SCRATCHING THE SURFACE

The county still lacks a comprehensive anti-crack strategy. And it
has chosen a new drug treatment agency based largely on anecdotal data.

"Crack is whack," the drug-addled star singer, Whitney Houston, once
famously told a television interviewer.

Amen to that, say area law enforcement officials, who expressed
concern last week about the potential early release of scores of
crack cocaine offenders from prison.

Many said they feared that the more than 400-plus inmates from the
Triad who may see their sentences reduced could pick up precisely
where they left off, selling and using the viciously addictive drug.

In principle, the changes in federal sentencing guidelines are fair
and reasonable. They shortened prison sentences for crack convictions
to make them comparable to sentences for powdered cocaine, and also
made them retroactive. That means some offenders will be eligible for
early release. But will they be ready for lawful lives on the outside?

"Whatever the law is -- crack or powder cocaine -- I think we need to
enforce it the same and be consistent," Sheriff BJ Barnes told the
News & Record. "But I can tell you that you can make a lot of crack
with a little powdered cocaine, and there are a lot of addicts out there."

Also last week, the Guilford commissioners heard a presentation from
the operators of the soon-to-open drug treatment facility on West
Wendover Avenue. Given the county's well-documented problems with
crack addiction in particular, some critics question whether the
operator of the center, Missouri-based Bridgeway Behavioral Health,
is the right agency. They also question whether its new treatment
model is the right approach.

The facility will treat crack addicts, among others. Yet, even if it
is successful, the center will make only a small dent in the county's
crack epidemic. The county still needs a broader, more urgent
strategy to stem crack use and the crime, disease, prostitution and
homelessness it breeds here.

To their credit, mental health officials have crafted a new drug
treatment model that stresses partnerships and intervention. But how
much of that plan is funded and implemented and at what pace is not clear.

At the commissioners' meeting on Dec. 13, several additional
questions surfaced:

* Why couldn't Bridgeway provide hard data on the effectiveness of
its treatment programs beyond assurances by its COO, Mike Morrison,
that "we're good." He's from Missouri; surely he could show us how
good they are.

* Where is a viable local option for long-term residential care? With
only 56 available beds, only some of which will be devoted to crack
treatment, the Bridgeway facility can't begin to scratch the surface.

Paul Nagy, a Duke University consultant, cited TROSA, or Triangle
Residential Options for Substance Abusers, in Durham, as an option
during the commissioners' meeting. But he conceded last week via
e-mail that TROSA "is only able to accept a limited number of these
individuals due to capacity and type of patient the program can
effectively serve."

* Finally, the proponents of the new center argue that long-term
residential treatment is necessary only for some patients. They cite
research to support that view. But doesn't that same research also
say that long-term residential treatment is more effective with poor
and homeless patients, which describes the majority of crack addicts
in the county?

Duke's Nagy agreed. However, he said in an e-mail that "supportive
housing can also be offered in lieu of expensive residential
treatment." Yet many of those programs already are strained to capacity.

Despite those loose ends, the commissioners seem intent on moving
ahead with the facility anyway. County mental health Director Billie
Martin Pierce and her staff told the commissioners that Bridgeway
will be held to strict accountability measures even though it
produced very little such data to the commissioners. County leaders
owe it to the taxpayers to hold fast to those benchmarks.

If Bridgeway doesn't show the results, the county should show
Bridgeway the door.

[Sidebar]

WHAT'S BEEN SAID

"Sometimes I get the feeling that everybody but me is using it." --
Elton Turnbull, a convicted drug smuggler, on the extent of crack use
in Guilford County (2004)

"Crack cocaine remains a plague which affects some of our most
vulnerable neighborhoods and citizens."

George S.B. Holding, U.S. attorney for the state's Eastern District
(December 2007)

"Programs such as Fellowship Hall, Mary's House, Malachi House,
Caring Services, Alcohol and Drug Services, and numerous others are
all excellent. But what we need is more long-term residential care."
- -- Jim Van Hecke, a drug treatment consultant hired by the Guilford
Substance Abuse Coalition (2004)

"There's no agreement that certain drugs require certain amounts of
time." -- Joe Fortin, a substance abuse "best practices" specialist
with The Guilford Center (2007)