Delaware needs more addiction treatment.
It's the resounding message from advocates, state officials, health workers and experts who have studied, lived in and worked in Delaware communities, every one of which hasbeen impacted by the opioid epidemic.
From grandparents in Sussex County who were overprescribed pain pills post-surgery to suburban kids in their 20s to adults fighting their cravings on Dover's streets, no neighborhood, no ethnic group has been spared.
Statewide overdose data from 2018 show at least one zip code in each county with fatality rates at least 1½ times higher than the state average.
But where do you put drug treatment centers when no community wants onein their backyard?
As the state has attempted to open more treatment facilities and expand access to treatment by placing facilities in communities directly impacted by overdoses, the outcry from residents has turned into full blown screaming matches at meetings.
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Fears of murderers and sex offenders living in their neighborhoods drown out the conversations about helping neighbors suffering from addiction.
"We're here because the state is undergoing a crisis," said Dr. Kara Odom Walker, secretary of the Delaware Department of Health and Social Services at a community meeting last week. "We're trying to figure out how to address this issue. ... It is everywhere in our state."
'Stereotypical fears or prejudices'
The latest facility to become a lightning rod is The Refuge, a residential treatment home near Red Lion where people in recovery receive transitional housing andaccess to treatment where they live.
The home opened earlier this year unbeknownst to nearby residents. State law, along with protections from the Fair Housing Act, do not require a treatment provider to notify residents of an opening, though a publicized press conference and ribbon-cutting were held at the home in February.
It was only when activity around the property increased, specifically the regular sighting of a Department of Correction van dropping off men from the Plummer Community Corrections Center for vocational training, that neighbors began asking questions.
Why were neighboring constituents neither consulted nor informed of the decision to operate The Refuge? How and why was this location selected? Does the operation of The Refuge at this location comply with all applicable federal, state and county codes and regulations?
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These are just three of at least 12 questions formally posed by neighbors.
"It's about the lack of information," said Peter Scarmozzi, who lives next door to The Refuge. "The explaining should have been done months ago."
This isn't the first property to come under fire, nor will it be the last in a state still actively battling the stigma that comes with drug addiction.
Many sober living facilities open as quietly as possible for this very reason, not wanting to draw added attention to residents who are often fresh out of detox and looking to get back on their feet.
The Fair Housing Act protects people recovering from addiction, as they are deemed to have a disability; any notification outside what a community would typically require is considereda discriminatory practice.
"In the same way a local government would violate the law if it rejected low-income housing in a community because of neighbors' fears that such housing would be occupied by racial minorities, a local government violates the law if it blocks a group home ... because of neighbors' stereotypical fears or prejudices about persons with disabilities," according to a joint statement fromthe U.S. Department of Housing and Urban Development and the U.S. Department of Justice.
Brandywine Counseling and Community Services, which has long called Lancaster Avenue outside of Wilmington its home, continues to feel the heat of the local community that desperately wants the outpatient treatment center to relocate.
Responsible for treating about 600people a day, the center says it is exactly where it needs to be to best serve its clients, many of whom live nearby orrely on public transportation to reach its doors.
About 55 percent of Brandywine'sclients at this location are from the 19805 zip code (where the clinic is located) or adjacent zip codes, according to the organization's data.
Brandywine Counseling has also faced backlash in attempts to expand services intoSouthbridge, where about 200of its 1,000 clients served at the Lancaster Avenue location reside.
"When you look at the statistics per capita, there’s a need for this service and a need for it here," said Brandywine Counseling CEO Lynn Fahey Morrison."Moving it puts it out of reach for folks, which means less people will be in treatment, and more people will be out there trying to manage their addiction on their own without a lot of financial means to do so."
'Way too heated too fast'
More than 200 people packed Wilbur Elementary School last week hoping to get answers about how a residential treatment home popped up in their neighborhood.
The room was hot as the air conditioning had been turned off for the day. Officials struggled to get the microphone working, making it even harder for them to be heard over shouting attendees.
By the end, most in the disgruntled community in attendance felt their questions weren't answered– at least, not with answers they wanted to hear.
"I didn't think it would go this way," Scarmozzi said. "It got way too heated too fast."
State officials were less than five minutes into their presentationwhen shouts erupted, demanding to know why a drug treatment facility was allowed to openin a community where children ride their bikes and play outside.
Residents claimed the value of their properties had already deteriorated, and that the noise coming from machinery on the property was a nuisance.
New Castle County inspectors did deem that the facility was in violation of county code by operating heavy construction machinery on the property. That aspect of vocational training– aimed at giving men construction skills– has been suspended at the facility, according to county records and state officials.
