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AID MONEY TARGETS CERTAIN DEMOGRAPHIC GROUPS

In State, Outlook Bleak for Getting Treatment

Drug addicts in Arizona have little chance of getting treatment.

Those who are wealthy or in jail can find programs, but the majority have
nowhere to turn.

A thousand people are on lists for a handful of programs. There would be
more, but the state stops taking names after 1,000.

Those who get a place usually wait 60 to 80 days to begin.

Most addicts can't wait two days, experts say. They lose their resolve; they
don't come back.

Those individual failures translate into a monumental failure for society: A
thousand people who don't get off drugs are 1,000 people who break the law,
who fill emergency rooms, who disrupt families, who waste lives.

None of it makes sense, said Lupe Quintero, director of Corazon, the only
bilingual residential drug treatment center for men in Phoenix.

"Millions of dollars are going to sophisticated technology to fight the drug
peddler, and forgotten are people needing help," Quintero said. "Get rid of
the demand for drugs by increasing prevention and making treatment easier to
get."

America's federal drug-fighting budget is nearly $18 billion this year.
One-third of that goes to treatment, education and prevention, but the
treatment dollars are hard to find in Arizona.

Abuse Growing

In 1998, the latest year for which figures are available, Arizona spent $44
million on drug treatment. The federal government kicked in $15 million of
it.

Arizona's contribution has remained about the same for the past 10 years,
despite a doubling of the state's population.

Spending hasn't kept pace with the state's growing problem, said Steve
Carter, whose family for decades has run the Maverick House, a treatment and
halfway facility in Glendale.

An estimated 36,000 Arizona adults abuse or are dependent on illicit drugs,
according to a 1996 telephone survey by the state Department of Health
Services.

The survey undercounted addicts because it did not include the homeless or
others without phones, said Christy Dye, director of the Bureau of Substance
Abuse for the DHS.

The population of drug users has grown in the past five years, primarily
because Arizona has become one of the biggest producers of methamphetamine,
Dye said.

"Three years ago, counselors started treating more meth users than crack
users," she said. Heroin abuse also is high in the state.

"We see 10- and 12-year-old kids come into the hospital who are already
addicted," said Don Aldridge, director of business development for Charter
Behavioral Health Systems/Glendale.

Not surprisingly, the number of drug-related deaths is climbing. In 1998,
the latest year for which figures are available, more than 500 Arizonans
died as a result of drug use. That was up 42 percent from five years
earlier.

Value Options

Sally Lara doesn't believe that things have ever been this bad.

"For the first time, we are turning people away," said the executive
director of the Phoenix branch of the National Council of Alcoholism and
Drug Dependence, which provides counseling. "We get over 200 calls a month
from addicts wanting to clean up, or their families. It keeps me awake,
knowing the addicts are probably out on the streets tonight."

Lara and others in the field blame the way the state distributes money to
non-profit programs such as hers, which provide the bulk of public drug
treatment.

Last year, the state hired a for-profit, Virginia-based health management
company, Value Options, to manage state resources for drug and alcohol
programs. The company made a number of changes that it said would make the
system more efficient and help more people.

For example, Value Options changed the way the state reimburses private,
non-profit treatment centers for addict care. The average stay in
residential care facilities across Phoenix dropped to under 30 days instead
of six months or longer.

"It's drive-through therapy," Quintero said. "The fog (of drug use) isn't
even removed . . . in many cases. There is not enough time to get to the
reasons behind a client's addiction."

Value Options also is challenging the amount of care outpatient counseling
centers provide.

"Value Options believes six group sessions is a lot, but we think the ideal
is at least 24 visits, three a week, with a year of after-care," Lara said.

In recent months, Quintero's facility, run by the non-profit Chicanos Por La
Causa, has had empty beds, even with demand up. The reason: Value Options'
requirements and paperwork are too costly, Quintero said.

Value Options counters that the problem is lack of money.

"In Arizona, there are not enough dollars to take care of all the people who
need the care," said Helen Sommer, the company's director of communication.
"Part of our job is to maximize the number of people who get treated."

David Miller, CEO of the Arizona Council of Human Service Providers, said
the problems are the result of years of underfunding by state lawmakers.

"It's easy to paint Value Options as the bad guy; it may or may not be
true," he said. "Almost all of the drug treatment centers in the state are
on shaky ground."

Following The Money

The availability of drug treatment in Arizona depends on the kind of
addiction and what kind of addict is being treated.

To survive, many drug rehabilitation centers are going after federal money,
which has been on the rise. The DHS received $7 million more from the
federal government for drug programs in 1999 than in 1998.

But much of the money is earmarked for special groups, such as pregnant
addicts, Native Americans, the homeless, those recently out of jail and the
impoverished.

As a result, there are five programs for pregnant addicts in the state but
none to help the mothers stay clean after they give birth.

New Arizona Family is one of the centers that has adapted. The east-central
Phoenix center used to serve male and female addicts of all ages, but it's
now switching to serve women only.

Many other rehab slots are reserved for drug users coming through the legal
system.

About a quarter of inmates in all U.S. prisons were convicted of
drug-related charges, and many require treatment while serving time.

Outside of jail, half of all Arizonans in treatment programs were ordered
there by a court. That's up from about one-third just three years ago.

Those paroled from jail can get into treatment in two or three weeks because
the court system purchases services for them and they have probation and
parole officers helping them through the paperwork.

That leaves fewer slots for everyone else.

"Once you start prioritizing groups like pregnant addicts and criminals, it
means you must turn other people away," Dye said.

One of the groups shorted: kids.

In Maricopa County, there are no residential rehab beds available for minors
who need to get out of their homes to get clean or who already live on the
streets, and there hasn't been since October, said Superior Court Judge John
Foreman, who started the first juvenile drug court program in Arizona three
years ago.

