OK, WE'VE GOT A DRUG PROBLEM

SO WHERE DO WE TURN FOR HELP?

VIRGINIA -- More and more people are seeking help with chemical
dependency.

And more and more people are being turned away.

Budget cuts, the rising cost of health care and tougher criteria to
qualify for insurance, state or county coverage are keeping many who
have a chemical addiction from getting treatment.

"There is never enough funding," Judd Perko, senior manager with the
Public Health and Human Services Department in Virginia said. After a
state budget cut two years ago, the department can provide chemical
dependency services to only those who meet very low income guidelines.

"Some insurance companies are still paying for it (treatment) but they
need to be more generous with their payments," he said.

Sue Neuttila, director of detoxification services at the Range Mental
Health Center, said that the decision whether a patient receives
treatment is now made largely by insurance companies.

"The decision is not made by the treatment center or the patient," she
said, because insurance often won't cover the cost of care.

"You can decide you want to go for treatment but if insurance says you
can't, the question left is, how are you going to pay," Neuttila said.
"Outpatient treatment starts at $5,000 to $7,000 and inpatient
treatment is $10,000 to $15,000 and up."

Government cutbacks and less philanthropic giving also recently forced
the Arrowhead Center to close two of their three facilities, the
center's director, Rick Goodman, said. They no longer offer an
outreach program in Ely or an inpatient treatment center at the Pine
Mill Court in Virginia.

Demands for their services have increased, though. Goodman has seen
all types of chemical dependency grow, from alcohol to
methamphetamine.

Enrollment in the Arrowhead Center's counseling groups are overflowing
numbers set forth in state guidelines.

Usually enrollment fluctuates throughout the year, Goodman said. "But
we've been full like this for six months now and that's unusual."

They are also scheduling intakes a month ahead of time, unable to keep
up with the people seeking help.

"With these people, if they're addicts, if you leave them out there
like that, they become harder to reach," Goodman said. So his staff is
putting in many extra hours to help people get the services they need.

The St. Louis County court and correctional systems are feeling the
same strain.

"There's a great deal of frustration by everyone in the system, from
law enforcement to prosecutors to corrections officers," Assistant St.
Louis County Attorney Gordon Coldagelli said. "The problem is so
widespread and it doesn't appear to be resolving. We don't have a good
answer and we don't have the resources to deal with it. Our budget
crisis couldn't have come at a worse time."

Neuttila agreed.

"There are lots of programs that are probably not going to survive if
the state keeps cutting funds," she said.

One option the County Attorney's Office has discussed to help ease the
strain is to discontinue prosecuting what they call "trace cases," in
which the offender has a trace amount of methamphetamine found on them.

"Some jurisdictions want a weighable amount and that philosophy is
valid," Coldagelli said. "But my thought is, we have to continue to
charge the trace cases. There was a weighable amount there before
there was a trace. And if we get these people into the system, there's
always the chance that we can make an impact and turn them around."

Dave Wagner, director of the Twelfth Step House in Virginia, has seen
the effects of the correctional systems' lack of funds and personnel.

"In the courts, people get arrested and get a little slap on the
hand," he said. "Then they get probation, but probation doesn't hold
them accountable. Then these people, because they're not held
accountable, end up going out and committing crimes and spending time
in jail anyway."

The jails are so full right now that the courts are sending people
back out into the community with probation, without the man-power to
monitor their probation very well, he said.

"Because of budget cuts, the jail is full and we don't have a work
release program anymore," Coldagelli said. "So at a time when our
problem is exploding, our means to deal with them is going the other
way.

"We're limited to jail, some sort of sentence to service program or an
electronic monitor, which, with an addict, they're subject to random
urine testing but if you don't have a way to keep people away from it
(drugs), it's difficult to deal with them."

Given the area's sparse population, though, many leaders in the
rehabilitation business said the Iron Range has a lot to offer those
seeking help.

