Substance Abuse in Florida
With a tropical climate and miles of beautiful coastline along the Atlantic Ocean and the Gulf of Mexico, Florida is a beautiful place to call home for nearly 6.5% of the U.S. population. However, it is also notorious for its pill mills and high rates of prescription drug abuse. According to the National Institutes of Health (NIH), in 2018 Florida providers wrote 53.7 opioid prescriptions for every 100 persons.
It is no wonder then that so many who are in crisis turn to Florida as a place of healing and hope. A range of comprehensive and effective treatment programs are available from the Georgia-Florida line down to the tip of the Panhandle, many of which are right on the water.
Rural Florida Substance Problems
Based on the 2010 Census published by the Florida Department of Health, there are 30 rural counties in the state of Florida. To be considered a rural county, the county must have a population density of less than 100 residents per square mile, and the average rural county had a population density of 45.1 in 2010.
Rural counties dot the state of Florida and often include a different population demographic than urban counties do. For instance, the Rural Health Information Hub (RHI hub) publishes that rural counties are often plagued with high unemployment and poverty rates, and low levels of education. These factors, combined with isolation, can contribute to high-risk behaviors, including drug and alcohol abuse. Residents in rural counties are often less likely to be insured as well, and residents may then be less likely to seek medical or mental health services.
Rural counties are often considered Health Professional Shortage Areas (HPSAs), meaning that there are not enough medical and specialty providers in close enough proximity to residents. Rural Florida residents may have to travel out of the county they reside in to obtain services. The Rural Health Plan Update, February 2009 reports that substance abuse treatment needs were ranked as the third highest unmet need among consumers.
Drugs are not only an issue within inner cities; they are prevalent in rural areas as well. Addiction treatment can improve communities, families, and individuals’ overall quality of life and wellbeing. Fortunately, there are options for residents of rural Florida to find and obtain treatment for drug abuse and addiction.
Rural Florida and High-Risk Behaviors
Alcohol is also a factor in motor vehicle crashes and deaths. In Walton County, the rate for alcohol-related crashes is 162.0 per 100,000 population compared to the state average of 89.9 per 100,000 population. The rate for alcohol-related crash fatalities was 13.2 per 100,000 in Walton County as opposed to a state average rate of 8.4 per 100,000 population.
Rural communities in Florida are often agricultural, which may contribute to illicit drug cultivation and manufacturing. Methamphetamine production and abuse are often associated with rural communities. The wide-open spaces and lack of nearby neighbors may allow for the presence of more clandestine laboratories and illegal activities.
The North Florida High Intensity Drug Trafficking Area (HIDTA), which includes several rural counties, including Baker and Columbia, cites cocaine, methamphetamine, heroin, marijuana, and prescription drugs as drugs of concern in the area, according to the Drug Market Analysis 2009. Marijuana growing operations and small-scale methamphetamine production are some of the more common drug production operations in the North Florida HIDTA and rural Florida, often run by Mexican drug cartels and drug trafficking organizations (DTOs).
Just like in other parts of the state, opioid drug abuse is an issue in rural Florida.
Controlled prescription opioids were widely dispensed through “pill mills” throughout Florida, and shady doctors contributed to the opioid abuse epidemic that the country is facing today. As pill mills were shut down due to increased law enforcement efforts, and drugs like OxyContin (oxycodone) were reformulated and became less easily accessible for recreational use, other opioids started rising up. For example, Opana (oxymorphone) abuse increased after OxyContin was reformulated and became especially prevalent in rural communities. Additionally, Reuters reports that residents of rural communities are twice as likely to overdose on prescription pills than urban residents.
Heroin and fentanyl abuse is up in Florida as well. The Guardian publishes that there was a spike in overdose deaths related to the two potent opioids between 2014 and 2015. Heroin is often a cheap alternative to controlled prescription opioids while fentanyl, which is around 50 times more potent than heroin and thus deadly in much smaller amounts, can be synthesized in illicit laboratories. Fentanyl may be used to “cut” and “stretch” heroin to make the product go further. It is also pressed into fake prescription pill resembling Xanax (alprazolam), sometimes called “death pills.” People buying these products may be unaware of what they are getting; thus, they run a high risk of suffering from a life-threatening overdose.
