"Maybe, since it took us 25 years to get into this problem, maybe we can in 25 years back our way out of it."
--- Bob Dey, DEA special agent in charge of the Sacramento office.
When you meet
Trisha Stanionis, she pulls out a set of clear plastic tiles with
colorful writing on them.
"These
are the dominoes," she says, making sure you are paying attention:
Business losses.
Seventy percent of all illegal-drug users are employed and in the
work force, and many aren't exactly working to their peak abilities.
Lost wages.
Substance-abusing employees will cost the employer 25 percent of
their paycheck per year. For a minimum-wage worker, that is $10
a day.
Education lost.
One in seven children goes to school every day from a home affected
by alcohol and drug use.
Health care
costs. More than 40 percent of all emergency room admissions are
affected by alcohol and drug abuse.
Child abuse.
At least 60 percent of all child abuse cases are directly related
to alcohol and drug use.
Criminal justice
system. Of the 160,000 incarcerated in California, 70 percent are
there for reasons directly related to alcohol and drug use.
Then she pulls
out one last domino. It reads: "Quality Treatment on Demand."
"If you
had this," she says as she sets it in front of the others then
pushes it over, sending the line toppling, "we'd knock them
all down. We are going to pay as taxpayers for this some way or
the other. The question is: Where do you want to send the check?"
Stanionis runs
a residential drug-treatment program in Sacramento called The Effort.
On her business card, underneath the logo in capital letters is
"TREATMENT WORKS." She knows it to be true. She can't
figure out why everyone else doesn't.
"The common
perception is that treatment doesn't work," she says while
sitting in her midtown Sacramento office. "Do people relapse?
Yes. But that is part of recovery. Treatment gives them tools to
use when they do."
Studies have
shown drug abuse costs the average taxpayer $1,000 a year in everything
from medical costs to incarceration costs. Other studies have shown
that for every $1 put into treatment, the public gets $7 back, mostly
from decreased criminal activity. Yet in 1998, federal budget figures
show, the U.S. government spent twice as much on drug-related matters
in the criminal justice system as it did in drug education and treatment
programs.
"I don't
want any more studies," she says. "I want a study that
shows me how I sell the results we have to Sally and Joe Taxpayer."
Selling the
results of drug treatment to taxpayers is only part of the problem.
Another is breaking down bureaucratic barriers for those seeking
help. In Sacramento County, staff members of various agencies, from
Probation to Child Protective Services, are trained to better understand
addiction issues and streamline the process for getting someone
into a program.
"We had
a worker population that really didn't understand the system,"
says Guy Klopp, special programs manager for Sacramento County's
alcohol and drug bureau. "No one had understanding of substance
abuse. Even getting people to raise the question was a huge barrier."
Since the assessment
training program started five years ago, waiting lists for getting
into a treatment program in the county have shrunk from more than
800 names to fewer than 120. Promising as that is, however, it is
only a start on a very long road.
 Treating drug
addiction costs money, and Carol Moltrum is out of it. She has burned
through roughly $100,000, which is all the money Butte County gives
her each year to put drug addicts into residential care. She has
been broke since the end of May. The only thing to do now is wait
the 11 days left in June. Come July 1, the new fiscal year starts
and she's flush again. Sort of.
Moltrum is
Butte County's gatekeeper. If you want to get into residential treatment,
you need to get past her. Every Monday from 1:30 to 3:30 p.m., she
takes calls from those hoping to get a bed. In those two hours,
she averages about 10 calls. Callers get referred to Moltrum from
all over -- children's services, probation, drug court. Methamphetamine,
cocaine and alcohol are the callers' favorites.
She can send
as many as five people a month at county expense. A lot of people
aren't going to make the cut. Her phone rings at precisely 1:30
p.m.
"This
is Carol, can I help you? . . . Who? Can you spell that?"
With a pencil,
she scratches notes on a legal pad the same color as her yellow
blouse.
"Have
you called before? . . . What is the problem? What kind of drug?
. . . How long have you been using? . . . What does 'on and off'
mean? . . . What has been your longest clean time? . . . So what
is your motivation this time?"