"In the city of Virginia and on the Iron Range, we have a really good
network of various treatment centers," Wagner said. From
detoxification services, to outpatient and inpatient programs, to the
community integration services of the Twelve Step House, he believes
the area has most bases covered.

The Range Mental Health Center alone offers detoxification, assessment
and residential programs, along with services for the area's homeless,
elderly and those with mental health issues.

"Not every rural area has a mental health center with as diversified
services as RMH," Neuttila said. "It's just a matter of getting people
hooked up with the services they need and finding funding so those
services don't have to close."

The Department of Public Health and Human Services also provides
chemical dependency assessments and treatment, including placement in
appropriate programs. Most of their clients -- about 75 percent, Perko
estimated -- are referred from the court or correctional system and
he's noticed a slight rise in those admitted for methamphetamine use.

It's a trend mirrored at the Range Mental Health Center.

"We've had quite a high increase in detox of meth users," Neuttila
said. "Usually, though, they're using more than one chemical," a
mixture of alcohol, methamphetamine and marijuana.

"I think the treatment center is doing a good job at offering a
variety of treatments for different chemicals," she said, and added
that opiate and oxycontin use is also on the increase.

The Arrowhead Center has also expanded its services to deal with the
multi-chemical use. It used to be called the Arrowhead Center for
Problem Drinking.

"But now, people are coming in, drinking, doing meth, doing
prescription drugs," Goodman said. So they changed their name and mode
of operation, performing baseline tests on everyone who comes in for
help. The tests check for seven types of drugs.

"It's a challenge," he said.

One challenge Goodman thinks the Iron Range hasn't risen to meet,
though, is youth treatment centers.

"Right now, what's missing is adolescent programs," Goodman
said.

When local juveniles are caught using drugs, they have nowhere to
stay, he said. Probation officers have to bring them to Duluth.
Goodman hopes the Arrowhead Center can eventually fill that void with
a new program in Hibbing.

"We're getting it going, but it may take months" to set up, he
said.

First, they have to find a suitable building and get the site and the
staff licensed, which is a two-fold challenge. The State of Minnesota
is changing its licensure procedure, stalling the process."Minnesota is
going to be changing its chemical dependency treatment
within 16 months, at best guess," Perko explained.

The state wants to consolidate all services, from detox and assessment
to treatment, into chemical dependency treatment centers instead of
separate "treatment silos," Perko said.

He also anticipates new programs without time restrictions or set
patterns, which he called "a waste of the public's dollars by throwing
treatment (too quickly) at a patient who doesn't understand."

To further hinder the Arrowhead Center's attempts to build a juvenile
center, budget cuts and less philanthropic giving have forced them to
lay off some workers, reduce others' pay and take away all their
employees' pensions. The Arrowhead Center would, then, have to rely on
the juvenile clients' parents' insurance to cover care costs.

But, Perko said, any funds put into solving chemical addiction
problems now will be worth it in the long run.

"The money we put in the front end of this will be paid back in back
end," he said. "People are sometimes reluctant to pay to correct
social problems, but this will pay off."

One area Perko thinks might have the biggest pay-back is
prevention.

"We need more education," he said. "Especially regarding meth, people
don't understand the real danger of that drug. We have seen a rise in
drug-induced psychoses due to meth and, sadly, there is a chance that
those conditions can become permanent."

The Arrowhead Center is participating in a local meth initiative,
focusing on prevention through education. Others working on the
initiative are school, media and government representatives, the
United Way, law enforcement and Iron Range Youth. Their first public
programs were held Thursday and Friday in Hibbing, Chisholm and
Virginia, with an adult target audience.

"This is a real problem," Wagner said about the increase in meth use
and chemical abuse in general. "I don't think it's so simply addressed
as to what we can do to prevent it ... but we need to have everybody
on same page. We need to have an alliance and educate the general
public on what's going on.

"We see it over here at the Twelve Step House all the time and it
becomes common-day stuff but the general public doesn't really know.
With the murders and stuff that are going on, it's getting scary."