County says detox clients increasingly younger, on fentanyl

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Activity at the entrance of Bernalillo County’s detoxification center in Albuquerque picks up around 6 pm on most nights but that doesn’t mean the CARE Campus isn’t buzzing at other hours of the day.

“In the last year we’ve seen a lot of individuals just looking for a place to be, and that usually happens at night,” Jessica Jaramillo said. “Sometimes they come all at once. There’s never a dull moment.”

Jaramillo is the operations manager and interim director of the county’s Behavioral Health Services Department, which runs the sprawling facility located in a former Charter Hospital complex at 5901 Zuni Road SE. Its services are key in helping those with severe alcohol and drug intoxication and addiction. Clients often have behavioral and mental health issues, too. 

The campus also alleviates law enforcement and emergency medical services personnel from the extra pressure of being inundated by people who could otherwise find assistance at the facility.

But the CARE Campus and its staff of 82 are also under pressure. Formerly known as MATS (Medication Assisted Treatment Services), it began by only offering detox and aftercare services but has since expanded into multiple units and programs both outpatient and inpatient. The staff can’t meet demands — in part due to a rise in clients who are experiencing chronic homelessness. Jaramillo said such clients represent about 90% of those who come through the doors — the highest it’s ever been.

Other emerging concerns are a demographic skewing younger, and for the first time, the synthetic opioid fentanyl has outpaced alcohol, methamphetamine and heroin as the No. 1 drug overdose concern.

“It was traditionally a lot of individuals with alcohol disorders, very little opiate use disorders,” Jaramillo said. “We weren’t checking [vital signs] like we do now. We’re kind of wondering what’s going to be next.”

Because of the rise in fentanyl overdoses, the facility is now a Narcan (Naloxone) distribution site, which comes in the form of a nasal spray that can save lives by reversing the effects of an opioid overdose.

Meanwhile, the increase in clients aged 18-to-24 has accelerated the need for a new young adult unit slated to open in the next couple of months. With 16 private rooms, the project will offer a 45-day program that’s modeled on the CARE Campus’s supportive aftercare service but tailored to a younger population.

“Some people may have just turned 18, and they’re coming in and we’re having to really question their age because they look so young,” Jaramillo said. “They may be 18 or 20, but they’ve got the mentality of a 15-year-old. We created a program for that population.”

Staffing woes

Jaramillo is well positioned to notice trendlines at the facility, and staffing issues are persistent. She’s worked at the facility for the better part of a decade — starting as an entry-level substance abuse technician and moving up the ladder to program supervisor and now operations manager and interim director.

While the facility’s observation assessment unit can accommodate 60 clients, a staff shortage, particularly of nurses, currently allows only 20 to be served. The facility contracts with the University of New Mexico Hospital nurses for needed medical treatments like withdrawal management. For more nurses to be hired, Jaramillo needs more funding.

She estimates an additional $2 million would need to be added to the current $20 million annual budget to bring staffing levels to par. As it stands now, some clients are turned away or referred to other limited options across the city.

In addition, Jaramillo said bumps in pay for certain positions would help shore up shortages. Substance abuse technician trainees start at $19 an hour and substance abuse technicians start at $25 an hour, but Jaramillo said that while it’s a decent wage, it doesn’t compete, for example, with similar positions at the city’s Albuquerque Community Services Department. 

The CARE Campus can be reached at (505) 468-1555.