Substance Abuse in Florida
Florida has a population of over 21 million residents making it the 3rd most populated state in the US. Over 25% of the population call the Miami metropolitan area home. The ethnic diversity of this high population density area has created an amazing array of communities, vibrant cultural hubs and and incredible span of socio-economic means. This area is also one of the hardest hit by the opioid epidemic and rife with drug trafficking due to miles of coastline.
Addiction is a common disease. In 2013, approximately 23 million Americans aged 12 and older needed some kind of treatment for issues related to drug or alcohol use or abuse.1 In addition, about one in four adults in the United States will suffer from some form of mental illness in a given year.2
Substance abuse, addiction, and mental illness are all considered mental and behavioral health issues, and they often occur simultaneously. Between 2009 and 2013, approximately 880,000 Floridians received treatment for any mental illness (AMI), which was only 36.3 percent of those who needed treatment, leaving a further 63.7 percent without treatment that may have helped them during that time.3
There may be several perceived barriers to treatment, from cost to health insurance to just not knowing where and how to get help. Within the state of Florida, there are many different forms of substance abuse, addiction, and mental health treatment options that can be tailored to the specific requirements of each individual. Help is within reach.
Florida a Hot Spot for Drug Trafficking
The central, northern, and southern regions of Florida are designated High Intensity Drug Trafficking Areas (HIDTAs) by the U.S. Department of Justice (DOJ). There are 28 in the nation and three within the state of Florida.4
- South Florida HIDTA:
This area contains Broward, Monroe, and Miami-Dade counties and was designated in 1990. The Miami International Airport (MIA) is the busiest airport for international cargo and the second busiest for international passengers. The Florida Keys and Florida coast seaports provide close access to the Caribbean, South America, and Central America. Much of the nation’s trade with these neighboring countries comes through Florida: 40 percent of trade with Central America, 35 percent of trade with the Caribbean, and 17 percent of trade with South America pass through South Florida. Marine smuggling operations and cruise ships porting in Miami and Ft. Lauderdale have been uncovered, and drugs have been seized all along the southern shores of Florida. Marijuana may also be regularly grown in this region. Drug-related violence and money laundering operations may also be common in South Florida.5
- Central Florida HIDTA:
This area contains Seminole, Orange, Polk, Pinellas, Volusia, Osceola, and Hillsborough counties and was designated in 1998. Four international airports, two seaports, 75 miles of coastline on the Gulf of Mexico and an additional almost 50 miles of Atlantic Ocean coastline, and the cities of Daytona Beach, Orlando, and Tampa make this a popular tourist location as well as high drug use area. Drugs may be smuggled along the US Interstate 4 or I-4 corridor, and drug labs may also be prevalent in this region.6
- Northern Florida HIDTA:
This area contains Baker, Clay, Columbia, Alachua, Flagler, Duval, Nassau, Putnam, Marian, and St. Johns counties and was established in 2001. Proximity to Atlanta, Georgia, as well as the eastern seaboard of the United States make this region attractive to drug smugglers. Significant nightlife in Jacksonville, Gainesville, and St. Augustine may increase drug-using populations, and large homeless populations may also contribute to rampant drug abuse. Big and growing cities such as Ocala may also see large drug-using populations.7
New and ‘Old’ Drugs Fill the Void
Unfortunately, as prescription drug abuse drops, use of other drugs may rise. One such drug that was commonly abused decades ago, declined in popularity, and now seems to be rising again is heroin. Between the first half of 2013 and the first half of 2014, drug-related incidents involving heroin jumped 119.7 percent.8 Heroin may be being substituted for opioid pain relievers and may prove more dangerous, as users may turn to injecting the drug for a more rapid and intense high. Injection drugs carry a plethora of risks in addition to accidental overdose, including the potential contraction of infectious diseases, engaging in criminal activity, and enhancing possible underlying or co-occurring mental illness symptoms.