"We need to take kids who are seriously addicted, detoxify them and get them
into a residential treatment right away," he said. "In most cases, the best
we can do now is to stick them in detention and detoxify them, and then send
them home where they couldn't stay clean before."

A few also get placed in a foster home or shelter.

"One other option is to send them to the Department of Juvenile Corrections,
but they have to stay at least a year to get into a substance abuse
program," Foreman said.

By not providing treatment to youngsters right away, their problems often
intensify.

"Most kids aren't serious addicts, but they are on a pathway to serious
adult addiction," Foreman said.

Foreman hopes that the juvenile detention center someday will have a wing
for substance abuse rehabilitation.

"Otherwise, we are relying solely on jail or prison," he said.

Seeking Support

Treatment and prevention programs have had tough sledding in the Arizona
Legislature over the past decade.

The last major legislation was five years ago, when subsidized substance
abuse programs were expanded to impoverished Arizonans.

"All we have done is some minor tinkering with drug programs the past
decade. We haven't looked at the system that exists and who it is serving
and what happens to them afterwards," said Sen. Ruth Solomon, D-Tucson, who
is leading an effort to fund more drug treatment.

She and state Rep. Sue Gerard, R-Phoenix, want a special appropriation of
$10 million this session from an untapped federal fund designed to provide
temporary assistance to needy families. Much of that would be used to help
parents get off drugs.

The two say that spending money on drug treatment would save taxpayers money
in the long run by keeping people out of jail and off welfare. It also would
help women have healthy babies and keep families together, they said.

"Isn't it a lot cheaper to treat them for $3,000 to $10,000 a year vs. the
$17,000 it costs to incarcerate them?" said Jay Levenson, vice president for
Southwest Behavioral Health in Phoenix.

But that's not an easy sell to legislators, many of whom view drug addiction
as a personal choice.

"Many legislators still have this old blind notion that treatment doesn't
work and all people have to do is just say no," said W. Mark Clark, chief
executive officer of CODAC Behavioral Health of Tucson, which recently
closed one substance abuse program and cut back another for lack of funding.

"Our Legislature is more willing to build prisons to lock up people who have
drug abuse problems than they are willing to spend money on treatment,"
Clark said.

Value Options' Sommer said she's heard legislators say, "We will give you
more money for mental health as long as you can promise none of it will go
to the substance abuser."

Legislators say they're not against treatment, they're just against
treatment that doesn't work.

"Almost everybody sees that there is a need. But a lot of people don't like
throwing money down a rat hole, and I am one of them," said state Rep. Karen
Johnson, R-Mesa.

As chairwoman of the Appropriations subcommittee on health and welfare,
Johnson said she sees "a lot of money being spent that is not accountable."

"Sometimes, the courts put people in drug rehab programs," she added, "and
if they don't want to go and don't want to recover, it seems to me that is a
waste of money. Before I fund anything, I want some definitive information
that proves this is working, the how and why."

That kind of information can be hard to come by.

The Department of Health Services released a study this fall of 415 addicts
who completed treatment and 60 who didn't. The study followed the addicts
for up to nine months.

Its conclusion: Those who went through rehabilitation were more likely to
have jobs and stay clean and less likely to be arrested than those who
didn't get help.

Many state-funded programs aren't scientifically evaluated at all, Solomon
said. She said the governor's drug policy council needs to do a better job
of gathering data so that legislators can make better decisions.

Gov. Jane Hull said she is studying ways to assess treatment programs,
although no assessments are under way.

She said that although more money for drug treatment is a good idea, it has
to be weighed against other needs.

"In state government, there are always more needs than there are dollars to
go around," she said. "At the same time, I am willing to push for more
dollars if they can be proven effective."

Though Johnson wants more accountability for drug dollars, she sees the
value in having enough treatment. She is pushing a bill through this year's
legislature for a new facility in the East Valley.

Gerard believes that the Legislature's resistance to funding rehabilitation
may be changing.

"If there is more attention being paid to drug addiction this year, it is
because there is more awareness of the problem as it touches more families,
including those of legislators," she said. "Once it has touched you in some
way, you understand it."

The value of drug treatment isn't lost on former drug users including,
Charlie DeMo, 46.

A recent graduate of the Salvation Army's Harbor Lights, a long-term drug
recovery program, DeMo now has his own apartment and car again. He visited
his 22-year-old daughter, whom he hadn't seen in many years. He plays
harmonica in a church group.

Look at him closely, and you will see a tiny black-and-white yin-and-yang
earring, reminding him to keep life balanced.

"I have my life back again," he says.

[SIDEBAR:]

FACTS ABOUT DRUG USE:

An estimated 6 million children in the United States live with parents who
reported using illicit drugs in the past month (National Institute on Drug
Abuse, 1994).

The portion of Arizonans ages 12 to 17 who in 1998 said they have used
illicit drugs was nearly 24 percent, far above the national average of 16.4
percent, according to a survey last year by the U.S. Department of Health
and Human Services.

9.9 percent of 12- to 17-year-olds nationally reported using some sort of
drugs within the past month. 11.5 percent of Arizona teens reported that
they were current marijuana users, compared with 7.8.3 percent in the rest
of the country.

Although overall teen drug use has dropped in Arizona since 1997, the number
of current cocaine users ages 12 to 17 increased to 2.3 percent from 1.9
percent.

There are only 12 publicly supported drug rehab beds in Arizona for kids who
need to get out of their home environment to get clean or who already live
on the streets.

Drug abuse is one of the most common factors leading to a child's entry into
the welfare system. In 1994, caseworkers nationwide reported that they knew
of parental substance abuse in at least one-third of families they were
serving.

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