Florida Prescription Drug Abuse Stats
The United States has struggled with prescription drug abuse in various forms for decades. The most recent epidemic predominantly involves prescription narcotic painkillers, which are chemically similar to heroin. Since the early 2000s, these drugs have been widely prescribed to treat moderate to severe pain, in many cases with the intention that the individual would heal and stop taking them.
Unfortunately, greater access to opioid painkillers has led many Floridians to develop addictions to these drugs. With tighter restrictions on the prescription, diversion, and sale of opioid drugs, many of these individuals have turned to heroin rather than struggle to get oxycodone or hydrocodone drugs. Many people in Florida also struggle with addiction to other types of prescription substances, including benzodiazepines and stimulants.
Although the southern state’s Prescription Drug Monitoring Program (PDMP) and strict laws against pill mills have helped slow the increase in prescription drug addiction, there are still many people who suffer form this condition in Florida.
Florida’s Decade of Prescription Drug Abuse and Death
A report from National Public Radio (NPR) in 2011 stated that, at the time, Florida was the center of the US’s prescription drug abuse epidemic with opioids surfacing as the leading problem. In fact, areas of the state with severe opioid addiction and overdose problems were referred pejoratively to as “The Oxy Express,” largely due to the startling rise of pain management clinics that were essentially barely legal drug distribution fronts.
Since these reports surfaced, Florida has taken many steps to improve its prescription drug abuse problems. In March 2018, Governor Rick Scott signed the latest piece of legislation aimed at preventing people with prescription painkillers from developing an addiction to these substances with the help of pharmacists and physicians.
Unfortunately, the Sunshine State still battles prescription drug abuse and death. The Centers for Disease Control and Prevention (CDC) reports that, between 2015 and 2016, Florida was one of the states with a significant increase in drug overdose deaths. From the previous year’s stats, the state experienced a 46.3 percent increase, which was overshadowed only by Maryland’s increase of 58.9 percent. However, in the 2014-2015 measurements, Florida also saw a statistically significant increase with 22.7 percent more drug overdose deaths. In 2016, there were about 4,728 overdose deaths in the southern state; in 2015, there were 3,228 deaths; and in 2014, there were 2,634 deaths.
According to the Florida Department of Law Enforcement’s Medical Examiners Commission report for 2016, opioids and benzodiazepines were the two prescription drugs most commonly found in overdose deaths. Prescription versions of amphetamine and methamphetamine were not separated in the autopsy reports, and the only other prescription drug that caused deadly harm was zolpidem, the active medication in Ambien.
The commission noted that prescription drugs, which they listed as benzodiazepines, carisoprodol/meprobamate, zolpidem, and all opioids aside from heroin and fentanyl, were more often the causes of or present at death than illicit drugs like cocaine, marijuana, or hallucinogens.
Another option for those suffering from opioid addiction is naloxone (Narcan), a medication that can reverse opioid overdose and prevent death. We recommend that everyone take the time to learn about how to find and use naloxone. If you, a family member, or someone you live with takes opioids as a prescription or abuses painkillers and/or heroin, please consider accessing naloxone to keep with you in case of emergency. It is much easier to get now than it used to be. We'll show you how to find it.
Timeline of Drug & Alcohol in Florida
For those who are out of state and hoping to put physical as well as psychological distance between themselves and the stressors at home that may have played a large role in the development of addiction, Florida is an excellent choice for treatment. With sunny skies and easy access to oceans, lakes, and bays, the climate is conducive to healing and wellness.
The Florida Alcohol & Drug Abuse Association (FADAA) is a nonprofit organization that provides certification to member programs, ensuring a specific high level of quality care in their centers.
The Florida Department of Health manages the Substance Abuse and Mental Health (SAMH) Program within the Florida Department of Children and Families (DCF), so many of the state’s rehabilitation programs provide support for families, adolescents, and pregnant women.
