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West Palm Beach, Florida, has a moderate population, with about 103,588 people living in the metro area. The average age is nearly 40. More people are moving to the area every year, but they could bring an increase in substance abuse problems with them. There is one mental health specialist for every 183 residents, and one primary care specialist for every 79 residents. West Palm Beach, and the county it resides in, needs wider access to substance abuse treatment as the South Florida city experiences changes in drug imports, alcohol abuse, and more.
The National Survey on Drug Use and Health (NSDUH) considers Palm Beach County to be part of the Miami-Fort Lauderdale-Pompano Beach metropolitan area for survey purposes. Between 2005 and 2010, the NSDUH found these rates of substance abuse among people ages 12 and older:
Palm Beach Drug Problems
The county of Palm Beach, which is home to several cities, including West Palm Beach, has been hit especially hard by the heroin abuse and overdose epidemic that is ravaging Florida. In 2015, there were 779 overdose deaths from heroin abuse, 165 of which were in Palm Beach County. Of those, 158 were caused by heroin, although only 16 involved just heroin with no other drugs present. In 2016, West Palm Beach alone experienced 70 overdose deaths, according to the Sun-Sentinel; the county overall experienced one opioid overdose death every 15 hours, which was double the rate of fatal car crashes and murders.
With so many people struggling with heroin abuse, illicit fentanyl abuse has become one of the leading causes of opioid overdose in the country, including in Florida. Fentanyl is often mixed with heroin or sold in place of heroin, so people who struggle with heroin addiction may accidentally purchase this drug. This leads to numerous overdose deaths because fentanyl is more potent than heroin, so people accidentally ingesting fentanyl take too much.
Prescription Drug Abuse in Florida
In West Palm Beach in 2015 alone, there were 103 deaths involving fentanyl; 90 of those were caused by fentanyl specifically, nine of which were just fentanyl with no other drugs present. Police reports from 2016 in West Palm Beach show that the same sources illegally importing cocaine and pills in the 1980s and 1990s are now responsible for heroin and fentanyl; Mexico and South America bring in the majority of heroin and fentanyl, often mixing the two up. West Palm Beach officers report that after drugs are seized, they no longer test capsules believed to be opioids; this is because fentanyl residue was inhaled by two field officers who experienced overdoses and were rushed to the hospital.
Younger people tend to struggle with heroin and fentanyl abuse more compared to older adults:
Carfentanil, a drug commonly used as an elephant tranquilizer, is leading a surge of opioid overdose deaths in PBC in 2017. In one three-month span prior to February 2017, officials reported 87 overdose deaths involving this opioid, which is 10,000 times stronger than morphine and 100 times stronger than fentanyl.What Is Carfentanil?
Four out of five people in the state who struggle with heroin addiction began by abusing prescription painkillers, like oxycodone, hydrocodone, or morphine. Overdose deaths from these drugs are high in West Palm Beach. In 2015, medical examiners found:
Many prescription painkiller deaths involve older adults. Of the 47 overdose deaths in West Palm Beach caused by oxycodone, none were under 18 years old while 16 were between ages 35 and 50, and 17 were people over the age of 50. The same was true of hydrocodone: Of the 16 deaths caused by a hydrocodone overdose, none occurred in people younger than 35; four people were between the ages of 25 and 50; and the other 12 were in individuals over 50 years old.
Heroin & Prescription Opioid Overdose
West Palm Beach also experienced shockingly high rates of morphine-related overdose deaths:
Of the 48 morphine overdose deaths, 21 were people 50 years old or older, and 18 were between the ages of 35 and 50.
Methadone is also abused in West Palm Beach, and it led to 15 overdose deaths in 2015; 13 of those were caused by methadone, and one involved just methadone with no other drugs present. This suggests that people who struggle with methadone abuse are likely to be polydrug abusers. Because methadone is being prescribed to low-income individuals to ease pain, many people who overdosed on methadone were older adults; five of the 15 who died were over the age of 50, and six were between 35 and 50 years old.