New designer type drugs are also showing up on Florida streets, especially in the club scene. New drugs like Budder, which is made by soaking marijuana stems and leaves in a solvent such as butane and producing high levels of THC, and flakka, a new version of bath salts, or synthetic cathinones, similar in structure to crystal meth are being added to e-cigarettes and smoked, or vaped.9 Miami-Dade, Broward, and Palm Beach counties all report instances of Budder abuse, and in Boca Raton, a large explosion of a grow lab may have been linked to the dangerous new drug.9 These drugs are unpredictable and can have dangerous and potentially fatal consequences when taken even once.
Legislation Impacts Drug Diversion and Abuse
lorida has taken several steps to combat the prescription drug abuse explosion within the state, and fortunately, abuse and diversion rates seem to be declining. There was a 3.4 percent drop in drug overdose fatalities in 2014 from 2013 when considering the timeframe from January to June.10
In 2011, it was estimated that doctors in Florida dispensed more than 10 times the amount of oxycodone to patients than those in any other state.11 Around the state “pill mills” were common, and pain pills especially were diverted and abused like candy. The Florida Prescription Drug Monitoring Program (PDMP) and the Electronic-Florida Online Reporting of Controlled Substances Evaluation program (E-FORCE) have been working to change that by requiring healthcare practitioners to log their prescriptions of controlled substances, such as opioid pain pills and benzodiazepine medications, into a database making them more accountable.12
Interstate 75, or I-75, is a known route for drug trafficking along which in cities like Miami, Fort Lauderdale, Jacksonville, and Palm Beach lie in the infamously drug-heavy South Florida. In 2011, the Drug Enforcement Administration, or DEA, made more than 20 arrests in a joint law enforcement operation cracking down on some of Broward County’s pill mills.13
Declining prescriptions of these controlled substances, stricter criminal legislation, and more regulation may have directly impacted the number of overdose deaths caused by these drugs. The number of drug overdose deaths decreased 16.7 percent between 2010 and 2012 after stricter laws and legislation regarding prescription drug regulation was enacted in Florida.14
Drug abuse prevention methods have also been ramped up and Florida scored a 7 out of 10 on strategies being used to prevent prescription drug abuse within the state.15 Drug courts in the state of Florida also exist to help divert people from the criminal justice system into substance abuse programs.
There are many services available to help during a drugs or alcohol crisis in Florida. Floridians have many options for getting help in their state including hotlines, government services, public or private rehabs, and a variety of support groups.
For anyone that is personally suffering with opioid addiction or who has a loved one that is using opioids naloxone (Narcan) is 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.
Florida's Drug & Alcohol History
- 1865: The Civil War ends. Morphine—a pain killer derived from opium—gains popularity for its effectiveness in treating wounded soldiers during the war. Physicians begin prescribing morphine and other opiates to relieve symptoms of almost any ailment.1 The end of the Opium Wars makes opium more available in the United States. Opium dens begin gaining popularity in the U.S.2
- 1884: Sigmund Freud publishes Uber Coca (On Coca) describing the effectiveness of cocaine in treating a variety of conditions. As a result, cocaine becomes a popular treatment for everything from hay fever to morphine addiction.2
- 1909: The Smoking Opium Exclusion Act is passed, limiting the supply of opium and driving addicts to abuse stronger opiates like morphine and heroin.3
- 1912: The first free narcotic maintenance clinic in the U.S. is opened by Dr. Charles Terry in Jacksonville, Florida.1
- 1914: The Harrison Narcotics Act is passed, making opiate and cocaine manufacturing and sale illegal.3
- 1920: The Volstead Act is passed, outlawing alcohol in the U.S. and beginning the age of prohibition.4
- 1927: A Broward sheriff, several deputies, and the Chief of Police are arrested in Fort Lauderdale after a “rum raid.” Fort Lauderdale is subsequently nicknamed “Fort Liquordale.”5
- 1933: Victor Lacata—a man suffering from severe mental illness—kills his family in Tampa, Florida. Authorities blame the grisly murders on his marijuana use, which leads to cannabis legislation.6
- 1937: The Marijuana Tax Act is passed, effectively making the drug illegal.3
