DETOX CENTERS COPING WITH LACK OF RESOURCES

Mabel Toscano treasures the mementos, letters and artwork of her father,
who underwent successful treatment at the Casa Blanca detox program but
died in December from complications from his addictions.

January is the cruelest month. All the resolutions to stay sober have
fallen like needles from a brittle Christmas tree. Families, finally fed
up, shut their doors. It's cold outside, living under the bridges off
Yarbrough and Lomaland. And when the drunks and the addicts and the crazy
people get sick and tired of being sick and tired, this is the month they
finally ask for help.

January is one of the busiest times at alcohol- and drug-treatment
programs. This year, the options for El Paso's poor who want to get clean
and sober are fewer.

After 32 years, Casa Blanca Therapeutic Communities, the largest provider
of detox services to the poor in El Paso, closed in November, a victim of
shoddy management, according to the Texas Commission on Alcohol and Drug
Abuse, which supplied much of the agency's budget. With Casa Blanca's 40
detox beds and residential program gone, the state has tried to create a
temporary safety net for the approximately 900 people who used Casa
Blanca's services every year until a new, permanent detox provider can be
found.

People who work with the indigent say it's not enough.

"We can't get people into detox now," said Ray Tullius Jr., coordinator for
the Opportunity Center for the Homeless. "There's just no option right now."

The Opportunity Center is El Paso's homeless shelter of last resort. While
other shelters may shut their doors to active drug abusers or the mentally
ill, the Opportunity Center will take people regardless of whether they're
psychotic or sane, sober or high. One night last week, the center had 148
men and a few women sleeping on mattresses on the floor.

The Texas Commission on Alcohol and Drug Abuse has signed a short-term con-

tract with Aliviane, another El Paso drug treatment program, to provide
detox services to the indigent. Until Casa Blanca shut down, counselors at
the Opportunity Center had been sending about 10 patients a month to Casa
Blanca for treatment. But Tullius says the Aliviane admission criteria are
too restrictive and his counselors have had trouble getting patients in.

"Here's what they won't take," Tullius said, pointing to a list of
characteristics Aliviane has told Tullius' staff would disqualify clients
for admission: people with delirium, people with suicidal tendencies,
people who are drunk.

"They'd have to be past the point where they'd be a liability," Tullius
said, shaking his head.

Where does that leave most people who want help?

Tullius laughed.

"Right here. We give them a buddy and tell them to stay close."

Heavy drinkers coming off alcohol may develop hallucinations and
convulsions -- a medical crisis. "It's a risky situation, especially when
you do it by yourself," said Dr. Oscar Perez, a Santa Teresa psychiatrist
who specializes in addiction medicine. "There's a real potential for death."

Like relatives in an alcoholic family, the counselors at Casa Blanca had
seen signs of trouble in the organization for months. When checks bounced,
vendors demanded that food for patients and supplies be paid COD.

"Our paychecks were late. Our insurance was canceled," said Daniel Barraza,
a licensed chemical dependency counselor who worked at Casa Blanca for four
years.

"They blamed it on state cuts, but every explanation they gave us didn't
make sense," Barraza said. "It was just like the household of the addict,
where you start to lose things because the addict is selling them."

The Texas Commission on Alcohol and Drug Abuse found that Casa Blanca
violated federal tax laws and misused state funds, and the commission
accused Chief Executive Officer Richard Cuellar of writing checks to
himself from state coffers. The state pulled Casa Blanca's nearly $825,000
annual budget, effectively closing the agency.

Cuellar declined Friday to comment on the charges.

Like many other treatment programs, Casa Blanca had a success rate that was
less than perfect. Many patients were "frequent fliers," drifting in and
out of sobriety, in and out of detox. One of its last patients was Mario
Armando Toscano, a 45-year-old Vietnam War-era Army veteran and
schizophrenic who had already been through detox programs in Waco and
Albuquerque before cirrhosis and homelessness brought him to Casa Blanca
last June.

"When he first started at Casa Blanca, I had very low expectations," said
Mabel Toscano, his 27-year-old daughter, who lives in East El Paso. Mario
would show up at her grandmother's, begging food or money for heroin, then
disappear for weeks or months. Toscano and her father had been estranged
for years.

But with Mario in treatment again, Mabel Toscano allowed herself a tiny bit
of hope. "Because he was my father," she said.

She visited him at Casa Blanca, and accepted the small gifts he gave her --
a black scarf, a baby doll. He told her he felt like Rip Van Winkle,
feeling the sun on his skin and hearing the birds singing for the first
time in years.

By September, the man who had been living under bridges in El Paso attended
Toscano's wedding, stone-cold sober, dressed in a black tux, and danced
with her.

"I felt like a little girl again," Toscano said, flipping through an album
of wedding pictures. "I hugged him so much. It felt so strange, to have my
father to hold."

Mario continued to live at Casa Blanca at night, and attend a treatment
program at the El Paso VA clinic during the day. By late summer, he was
ready to move into his own place. Though he stayed sober, the years of
addiction had hurt too much. He died Dec. 10 from complications of his disease.

At the funeral home, Toscano cried when the funeral director asked for
Mario's last address.

"The thing was, I didn't have to find him on the street or have him die
homeless," Toscano said. "I'm really grateful I had another chance with him."

The Texas Commission on Alcohol and Drug Abuse is negotiating with other El
Paso health care providers to run a new detox program for the poor.
Aliviane Deputy Director Richard Perkins said last week that his agency is
not the "long-term solution" to the detox shortage in El Paso.

The commission had hoped that Texas Tech University would run a detox
program at the El Paso Psychiatric Center. But Tech has yet to sign an
agreement with the state Department of Mental Health and Mental Retardation
to manage the center and is now unsure whether state funds will be adequate
to run a treatment program there, said Earl Balzen, Tech's associate vice
president for health care systems.

Southwestern General Hospital in El Paso has also been mentioned as a
possible provider, but no agreement has been reached. Commission
spokeswoman Stephanie Goodman would not comment on the negotiations.

In the meantime, former Casa Blanca counselors such as Daniel Barraza worry
about the patients they used to help.

"I can't get these people out of my head," Barraza said. "There's about 20
of them I can't stop thinking about. I wake up in the morning and read the
obituaries now. And I wonder where they are."