DAWN BY THE THOUSANDS

Kentucky Needs More, Better Drug Treatment Programs

This past week, reporter Mary Meehan and photographer David
Stephenson have recounted Dawn Nicole Smith's struggle with
prescription drug abuse.

It's a painful, ugly story that started before Smith was born and
will outlive her as her five children make their way through the world.

It's a complex story about the link between abuse and addiction, each
nurturing the other, generation to generation.

Smith's story ripples beyond her family to the foster homes, courts,
recovery programs, churches, hospitals and jails where she's spent
time and the courts, schools, social workers and foster homes that
will try to fill the voids for her children.

A reader is tempted, after days of the unflinching account, to give
up and agree with Smith that she might not be worth the trouble. Put
her in jail and let the rest of us get on with our lives.

Cold as it is, one could argue that would work for society, if
Smith's story were unique.

But it's not.

Each year, 375,000 Kentuckians need treatment for drug abuse,
according to Kentucky's Office of Drug Control Policy.

But most won't get it.

The denial that marks Smith's unsuccessful path through drug court
and rehabilitation attempts also dominates our public approach to
drug addiction.

Of the 375,000 who need treatment only one in 12, about 31,000 will
get in it. Despite the long waiting list, state funding has been
stuck at $10 million for 15 years.

Unlike a majority of states, Kentucky doesn't generally pay for drug
treatment for adult addicts who qualify for Medicaid, forfeiting the
$3 federal match for every state Medicaid dollar spent on addiction
treatment benefits.

Without treatment, some version of Smith's story will play out for
most. Each damaged life will reverberate through legal, social and
medical systems, bringing stress and agony to families, friends and co-workers.

Without treatment, many will continue to drive on the streets, some
will shoplift, steal prescriptions or cars or copper from electric
wires. They will lie, ignore bills, neglect their families. Their
children will struggle through the chaos of unsettled homes to
survive in school.

Meehan reported that about half of all violence and domestic abuse
and 70 percent of child abuse and neglect are associated with
substance abuse, and over half of all theft and property crimes.

In Kentucky, the political corruption that feeds off this epidemic
comes to light when mayors, county judges, sheriffs and other
officials tainted by drug money are tried or sentenced.

There are signs of hope.

Drug courts, which combine intense supervision, drug tests, and group
counseling as an alternative to prison, are spreading. Pioneered in
Fayette County 15 years ago, every county will have a drug court by
the end of this year.

Although it didn't work for Smith, just over half of drug abusers in
Kenutcky who have completed drug court have stayed clean, a
remarkable achievement.

The state is also adding 10 inpatient recovery centers that will be
able to treat 1,000 people. It's a small step considering the waiting
list, and that successful programs generally involve 30 to 90 days of
residential treatment.

As Kentucky sinks ever deeper into the mire of drug abuse, we cling
to public policy focused on enforcement that shortchanges the
essential role of treatment. Enforcement is critical but it won't
conquer drug abuse.

Operation UNITE, Eastern Kentucky's largest anti-drug program with a
budget of more than $9 million, has conducted dozens of drug
roundups, arrested well over 1,000 people and removed or seized drugs
with a street value of about $6 million.

"We tried for the past 50 years to arrest our way out of this
problem, but it did not, has not and will not work," Dan Smoot, the
head of UNITE's law enforcement divisions, said late last year.

Smith, sexually abused at 14, child of a family with a history of
substance abuse, a teen mother without a high school degree, made
disastrous choices.

Kentucky has to make better choices.