Benzodiazepine abuse and addiction have been called a shadow epidemic. These drugs are widely misused for nonmedical reasons, but more often in combination with other drugs than alone. Still, reports from medical examiners on overdose deaths in West Palm Beach have found that benzodiazepines play a large role in overdoses and poisoning deaths by themselves too. Between January and December 2015, deaths in West Palm Beach involving benzodiazepines included:
A September 2012 community health assessment for Palm Beach County found that one-fifth of adults in Palm Beach County engaged in binge drinking or heavy drinking. Florida’s rates as a whole were 19.8 percent while PBC had slightly higher rates at 20.1 percent. About 9.8 percent of those individuals were female.
Although alcohol consumption patterns are a problem in the county, alcohol-related traffic accidents are decreasing. Between 2008 and 2009, according to a different community health survey, Florida saw a statewide decrease of 23.8 percent in roadway traffic crashes caused by alcohol; Palm Beach County was found to have a lower traffic death rate compared to the state overall. Current PBC measures suggest that 17.6 percent of the population drinks excessively, and 30.3 percent of driving deaths involve alcohol.
Cocaine is a surprisingly large problem in southern Florida, especially compared to the rest of the country. NSDUH data estimates that there were about 19,507 people over the age of 12 struggling with some kind of cocaine abuse in PBC. While the state as a whole experienced a 10 percent increase in cocaine-related overdose deaths between 2012 and 2014, Palm Beach County experienced an astonishing 53 percent increase.
Medical examiners found, in 2015, that there were 173 overdose deaths involving cocaine, with 109 of those deaths being caused by cocaine. However, 157 of the overdoses involved other drugs, indicating that cocaine is one drug common in polydrug abuse. Most people who died from a cocaine overdose were between 35 and 50, although several were also 26-34 as well as over the age of 50.
Overdoses involving cocaine have gone up in the past several years, though between 2001 and 2015, the peak years of cocaine overdose occurred in 2004 and 2005. Still, after dropping to a low of 87 in 2012, more people in West Palm Beach have been overdosing on cocaine or a combination of several drugs.
In 2014, Palm Beach County treatment facilities found that 184 people entered programs to overcome addictions to crack cocaine while 111 entered due to problems with powdered cocaine. These admissions represented about 5 percent of the overall treatment admissions that year.
The 2016 Florida Youth Substance Abuse Survey (FYSAS) lists percentages of self-reported substance abuse among teenagers in the state, ages 12-17. Like the Monitoring the Future (MTF) survey, nationally, FYSAS examines middle and high school grade levels. Palm Beach County had 1,847 students in grades 6-12 who participated in the survey.
In Palm Beach County, middle school students ranked Level 3 for past-30-day alcohol consumption, with 9.2 percent of those students reported consuming alcohol in the past month and 3.3 percent reporting at least one episode of binge drinking. High school students in PBC hit Level 4: 27 percent reported consuming alcohol in the month before the survey, with 9.8 percent reporting an episode of binge drinking. Palm Beach County high schoolers were some of the least likely to ride with a driver who had been drinking, with 15 percent of students reporting this activity in the past month. These students were also among the least likely to drive after drinking, with 4 percent across the southern Florida county reporting this activity in the past month.
Cigarette smoking among adolescents and young adults has been declining nationally, and Palm Beach County is no exception: Middle schoolers were in Level 2, with a reported 1 percent of students smoking cigarettes; high school students were in Level 1, with 3.8 percent reporting smoking in the past month. Vaporizer product use, however, was higher, as e-cigarettes and marijuana vaporizers are very popular. Palm Beach County’s middle and high school students both ranked in Level 3 for vaporizer use, with 5 percent of middle schoolers using these items and 13.2 percent of high schoolers using them in the past month.
