Pubdate: Tue, 18 Jan 2000
Source: Seattle Times (WA)
Copyright: 2000 The Seattle Times Company
Contact:  http://www.seattletimes.com/
Author: Warren King, Seattle Times medical reporter

NEW PUSH TO GET HEROIN ADDICTS MORE TREATMENT

The familiar young voice on the phone was desperate. It sent a shock wave of
fear and adrenaline through Susan Hubenthal.

"Mom, help me," pleaded 20-year-old Kelly Hubenthal. "I'm in a phone booth
in Seattle. I've just taken heroin, and I think I'm dying."

Susan Hubenthal began her rescue.

Police and fire departments couldn't help right away, but Hubenthal quickly
found a drug-treatment program that could. Tracing the phone-booth number,
clinic workers located Kelly and took him into treatment.

Kelly Hubenthal, the long-troubled son of a middle-class Olympia family,
wasn't dying as he lay in the Capitol Hill phone booth that winter night
over 10 years ago. But it was the beginning of a long off-and-on battle with
heroin that eventually killed him in 1996, and devastated his family.

About 300 to 450 Washington residents die every year of heroin overdoses.
With the availability of cheaper and stronger heroin, the problem has
worsened in recent years. Now, at the urging of health officials, government
is trying to do something about it.

Metropolitan King County Council members recently addressed a surge in the
deaths - 144 in the county in 1998 - by increasing the number of licensed
methadone-treatment slots by 50 percent. The Legislature also is
reconsidering a bill that would increase treatment availability statewide.
The bill passed the Senate last year but died in a House committee.

State law only allows King, Pierce, Spokane and Yakima counties to license
methadone use. The synthetic drug keeps patients off heroin and enables them
to lead normal lives. Experts say the treatment programs decrease crime by
addicts and prevent the spread of diseases such as AIDS and hepatitis C.

The legislation sponsored by Sen. Julia Patterson, D-SeaTac, would shift all
licensing authority to the state, allowing a clinic to be established in any
county. It also would remove present limits on the number of clients per
treatment facility, although it would still limit growth to only 10 percent
a year. And it would establish a pilot program to allow private physicians
to prescribe methadone.

Legislative analysts say cost increases would be about $175,000 every two
years to license and monitor the new methadone programs. But the analysis
does not include increased Medicaid costs that would come with more
patients.

About 4,250 methadone patients, 85 percent of the state's total, are now on
Medicaid, and it costs about $3,000 a year to treat each. About half of the
bill, $6.4 million, is paid from state coffers; half is from the federal
government. About 20,000 state residents a year could benefit from
treatment, but no one knows how many would seek treatment if it were
available.

Who addicts are, what they cost

According to the state Division of Alcohol and Substance Abuse, heroin users
in Washington come from all sectors. The average age is 35, and the average
time someone has been using is 15 years. Income levels range from poor to
wealthy.

A University of Washington study estimated the total cost of state
residents' alcohol and drug addiction at $2.3 billion a year in health care,
criminal justice, social-services expenses and lost productivity at all
jobs. Drug abuse accounts for about 40 percent of the cost.

For every dollar spent on alcohol or drug-abuse treatment, $3.71 is saved in
criminal-justice, health and social-services costs, researchers say.

"You can pay now or pay later," said Ken Stark, director of the state
Division of Alcohol and Substance Abuse. "If they don't do treatment, they
don't move to Oregon. They run up these ... costs, or they die."

Critics of methadone treatment say it only substitutes one drug for another.
They also point out that fewer than 10 percent are ever able to stop taking
methadone. But Patterson and others contend it enables patients to hold
jobs, to stop stealing to support their habits, and to stay healthy. All
treatment programs come with counseling.

"It's a question of harm reduction we're talking about," Patterson said.
"Most thinking people would support this proposal."

One addict's story

Susan Hubenthal and Kelly's widow, Pat Hubenthal, wonder if methadone would
have altered the tragic course of his life. They wonder how many other young
people might still be alive if the treatment had been available.

"I feel like all those young people who have died are guiding me to open my
mouth, to speak out about this," said Susan Hubenthal, 58.

Kelly Hubenthal, 28 when he died, had more than his share of trouble early
in life. It was plenty to erode the self-esteem of a growing boy.

Asthma plagued him from the time he was small. Smothering attacks of the
disease took him in and out of emergency rooms more times than his mother
can count. Injections of powerful steroids helped him breathe but also made
him combative and difficult.

Kelly also had a learning disability and, as a teenager, had severe acne
that caused other kids to tease him unmercifully.

"It seemed like people either really loved him or they couldn't stand him,"
his mother said. "He was sort of in your face all the time."

But there was also a bright side to Kelly, Susan Hubenthal said.

