Pubdate: Tue, 28 Dec 2004 Source: Courier-Journal, The (KY) Copyright: 2004 The Courier-Journal Contact: http://www.courier-journal.com/ Details: http://www.mapinc.org/media/97 Note: does not publish LTEs from outside their circulation area Author: Deborah Yetter Series: A RIsing Blight - Day 3: The Solution - Part 3B Treating Addiction CASH-STRAPPED SYSTEM HELPS ADDICTS Programs Save States Money BOWLING GREEN, Ky. - By her early 20s, Felecia Peacock was well-acquainted with alcohol, marijuana, cocaine and pills, but meth was her drug of choice for r six years. "It's euphoric," she said. "You stay up for hours. There's no eating. There's no sleeping." Despite the drug's powerful grip, Peacock found what two recent local studies underscore: Kentucky's publicly funded system of drug and alcohol treatment is highly effective in helping people beat methamphetamine. The University of Kentucky's Center on Drug and Alcohol Research studies of the past two years found that treatment helps significant numbers of addicts stop abusing all drugs, find full-time jobs and stay out of trouble. The most recent study, released in October, found that 60percent of people surveyed had stayed off illegal drugs; 64percent abstained from alcohol; full-time employment increased by 45percent; and arrests were cut by 51percent. Further, it found, the state gained about $100million by spending about $25million on treatment instead of prosecuting and jailing offenders. The UK studies examined 1,730 people who agreed to follow-up interviews after entering treatment during a 12-month period in 2000 and 2001-2002. Hope for Meth users and society A survey by the University of Kentucky found that 12 months after treatment in the state's public-funded programs: 60% had abstained from illegal drugs 64% had abstained from alcohol 45% increase in full-time employment 51% cut in arrests Robert Walker, project director for the study, said UK's findings mirror numerous national studies that conclude well-run treatment programs work and save states money. Yet advocates said Kentucky needs to spend at least $50million more on mental-health and substance-abuse treatment to move it from 44th in the nation in state spending to about 25th. Walker said Kentucky spends about $25million a year - mostly federal money - - on programs to treat drug and alcohol abuse. "Hey, this stuff works," Walker said. "I couldn't tell you the number of studies that have shown positive outcomes and cost savings." Martin Wesley, executive director of Park Place, a community mental-health treatment center in Bowling Green, said meth users respond well to treatment. "They're sick of it," he said of meth and the host of problems it brings. But the drug "is spreading like wildfire" in rural Kentucky and more slots are needed for treatment, he said, adding "We're just maxed out." Wesley and other advocates said the state should take advantage of a Medicaid provision that would allow Kentucky to provide more treatment through 70percent in federal matching funds for the 30percent in state money. "We obviously continue to advocate for additional money for substance-abuse treatment," said Dan Howard, executive director of the Association of Regional Mental Health Boards. "It makes more sense to treat substance abusers than to lock them up in jails." Getting Treatment Programs Based On 12-Step Approaches Research shows that nicotine tends to be the most addictive substance - 32percent of people become dependent, Walker said. Among illegal drugs, heroin was the next highest, with 23percent becoming dependent, followed by cocaine, with 17percent becoming dependent. Although meth is not listed in the research, Walker said it would probably be about the same as cocaine because both drugs are stimulants and act on users in similar ways. "The faster-acting the drug, the greater likelihood of addiction," he said. Walker said most drug-treatment programs in Kentucky are based on the Alcoholics Anonymous model of following 12 basic steps to sobriety. The first step is for participants to acknowledge powerlessness over alcohol or drug use, then proceed through a series of steps to accept help and regain control of their lives, Walker said, adding that the first step is essential. "You can't decide, 'I'm through,'" he said. "You cannot by yourself fix it." Most programs - either outpatient or residential - then guide the person through intensive education and discussion on the nature of substance abuse. That includes how to recognize what triggers abuse - such as stress or depression - and then provide steps on how to avoid it or find another way to deal with the trigger, he said. Programs generally fall into two categories: the "medical model," run by licensed psychologists and counselors; and the "recovery model," which relies heavily on recovering addicts who work as peer counselors to others in the program, Walker said. The community mental-health centers operate mostly on the medical model for residential and outpatient treatment. A Range Of Aid Approaches Can Vary By Cost, Success Several private nonprofit centers in Kentucky use the recovery method, including The Healing Place in Louisville and Hope Center in Lexington, Walker said. Walker said residential treatment offers a more intense, structured program supervised by professionals with medical training. But such programs are far more costly, about $150 a day per person. Jay Davidson, president of The Healing Place, said his recovery program - run entirely by peer counselors under the supervision of a few trained staff members - costs about $25 a day per person. Rodney Brannon, program director for The Healing Place, said the peer method can have a powerful effect on clients who often are homeless and desperate by the time they reach the center. "They're given the opportunity to talk to someone face to face who's been right where they were," he said. Davidson said The Healing Place is not equipped to provide mental-health treatment and generally arranges for outside care, usually through Seven Counties Services Inc., the regional mental-health provider. Walker said both models can be effective, depending on the person. The state's public treatment centers have adopted a residential treatment program of 30 days or less, which officials said gets results while allowing the state to serve more people. "We just don't have enough beds," Howard said. "We don't have enough dollars to open the kind of beds we need to treat substance abuse." The UK study found people in residential treatment were more likely to stay clean. For example, people who reported using illegal drugs when they entered residential treatment reported a 56percent drop in illegal drug use afterward. People who got outpatient treatment reported an 18percent reduction in illegal drug use after treatment. Of the about 26,300 people treated for substance abuse through the state's regional mental-health system, about 30percent received residential treatment, according to the UK study. Peacock, the recovering meth addict, now works at the Bowling Green halfway house where she stayed after completing a 28-day treatment at the Jefferson Alcohol and Drug Abuse Center in Louisville. The 32-year-old said she no longer wakes up needing meth to start the day. She is rebuilding a life with her husband and two sons, and she loves her job at Phoenix House. "I don't think about getting high," she said. "I don't have a daily desire to use." Peacock said that at the halfway house, she hears firsthand the stories of women struggling to recover. She said she believes what the state is doing simply is not enough to meet the need. "I think we are losing the war on drugs," she said. "I think we are putting a Band-Aid over an absolute disaster." About a dozen private non-profit organizations offer additional treatment or recovery programs, mostly in Louisville and Lexington. They include the Volunteers of America in Louisville, which offers several programs, including a 45-bed residential treatment center for men with alcohol or drug problems that put them at risk of incarceration, usually because they have violated a parole order by using alcohol or drugs. The program is funded by the state Corrections Department. Men stay in the program for a minimum of six months because research suggests that longer treatment improves results, said Pat McKiernan, who oversees drug, alcohol and mental-health treatment for the organization. "The longer someone stays in treatment, the greater the likelihood they'll succeed," McKiernan said. Volunteers of America offers several other residential or outpatient programs for people with mental-health or substance-abuse problems. But the organization cannot keep up with demand, he said. "We probably have a waiting list for every program that we operate," he said. - --- MAP posted-by: Beth