A Madness Called Meth: Chapter Fourteen

GETTING STRAIGHT

The Long, Slow Road To Recovery

"Maybe, since it took us 25 years to get into this problem, maybe we can in
25 years back our way out of it."

Bob Dey, DEA special agent in charge of the Sacramento office.

When you meet Trisha Stanionis, she pulls out a set of clear plastic tiles
with colorful writing on them.

"These are the dominoes," she says, making sure you are paying attention:

- - Business losses. Seventy percent of all illegal-drug users are employed
and in the work force, and many aren't exactly working to their peak abilities.

- - Lost wages. Substance-abusing employees will cost the employer 25 percent
of their paycheck per year. For a minimum-wage worker, that is $10 a day.

- - Education lost. One in seven children goes to school every day from a
home affected by alcohol and drug use.

- - Health care costs. More than 40 percent of all emergency room admissions
are affected by alcohol and drug abuse.

- - Child abuse. At least 60 percent of all child abuse cases are directly
related to alcohol and drug use.

- - Criminal justice system. Of the 160,000 incarcerated in California, 70
percent are there for reasons directly related to alcohol and drug use.

Then she pulls out one last domino. It reads: "Quality Treatment on Demand."

"If you had this," she says as she sets it in front of the others then
pushes it over, sending the line toppling, "we'd knock them all down. We
are going to pay as taxpayers for this some way or the other. The question
is: Where do you want to send the check?"

Stanionis runs a residential drug-treatment program in Sacramento called
The Effort. On her business card, underneath the logo in capital letters is
"TREATMENT WORKS." She knows it to be true. She can't figure out why
everyone else doesn't.

"The common perception is that treatment doesn't work," she says while
sitting in her midtown Sacramento office. "Do people relapse? Yes. But that
is part of recovery. Treatment gives them tools to use when they do."

Studies have shown drug abuse costs the average taxpayer $1,000 a year in
everything from medical costs to incarceration costs. Other studies have
shown that for every $1 put into treatment, the public gets $7 back, mostly
from decreased criminal activity. Yet in 1998, federal budget figures show,
the U.S. government spent twice as much on drug-related matters in the
criminal justice system as it did in drug education and treatment programs.

"I don't want any more studies," she says. "I want a study that shows me
how I sell the results we have to Sally and Joe Taxpayer."

Selling the results of drug treatment to taxpayers is only part of the
problem. Another is breaking down bureaucratic barriers for those seeking
help. In Sacramento County, staff members of various agencies, from
Probation to Child Protective Services, are trained to better understand
addiction issues and streamline the process for getting someone into a program.

"We had a worker population that really didn't understand the system," says
Guy Klopp, special programs manager for Sacramento County's alcohol and
drug bureau. "No one had understanding of substance abuse. Even getting
people to raise the question was a huge barrier."

Since the assessment training program started five years ago, waiting lists
for getting into a treatment program in the county have shrunk from more
than 800 names to fewer than 120. Promising as that is, however, it is only
a start on a very long road.

Treating drug addiction costs money, and Carol Moltrum is out of it. She
has burned through roughly $100,000, which is all the money Butte County
gives her each year to put drug addicts into residential care. She has been
broke since the end of May. The only thing to do now is wait the 11 days
left in June. Come July 1, the new fiscal year starts and she's flush
again. Sort of.

Moltrum is Butte County's gatekeeper. If you want to get into residential
treatment, you need to get past her. Every Monday from 1:30 to 3:30 p.m.,
she takes calls from those hoping to get a bed. In those two hours, she
averages about 10 calls. Callers get referred to Moltrum from all over --
children's services, probation, drug court. Methamphetamine, cocaine and
alcohol are the callers' favorites.

She can send as many as five people a month at county expense. A lot of
people aren't going to make the cut. Her phone rings at precisely 1:30 p.m.

"This is Carol, can I help you? . . . Who? Can you spell that?"

With a pencil, she scratches notes on a legal pad the same color as her
yellow blouse.

"Have you called before? . . . What is the problem? What kind of drug? . .
. How long have you been using? . . . What does 'on and off' mean? . . .
What has been your longest clean time? . . . So what is your motivation
this time?"

While the caller sorts through his past, Moltrum urges him on with
"Mmm-hms" and "Uh-huhs." Through her open door, you can hear other doors
opening and slamming down the hallway.

"I'll tell you what. I'd like you to come in for an appointment to
interview with me. I'll make the appointment for the week of July 10. . . .
No, it's not going to happen before that. There is no money until July. . .
. Now just because I made an appointment doesn't mean you are going in.
We'll talk."

The call ends nine minutes after it started. A minute later, the phone
rings again. "This is Carol . . ."

A few counties to the south, Deborah Williams knows exactly what the people
on the other end of Moltrum's phone are feeling. She has been calling,
every day, to make it into Laura's House in Modesto. Though not a
residential treatment pro-gram, the house offers clean and sober living to
women who are pregnant or have young children.

