Before walking up the stairs to the home’s entrance, three people — two from Centerstone of Florida and one Manatee County Community Paramedic — huddled in a chat while taking shelter in the car port from the early afternoon rain.
Earl Kulpa, the community paramedic, was getting Wally Acevedo and Charles Whitfield, Centerstone representatives, caught up on their latest patient. She had been accepted into the community paramedic program to receive assistance for her addiction and other health issues. The woman asked not to be identified.
Acevedo and Whitfield attended the Wednesday afternoon appointment to get the woman set up with Centerstone services and medication assisted treatment.
Once inside, Whitfield was able to secure an appointment for the woman the next day while Acevedo helped her complete a few forms. Kulpa took a reading of the woman’s stats, went over her prescriptions and they discussed her general health. He has worked with her before.
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When asked if she was glad to be starting treatment, the woman smiled and said she was ready.
“I’m ready to start my life again,” she said.
It was a typical appointment in a partnership between the Community Paramedic program and Centerstone, Acevedo noted.
Patients, Kulpa said, are referred to the program after Manatee County EMS treats them for an overdose. After a screening, if they are accepted into the program, Kulpa or the other community paramedic will schedule an appointment. For these types of appointments, the community paramedic will be joined by a Centerstone representative. Once the patient is connected with an appointment, they’re started along a path, hopefully, to recovery.
The partnership between the two organizations is aimed at helping those who struggle with substance abuse link up with medicated assisted treatment, counseling and regular health checks. It’s all part of a collaborated effort to connect those who want to beat their addiction to the local resources that can help them on their path to sobriety.
James Crutchfield, chief of community paramedicine in Manatee County, said its community partnerships like this that create successful outcomes.
“(Centerstone has) been a strong supporter of public safety for a long time,” Crutchfield said, noting that the two organizations have been working together for more than a year. Centerstone serves as a mental health screening tool in their joint appointments.
While pinning down an exact number of patients the program has helped would be difficult, community paramedics average 30 patients at a time, with a waiting list. Community paramedics will see their patients an average of 12 to 18 times, depending on their needs, before they are graduated from the program, Crutchfield said.
If the patient provides a working phone number to EMS, nine out of 10 times the patient will accept the offer of services from the program, according to Crutchfield.
“There are other people that are very serious about stopping their addiction; those people are a lot easier to work with because true change has to come from within,” Kulpa said. “They’re the more rapid success stories where you can see the evolution going on in their road to recovery.”
It’s best, according to Kulpa, Acevedo and Whitfield, to get the patient an appointment as soon as possible. In this case, they were able to get the woman an appointment for the next day.
However, not every patient is so willing.
“There are some more focused on scoring their next high. Recovery and their health care are not a priority, and so then they will do things to avoid us intentionally,” Kulpa said. “There’s some that want some help but are still chasing that next high.”
Addiction’s hold on Manatee
The efforts are all to make a dent in the opioid epidemic gripping Manatee County. By teaming up, Centerstone and the community paramedics program are working to directly link patients with all the resources possible to help them overcome addiction. But the patients have to be ready to take the step themselves.
In the first six months of this year, the Manatee County Sheriff’s Office responded to 787 suspected overdose calls, an increase of 156 percent compared with 307 calls between January and June of last year.
In 2015, Manatee County had the highest number of deaths per capita among Florida’s 67 counties in which the medical examiner found a presence of heroin, fentanyl, morphine or cocaine, according to the Medical Examiners Commission annual report. Fentanyl is an opioid 50 to 100 times more powerful than morphine that is often mixed into other drugs such as heroin.
On Thursday, President Donald Trump said the White House is working on the necessary paperwork to declare a national emergency on the opioid addiction crisis. Gov. Rick Scott signed an executive order May 3 declaring a public health emergency in Florida due to the opioid epidemic.
Just an hour after meeting the woman at her home, Kulpa drove to Rubonia to meet Clayburn Alligood, who is working on his own recovery. Alligood’s past, littered with drug use and several felony convictions, reveals his spiral into opioid addiction. But it started with pain management treatment for his knees in 2002 when he was prescribed Oxycodone, he noted.
His dosage was later increased, and eventually he was doctor shopping in pill mills across the state. By 2008, he said he was a “full blown” addict. By 2010, he was using a needle.
In 2014, Alligood said he had knee surgery, which meant more drugs.
“Two days after surgery, went into pop’s bathroom, saw needles, grabbed one and started a cycle that is killing me and everyone close to me,” Alligood wrote in a note detailing his addiction timeline.
He started using heroin in 2015 when the price of pills was more than he could pay. Alligood said he was using about a bag a day, sometimes more. He’s even gone so far as to seek out straight carfentanyl, he said. Alligood, 40, has tried to get clean and relapsed before.
“I’ll go good for a long time, it’s just a culture thing, I think I can do it. But it’s a lot stronger than we are and I can’t,” Alligood said. “I always go back to where I know I can get away with it. That’s an addict’s problem, they go where they’re comfortable.”
But his wakeup call came on June 30, when he said he overdosed for the second time in less than two weeks. Alligood was working in Manatee County when he overdosed the second time and was fired from his job as a plumber. He was revived and has since been accepted in the community paramedic program.
“I don’t want to die, but you get tired. But I can work, all I think about is plumbing,” Alligood said.
He’s trying to get clean before he has to report for an upcoming jail sentence in an unrelated case, so he’s getting help from the Community Paramedics program.
Kulpa said they meet for appointments at various places in Manatee County, but Wednesday they met at a church near Rubonia where Alligood said his parents attend services.
During his Wednesday appointment, Kulpa called and arranged an appointment at Centerstone for Alligood the next afternoon and another appointment for the two of them later that week.
While he’s interested in getting clean, Alligood said he’s not interested in medically assisted treatment. It’s something he said he’s tried before, but it didn’t work for him.
But Alligood is glad to have Kulpa’s help this time around, saying it gives him a purpose.
“Maybe if somebody sees I can do it, give them like, ‘If he can do it, damn,’ ” Alligood said. “People are so judgmental. That’s the thing of an addict is we know it’s a problem, we don’t need to hear it. Pick somebody up, don’t knock ’em down.”