One of the few drugs more popular than ever among adolescents in the US is marijuana. The 2016 MTF found a steep decline in marijuana abuse among middle school students in particular, but high school students appear to abuse this drug at high rates. Thirty-six percent of 12thgraders across the US have ever abused marijuana ever, and about one in every 17 senior high school students uses marijuana every day.
Palm Beach County reflects this general trend in the US. The 2014 NSDUH estimates that, of 59,321 people struggling with marijuana use, ages 12 and older, 58 percent are younger than 18 years old. About 2.4 percent of middle school students reported past-month use of marijuana while 15.4 percent of high school students used marijuana in the past month.
Among risky marijuana-related behaviors, though, Palm Beach County high schoolers were more likely to get in a car with a driver who had been abusing marijuana than alcohol: 19.1 percent of students reported this potentially dangerous behavior. In addition, 8.7 percent of high school students reported driving themselves after abusing marijuana.
Palm Beach County’s middle school students had average rates for abusing other illicit drugs, but this still indicates a potential problem among those young adolescents. In that county, 1.2 percent reported prescription painkiller abuse, and 1.2 percent also reported abusing other depressant drugs; and 1.9 percent reported abusing over-the-counter drugs. Those percentages did not change much among high school students, indicating a potential lifetime substance abuse risk among some children: 1.3 percent reported prescription painkiller abuse, and 1.3 percent also reported abusing other depressants. In addition, 1.7 percent reported abusing over-the-counter drugs.
The Mental Health Substance Abuse Commission Report of the States (MHSAC) found that the state of Florida meets only about 19 percent of treatment needs among those struggling with substance abuse or addiction. In Palm Beach County, 2015’s treatment admissions:
Like much of the Sunshine State, Palm Beach County’s focus is on law enforcement rather than treatment. For example, a person can face jail time and have their driver’s license revoked for two years for possession of one joint; however, entering the county’s drug court system for treatment can reduce or eliminate these penalties.
DOH can help with access to treatment providers, including free, low-cost, or state-funded options. One treatment provider is the Substance Abuse and Mental Health (SAMH) program, managed by the Florida Department of Children and Families (DCF). SAMH provides credentials to various treatment programs, and DCF also offers a residential option itself. DCF also manages a comprehensive list of treatment providers across the state of Florida; the 89-page document is categorized by city in alphabetical order, and West Palm Beach’s great services can be found starting on page 82.
The Mental Health Association (MHA) of Palm Beach County keeps a list of resources on their website, with mental health crisis lines, treatment facilities, and hospitals. These may be good options for people who struggle with co-occurring substance abuse and mental illness.
Those who are charged with, or convicted of, either felony or misdemeanor drug crimes may enter Florida’s drug crimes court – the state invented Drug Court in the 1980s – as long as the charges are nonviolent and do not include trafficking or selling drugs. Palm Beach County has a drug court that works with citizen-defendants on intensive rehabilitation for at least one year, with the potential to extend the program’s timeline if the defendant experiences problems along the way. While this program works through the criminal justice system and is considered punishment for offenders, it is a way for people who may not have access to these resources, or who are ambivalent about entering treatment, to get the help they need to overcome addiction.
The Drug Abuse Foundation of Palm Beach County (DAFPBC) is a nonprofit resource that helps people get all kinds of drug addiction treatment – from science-based prevention programs to withdrawal management services to both inpatient and outpatient rehabilitation programs.
The Palm Beach County Sheriff’s Office provides prevention support, including education classes on Good Samaritan laws in the county and state. This helps people understand that reporting an overdose is not a crime in order to reduce the risk of overdose deaths. The West Palm Beach Police Department has also hosted a series of extremely popular opioid epidemic workshops.
Of course, the Substance Abuse and Mental Health Services Administration (SAMHSA) has a thorough Behavioral Health Treatment Services Locator, which can locate resources for medication-assisted detox, inpatient and outpatient rehabilitation, and much more. Psychology Today also has in-depth listings for West Palm Beach, Florida treatment options.