For many homeless in Duluth, 'Detox' a refuge from cold

DULUTH -- About 7 p.m. on a cold January night, 45-year-old Joseph Howard of Duluth says he has been drinking all day and doesn't know where he'll sleep. He was kicked out of the city's only homeless shelter a week before and now has to find a place outside.

Though he has a backpack with a blanket, he knows, even though he's extremely drunk and his breath exudes the smell of alcohol, he's in no condition to endure the cold.

"I'd rather go to Detox than sleep outside," he says, trying to put words together while waiting for a cab to take him to the Duluth Detoxification Center. "When you're living on the streets, you've got to find ways to survive."

Talk to the homeless on the street and you quickly find out that, though it was never intended for it, Detox is in many ways the preferred temporary shelter when it gets too cold to survive outside.

Ironically, many homeless people say they drink purposefully to get into Detox, believing that admission requires a certain blood-alcohol level.

Perhaps even more ironically, the director of Detox says that's largely not true.

'Three hots and a cot'

When he was homeless and it was too cold to sleep outside, Steve Fullerton said, he'd purposely get drunk to go to Detox.

"A lot of people I knew did it," said Fullerton, 43, who now lives at the San Marco apartments. "All you got to do is drink some vodka and they let you in."

Kathy Jo Harr, 43, who was homeless for four years, said she, too, drank to get into Detox. "It's three hots and a cot, and you're warm for a few days."

Generally, said Laurie Hull, the center's program director, to be admitted to Detox you need to show signs of being drunk. But there is no minimum blood-

alcohol level needed, she said. And patients who are showing signs of withdrawal or have a potential for severe withdrawal will be admitted, she said.

The Duluth Detox Center averages about 2,500 admissions a year to treat alcohol and drug abuse, according to statistics kept by the center. And while some do use the center for temporary shelter, the majority are looking to recover from drug or alcohol addiction, said Gary Olson, executive director of the Duluth Center for Alcohol & Drug Treatment.

"It's a misnomer that people use this primarily as housing," he said.

"It's not a nice place to stay," adds Laurie Hull, the center's program director. "We're bugging people all night, checking blood pressure and temperature."

Clients, as they're called, are confined to the locked facility

24 hours a day, can't smoke, have their belongings confiscated and have to share a room with up to two others.

"You have no real privacy where you can be alone and by yourself," Hull said.

Those admitted to Detox generally stay two to three nights and must show no withdrawal symptoms for 24 hours before they can be released.

Sometimes, Harr said, people do try to escape. "It's like jail," she said. "With pajamas."

The $260-a-day cost for individual treatment is a tab generally picked up by taxpayers, Hull said. The $1.3 million annual operating cost for Detox is paid for largely by a consortium of St. Louis, Cook, Lake and Douglas counties, which share use of the facility. Only 3 percent of Detox clients pay for their treatment, Hull said; the rest is picked up by the county or insurance.

Duluth Detox trails other centers

Outreach workers say that some homeless people do try to turn their lives around after being discharged from Detox, but the homeless say most don't.

"A majority of us would go right to the liquor store," said Harr.

Some statistics suggest that Duluth Detox lags behind other treatment centers in the state when it comes to clients getting help after being discharged, while the rate at which patients return to Duluth Detox is higher than at detox centers around the state.

From Jan. 1 to June 30, 2009, patients at Detox centers statewide were two to three times more likely to be referred to counseling or education and prevention services than patients in Duluth, according to data from the Minnesota Department of Human Services.

Hull explained that the center offers assistance to everyone leaving the center, but many refuse.

Of the 1,283 clients admitted to Detox between January and June 2009, 43 percent said they had been to the center five times or more during their life, and another 26 percent said they had been to Detox five times or more in the last year. In comparison, only 17 percent of clients at facilities across the state said they'd been to a detox center five or more times in their life and 9 percent said they had been there five times or more in the last year.

Another statistic suggests that more of Duluth's transient and homeless population use Detox as a temporary shelter than the same population does at detox centers statewide. Nearly 25 percent of people admitted to Duluth Detox during the first six months of 2009 were homeless, compared to 10 percent statewide.

Hull said she was at a loss to explain those numbers, but she speculated that it was due to a group of seven to 10 homeless people who consistently use the Detox center and inflate the numbers.

"The rest, we really don't see that often," she said.

To reduce the return rate among homeless clients, Hull said Detox staff work to refer them to treatment and temporary housing. Beyond that, there's not much the center can do, she said.

"We can't forcibly hold someone here if they're not legally committed," she said.