"Every day I call, 'Deborah, checking in.' "

She already did 28 days in Reality, Stanislaus County's only residential
treatment program. It took her two months of calling every day to get in
the program, and she graduated in mid-April. Since then, she's been waiting
to get into Laura's House. In late May, she works up the nerve to ask.

"How much longer?"

The response makes her gut sink. A month.

"I've almost said forget it," she says, sitting on the patio outside of
Reality's Alumni Center. "But I went to my Blue Book. I went to a couple of
meetings. I kept looking at my kids' pictures."

Williams is 34 and has been a drug user since she was 10. She started using
meth daily eight years ago. Her three kids, ages 13, 7 and 6, have been in
foster care almost two years now. Six months ago, Williams went to jail for
a failure to appear on her 1998 under-the-influence conviction: It was her
second term. She has a court date in November and will try to convince a
judge she has earned the right to have her children back.

"I got what I deserved, but my children didn't deserve what happened," she
says. "The one thing I never wanted to do was hurt my kids. Now that I've
lost them, I have to look at them. My son is angry, and my daughter wants
to come home."

So she calls, every day, to get in. Days turn into weeks. Weeks into months.

"That's a long wait," Williams says, "for a dope addict."

Getting off meth is a numbers game. How much is treatment? How many days do
I have to wait to get in? How long will I be in? How long can I stay clean?
Twenty-eight days, 30 days, 90 days, 6 months, a year. There are 12 steps.
There is one day at a time.

For those filling limited county treatment slots, working the numbers is
crucial. It costs Butte County $64 a day to keep an addict in residential
treatment. If they qualify, addicts go to the Right Road Residential
Program in neighboring Tehama County. Butte County, like most California
counties, contracts its residential care out to private, nonprofit
treatment centers.

The normal stay in Right Road is 30 days. More days for one person means
fewer for another. Moltrum knows this all too well. In her three years on
the job, she has sent only two people for 90 days. "I work real hard to
spend every penny, to the penny," Moltrum says in her office in Chico.
"I've never gone over the budget."

Her job is not for softies. "No" is a frequent part of her vocabulary.
People call, their lives shattered, reaching for hope. She must sort
through to find the weakest, neediest and most ready of the bunch.

"It is a bittersweet job," she says. "You love being able to send the
people you can. You hate not being able to send the people you can't."

The phone rings again.

In Reality, the treatment program she was in in Stanislaus County, Williams
learned what it meant to be a meth addict, which she has been for the best
part of a decade. They taught her to use tools -- critical thinking and
coping skills -- not just excuses when she wants to use. That made her face
what got her started in the first place.

"It's not because I needed to lose weight. It's not because I needed money.
It's not because

I was tired," Williams says. "Basically, I liked dope."

In treatment, Williams came to understand her addiction was like having a
chronic and sometimes fatal disease. Taking that perspective helps release
a lot of the guilt and shame that can bog down recovery.

She explains her cravings in terms a chocoholic can understand. Drugs are
like that piece of chocolate cake when you are on a diet. Most people can
lick the frosting and go on. For her, licking the frosting was having a
beer. But she couldn't have just one beer. It wasn't enough. A cold beer
turned into six more, which turned into a 12-pack, which turned into meth.

She says matter-of-factly: "I can't lick the frosting anymore."

Williams has graduated from the Reality program, and until she gets into
Laura's House, she's in limbo. That makes her feel useless. She attends
five Narcotics/Alcoholics Anonymous meetings a week to fill the time.

"I get bored really, really easy," she says. "That is the problem. Then I
start feeling fat, or useless, or anything. It's dangerous."

It is early July, and Williams still is waiting.

Getting into treatment is a slow road in Butte County. It is impossible for
addicts to get into residential treatment the day they call. First, they
must pass a skin test for tuberculosis and a head lice check. Then they
have to find a way to cover the $200 medical expense fee. Most take care of
it by signing up for general aid. All that takes two days, at least.

Butte County has no official wait. Moltrum keeps a log of who called and
acts as moderator. She knows when there is space and when there isn't, and
she plans accordingly.

At 3:14 p.m., Moltrum picks up her last call for the day.

"Hi, this is Carol . . . Hi, Joseph. What is the problem? . . . So the
crank is bothering you more than the pot or alcohol? . . . Are you going to
any 12-step meetings . . . What have you been doing recently besides going
to church?"

Joseph is not signed up for any of the county's outpatient programs. No one
gets into residential without at least trying the groups first, Carol
explains. She tells him where to sign up in Chico.

"After you have been doing that a couple weeks, if you are still having a
really serious problem staying clean and sober, you talk to your counselor
and call me back."

She hangs up at 3:25 p.m. In all, she has taken eight calls. Six people
told her methamphetamine was their drug of choice. She scheduled three
appointments, told two to call her, told another two she would call them
and referred one to outpatient care.

"The calls stop now," Moltrum says, "but the work doesn't stop now."

Chapter 14b, http://www.mapinc.org/drugnews/v00/n1504/a07.html