- 1951: The Boggs Act is passed, establishing the first mandatory minimum sentences for drug crimes. 5 years later, these penalties are increased, allowing the death penalty to be carried out for adults that sell opiates to children under 18 years old.3
- 1956: Miami News reports that a 22-year-old Jamaican man is sentenced to 2 years in prison for the attempted sale of “563 grains of marijuana,” which is slightly above 1 oz.6
- 1969: The Palm Beach International Music & Arts Festival attempts to imitate Woodstock. The failed event results in 130 drug arrests. The Palm Beach Post reports 133 drug overdoses.6
- 1978: Robert Platshorn and Robert Meinster of the “Black Tuna Gang,” are arrested and indicted for running the “biggest and slickest” smuggling operation of marijuana into South Florida.6
- 1979: Miami’s violent cocaine trafficking wars erupt in a shootout between Columbian traffickers dubbed “cocaine cowboys” in the Dadeland Mall. 2 men involved in trafficking are killed and 2 bystanders are injured when gunmen open fire.7
- 1982: A deal is struck between notorious drug trafficker Pablo Escobar of the Medellin Cartel and Panamanian General Manuel Noriega, which allows Escobar to ship cocaine through Panama to Florida.7 The South Florida Drug Task Force is created by President Reagan and headed by Vice President Bush. Reagan also declares the “War on Drugs,” and the largest seizure of cocaine in America (an estimated $100 million worth) is made at the Miami International Airport, alerting authorities to the existence of the sophistication and scale of the Colombian drug trade.7, 8
- 1984: A DEA informant infiltrates the Medellin Cartel and discovers links between the Sandinistas (communist forces in Nicaragua) and the drug trade. The story is leaked to the Washington Times. A Miami federal grand jury indicts leaders of the Medellin Cartel, including Pablo Escobar and Jorge Ochoa. Barry Seal is assassinated 2 years later. Most of the major players in the Colombian cocaine trafficking business are captured or killed in the following years.7
- 1990–2001: Fatal overdoses rise 325% in Florida.9
- 1995 and 1998: The Food and Drug Administration (FDA) approves two highly addictive and potent prescription opioids for pain relief—OxyContin and fentanyl.10
- 2000-2010: Fatal prescription drug overdoses skyrocket 1230.92% in Florida.11
- 2015: Approximately 12% of the nation’s opioid-involved deaths occurred in Florida.12
- 2017: Governor Rick Scott declares a public health emergency in Florida in response to the state’s devastating opioid epidemic.12 Meanwhile, Florida also contends with a growing methamphetamine problem and increase in cocaine trafficking.13, 14
- 2019: Medical marijuana is officially legalized in Florida.15
The Florida Mental Health Act, or the Baker Act, may be enacted in the case of individuals who present symptoms of mental illness, are potentially a danger to themselves or others, and may not perceive or understand that treatment can help.4 The Baker Act provides legal recourse to mental health and medical professionals, as well as law enforcement and officers of the court, in order to submit someone for an involuntary psychiatric exam and further treatment if necessary.
Each of the facilities in Florida offering behavioral health services is likely to offer their own selection of services that may be different from location to location. Substance abuse treatment programs may offer an array of services, including but not limited to:
- Medical detox
- Mental health assessment
- Group and individual therapy
- Life skills training
- Parenting education and skills training
- Transitional housing
- Peer-support groups
- Family support and counseling
- Recovery support
In 2011, approximately 150,000 people in Florida received an involuntary exam.7Medical and mental health professionals initiated involuntary exams in 49 percent of the cases, while law enforcement initiated another 49 percent and circuit courts initiated 2 percent of the exams.3 In many cases, how someone enters into treatment may not be as important as getting them there. Motivation can come in many forms and involuntary admission into a program may work just as well as voluntarily entering into treatment.
In Florida, when treatment admissions were measured in 2010, marijuana was the most common primary drug found in people admitted for substance abuse services, followed by opiates and then cocaine.4 Treatment services may be offered in a residential or outpatient basis, depending on the situation of the individual seeking treatment. Residential treatment may also be called inpatient care, and individuals may stay on site in a specialized facility receiving around-the-clock treatment, care, and medical supervision for a certain amount of time.
