MANATEE -- Law enforcement, first responders and treatment centers all see huge costs as a result of drug addiction, not to mention the untold costs to families who watch loved ones slip away as a result.
Officials generally agree the best way to solve the issue is by cutting off demand -- stopping people from becoming addicts in the first place and treating those who already suffer from addiction.
But money talks, and money isn't being heavily invested in prevention or treatment in Manatee County.
"That's the age-old question, right? I mean how do we address the number of deaths that we see, how do we address the ongoing epidemic of drug use in society?" asked Dr. Russell Vega, chief medical examiner for the 12th Judicial District, who sees the bodies of those who die from drug overdoses. "You can attack supply but probably better is to try to decrease demand."
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Rod Huff, a recently retired FBI agent focused on violent, organized crimes and drug trafficking in the Tampa Bay area, agrees cutting off demand is the better route. Shutting off the supply of drugs such as heroin is like plugging holes in a leaky, sinking boat: You might be able to successfully patch one hole at a time, but other drug traffickers will continue to flood the boat.
"You can make it difficult" for traffickers, Huff said. "Law enforcement has a pretty rational organization in it, that you target the top of the organization," Huff said. "But everybody is strapped. When resources are cut, priorities are set and we don't prosecute people that we should."
Lt. Darin Bankert of the Manatee County Sheriff's Office said it isn't enough just to shut off supply -- there needs to be more focus on decreasing demand.
"A lot of times it's like squeezing a balloon, and it's our job to combat the situation at hand. And right now that happens to be illicit narcotics, like heroin at the moment, and we do our best in interdicting whatever we're dealing with at the time," Bankert said. "As far as ongoing treatment, I think it's best to be addressed medically than from a law enforcement standpoint."
Decreasing demand comes from preventing people from becoming addicts in the first place through education and turning addicts into productive members of society through treatment.
Prevention is obviously preferable. Education is much less expensive than treatment, which varies greatly among addicts and doesn't have a high success rate.
'Another relapse, no recovery'
Angelina Dash, 32, a recovering opioid addict who has been clean for one year in Manatee County, went through inpatient treatment with 30 people for just more than a month at Manatee Glens. Only five people, she says, haven't had a relapse. That's a success rate of 16.7 percent.
One of those who didn't succeed -- Dash's best friend, whom she prefers not to name -- died of an overdose.
"I don't know what happened. I don't know why she felt that there was no way out," Dash said. "She wasn't honest in her recovery, and it cost her her life."
Dash said she experienced horrors during her five-year opioid addiction -- staying in a dope house without electricity for months, using sex to obtain drugs, being thrown to the ground and arrested by police -- and it all motivates her to stay clean. The stark reminder a relapse could kill her hangs over her head.
"She didn't have a chance to come back and say: 'This is where I messed up.' She was gone," Dash said. "Her family was very private, and there wasn't a funeral, there wasn't a viewing, there wasn't anything.
"I have another relapse in me, but I don't have another recovery."
Recovery, says Dash, is complicated, difficult and, at times, painful. The programs at Manatee Glens and in Manatee County's drug court helped her -- when she was ready to stop.
"If you're not ready inside yourself, you're not going to do it," Dash said. "You're just not."
No higher cost
Brandilyn Karnehm, another recovering opioid addict in Manatee County, agreed treatment didn't work until she was ready to quit. She gives other addicts looking to quit the same advice.
"Some people aren't ready to be saved. ... I can give them advice, but I know that I'm not responsible because I remember when I was in their position and I wasn't ready," Karnehm said. "They have to truly be ready themselves."
Melissa Larkin-Skinner, chief clinical officer at Manatee Glens, says they hear that a lot. One of the first issues they have to deal with in treatment is convincing addicts there is a better life, and they should want it. She tries to get them to remember the 8-year-old version of themselves, who grew up saying what they wanted to be when they were older such as a doctor, firefighter or a police officer.
"If people come here and they're saying they're not ready to quit, and they will say that, 'I want to keep using,' we know they don't, not really, not that person who was 8 years old," Larkin-Skinner said. "Our job is to make them see that there's hope, and to try to help them see that there is a way out, and to convince them that it's the drugs or alcohol talking, not really them."
Taking that time is necessary for each addict, but it gets expensive. Going through the recommended times for detoxification, inpatient and outpatient treatment at Manatee Glens costs about $12,779 in state funding per uninsured addict, according to Larkin-Skinner. Manatee Glens provided 1,151 treatments in 2014, and unfunded charity care amounted to $2.4 million. Manatee Glens offsets those costs by either taking money from positive margins in their hospital unit or absorbing them and making cuts.
The issue is killing people and leaving devastation in its wake throughout Manatee County, with suspected overdose deaths increasing from eight people in 2012, to 19 in 2013, to 63 in 2014, to 54 through mid-May 2015.
The resources to realistically fight drug traffickers, who don't have to deal with the same budget limits, continue to elude local, state and federal officials trying to cut off drug supply and demand.
"These are people used by these drug organizations for profit," said Huff, a retired FBI agent. "They literally profit from their misery. And they'll continue to profit from it if something doesn't change."
Kate Irby, Herald online/political reporter, can be reached at 941-745-7055 or at firstname.lastname@example.org. You can follow her on Twitter@KateIrby.