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Copyright © 2016 Albuquerque Journal
Daniel Garcia had two options after a probation officer learned in January that he was using methamphetamine: He could enter the adolescent drug treatment unit at Turquoise Lodge Hospital, or he could return to jail.
“I’m just happy that Turquoise accepted me, because I got a second chance at life, pretty much,” said Garcia, 18, who today lives in a residential drug treatment program for juveniles and attends an Albuquerque high school.
Garcia was among the last New Mexico youths treated at Turquoise Lodge, which closed its 20-bed adolescent unit this month.
The state Department of Health, which operates the hospital, said the adolescent wing was “underutilized,” with an average census of five youths in fiscal year 2016, which ended June 30.
Turquoise Lodge will use the space to expand services for adult addicts, for which there is a waiting list.
The closure has angered advocates for teenage addicts, who say that Turquoise Lodge provided the state’s only inpatient medical detoxification treatment center for youths ages 14 to 18.
Medical help needed
“Most people don’t withstand the withdrawal and the detox phase; therefore, they go out and relapse,” said Jeffrey Holland, executive director of Endorphin Power Co., a nonprofit that provides housing and other services for recovering addicts.
Teenagers in particular are unlikely to stick out the agony of withdrawal without the help of medical detoxification, which can alleviate withdrawal symptoms with a variety of medications, and under medical supervision, Holland said.
“Imagine a 15- or 16-year-old kid feeling like he’s going to die,” he said. “With kids, you have to exploit the opportunity at that moment.”
Advocates for teenage addicts say the Aug. 7 closure of the hospital’s adolescent wing has left them scrambling for medical detoxification services for youths.
The New Mexico Department of Health operates no other inpatient detoxification centers for adolescents. Nor is the agency aware of any other New Mexico facilities that offer services comparable to the now-closed Turquoise Lodge adolescent unit.
“We are not aware at this time of any other facilities that offer inpatient detox services in a facility setting like (Turquoise Lodge),” said Kenny Vigil, spokesman for the Department of Health.
The Turquoise Lodge adolescent unit played a unique role in that it was intended to help youths through the difficult first days of withdrawal from addictive drugs.
Five days of sobriety
Long-term residential addiction treatment programs for teenagers are not licensed to offer medical detoxification and can’t accept addicts until they have achieved at least five days of sobriety, said Jennifer Weiss-Burke, executive director of Serenity Mesa Youth Recovery Center in Albuquerque.
Treatment at Turquoise Lodge was a required first step that allowed Garcia to begin long-term treatment at Serenity Mesa, she said.
Turquoise Lodge provided detox services for eight of the 32 youths who have lived at Serenity Mesa since it opened in May 2015.
The unit’s closure means that teenagers must either detox on their own, which often ends in failure, or pay for private detox services, which typically cost $3,000 to $5,000 for a week, Weiss-Burke said. And those services for adolescents are all out of state.
Medicaid does not pay for inpatient detox treatment, and private insurance coverage is spotty, she said.
“Not very many people have that kind of money, especially if you don’t have family support, or your family is part of the problem,” Weiss-Burke said.
Garcia was among six youths in the adolescent wing when he began his 30-day medical detox treatment Feb. 8. Today, he lives at Serenity Mesa Youth Recovery Center and is enrolled at Robert F. Kennedy High Charter School with plans to graduate in December.
“If it closed, there are a lot of kids who wouldn’t get what I got,” Garcia said just days before Turquoise Lodge’s scheduled closure last Sunday.
Garcia’s only other option had been to detox in jail, “and that’s not the best place to detox,” he said.
‘Alternative for kids’
Turquoise Lodge Hospital opened decades ago as a detoxification hospital for adults. The existing 40-bed adult hospital moved to its current location at 5901 Zuni SE in 2007. The state-funded hospital had a 2016 budget of about $5.2 million for both the adult and adolescent wings.
The state opened the adolescent unit in June 2013 to provide access to inpatient services previously unavailable for teenagers in New Mexico, officials said at the time. Gov. Susana Martinez said at a ribbon cutting that month that the program “has the potential to be a model for teen drug treatment across the country.”
Dr. Miriam Komaromy, a former medical director at Turquoise Lodge, helped persuade lawmakers to fund the adolescent unit. The need for the center was clear, she said.
“We have a horrific opioid overdose rate in our state,” said Komaromy, who stepped down from the post in 2013, shortly before the adolescent unit opened.
New Mexico has the second-highest overdose death rate in the U.S. West Virginia’s death rate is higher.
A 2015 survey of high school students found that New Mexico youths report some of the nation’s highest rates of drug use across a broad range of illegal substances. The Youth Risk Behavior Survey of U.S. high school students in grades 9-12 found that New Mexico students reported the second-highest rates of cocaine and ecstasy use, fifth-highest for methamphetamine and eighth-highest for heroin.
Affluent parents of addicted teens “send their kids to Arizona, Minnesota, states that have inpatient programs to help them stabilize,” Komaromy said. “We wanted to open that unit at Turquoise to have an in-state alternative for kids who are at risk of dying.”
Gov. backed closure
Martinez said last month that she supports the Department of Health’s decision to close the unit, because too few adolescents used the facility, while services are lacking for adult addicts.
The adolescent population at Turquoise Lodge peaked at an average of 7.9 youths per day in 2014, declining to five per day in 2015, according to figures provided by the Department of Health.
Juveniles often decided a few days into treatment that they did not want to remain at Turquoise Lodge, Vigil said.
“Closing this unit was a difficult decision,” Vigil said in a written statement. “But as we’ve said before, there is a growing need to treat adults, and this will help us in those efforts and help clear the waiting list.”
Wait times range from one to three weeks for adults who want treatment at Turquoise Lodge, Vigil said. The adult unit operates at capacity, and closing the adolescent unit will allow Turquoise Lodge to increase the number of adult beds from 40 to 60, he said.
Sen. Gerald Ortiz y Pino, D-Albuquerque, and others contend that the state didn’t do enough to market the adolescent unit.
“My impression is that after (state officials) had their press conference, they didn’t do a darned thing to make sure it had a wide base of referral sources in the community that would utilize it,” Ortiz y Pino said.
Vigil responded that the main referral source for the adolescent unit was the New Mexico Children, Youth and Families Department, which oversees juvenile parole officers across the state.
The adolescent unit at Turquoise Lodge received 198 referrals in fiscal year 2016, Vigil said.
Of those, 121 referrals, or 61 percent, came from CYFD. Another 18 percent were referred by family members or friends, and 11 percent were self-referrals. The remaining 10 percent were made by hospitals, schools and the Behavioral Health Services division of the state Human Services Department.
In some cases, teenagers referred to Turquoise Lodge chose not to seek treatment in the voluntary program, he said.