No two people are exactly alike; therefore, treatment for addiction or mental illness should be customized to the individual in need. Many services can be provided on an outpatient basis wherein the individual returns home to sleep at night.
There are differing levels of care even within inpatient and outpatient treatment. An assessment is typically done first in order determine what level and type of treatment is best in each individual case, so the correct form of comprehensive care can be provided. Individuals may move between levels of care as needs and situations change as well.
Requirements to Treat Substance Abuse in Florida
In the state of Florida, providers offering substance abuse and/or mental health services to families or individuals must be licensed through the state in accordance with what level of care they are providing.5 For example, a facility providing detox services needs to be specifically licensed to handle this level of care. There are several levels of substance abuse counseling certifications a person can receive in Florida as well:
- Certified Addiction Specialist (CAS): lowest certification level that requires 150 hours of training, passage of a background check, three professional letters of referral, 2,000 hours of supervised experience, passage of the Florida A&D exam, and agreement to FCB’s code of ethics.
- Certified Addiction Counselor (CAC): middle-tier certification that requires 250 hours of training, three professional letters of recommendation, 6,000 hours of supervised experience (unless an associate’s degree in a behavioral science is held; then only 4,000 hours are required), passing the Florida A&D examination, agreeing to and signing the FCB code of ethics.
- Certified Addiction Professional (CAP): higher certification level that requires 350 hours of professional training, three professional reference letters, a bachelor’s degree in a behavioral science from an accredited school, 6,000 hours of supervised experience (unless a master’s degree or PhD in counseling is held; then only 4,000 hours are necessary), passing the Florida A&D exam, and signing the FCB code of ethics.6
- Certified Master’s Level Addiction Professional (MCAP): new certification offered to those with a CAP and a master’s degree in a related field; individuals may be able to apply to upgrade their CAP to an MCAP.7
Other Florida certifications include:
- Certified Criminal Justice Addiction Professional, Counselor, and Specialist (CCJAP, CCJAC, CCJAS)
- Certified Recovery Support Specialist (CRSS)
- Certified E-therapist (CET)
- Certified Gambling Addiction Counselor (CGAC)
- Certified Tobacco Treatment Specialist (CTTS)
- Certified Mental Health Professional (CMHP)
- Certified Behavioral Health Technician (CBHT)
- Certified Peer Recovery Specialist (CPRS)
- Certified Prevention Professional and Specialist (CPP and CPS)8
Medical doctors, nurses and other medical professionals may also work with individuals suffering from addiction or mental illness in an integrated care format to ensure the highest levels of comprehensive treatment are being provided.
Paying for Services
Alcohol and drug abuse is expensive, producing a drain on the economy and costing the state of Florida $43.7 billion each year.9 Much of cost is reflected in healthcare, criminal justice, and lost workplace production costs. Treatment can save both the community and individuals money.
For example, in Florida the average cost of an emergency room visit is close to $3,000, each day spent in the hospital may cost an average of $2,000 a day, and drug offenders in prison cost the state $55,000 a year.9
In contrast, crisis stabilization beds cost around $300 a day, detox services are usually just over $200 a day, and drug or alcohol abuse treatment costs may be about $2,400 a year, while mental health treatment may cost about $1,500 annually.9
Florida has several state-funded substance abuse and mental health treatment options that may be low-cost or no cost to individuals needing services. The goal is to ensure that all Floridians have access to mental health and substance abuse services regardless of financial standing.
Florida even has a specialty fund for families experiencing temporary financial difficulties or employment issues due to mental health or substance abuse problems that can provide help with screening, outreach, and treatment services to those in need under the Temporary Assistance for Needy Families Substance Abuse and Mental Health (TANF SAMH) program.10
Those seeking private or additional treatment may have the option of using their individual or employee insurance policy to cover some of the costs of care. Most substance abuse and mental health facilities will have a designated hotline or group of professionals trained in helping individuals figure out what insurance may cover and how to fund treatment.
