A NEW FOCUS ON DRUG ADDICTION

Prop. 36 Forces Changes In The Way Substance Abuse Is Viewed

Editor's note: This is the second in a two-part series on Proposition 36
and its implementation locally.

Twenty-eight-year-old Tracy Graham, a drug addict for 10 years, had her
four children taken away from her while she battled her addiction

She went through a rehabilitation program and lived in a transitional house
and a safe house until she was certain she could remain clean.

Today Graham, drug-free for nearly three years, is enrolled in the laser
optics program at Yuba College and lives in Linda with her four children.

Since the passage of Proposition 36 in California in November, which became
effective Sunday, many more people are expected to be treated at drug
rehabilitation programs."I think everybody deserves a chance (at
recovery)," Graham said. "Addiction is cunning and baffling ... It's scary,
especially when you've grown accustomed to it and getting loaded becomes
your only knowledge of survival."

Proposition 36, also known as the Substance Abuse and Crime Prevention Act
of 2000, is aimed at first- and second-time nonviolent drug offenders
arrested on charges including possession, use and transportation for
personal use. It gives them the opportunity to be on probation with
treatment rather than incarceration or other sentencing.

"Proposition 36 is a dramatic change in the way substance abuse is being
viewed in California," said Mike Noda, director of Human Services in Yuba
County and chair of Yuba County's Proposition 36 Steering Committee.

"It focuses on treatment rather than on criminalization," he said.

Joan Hoss, chair and administrator of the Bi-County Alcohol and Drug
Program, said, "(Proposition 36) provides us with an expanded ability to
deliver treatment services locally."

The district attorney determines whether a person is eligible for the
program and gives it to the court for review. If the individual
participates, he or she will be evaluated by a Bi-County Drug and Alcohol
assessor. A conviction may be set aside upon successful completion of the
program.

While few in the health profession question whether quality drug treatment
programs can be effective, the real question, they say, is whether
Proposition 36 can and will be effectively implemented.

Noda thinks the proposition is a good one because many addicts would not
participate in treatment unless they are mandated to do so.

"The focus (of Proposition 36) is to use court coercion working with a
supportive, multifaceted addiction and substance abuse treatment program to
address the person's addiction," he said.

Ray Monroe, executive director of Pathways, a rehabilitation program that
provides both residential and outpatient services, said a motivational
crisis is often needed to get an addict into treatment.

"If their motivation is to avoid incarceration, that will work to get them
into treatment and then we can do our job," Monroe said. "That's where we
can start to address the characteristics of denial, and the psychological
and social components of addiction."

But many county officials wonder how they will be able to secure enough
funds for implementation.

While those who can afford to pay for their treatments will be expected to
do so, the counties will cover the cost for the majority who cannot.

The state has allocated a total of $120 million through fiscal year 2005-06
for the implementation of Proposition 36. Yuba County will receive about
$388,000 for fiscal year 2001-02, while Sutter County will get about $369,700.

"We are concerned about the fiscal support to do the program," Noda said,
adding that the initial allocation is not sufficient to cover the treatment
they anticipate the clinics will need. "We are going to aggressively look
at where we can add funds in Yuba County ... Our commitment is to provide
treatment and to really make this work."

The proposition does not allow funding for drug testing, Hoss said, but
there is pending state legislation, SB 223, that would.

"If the legislation proposed doesn't pass, it will be problematic for us,"
Hoss said.

Determining what works

County officials also recognize that not all drug treatment programs are
effective.

Developing a continuum of care and addressing social issues as well as
behavioral addictions will be an important part of an effective drug
treatment program, Noda said.

"It's getting them into an environment where they can be more supported and
where living drug free is more of a culture and is more comfortable for
them," he said.

Yuba County Health Officer Dr. Joe Cassady said many different kinds of
treatment should be made available to program participants.

"Programs that offer minimal services that emphasize mostly education or
outpatient (services) will not be as successful as those offering numerous
avenues for treatment," he said. "There is not one kind of program that
works for everybody."

Most of Yuba County's program participants will be diverted to the For Our
Recovering (FOR) Families program, an intensive county outpatient program
established about a year ago to alleviate impacted programs.

