BRANDON ROBINSON FIGHTS ADDICTION THAT BEGAN AT AGE OF 12

Brandon Robinson got hooked on heroin when he was 12.

Now, at 22, he is trying to quit.

He has a lot of reasons to get clean. Friends have died or gone to
jail because of drugs. He faces a possible felony conviction after an
arrest last year for possession of painkillers without a prescription.

But his motivation goes deeper.

His top goals: To be a good father to his two young daughters. To make
his mother proud. To have a future.

About 22 million people nationwide abuse or are addicted to drugs,
according to government statistics. That figure includes alcohol,
illegal drugs and prescription medication.

In the St. Louis region, that means about 10 percent of residents -
about 280,000 people - struggle with alcohol or drug abuse at any
given time. Many want to quit. But they can't always do it alone.

"Some people go through treatment more than once and some never
respond to treatment," said Dan Duncan of the National Council on
Alcoholism and Drug Abuse, St. Louis area. "But most people put their
lives together quietly, silently, anonymously. You don't see or hear
from them, so we are left with gauging our impressions of treatment on
those who have failed or relapsed, and that gives a grossly incomplete
picture."

Drugs tore apart Robinson's family. He started smoking marijuana and
snorting heroin when he was 12, a history that counselors and others
who have reviewed his case believe.

His use began after befriending an older boy who used drugs.

"I thought hanging out with an older guy was the thing to do,"
Robinson said. "I wanted to fit in and be exactly like him. He was
getting high. He was living the street life. I got addicted to being
in the streets."

A stay at Boys & Girls Town in Springfield, Mo., when he was 14, put
Robinson on the right path - but only for a while. When he returned to
St. Louis, he fell in with the same crowd and his life got worse.

Then last fall, Robinson got another chance. This time, even more was
at stake.

Finding help

After he was arrested for illegal possession of painkillers, Robinson
was accepted into a program at St. Louis Drug Court. It offered him
something he hadn't had before - treatment.

If an addict lacks health insurance or substantial savings, treatment
on demand is almost impossible to get. Even with money, there are obstacles.

Most private programs closed years ago.

The only private inpatient treatment program in the area is at
CenterPointe Hospital in St. Charles, which operates 20 substance
abuse beds. In 1990, there were 800 private treatment beds available
in the region.

The number of public beds also has declined dramatically, leaving the
region with a severe shortage. Local publicly funded treatment
programs have waiting lists.

As they wait, some addicts land in prison, overdose or give up on the
idea of sobriety.

Of an estimated 598,000 people nationwide who felt they needed
treatment for illicit drug use in 2004, about 194,000, or 32 percent,
said they had made an effort but were unable to get treatment,
according a government survey released in September.

"We lose so many Brandons because there aren't enough treatment beds
to go around," said Algin Robinson, Jr., director of Bridgeway
Counseling Services in St. Louis, which has a waiting list of 145
people. (The men are not related.)

Brandon Robinson doesn't have health insurance. Drug Court referred
him to two treatment programs and pays the bill.

He gets individual and group therapy at Bridgeway. He goes to
Addiction Recovery Centers of America three times a week for a
medication called naltrexone to relieve his heroin cravings.
Naltrexone is prescribed, usually for three months to one year, to
ease withdrawal.

Robinson said naltrexone reduced his cravings to a level that he could
manage without drugs.

By his own admission, he didn't take drug court seriously at first.
But soon he worked hard to meet the requirements.

Drug courts are designed for people arrested for non-violent drug
offenses, offering intensive court supervision, drug testing,
treatment services and immediate sanctions and incentives.
Participants are chosen by the St. Louis Circuit Attorney's office,
based on specific guidelines, and approved by a team of officials that
includes the prosecutor, defense attorney, a treatment specialist,
drug court administrator and others.

Participants must make frequent court appearances, get and keep a job,
undergo drug and alcohol treatment, and submit to regular breath
testing for alcohol and urine screening for drugs, among other
requirements. They are required to pay a $250 fee.

Robinson took his medication, attended court, participated in therapy,
submitted to regular drug testing and got a job at Arby's.

Things were looking up.

