STATE LAST IN DRUG THERAPY SPENDING

Addicts May Face Waits, Short Treatments, Jail

By the time drug addicts call treatment centers such as Aletheia
House and Pearson Hall, they are in dire straits. They have lost
jobs, found jail, been kicked out of homes.

Here's what the counselors and intake workers must tell them: Take a
number. Your name is on the waiting list. We'll be in touch.

"I had someone who needed detox, and I called a detox center, and
they told me four to six weeks. That was this morning," said Aletheia
House Assistant Director Gloria Howard on Thursday.

Alabama ranks last in per capita spending on drug treatment of 46
states that reported in a study conducted by the National Association
of State Alcohol and Drug Abuse Directors. In fiscal 1999, the state
spent $4.3 million to help poor addicts get off drugs. That amounts
to $1 per capita.

"It's pretty miserable, as usual," said Foster Cook, director of the
University of Alabama at Birmingham's substance abuse program.

The federal government gives the state another $22 million.

80 Percent Lost

Drug treatment centers have condensed the length of time patients can
stay to shorten the wait. But the shortage of space and beds
translates into an average wait of 17 days for a hard core addict who
needs residential care, said Kent Hunt, assistant commissioner for
substance abuse at the Department of Mental Health and Mental
Retardation, which handles most of the money.

Chris Retan, director of Aletheia House, a 98-bed rehabilitation
center in Birmingham, estimates that the center loses about 80
percent of addicts who call for help. "We know there's a small window
when they say the consequences of my drug problem are so bad I need
to do something today," Retan said. "And we as a community say, we
can't help you. It leads them to despair, and they return to drug
use."

Aletheia House also performs assessments, the evaluations to
determine what kind of treatment an addict needs. There's a two-week
wait for assessments, on top of the wait to get into a treatment bed.

The shortage also can limit options for judges.

Sixty-seven percent of people arrested in Alabama test positive for
illegal drugs, according to figures compiled by Cook. He monitors
drug abuse among persons arrested for the National Institutes of
Justice.

Faced with long waits for a drug program in the community, judges
often resort to locking up an addict who's a small-time criminal.

Alabama's prisons are full, forcing county sheriffs to pack about
3,300 state prisoners in county jails, many doing time for drug
possession or stealing to obtain drugs.

"The choice, particularly in rural counties, is to send people to
prison for treatment, which compounds the prison crowding," said
Cook. "The short-sightedness is evident. We pay more for locking
these people up, than we would have to pay if we funded treatment."

Jefferson County District Judge Pete Johnson, who presides over the
county's Drug Court, doesn't view the situation as quite so dire.
There may be a waiting list for long-term residential care, but other
treatment is available.

"I can dry them out in jail," Johnson said.

Johnson will recommended outpatient treatment or Narcotics Anonymous
meetings if no bed is available. Or he'll order long hours of
volunteer work, and make sure an addict keeps a job. Those parameters
are often enough.

"Everybody doesn't need to go take a bed, that's a last resort prior
to sending someone to prison," Johnson said.

Already about two-thirds of treatment beds are taken by addicts
referred by judges. It is more likely that someone whose addiction
has led to crime will get help before someone who tries to sign
themselves up, said Hunt, at the Department of Mental Health.

It's a fact that troubles him.

"Do we want a system in Alabama that in order to get substance abuse
treatment, you have to be headed to prison?" he asked.

One Birmingham shelter is responding to the backlog by offering
homeless addicts intermediate help as they sit out the wait.

The Old Firehouse Shelter offers classes on abuse and employment, and
an introduction to the 12-step model of recovery, said Director Steve
Freeman.

"If we're going to get serious about dealing with the issues of
homelessness, we've got to deal with the issue of substance abuse,"
he said, calling the $4 million in state spending "disgraceful."