The Affordable Care Act of 2010 (ACA) changed the face of mental health and addiction treatment as well, opening up care to more people. For instance, Medicaid benefits are being extended to 1.2 million uninsured Florida residents by 2016 under the ACA, providing more people with access to healthcare.11
Additionally, adding on the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), substance abuse and mental health services are required to be covered under most insurance plans now and not excluded for coverage even if the conditions are considered pre-existing.12 This is the largest expansion of mental health and substance abuse coverage in over 50 years and may provide about 62 million Americans access to substance abuse and mental health services that may not have had coverage before.13 Preventive medicine is also included in the ACA. Check with the insurance provider to see if these benefits apply and how to use them to pay for addiction or mental health treatment.
Treatment and Substance Abuse Prevention Resources in Florida
There are many agencies within the state of Florida that offer support and guidance for individuals and families who need help understanding how to find and receive the proper treatment for addiction, substance abuse, or mental illness. Some of these resources are operated by the state or other government agencies while others are nonprofit organizations or community groups. Some of these resources and links to their website for more detailed information are included here:
- Rehabs.com is an online directory to help individuals find treatment facilities offering substance abuse services including inpatient, outpatient, and sober living.
- The Florida DCF provides a list of state-run mental health treatment facilities; currently there are seven.13
- Florida has 31 Florida Assertive Community Treatment (FACT) teams that provide public mental health services, including clinical services, housing, medications, and funding subsidies for individuals.14
- The State Mental Health Planning Council of Florida provides a list of resources for Florida residents with mental health concerns.15
- Florida’s DCF provides a tool on their com website that allows individuals to choose their Florida county from a drop-down menu and find local providers that way.16
- The Florida DCF also keeps an updated list of officially licensed substance abuse treatment facilities and providers that are organized by city.17
- The Mental Health America of Northeast Florida seeks to improve and advocate for mental health services within the region by providing education, individual, and family resources and connecting people to community programs.18
- Community-based mental health and substance abuse services are represented by the nonprofit the Florida Alcohol and Drug Abuse Association (FADAA), which strives to positively impact substance abuse policy across the state.19
- The Drug Abuse Resistance Education, or D.A.R.E. program, is active within the state of Florida and provides education to children to help prevent them from turning to drugs. The new keepin’ it REAL program was taught in 261 elementary schools and 18 middle schools in 2014 with positive results. The D.A.R.E. program is a drug abuse prevention resource used around the country.20
For every $1 invested in treating mental health issues, almost $4 are saved in hospitalizations and criminal activities while $1 spent on drug or alcohol treatment can save the local taxpayers over $7.21 Mental illness and addiction are treatable disorders, and there are many locations and resources within Florida that can help.
Getting Help for Substance Abuse
In Florida, there are numerous ways to find help when you or someone you love is struggling with addiction, but understanding these options can often be difficult and overwhelming. Many people have questions about how to get sober, costs associated with rehab, and ongoing support. We are here to help with those questions.
Paying for Treatment
One of the first questions people often ask when considering rehab is, "what will it cost?" Starting recovery does not have to be expensive; in many cases, medical insurance will cover some or all of the costs. Learn more about options for paying for rehab and how medical coverage can help cover costs.
Serving individuals and groups, as well as Medicare and Medicaid recipients, Coventry Health Care offers a wide range of comprehensive healthcare coverage options. Coventry Health Care provides behavioral health care services, which includes substance abuse services and mental health needs, through the MHNet behavioral healthcare company. Services provided through MHNet are confidential. Learn more
Blue Cross Blue Shield (BCBS)
To learn more about your potential coverage, you’ll need to understand the specifics of your Blue Cross / Blue Shield carrier. Although BCBS is known throughout the country, there are actually thirty-nine different companies which operate under the brand name. These companies provide insurance to wide variety of people, and they are all subject to the restrictions and regulations of their specific home states. Learn more
As of 2011, Aetna provides mental health and substances abuse coverage as part of standard provisions package for its health insurance offerings but is dependent on your specific plan sponsor. We recommend you check with your particular plan. Learn more about what information you are looking for here.