He wrote a thank-you note to Judge James E. Sullivan, St. Louis Drug
Court Commissioner, two days before Christmas.

"This is the first Christmas in many years that I am clean and sober.
This is the best gift I have received," he penned in neat cursive. "I
am very grateful to you for giving me this opportunity. I know I can
put my life back together."

Three weeks later, on the second Tuesday in January, he crashed.

Pothole in the road

Percy Menzies suspected something was wrong when Robinson failed to
arrive first thing Wednesday morning for his naltrexone. Robinson was
rarely late.

Menzies is a pharmacist and president of Assisted Recovery Centers of
America.

When Robinson showed up the next day, he wasn't his usual smiling
self. He couldn't even look Menzies in the eye.

Suspicious, Menzies did a urine screen. It came back positive for
cocaine. Naltrexone does not block the high of non-opiate drugs like
cocaine.

The day before, Robinson had socialized with two close relatives, both
cocaine addicts. The trio went to a casino boat, gambled and drank. By
the end of the night, they were sitting in one man's van snorting cocaine.

Menzies was disappointed but realistic.

"What we like is that he came back to us, he didn't give up," Menzies
said. "Rarely does someone go from addiction to zero drug use without
lapses. We want to see the lapses get less frequent, and each lapse
should be of shorter duration...It may take 8 to 10 attempts to
finally get there."

Even so, there were consequences for Robinson.

At his next court appearance several days later, Sullivan was angry.
He pointedly reminded Robinson about the cost of his treatment, paid
by taxpayers, and Robinson's obligation to try to turn his life around.

He ordered Robinson confined immediately for 24 hours at the St. Louis
County Justice Center. He also tightened Robinson's requirements for
staying in drug court.

Repeated failure to follow rules, or being arrested on another felony
charge, results in dismissal. Termination would have meant immediate
sentencing on his felony arrest. If he successfully completes the
program, which typically lasts about 18 months, the charge will be
dismissed.

Sullivan aimed to make the punishment therapeutic.

"It was a long 24 hours, but I had time to think about what really
happened," Robinson said afterwards. "I have a choice. I'm either
going to stay down because of my shame and guilt, or pick myself up. I
haven't given up."

In an interview in his chambers days before Robinson's court
appearance, Sullivan said addicts revolve in and out of the court and
correctional systems, and drug courts make it possible for them to
break out of the cycle and become productive citizens.

Because court and treatment records are confidential, Sullivan talked
about Robinson's case only after obtaining Robinson's written permission.

"It's certainly cost-effective if we can keep people like Brandon
clean and sober," he said.

Missouri has more drug courts per capita than any other state, with
more than 90 of the 1,500 nationwide.

The Institute of Applied Research in St. Louis did a cost-benefit
analysis in 2004 of the first 219 graduates of the 22nd Judicial
Circuit Drug Court, in which Robinson participates. The study found
that the financial benefits of the program after its first four years
exceeded costs by $298,399, or $1,362 per drug court graduate.

The study looked at wages earned and government taxes paid by
graduates, lower probation and jail costs, and reduced or eliminated
welfare expenditures, among other things.

Since his relapse in early January, Robinson has consistently tested
negative for drugs.

"Before Drug Court, I didn't think I had a problem. I didn't think
drugs were affecting how I was living," Robinson said. "I'm thankful
(for the initial arrest) because otherwise I don't know where I'd be."

Algin Robinson, the director of Bridgeway, has taken a personal
interest in Brandon's recovery. A former heroin addict himself, he
understands what Brandon's going through.

In a counseling session in early February, Robinson focused on helping
Brandon learn ways to avoid relapse. He gave him an assignment: to
write two lists, an inventory of triggers to relapse, and another of
ways to cope with them.

Just like falling off a bike is part of the process of learning to
ride, lapses can teach valuable lessons and coping skills for
overcoming addiction.

"I want to know what you learned from the experience," Robinson said
firmly.

Brandon listened attentively. A wall clock nearby ticked loudly.

"The moment I let up, the addiction can take over," Brandon said
later, as he pondered his assignment. "I realize that the addiction is
here all the time."