VOUCHERS HELP FUND ADDICTS' PATH TO RECOVERY

Program's Future Uncertain After Three-Year Federal Grant Expires

Stephanie was an honor-roll student from a good family, she said,
when that first blast of heroin filled her nostrils. She was 17 and
hanging out in a Santa Fe college dorm with a bunch of "white
hippies" and her boyfriend.

The next four years, she was strung out and ran into serious trouble
with the law for dealing drugs. She got clean for a while, then
relapsed on July 17, 2005, a date she remembers as clearly as her birthday.

Around that time, Stephanie -- who says she is a federally convicted
felon -- landed in jail for violating probation. Four months later,
she entered Vista Taos Renewal Center, an $18,000-a-month inpatient
treatment program.

Though her four months there went well, the transition from a
resortlike setting back to run-of-the-mill life in Santa Fe felt
awkward. She knew she needed support, but her family couldn't afford
the outpatient program she liked at Focused Recovery.

Luckily, someone at Focused Recovery pointed her to a Santa Fe
County voucher program called Access to Recovery. The voucher
covered 12 weeks of intensive outpatient treatment, and Stephanie
still uses it for group and individual sessions. Now, at age 25,
she's being treated for an eating disorder and has been clean for
more than a year, she said.

When the voucher runs out this year, Stephanie said, she's not
worried because she has a good job with health insurance. "I'll be
able to keep on going," she said. But she still feared to have her
real name used in this article because people "don't look at the
good side of people" when they know you've been a drug addict.

'It's Going To Come Apart'

On the drug and alcohol treatment scene in Santa Fe County, the
voucher program has been a bright spot, providers say, but when the
three-year federal grant expires, the huge pot of treatment dollars
will dry up.

Another $1.4 million in vouchers came through July 1. But when that
grant runs out in a year, no one is sure whether the state or
behavioral-health services contractor ValueOptions of New Mexico
will keep it going.

"It's going to come apart," said Marty Klehn, an addiction counselor
in private practice. "If we could keep something like that
permanent, we could see the problem (of untreated addiction)
drastically reduced."

Alcohol and heroin are the most common substances abused in Santa Fe
County, providers say, and addiction can run so rampant in families
that grandmothers teach granddaughters how to shoot up.

At CARE Connection, the county's central intake center for addiction
and mental-health problems, 1,000 people have used vouchers over the
past two years. Consumers choose from a list of 24 treatment and
support programs. The Access to Recovery voucher system has
attracted new providers to the region, said CARE Connection's
clinical director Mark Boschelli, and competition has encouraged
directors to rev up their programs or else lose out.

"I've been around when we didn't have it, and there was a dearth of
services," he said.

Yet one voucher per resident, the federally set limit, isn't enough,
Boschelli said, since the typical addict goes through treatment at
least three times before abstinence sticks.

Overall, some aspects of the continuum of care available in Santa Fe
County have gotten better, though providers complain about cuts in
the state budget that undermine good programs. "We have
best-practice models, but the funding needs to increase to make the
impact that everyone is looking for," Boschelli said.

Limited Options

A new sobering-up center in downtown Santa Fe -- slated to open in
September -- will give police an alternative when they pick up
someone who's drunk. Instead of spending the night in the drunk tank
or going to the emergency room, these people can have five days
without alcohol or drugs in a supportive place. "It's kind of like
an island," said director Richard Lucero.

St. Vincent Regional Medical Center may prescribe drugs to help
patients deal with withdrawal, but no doctors or nurses will be on
the center's staff, Lucero said. The hospital does some detox now,
which is overseen by clinicians, but critics say it's not enough.

When domestic violence survivors show up drunk and out of control at
the Esperanza Shelter, there is no place to send them, and some go
home, said agency director K.C. Quirk. "It's a bad deal for them," she said.

"The only way they can stay at the hospital is if they say, 'I'm
going to kill myself,' " said Scott Gilbert, the former owner of
Focused Recovery, which opened a fast-growing Santa Fe office two
years ago. "What (St. Vincent doctors) usually do is hand them a
bunch of pills and send them home, if they'll even do that." The
hospital said it stabilizes all such patients but does not track the
percentage admitted or sent home.

Gilbert, who still works for Focused Recovery, sends clients to
Albuquerque if he can find detox space there. After spending hours
searching for detox for one patient, he said, he decided to sell his
business this summer to The Right Step, which operates several detox
and inpatient programs in Texas.

Gilbert has also had a hard time finding high-quality inpatient
programs in New Mexico, especially for clients with health insurance
that isn't accepted by some treatment programs, and sent 170 people
out of state last year.

New staff at the Santa Fe Recovery Center, which emerged out of the
ashes of another program that went belly up, have restored the only
residential treatment facility in the county. Three months ago, the
center added an outpatient treatment program. "We're really doing
great," said director Yolanda Briscoe. "We actually put money in
savings last month."

But in this business, there's always a caveat. The wait for a 30-day
stay at the Santa Fe Recovery Center can be six weeks, she said, and
insurance companies are strict about who can get coverage.

Little help is available overall for young people. "Adolescent
mental health and treatment in town -- there's very little, and what
there is is totally overwhelmed," said Steve Shepherd, director of
the county's Health and Human Services Department.