction, but Anthony says that it was an important first step, one that hasn’t been available to addicts in Taos County for nearly four years.

The Weimer Road detox center was the last place an alcoholic could go in Taos to dry out that wasn’t the county hospital or the county jail, facilities whose capacity to treat serious addictions is limited.

A majority of health providers and those struggling with addiction say a detox facility is a vital piece missing from treating addiction in Taos County.

Competing models

Earlier this year, Taos County awarded a request for proposal to reopen a “social” (nonmedical) detox center to Río Grande Alcoholism Treatment Program. The local nonprofit has provided intensive outpatient treatment services for addicts in Taos for 40 years. Río Grande also operates an office in Las Vegas. After Tri-County closed down in 2018, Río Grande was one of several local organizations that absorbed a portion of Tri-County’s patients.

But after winning the county’s nod to open a detox facility, Río Grande was faced with its first challenge: The former Weimer Road location was deemed unacceptable – in part, because it was thought to be too small – and there were no county-owned buildings available to fit the bill, according to Taos County Manager Brent Jaramillo.

That left Río Grande’s director Lawrence Medina to find another, town-owned building that would be suitable for detox. To use it for that purpose, he would then have to seek a special use permit from the town’s planning and zoning commission.

“Currently, there is no contractual relationship until Río Grande has secured a location to operate the center,” Jaramillo said, adding that the contract will be for one year with a renewal clause for up to three additional years. At the end of the fourth year, a new request for proposal will be issued, Jaramillo said.

Medina recently signed a lease and submitted an application for a building at 920 Salazar Road. The space was formerly occupied by an outpatient counseling program for opioid addicts run by Tri-County.

He estimates the space could hold up to 16 beds, but said it would require renovations before it could house clients. His special use permit application will be up for consideration before the town’s planning and zoning commission on Aug. 7 at 6 p.m.

Town Manager Rick Bellis has made it known that he doesn’t support Medina’s particular model of detox.

With Tri-County’s financial collapse still fresh in his mind, Bellis said he’s wary of handing over the reins to another nonprofit to run detox. But he wouldn’t specify why Río Grande, in particular, has caused him to withhold his support.

“I have my reasons,” he said. “We do our homework. If you’re associated with a number of programs that have failed,” he paused, “that’s the weak link in most nonprofits: Do they have capable qualified staff, including somebody watching their finances, and a director who has a track record of success in difficult programs? And they don’t get more difficult than substance abuse and mental health.”

Medina said that his organization will receive $300,000 from the county for initial startup and operational costs, which he estimates at $500,000 for the first year.

But how would the detox center be sustained financially in the long term?

“We have been in discussions with the State of New Mexico’s Human Services Department Cabinet Secretary Dr. David Scrase in efforts to restore the $300,000 perpetual funding Tri-County Community Services was receiving for years to provide detoxification services here in Taos,” Medina said and added that Sen. Carlos Cisneros has been a part of those initial conversations.

But Bellis said there’s too much uncertainty about how the center would be funded moving forward and has toyed with other alternatives that might fill the same need.

In the past, the town has offered the old detox center – free of charge – to Holy Cross Medical Center to open a medical detox program. Since Holy Cross turned that offer down, Bellis has been working this year to push through another model, which he says is aimed at offering long-term, residential treatment, instead of detox.

His idea is that Valle del Sol, currently located across the street from Enos Garcia Elementary, would relocate to the location of the old detox center on Weimer Road. There, Valle would serve as a central intake for patients, referring them to nearby Holy Cross as needed for a medical assessment. If a patient qualifies, Holy Cross staff would then refer them to Shadow Mountain Recovery, a residential treatment center located in the mountains east of Taos.

He says the model he’s proposed would be eligible for federal funding, providing greater assurance that the program would not close down if it found local sources of financial support unreliable in the long term.

“The town supports what the state and federal government have found to be the only acceptable and reasonably successful model of treatment: a medical detox supported by a full continuum of care, all coordinated by a managed care organization to provide wraparound services from prevention and outreach to aftercare, with a full mental and physical health component,” Bellis said.

But Bellis’ model has also hit a snag.

In order to serve a population that often does not have private insurance, Shadow Mountain, a private organization, would first have to gain approval from the state to accept public health insurance, like Medicaid.

Several months after they applied, however, Shadow Mountain’s application is still pending.

But Bellis said the approval could come any day now.

Deeper disagreements

At more than one public meeting held to discuss Medina’s special use permit, including one held last Thursday (July 11), Bellis and Medina have continued to clash over whether opening the detox center on Salazar Road is the proper solution for addicts in Taos County.

Bellis has also questioned whether the addiction in Taos is as dire an issue as many behavioral health providers believe it to be. He said Medina’s and some county commissioners’ reasoning for reopening a detox center is filled with hyperbole.

“He said, ‘Thousands of people have died while the city plays politics,’ “ Bellis said in an interview with the Taos News this week, recalling Medina’s impassioned argument for approving his application. “I asked Lawrence to show me that, because I get the police report every day and I read it. I’m not seeing dead bodies all over the streets. In fact, we seem to have probably less of a homeless problem, less of a substance problem now than we’ve had.”

Bellis emailed the Taos News after the interview to clarify that he does support the idea of a detox center. He listed many nonprofits the town supports, like Community Against Violence and Taos Men’s Shelter.

Still, he said he’s not convinced that addiction in Taos is as serious an issue as some have claimed.

While many people believe Taos is in the midst of an addiction “crisis,” he said he believes no has yet to “quantify” the problem.

But the problem is actually quantified every year.

Addiction quantified

According to New Mexico’s Indicator-Based Information System, Taos County – and the town of Taos – both have an ongoing problem with alcohol and drug abuse, which are historic problems throughout New Mexico. The state ranked second in 2014 for the highest rate of drug overdose deaths in the country, according to the Centers for Disease Control and Prevention.

The most recent data for Taos, gathered from 2012 to 2016, indicates that 31.7 people per 100,000 die in town due to drug overdose. An estimated 78.3 per 100,000 die from alcohol-related deaths. While Taos does not record the most troubling numbers in the state, the area is among a cluster of areas in north-central New Mexico that stand out when compared to other parts of the state.

Another study, conducted in 2016 by The Journal of Global Health with local health care providers in Taos, found that “prescription and illicit opioid abuse are intertwined and affect a wide range of people in Taos.”

The study also found that “local attitudes toward treatment including concerns regarding treatment efficacy and social stigma are also important considerations.”

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