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Erik Burgess, Published August 05 2012

Familiar faces common at F-M detox centers

MOORHEAD - There is a bed, four walls and a place to get sick.

To get there, take the elevator with the flickering light to the second floor and walk the long hallway with chipping sky-blue paint. A blue lock box hangs like an old picture at the end of the hall, asking law enforcement to deposit their weapons before entering.

That path, which leads to Clay County’s alcohol detoxification center in Moorhead, is familiar for local police, who are the reason most of the facility’s clientele – people who are dangerously drunk – end up there.

It’s also familiar to many of those served by the center in Moorhead and a similar facility in Fargo. Local officials say and intake data show the number of admissions is growing dramatically and the same faces are seen time and time again.

In 2011, one person was admitted to the detox in Fargo 91 times. In 2010, one was admitted 72 times.

“It’s a difficult population. They’re resistant, and for some reason their addictions are very, very strong,” said Marty Olson, director of the detox facility run by Centre Inc. at 123 15th St. N. in Fargo. “You don’t seem to see much change in them.”

The 916 people admitted at least once or twice at the Fargo detox center in 2011 were responsible for 31 percent of intakes. The 248 people admitted three times or more accounted for 69 percent of the intakes, an increase from 65 percent in 2010.

In 2011, 50 people were admitted to the Fargo detox more than a dozen times. Of those, 11 were admitted at least 37 times.

Data provided by the Clay County detox center show that in the last six months, between eight and 12 clients came in two to four times a month.

There were 681 people who accounted for 1,084 total admissions in Clay County in 2011, according to the center’s data.

Olson, who has been at Fargo’s detox center for 20 years, knows some clients as if they were close friends.

“I see some of the same people since the day I started working in detox. They’re still around,” Olson said. “I could almost name ’em.”

Inside the center

It’s a late night at Clay County’s detox. As the door opens, beds creak and heads turn to see what the racket is in the doorway. A man in an oversized shirt with a stretched-out chest pocket and mismatched pants shuffles past, eyes fixated on the floor beneath him.

Another man approaches. He’s heavyset, with a tired look in his eyes. He’s working the graveyard shift again.

“Unfortunately, since no one wanted to pick it up, and I’m the director, it falls to me,” said Donald Johnson, 59, who has worked at the center for 18 years and has been its director for more than a year.

Many of the people he helps have treaded the same path for just as many years as he has, unable to escape the cyclical rut of alcohol addiction.

“We’re a detox, and that’s what we’re here for – detox,” Johnson said. “We have some people who go out and drink just to come back here.”

The Fargo and Clay County detox centers take in those who are heavily intoxicated and have nowhere else to go. Detox gives them a safe place to sober up.

Clay County’s detox is a “medical detox,” with a registered nurse always on call. Fargo’s operation is a “social detox,” so there are no nurses, though workers at both centers receive first-aid training.

Medicine is sometimes administered for pain, but the facilities are not hospitals or addiction treatment centers.

The majority of clients are brought in by police, and they are held until they are no longer a danger to themselves or others.

Both detox services offer referrals to treatment programs or to more permanent housing options – such as the Southeast Human Service Center or Cooper House in Fargo – in an attempt to help repeat clients improve their lives, but the success rate of the referrals is murky.

“You have to want to get better, and some people don’t,” Johnson said. “You can offer all you want, but they have to want to get better.”

The issue is alcoholism, he said. These are not just homeless people looking for a place to sleep.

“Why don’t they just quit? If it was that easy, we wouldn’t have or need treatment or counselors or anything like that,” said Brad Brown, addiction service supervisor at Southeast Human Service Center. “There’s a lot more to it.”

In cases of severe health issues – if someone’s life is on the line – detox center officials can attempt to have the person committed to a treatment facility.

“It’s not that often. That criteria is pretty strict,” Olson said. “You’re extremely ill when that happens.”

Overall admissions up

Johnson said admission numbers have risen in recent years in Clay County’s detox, which is licensed by the state Department of Health and Human Services and funded by the county. Between 2008 and 2011, the number of total admission is up nearly 25 percent.

It’s much the same in Fargo.

Overall admissions to Centre Inc. Detox nearly tripled in the past six years, said Scott Stenerson, a retired Fargo police officer who now works as a department liaison for the city’s homeless.

“We had a record-high number of admissions in 2011, and we are currently on pace to break that record set in 2011,” Stenerson wrote in an email to The Forum.

Data provided by Centre show that 1,159 people checked into detox in 2011. That’s up from 983 in 2010.

The numbers have gotten so bad that Olson said occasionally people will be sleeping in the hallways of their eight-bedroom facility.

Officials from both sides of the river speculated that the cities’ growth might be a partial culprit, as well as the oil boom in western North Dakota.

“The city is growing; that’s part of it,” Olson said. “Some attribute it to an influx of people because of the oil field boom. I really do not know.”

Johnson agreed.

“I can give the reasons why I feel it’s going (up), but I’m not sure why,” he said. “I’m thinking the economic boom out in the west.”

He also said the availability of other services for the homeless in the area makes the metro a draw for that population.

Stenerson said homelessness is definitely tied to chronic repeaters in the detox system.

“Statistics show that approximately 60 percent of the admissions to Centre Detox involve homeless individuals,” he said.

The number in Clay County is lower, about 33 percent, Johnson said.

But if any of these people found more permanent housing, “their interactions with police or admissions to Centre Detox decreased significantly,” Stenerson wrote.

Olson said the connection with homelessness is clear.

“If you don’t have a place to go and you do some drinking, it’s kind of hard to stay out of the way of the police,” he said.

What can be done?

Johnson said he’s determined to help those the Clay County center serves, even if they keep coming back.

“It’s what I do, so I don’t get frustrated,” he said. “That’s what detox is for. We are not here for a treatment facility.”

He said he often suggests to the longtime clients that they seek other help, but it’s something they can’t be forced into.

Stenerson said Fargo police started a case management program in 2002 to help coordinate and integrate services for vulnerable adults, including those who are repeat users of detox services.

“We have experienced a number of ‘success stories’ over the years,” he said.

Police officers who work in downtown Fargo, such as Todd Wahl, said police take people to detox on a daily basis but also try to refer them to addiction services.

“We’ll take people to detox, but we would rather try to help them overcome their addiction,” he said.

Detox can’t be the only option in helping people overcome addiction, said Jan Eliassen, director of the Gladys Ray Shelter in Fargo, the only homeless shelter in the metro area that will let homeless people who have been drinking stay the night.

“We can’t really address it from just a detox perspective,” she said. “There has to be so many services in place for somebody who’s just become really chronic.”

Olson said he is troubled by the steady increase in detox admissions.

“Does it work? Yeah, there’s been successes. People have made changes in their life and gotten healthier, and some have not,” he said. “It’s hard to gauge that kind of success. It’s really hard to measure it.”

Pointing to the number of people who use the service only once – 68 percent of individuals in 2011 and 70 percent in 2010 – Olson said that population is proof detox matters.

“They might have an unfortunate night,” he said. “That situation may have been acute for them at the moment. I don’t know that what happened is therapeutic, but it definitely kept them safe.”

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Readers can reach Forum reporter Erik Burgess at (701) 241-5518