Her son loved children, and because of his playful nature and easy laugh,
they adored him. He also loved animals and was a great defender of the
disadvantaged, frequently handing out money to the homeless and to
charities.

"He was just a very sensitive, caring person," she said.

Hubenthal said a major issue in her son's life was his adoption. He couldn't
understand why his birth parents would have given him up. He struggled with
the fact that his younger sister, Jennifer, was his adoptive parents'
biological daughter. Jennifer nurtured and cared for him, but it all
frustrated and angered him.

Hubenthal worked hard to help her son. She took him to counselors beginning
at age 7. She hired tutors and worked with his teachers.

The drug use begins

She first suspected Kelly was using drugs when he was 14. The family was
living in Jacksonville, Fla., where Kelly's father, Bert, had been
transferred from Washington. Kelly was angry and withdrawn much of the time.
He slept a lot. Other kids came in and out of the house at night. Hubenthal
searched his room, found marijuana inside a stereo speaker and made it clear
drugs were forbidden.

But a year or so later, Hubenthal knew her son had a serious problem when
his friends brought him home after a football game and left him passed out
on the garage floor. After he went through detox at a hospital, she enrolled
him in a six-week residential-treatment program.

The program appeared to help Kelly, who had been using pot, LSD and cocaine
for about two years. After discharge, he attended regular counseling
sessions. He even spoke to his high-school class to help others learn from
his experience.

"In my little naive world, I thought he was cured," Susan Hubenthal said.

Besieged by his low self-esteem, however, Kelly returned to drugs in six
months. Again he went into treatment, and a pattern emerged:Treatment,
relapse, treatment, relapse. The divorce of his parents when he was 17 was
difficult. His father died when he was 19.

By then, Kelly had been in treatment three times. He also had dropped out of
school. Before he was 20, he moved back to the Seattle area with a friend.

After working odd jobs, Kelly joined the Jobs Corps, a federal job-training
program for youth. He learned to be a restaurant cook, but not before
repeatedly failing to complete the program's requirements because of his
drug abuse.

Hubenthal said her son supported himself working as a cook in Seattle. When
he called from the phone booth, desperately high, he had been regularly
using heroin for three months.

A turn for the better

Finally, at age 21 and with the urging of his grandfather, he enrolled in a
Job Corps program in Troutdale, Ore. There he blossomed. He did well in his
courses, earned his high-school equivalency diploma and was elected class
president.

"He finished full of hopes and dreams. He was clean and sober. He found a
good job in Portland and an apartment," said Susan Hubenthal.

Kelly Hubenthal also soon met the love of his life. A mutual friend
introduced him to Pat at a Portland tavern after a dart-throwing contest.

A computer programmer, Pat shared Kelly's love of ice hockey and other
sports. Soon they moved in together. Kelly switched from restaurant work to
selling satellite dishes. Life was good.

Pat knew of Kelly's past drug problems but "thought that was behind him."
She said the only time she knew he used anything was when he smoked
marijuana to ease the pain of an old back injury.

During the relationship with Pat, Kelly decided to fulfill his longtime
desire to seek out his biological parents. He found them in Oregon, but the
reception was lukewarm. Though he said little, his disappointment was
apparent.

A 'feeling I was losing him'

Kelly and Pat moved to the Olympia area in late 1992 to be closer to Susan
Hubenthal. They married, bought a house and began trying to have a baby. But
in a few years, Kelly ran into a former friend and - feeling sorry for the
man - hired him to do some landscape work at his house.

Pat didn't know about the friend's drug or criminal history, but said she
did have an uneasy feeling about him.

Much to Pat's dismay, the two quickly renewed their friendship. Kelly
reassured her that he was not using. But Pat worried constantly.

"I had this intuitive feeling I was losing him," she said.

The night Kelly died, June 29, 1996, Pat had gone to Seattle overnight to
buy plants for her garden. Kelly's friend came to the house with his
girlfriend, ostensibly to drink beer and celebrate her birthday.

Pat said the couple told police that when they went to bed after using
heroin with Kelly, he was watching a video in the living room. They said
they found him dead when they woke up about noon the next day.

Pat and Susan Hubenthal still agonize over Kelly's death.

They resent the awkward silence or insensitive questions when people learn
how he died. Like all survivors, they are filled with guilt and questions
about what they could have done to prevent it.

"I blame myself," said Susan Hubenthal, fighting tears. "I didn't know what
else we could do. . . . If only we had had more answers."

Pat is the same. At one point, Kelly told her he might like to "go away" to
a weight-loss treatment program. She still wonders if that was an indirect
plea for drug treatment. Did he hold back because treatment was too far away
or too expensive? She doesn't know.

"I found out about his heroin use and that he was dead all in one piece of
information," Pat said. "There was not a chance of doing anything about it
then."
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