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Closure of Faulkner detox unit opposed

Kitty Dukakis says addicts need its help

Kitty Dukakis asked the Partners chief executive for ways to keep the detox unit open.

Globe File Photo

Kitty Dukakis asked the Partners chief executive for ways to keep the detox unit open.

Kitty Dukakis, the state’s former first lady who has spoken openly about her struggles with addiction and depression, has joined a grass-roots effort to stop Partners HealthCare from closing a 15-bed drug and alcohol detoxification unit at its Brigham and Women’s Faulkner Hospital in Boston.

Many staff members and former patients say they are devastated by news that the unit that last year treated some 1,000 hospitalized patients is slated to close in mid-April, especially when they say the state has a shortage of inpatient detox beds.

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The Faulkner unit, in existence for nearly three decades, has a particularly loyal following of successful “graduates” who maintain a deep affection for the place they call “7S” — the seventh-floor, south side unit where they launched their recovery.

Hospital officials acknowledge they plan to close the unit as it now exists, but say they are restructuring their addiction work, shifting to a smaller number of inpatient detox beds on medical floors and enhancing outpatient services — and they hope to end up serving more addicts and alcoholics.

Though Faulkner had asked that a public hearing on the closure be waived, the state Department of Public Health last week scheduled a hearing for Feb. 15. Agency spokeswoman Anne Roach said via e-mail that state officials would work with Faulkner “to ensure that any plan includes the appropriate continuity of care for patients in the area.”

State officials said there are 881 adult hospital detox beds in Massachusetts, of which about 140 — including the 15 at Faulkner — are considered high-level beds that serve addicts with more serious medical conditions.

Dukakis placed a call last week to Dr. Gary Gottlieb, Partners chief executive, asking for ways to keep open the detox unit. She said one of her close relatives who battled addiction credits the Faulkner service with turning around her life.

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“We want to see if we can change their minds,” Dukakis said in a telephone interview from Los Angeles, where she and her husband, former governor Michael Dukakis, are spending the winter.

In an interview with the Globe, Gottlieb did not answer when asked whether he would reconsider the decision to close the unit. He insisted that the closure of Faulkner’s standalone inpatient detox unit does not in any way suggest that Partners is turning its back on substance-abuse patients.

He said about five of the current 15 detox beds will blend into the regular medical unit, enabling the hospital to offer those patients who have complex medical issues enhanced monitoring services. Other patients now seen in the unit — who typically suffer from opiate addiction — will be treated in a newly created outpatient service and offered treatment with Suboxone, a drug that helps reduce opiate cravings so patients can go through detox in their homes. These changes, he said, show Partners is not shutting down a unit, but “we’re transforming the addiction unit.”

“I’m passionate about delivering these services,” Gottlieb said.

Though other local hospitals have cited low insurance reimbursement rates to justify closing their inpatient detox units, Gottlieb said Faulkner’s changes were not “a financial issue.”

Ed Liston-Kraft, vice president of clinical and professional services at Faulkner, said the hospital has yet to decide if any of the unit’s employees — roughly 12 full-time-equivalent positions — will need to be laid off.

The proposed closure comes at a time when many advocates for substance-abuse treatment say there are not enough detox beds, despite improvements in recent years in restoring state cuts for such services.

“Access is tight,” said David Matteodo, executive director of the Massachusetts Association of Behavioral Health Systems, which represents inpatient mental health and substance abuse hospitals. “It’s not like there are all sorts of empty beds.”

Victor DiGravio, president of the Association for Behavioral Health Care, which represents community-based mental health and substance abuse organizations including outpatient providers, praised the creation of the Suboxone unit at Faulkner, though he acknowledged there is much “unmet need” in terms of detox beds.

Some of the unit’s mental health counselors, who asked to remain anonymous for fear of losing their jobs, said the standalone feature of the unit is essential to its success, because addicts, who often feel judged, need the support of others like them. Integrating these patients on the medical floor, they said, will deprive them of a separate space to be among staff and patients who know their struggles.

A 78-year-old Dorchester grandmother of four said she entered the Faulkner unit on the day after Christmas in 1986, when she decided she had to stop drinking up to a dozen beers a day. The woman, who asked not to be identified to protect her privacy, said she dreaded entering a hospital where she believed people would see her as “morally” weak.

Instead, she said, she found clinicians who told her for the first time she had a disease. She said she has been sober since, though not without the help of a gathering of Faulkner “graduates” every Sunday and her thrice-weekly Alcoholics Anonymous meetings in Milton.

Patricia Wen can be reached at wen@globe.com.
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