FOR Families currently serves about 35 people and has the capacity for 125.
Noda said the facility will expand to be able to serve a total of 175
people in the coming year.

"It's really the only facility that has that kind of capacity right now,"
he said.

Most of the program participants in Sutter County will be served by Options
For Change, an outpatient program through Bi-County Drug and Alcohol
Services, however some money has also been set aside for residential programs.

"In the longer term, we will continue to consider contracting with a whole
range of providers in the community," Hoss said.

Monroe said he is expecting an influx of patients into Pathways from
Proposition 36, and said his inpatient and outpatient programs are filled
to about 80 percent capacity. He added that Pathways and the county
programs have been working together to accommodate the program participants.

Envoy Jim Rhoades, pastor/administrator of the Salvation Army programs in
Yuba and Sutter counties, said the Salvation Army Depot Family Crisis
Center, a program shelter in Marysville which provides drug counseling and
support services, is trying to become licensed by the state as a treatment
facility which would qualify for Proposition 36 funding.

With a waiting list of at least four weeks, Rhoades said the center is
attempting to double its maximum occupancy rate which is currently at 60.
There is no charge to residents as the cost of the services is absorbed by
government grants and private donations, he said.

"Because we have to deal with substance abuse issues in dealing with
homelessness, we have created a pretty effective rehabilitation program
in-house," Rhoades said.

Different assessment tools

While the tools that will be used to assess individuals for level of
treatment are standard tools in the industry, an individual's readiness for
treatment should also be assessed, Cassady said.

"Not everybody who needs treatment is ready to receive treatment," he said.

Dr. Larry Sideman, clinical director for Treatment Assessment Screening
Centers Inc. in Arizona, where a similar proposition was passed in 1996,
agreed that matching people to programs according to a person's motivation
is an important factor of success.

"If you refer somebody to a treatment modality that's not in line with
their level of motivation, usually there's not going to be a positive
outcome," he said.

While the assessment tools used by Sutter County will include a way to
measure an individual's motivation and readiness for change, those used by
Yuba County will not.

"For those (in Sutter County) that are not ready yet for that level of
change, we are going to engage them in an educational and motivational and
counseling process that is specifically designed to get them ready for more
intense levels of treatment," Hoss said.

The two counties can evaluate how well the different assessment methods are
working and then modify or adapt to the other if it seems to be working
better, both Hoss and Noda said.

Hoss said the challenge for treatment providers will be to convey hope to
addicts and the message that their lives can be meaningful without drugs.

"People don't go up and say I want to be a drug addict," she said. "All
these people have dreams of who they are going to be in their life, and
what they will achieve, and what kinds of jobs they'll have and
contributions they'll make, and drug and alcohol addictions destroy all of
those dreams.

"Our goal is try to help people recapture them."

(SIDEBAR)

LOCAL REHABILITATION PROGRAMS Drug and Alcohol Rehabilitation Programs and
Support Services available in Yuba-Sutter:

Alcohol-Drug Treatment Referral-Adult & Adolescents (800) 454-8966

Alcoholics Anonymous (A-Anon) (Alateen) (Al-Atot) 673-9380

Alternative Solutions 552 N Palora Ave., Yuba City 751-3963

Coplin Counseling & Consulting Service 743-9243

Feather River Teen Challenge 695-8006

First Steps (perinatal outpatient treatment program for women) 822-7263

For Our Recovering (FOR) Families (outpatient program) A program of Yuba
County Health Services 6000 Lindhurst Ave., Suite 700 B 749-6798

Naranon-Family Support 1965 Live Oak Blvd., Yuba City Contact: Keith 674-9911

Oak House Recovery Treatment Center (residential care) (916) 786-0255

Options For Change (outpatient program) A program of Sutter-Yuba Mental
Health Services 822-7200

Pathways (residential and outpatient rehabilitation services) 742-6670

Right Road Recovery Program in Corning: (residential and outpatient
services provided) 824-0669

Salvation Army Depot Family Crisis Center (program shelter offering drug
courses and counseling) 408 J St., Marysville 742-0867

Father's FIRST (a support group) 742-7761