Alaska's two providers of inpatient opiate detox services have temporarily stopped admitting new patients because they were "caught off guard" by a change in federal regulation, the state's top treatment authority said Sunday.
That leaves Alaska temporarily without any bed space available for people to detox from heroin or prescription opiate addiction in an inpatient environment -- in the midst of what officials agree is an opiate epidemic.
The Gateway to Recovery Detox Center in Fairbanks and the Ernie Turner Center in Anchorage both decided to suspend admitting new patients last week, said Bradley Griggs, the state treatment and recovery program administrator for the Alaska Opioid Treatment Authority, part of the Division of Behavioral Health.
Each center has a long waiting list for a limited number of beds. Both will continue to offer detox services to people coming off alcohol and other substances.
The suspension was forced by the discovery that the centers weren't in compliance with a change in federal regulation, Griggs said.
In the past, the centers have used the medications Tramadol and Zyprexa to help ease people off of heroin and other opiates, with a physician assistant overseeing the detox protocol, Griggs said.
"Up until this federal mandate came down our agencies have been able to use a physician's assistant to treat someone in detox," he said. "This federal shift requires (a medical doctor); in addition the MD has to be certified by the (Drug Enforcement Administration)."
Griggs couldn't cite the exact federal regulation that forces the change. It was not clear whether the change cited by the treatment providers was related to Tramadol's classification in 2014 as a Schedule IV controlled substance.
The problems came to light during an internal audit of operations at the Fairbanks Native Association's Gateway to Recovery Center, Griggs said. Last Wednesday, the organization made the call to suspend new admissions, Griggs said. On Thursday, the Ernie Turner Center, which is run by the Cook Inlet Tribal Council, followed suit.
"We frankly did not see this coming," Griggs said.
The impression that the detox centers are entirely closed is not true, Griggs said. The Ernie Turner Center "will remain open" and will continue to serve admitted participants, the Cook Inlet Tribal Council said in a statement Sunday.
"In the wake of recent federal regulatory changes regarding treatment for opiate addition (sic), we are quickly reacting to these changes and will reassess our treatment protocols accordingly through appropriate partnerships and medical direction," the statement said.
Officials with the Fairbanks Native Association and the Gateway to Recovery Center could not be reached Sunday.
Both organizations are hoping to fix the problem and start admitting new opiate detox patients within the month, Griggs said.
The change could open an already financially starved system to new peril: Already the $365 per day the state reimburses the centers isn't sufficient to cover costs.
Finding, hiring and training doctors to do work previously performed by physician assistants will be even more expensive, Griggs said.
Inpatient detox beds are scarce in Alaska, Griggs said. But they're not the only way people get off heroin and other opiates: Some patients are prescribed replacement medications that reduce withdrawal symptoms, such as suboxone, on an outpatient basis.