In Florida, public substance abuse treatment is provided by local community-based providers that are contracted through one of seven Managing Entities (MEs) that are in turn contracted through the Florida Department of Children and Families (DCF). Within DCF, the Substance Abuse and Mental Health (SAMH) is the single state authority on behavioral health treatment, and it oversees public addiction treatment programs. Treatment for addiction is localized and depends on where a person lives.
A public program often receives money in the form of federal, state, or local government grants and other funding to cover the costs of services. Public programs that receive funding from these sources in Florida must be licensed by the state. DCF-provided services may include detox, crisis management and stabilization, case management, assessment, counseling, inpatient treatment, outpatient services, life skills training, peer-based group and individual counseling, parenting classes, transitional services, and recovery support.
Public services are provided to all residents regardless of their financial situation or ability to pay for services. Services are offered on a “sliding scale,” depending on a person’s financial circumstances. Treatment providers may accept Medicaid, Medicare, or private insurance to help pay for services as well.
To find a treatment provider in rural Florida, individuals can use their regional ME to locate a nearby provider.
Barriers to Treatment in Rural Areas in Florida
Residents of rural counties in Florida often have lower incomes than those in suburban and urban counties, and many fall below the poverty line. Unemployment, manual labor, and low-paying jobs are common. Residents often do not complete high school. This coupled with the fact that there may not seem like much to do in a rural community can contribute to drug abuse. Boredom, stress, and lack of education are all risk factors for drug use.
Addiction is a treatable disease, but specialty services may be farther away and tougher to access in a rural community. Residents of rural communities may not have health insurance and are often isolated. In addition, drug abuse prevention, education, treatment, and recovery options may not be as numerous in a rural community as they are in more urban ones. Small communities where everyone knows everyone else may also make a person less likely to see, out treatment due to associated stigmas and privacy concerns.
Emergency services are often more spread out in rural communities, which can make a drug overdose even more potentially dangerous. Per the Florida Department of Law Enforcement Medical Examiners Commission 2015 Annual Report, close to 10,000 Floridians died with at least one drug in their system in 2015. There were over 2,500 reported fatalities caused by opioid drugs in Florida in 2015.
An opioid overdose can be reversed if the antagonist drug naloxone (Narcan) is administered quickly enough. This drug is available to Florida residents without a prescription at local pharmacies. First responders often carry it as well; however, emergency services may be more stretched in a rural community, making education and prevention efforts even more important.
Teaching parents and students about the potential hazards of prescription drug abuse and overdose risks is vital to helping communities. Community-based programs that offer preventative measures and educational programs promote healthy communities.
Addiction treatment programs help clients to achieve sobriety initially and then teach healthy life skills for minimizing relapse and enhancing long-term recovery. Behavioral therapy sessions show clients how to positively modify the way they think in order to become more self-sufficient. Potentially self-destructive and risky behaviors are explored and changed as needed.
Recovery services and peer-support groups like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) host meetings all over the state of Florida to sustain and manage recovery while minimizing relapse. Developing healthy habits, such as eating balanced and nutritious meals, getting enough sleep, and exercising regularly, can enhance sobriety. Creative outlets, such as photography, art, dance, or music, can provide healthy drug-free ways to spend time.
Reducing stress and learning how to manage potential triggers and stressors can go a long way toward minimizing relapse and living a more balanced life. Holistic measures like yoga and mindfulness meditation can be beneficial as well. Keeping busy, occupying the mind, and not being afraid to reach out and ask for help when it is needed can go a long way toward managing recovery.
No matter where someone lives, addiction treatment programs can help them to overcome addiction and embrace a healthier life. While those who live in rural Florida may have to travel farther to get treatment, there are options available. If addiction treatment facilities are not local, an inpatient stay may be the best choice even if travel is needed.
Getting Help for Substance Abuse
It's common to feel stuck and overwhelmed when you or a loved one is struggling and you need to think about treatment. Often, those looking for rehab will have numerous questions and may not know where to start. We're here to help you.
Florida Addiction Treatment Resources