But most importantly, residents wanted to know why they weren't informed that people with substance use disorders were moving into their neighborhood, regardless of the law.
Communities and state officials sometimes clash when it comes to dealing with quality of life issues in their neighborhoods.
Why should certain neighborhoods bear the burden of an addiction epidemic? And what happens when it affects their children or the value of their homes?
Residents from neighborhoods near Brandywine Counseling have complained to officials for years about loitering, drug dealing and prostitution that they say are being driven by treatment clients, or criminals seeking to prey on clients.
“Loitering is a big problem,” said Jim Miller, a 10-year resident of Wilmington's Union Park Gardens neighborhood and a former candidate for state representative. Miller said while knocking on doors in the district, he heard numerous complaints about the clinic.
“I spoke to families that said we don’t want the kids to play in the park because the kids brought back a hypodermic needle,” Miller said. “It wasn’t this way three to four years ago."
Truth or fiction?
Some residents in Delaware suburbssay they moved away from cities like Wilmington to avoid having services like these near their homes. In some cases, city officials have made direct efforts to move these social services outside city limits to ease the burden officials say they place on communities.
Others say services shouldn't be allowed anywhere near neighborhoods, seeking to locate them in industrial parks along public transportation lines far from homes.
"I don’t oppose effective drug abuse treatment programs or effective prison re-entry programs," wrote Brad Siegfried, a resident who started a website in opposition to The Refuge. "I do oppose the ill-considered decision to place a drug abuse treatment program and a prison re-entry program (here)."
A studyby the National Bureau of Economic Researchfound that substance usetreatment facilities do not reduce property values over the long term and claims that neighborhoods see a large drop "are potentially overstated."
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Researchers found no statistically significant evidence to prove property values decrease, and actually found that these treatment centers can make communities safer, which can drive upproperty values.
Property values are far more affected negatively by airportor train noise, nuclear waste sites, wildfires and criminal activity, according to the report.
Local police also say they don't see a rise in criminal activity around these properties.
For state officials and those treating addiction across the state, the larger concern is placing people who are attempting to recover from addiction in a location where they can reintegrate into society.
That means they have to be in areas where there are people to interact with, jobs to acquire, and transportation to get there, said Elizabeth Romero, director of the state Division of Substance Abuse and Mental Health.
"If we can't work together to do this, then we're going to have a stigma issue that we will not be able to meet anybody's needs," she said.
What's next?
Though the state has tried many times, the image of what a person recovering from drug addiction looks like has long plagued advocates and those trying to add resources.
What's lost in this conversation is just how personal this epidemic has become to nearly everyone in the state.
Four hundredpeople died in Delaware from drug-related overdoses last year, a dismal state record that has officials nervous about what total loomsthis year.
An estimated 11,000 people struggle with opioid use,the majority of whom aren't receiving treatment for it, according a 2017 report commissioned by then-Attorney General Matt Denn.
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While the state is attempting to lower fatal drug overdoses, the number of people surviving– and then potentially connecting with treatment options– is on the rise, Romero said.
Brandywine Counseling reported a 5 to 10 percent annual increase in clients accessing their treatment options over the last five years, signaling the growing need for more addiction treatment here.
"We need more places that can provide that help," Romero said, noting that only two providers stepped forward last year when the state put out a request for proposals to fill the gap of "integrated treatment" like that offered at The Refuge.
"If people are afraid that they're going to be judged or screamed at, then you're going to get less people accessing that (treatment)," Romero said.
It is all a good reminder to state officials that more trust-building is needed.
Communication up front coupled with quality treatment outcomes can make a huge difference, said Lt. Gov. Bethany Hall-Long, who heads the Behavioral Health Consortium.
The group, through a more focused committee, wages campaigns to reduce stigma. The main goal is humanizing the brain disease of addiction and the co-occurring mental health issues that often prompt addictive behaviors.
State officials agree that putting a face to a name and reminding residents that they likely know someone who has been impacted by addiction will help make people more understanding of what people are fighting.
But proving to communities that treatment is effective and working often has the greatest success, Hall-Long said.
"Ascommunities get information, its been my experience ... that if you have quality service,quality treatment,a lot of the concerns never happen," she said. "I've hadsome of the biggest critics within these neighborhoods be the biggest supportersby the end."
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Reporter Jeanne Kuang contributed to this story.
Contact Brittany Horn at (302) 324-2771 or bhorn@delawareonline.com. Follow her on Twitter at @brittanyhorn.
