State and federal officials are concerned that when some Minnesotans become severely intoxicated they may not receive the care they need to safely sober up.
According to a Minnesota Department of Human Services report, about a third of detox facilities in Minnesota have closed over the past decade. During the same period, admissions to detox facilities fell by 20 percent. But the report concludes there is no reason to believe fewer people are using alcohol and drugs.
The shortage of detox services has led to a state and federal review scheduled for completion late this month that state and federal officials will use to try to develop new ways of providing detox services throughout the state.
Among the law enforcement officials in Minnesota worry that there aren't enough detox facilities to handle intoxicated people is Pine County Sheriff Robin Cole.
During a recent Demolition Derby night at the Pine County Fair, the beer garden was open until 1 a.m., and Cole prepared for a lot of partying. About 2,000 people were there, and the sheriff's deputies expected to drive some of them home.
Consuming too much alcohol to legally drive is one thing. To be falling-down, dangerously drunk is another, and helping those people is a growing problem in Pine County, as it is around Minnesota.
"When someone is intoxicated, they can't take care of themselves," Cole said. "Then it's up to us to take care of them, and we just don't have any place to bring them. And that's our biggest problem."
Pine County has a contract with a detox center in Duluth -- as much as two hours away from some parts of the county. Driving that far cuts significantly into a deputy's shift. They make the trip, but only after looking for other options, like finding a relative or friend, or dropping the person at a hospital, Cole said.
But sometimes, sheriff's deputies turn to a last resort: jail.
Being publicly intoxicated is not a crime in Minnesota, but because people who are drunk in public often violate laws, they can legally be incarcerated, Cole said.
But he doesn't think that's right.
"They don't need to go to jail," Cole said. "They need to go to detox. They're having a medical issue."
Not having a detox center close at hand creates serious liability concerns for police departments.
Being publicly intoxicated is not a crime in Minnesota, but because people who are drunk in public often violate laws, they can legally be incarcerated.
"I certainly would not want to get a call in the middle of the night that a person that should have gone to a detoxification facility or a medical facility was brought into the jail and then died in the jail because they were so intoxicated and weren't cared for properly," Cole said.
The lack of detox facilities is a "significant issue" in Minnesota, said Dave Hartford, assistant commissioner for chemical and mental health services at the Minnesota Department of Human Services. Deciding how to handle intoxicated people, he said, produces a dilemma for many counties.
"There are no services readily available in their counties," said Hartford, who oversees chemical and mental health programs.
Federal officials also are concerned about the way potentially dangerously intoxicated Minnesotans are being cared for.
The Center for Substance Abuse Treatment at the U.S. Department of Health and Human Services is conducting a review of detox services in Minnesota that will soon recommend changes, said its director, Dr. Westley Clark.
"Both we and the state agreed that the state should receive technical assistance to help it determine the extent to which the level of detox in different regions of the state is consistent with the need. So we know that there is clearly a need," Clark said.
One option would be to pay for detox services through Medicaid, Hartford said. That would take the cost off of counties and put it on state and federal taxpayers.
Hartford said officials also are studying ways to use technology to help cut the cost of detox. Department of Human Services officials say they hope to have a detox proposal ready for consideration in time for the 2014 legislative session.