For homeless on heroin, treatment can be elusive with no ID

August 4, 2017 by Anthony Izaguirre
In this Monday, July 24, 2017 photo, Steven Kemp, who is addicted to heroin and is homeless, speaks with The Associated Press after meeting with a Philly Restart representative for help to obtain an identification card in Philadelphia. As an opioid epidemic ravages the nation, small but vulnerable populations of homeless people who are seeking respite from their addictions are sometimes turned away from the country's already threadbare system of drug treatment centers because they do not have valid photo identification (AP Photo/Matt Rourke)

Nearly two decades of using heroin and a year of living on the streets of Philadelphia had led Steven Kemp to a simple conclusion: It was time to get sober. But when he staggered into a detox facility on a recent Friday night, his head brimming with the thought that suicide would end the pain, he was told he couldn't be admitted because he didn't have a photo ID.

Kemp said he was turned away from the hospital and spent the night stealing enough small items to trade for a handful of Xanax. He swallowed the pills, cooked up some heroin and injected the drug into his arm with the intention of killing himself.

"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."

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

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.

In this Monday, July 24, 2017 photo, Steven Kemp, second left, who is addicted to heroin and is homeless, waits in line for help from a Philly Restart representative to obtain an identification card in Philadelphia. Many homeless people addicted to heroin are being turned away from drug treatment centers because they don't have photo identification. The numbers are difficult to quantify. But advocates say they encounter homeless people every day who are seeking treatment but are mired in the monthslong process of getting an ID. (AP Photo/Matt Rourke)

"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 at a high to combat 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 statistics 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 facilities waive the requirement.

In this Monday, July 24, 2017 photo, Steven Kemp, who is addicted to heroin and is homeless, waits in line for help from a Philly Restart representative to obtain an identification card in Philadelphia, Monday, July 24, 2017. As an opioid epidemic ravages the nation, small but vulnerable populations of homeless people who are seeking respite from their addictions are sometimes turned away from the country's already threadbare system of drug treatment centers because they do not have valid photo identification (AP Photo/Matt Rourke)

"Every time we delay someone from getting into treatment, it puts them at risk for their life," said Jose Benitez, the 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 Substance Abuse and Mental Health Services 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 this Monday, July 24, 2017 photo, Adam Bruckner with Philly Restart, left, helps Steven Kemp, who is addicted to heroin and is homeless to obtain an identification card in Philadelphia. Many homeless people addicted to heroin are being turned away from drug treatment centers because they don't have photo identification. The numbers are difficult to quantify. But advocates say they encounter homeless people every day who are seeking treatment but are mired in the monthslong process of getting an ID. (AP Photo/Matt Rourke)

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 for bringing 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."

In this Monday, July 24, 2017 photo, Adam Bruckner with Philly Restart, left, helps people, including those addicted to heroine and who are homeless to obtain an identification card in Philadelphia, Monday, July 24, 2017. Many homeless people addicted to heroin are being turned away from drug treatment centers because they don't have photo identification. The numbers are difficult to quantify. But advocates say they encounter homeless people every day who are seeking treatment but are mired in the monthslong process of getting an ID. (AP Photo/Matt Rourke)

Not yet three full days after his suicide attempt, Kemp stood in a park in central Philadelphia in the shadows of new high-rise apartments. Pinhead-size scars and bruises with small scabs at their centers dotted his forearms. He said he just wants to "feel normal."

"There's just like a helplessness, a hopelessness," he said. "I know this is my fault; I've grow aware of the consequences of my actions. I don't want to do it anymore."

Explore further: Opioid abuse down in younger americans, but up among older adults

Related Stories

Opioid abuse down in younger americans, but up among older adults

July 26, 2017
(HealthDay)—While opioid abuse has fallen among younger Americans, the same cannot be said for older adults, a new government report shows.

More access to opioid treatment programs needed in Southeast, says study

March 30, 2017
In 2015, more than 30,000 Americans died from overdosing on opioids, and a new study led by the University of Georgia shows that one of the hardest hit populations-low-income Americans on Medicaid-isn't getting the help it ...

Opioids commission recommends that Trump declare a national emergency

August 1, 2017
The White House commission on opioid addiction has recommended that President Donald Trump declare a national emergency over the epidemic that each day kills dozens of Americans.

Steep rise in births to U.S. women using opioids

January 17, 2017
(HealthDay)—Over a decade, there was a nearly fivefold increase in the number of babies born each year to American women who have used opioids, a federal government report says.

Panel calls on FDA to review safety of opioid painkillers

July 13, 2017
The U.S. Food and Drug Administration should review the safety and effectiveness of all opioids, and consider the real-world impacts the powerful painkillers have, not only on patients, but also on families, crime and the ...

Georgia losing patience with drug treatment tourists

May 3, 2017
In the northwest corner of Georgia, where cows and crops vastly outnumber people, a small cluster of privately owned treatment centers has sprung up in recent years for heroin and prescription painkiller addicts.

Recommended for you

Marijuana use amongst youth stable, but substance abuse admissions up

August 15, 2017
While marijuana use amongst youth remains stable, youth admission to substance abuse treatment facilities has increased, according to new research from Binghamton University, State University of New York.

Report reveals underground US haven for heroin, drug users

August 8, 2017
A safe haven where drug users inject themselves with heroin and other drugs has been quietly operating in the United States for the past three years, a report reveals.

Regular energy drink use linked to later drug use among young adults

August 8, 2017
Could young adults who regularly consume highly caffeinated energy drinks be at risk for future substance use? A new study by University of Maryland School of Public Health researchers, published in the journal Drug and Alcohol ...

Gamblers more likely to have suffered childhood traumas, research shows

August 2, 2017
Men with problem and pathological gambling addictions are more likely to have suffered childhood traumas including physical abuse or witnessing violence in the home, according to new research.

Incorporating 12-step program elements improves youth substance-use disorder treatment

July 26, 2017
A treatment program for adolescents with substance-use disorder that incorporates the practices and philosophy of 12-step programs like Alcoholics Anonymous (AA) produced even better results than the current state-of-the ...

Concern with potential rise in super-potent cannabis concentrates

July 21, 2017
University of Queensland researchers are concerned the recent legalisation of medicinal cannabis in Australia may give rise to super-potent cannabis concentrates with associated harmful effects.

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

BubbaNicholson
1 / 5 (1) Aug 05, 2017
Taking 250mg of healthy adult male facial skin surface lipid pheromone by mouth alleviates heroin addiction without withdrawal symptoms in anecdotal trials.
The pheromone emits an airborne sub-pheromone that is both potent and emotionally toxic, so use respirators, ventilate with oscillating fans to break up plumes, isolate patients for 40 days.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.