Pubdate: Sun, 21 Oct 2007 Source: Lexington Herald-Leader (KY) Copyright: 2007 Lexington Herald-Leader Contact: http://www.kentucky.com/mld/heraldleader/ Details: http://www.mapinc.org/media/240 Bookmark: http://www.mapinc.org/rehab.htm (Treatment) Bookmark: http://www.mapinc.org/find?159 (Drug Courts) 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. - --- MAP posted-by: Jay Bergstrom