Lack of ID a hur­dle to home­less ad­dicts

Ex­perts call for waiv­ing treat­ment rule

Northwest Arkansas Democrat-Gazette - - NATIONAL - AN­THONY IZAGUIRRE

PHILADEL­PHIA — As the na­tion’s heroin and painkiller epi­demic rages, small but vul­ner­a­ble pop­u­la­tions of home­less peo­ple are some­times turned away from the na­tion’s sys­tem of drug treat­ment cen­ters be­cause they do not have valid photo iden­ti­fi­ca­tion.

Steven Kemp, af­ter nearly two decades of us­ing heroin and a year of liv­ing on the streets of Philadel­phia, de­cided on a re­cent Fri­day night that it was time to get sober. But when he stag­gered into a detox fa­cil­ity, he was told he couldn’t be ad­mit­ted be­cause he didn’t have a photo ID.

“If some­body goes in and says, ‘I need help,’ they should get it,” said Kemp, 35. “I un­der­stand peo­ple have to get paid, but you’re sup­posed to be a health pro­fes­sional, you took an oath.”

Tran­sient life­styles are not con­ducive to keep­ing the iden­ti­fy­ing doc­u­ments that are of­ten nec­es­sary dur­ing the screen­ing pro­cesses for drug treat­ment fa­cil­i­ties. To reap­ply for the doc­u­ments can some­times take months, es­pe­cially if a per­son doesn’t have a sta­ble ad­dress, birth cer­tifi­cate or So­cial Se­cu­rity card.

The con­se­quences can of­ten be deadly or dan­ger­ous, ex­perts said.

“It’s Rus­sian roulette ev­ery time you in­ject. We let them die from a treat­able dis­ease be­cause they don’t have an ID,” said Dr. Corey Waller, chair­man of the leg­isla­tive ad­vo­cacy com­mit­tee of the Amer­i­can So­ci­ety of Ad­dic­tion Medicine, a group that rep­re­sents ad­dic­tion spe­cial­ists.

Even with po­lit­i­cal will high to fight an opi­oid epi­demic that killed more than 30,000 peo­ple in 2015, less than one in 10 of the coun­try’s sub­stance abuse treat­ment fa­cil­i­ties of­fer cer­ti­fied opi­oid treat­ment pro­grams, ac­cord­ing to data col­lected last year by the fed­eral Sub­stance Abuse and Men­tal Health Ser­vices Ad­min­is­tra­tion.

Peo­ple with­out IDs gen­er­ally don’t make it past the in­take process at med­i­cal fa­cil­i­ties, so tal­lies of their re­fusals are hard to come by, but ad­vo­cates said it hap­pens at least twice a day in Philadel­phia alone.

Ex­perts said they’ve never seen a con­sol­i­dated statis­tic on how fre­quently it hap­pens na­tion­wide, but the ID bar­rier to treat­ment is well known; a 2010 Bal­ti­more study rec­om­mended that fa­cil­i­ties waive the re­quire­ment.

“Ev­ery time we de­lay some­one from get­ting into treat­ment, it puts them at risk for their life,” said Jose Ben­itez, ex­ec­u­tive direc­tor of the non­profit Preven­tion Point Philadel­phia.

The ID re­quire­ments at drug treat­ment fa­cil­i­ties are in­tended to pre­vent peo­ple from en­rolling in mul­ti­ple pro­grams and sell­ing opi­oid med­i­ca­tion such as methadone on the black mar­ket, said a spokesman from the fed­eral ad­min­is­tra­tion , adding that pro­grams would be li­able for mis­use of the med­i­ca­tions.

Some detox cen­ters will ad­mit a per­son with­out ID first and make time later to sort out the per­son’s iden­tity, but do­ing so comes at risk of run­ning afoul of fed­eral and state reg­u­la­tions on dis­pens­ing med­i­ca­tions, ex­perts said.

And some­times med­i­cal fa­cil­i­ties er­ro­neously turn peo­ple away from ad­dic­tion ser­vices even when they have al­ter­nate forms of ID that are sup­posed to guar­an­tee ad­mis­sion to a pro­gram, said Roland Lamb, deputy com­mis­sioner of the Philadel­phia Depart­ment of Be­hav­ioral Health and In­tel­lec­tual Dis­abil­ity Ser­vice.

In Penn­syl­va­nia, state law re­quires fa­cil­i­ties that dis­pense med­i­ca­tions to ac­cept al­ter­na­tive photo iden­ti­fi­ca­tion cards, such as ones is­sued by schools or by other nar­cotic treat­ment pro­grams. But af­ter some med­i­cal cen­ters were er­ro­neously deny­ing peo­ple who used what were sup­posed to be ad­e­quate forms of iden­ti­fi­ca­tion, of­fi­cials sent a let­ter to the fa­cil­i­ties in May ask­ing them to make sure their em­ploy­ees were aware of the ac­cept­able ad­mis­sions doc­u­ments.

“It’s more im­por­tant for us to get peo­ple into the sys­tem than to keep them out,” said Lamb, who wrote the let­ter.

So­cial ser­vices for tran­sient peo­ple have al­ways been sub­stan­dard, but the na­tional opi­oid epi­demic has made bare the lack of ad­dic­tion treat­ment ser­vices for home­less Amer­i­cans, said Dr. Robert Schwartz, med­i­cal direc­tor of the ad­dic­tion-study­ing Friends Re­search In­sti­tute in Bal­ti­more.

“It’s hard enough for peo­ple to seek treat­ment when they’re us­ing drugs, and so if they’re be­ing thwarted it is frus­trat­ing,” he said. “This seems like a bar­rier that could be sur­mounted.”


Steven Kemp, a home­less heroin ad­dict, says he re­cently was de­nied care at a detox­i­fi­ca­tion cen­ter in Philadel­phia be­cause he didn’t have iden­ti­fi­ca­tion.

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