While the caller
sorts through his past, Moltrum urges him on with "Mmm-hms"
and "Uh-huhs." Through her open door, you can hear other
doors opening and slamming down the hallway.
"I'll
tell you what. I'd like you to come in for an appointment to interview
with me. I'll make the appointment for the week of July 10. . .
. No, it's not going to happen before that. There is no money until
July. . . . Now just because I made an appointment doesn't mean
you are going in. We'll talk."
The call ends
nine minutes after it started. A minute later, the phone rings again.
"This is Carol . . ."
 A few counties
to the south, Deborah Williams knows exactly what the people on
the other end of Moltrum's phone are feeling. She has been calling,
every day, to make it into Laura's House in Modesto. Though not
a residential treatment pro- gram, the house offers clean and sober
living to women who are pregnant or have young children.
"Every
day I call, 'Deborah, checking in.'
"
She already
did 28 days in Reality, Stanislaus County's only residential treatment
program. It took her two months of calling every day to get in the
program, and she graduated in mid-April. Since then, she's been
waiting to get into Laura's House. In late May, she works up the
nerve to ask.
"How much
longer?"
The response
makes her gut sink. A month.
"I've
almost said forget it," she says, sitting on the patio outside
of Reality's Alumni Center. "But I went to my Blue Book. I
went to a couple of meetings. I kept looking at my kids' pictures."
Williams is
34 and has been a drug user since she was 10. She started using
meth daily eight years ago. Her three kids, ages 13, 7 and 6, have
been in foster care almost two years now. Six months ago, Williams
went to jail for a failure to appear on her 1998 under-the-influence
conviction: It was her second term. She has a court date in November
and will try to convince a judge she has earned the right to have
her children back.
"I got
what I deserved, but my children didn't deserve what happened,"
she says. "The one thing I never wanted to do was hurt my kids.
Now that I've lost them, I have to look at them. My son is angry,
and my daughter wants to come home."
So she calls,
every day, to get in. Days turn into weeks. Weeks into months.
"That's
a long wait," Williams says, "for a dope addict."
 Getting off
meth is a numbers game. How much is treatment? How many days do
I have to wait to get in? How long will I be in? How long can I
stay clean? Twenty-eight days, 30 days, 90 days, 6 months, a year.
There are 12 steps. There is one day at a time.
For those filling
limited county treatment slots, working the numbers is crucial.
It costs Butte County $64 a day to keep an addict in residential
treatment. If they qualify, addicts go to the Right Road Residential
Program in neighboring Tehama County. Butte County, like most California
counties, contracts its residential care out to private, nonprofit
treatment centers.
The normal
stay in Right Road is 30 days. More days for one person means fewer
for another. Moltrum knows this all too well. In her three years
on the job, she has sent only two people for 90 days. "I work
real hard to spend every penny, to the penny," Moltrum says
in her office in Chico. "I've never gone over the budget."
Her job is
not for softies. "No" is a frequent part of her vocabulary.
People call, their lives shattered, reaching for hope. She must
sort through to find the weakest, neediest and most ready of the
bunch.
"It is
a bittersweet job," she says. "You love being able to
send the people you can. You hate not being able to send the people
you can't."
The phone rings
again.
 In Reality,
the treatment program she was in in Stanislaus County, Williams
learned what it meant to be a meth addict, which she has been for
the best part of a decade. They taught her to use tools -- critical
thinking and coping skills -- not just excuses when she wants to
use. That made her face what got her started in the first place.
"It's
not because I needed to lose weight. It's not because I needed money.
It's not because
I was tired,"
Williams says. "Basically, I liked dope."
In treatment,
Williams came to understand her addiction was like having a chronic
and sometimes fatal disease. Taking that perspective helps release
a lot of the guilt and shame that can bog down recovery.
She explains
her cravings in terms a chocoholic can understand. Drugs are like
that piece of chocolate cake when you are on a diet. Most people
can lick the frosting and go on. For her, licking the frosting was
having a beer. But she couldn't have just one beer. It wasn't enough.
A cold beer turned into six more, which turned into a 12-pack, which
turned into meth.
She says matter-of-factly:
"I can't lick the frosting anymore."
Williams has
graduated from the Reality program, and until she gets into Laura's
House, she's in limbo. That makes her feel useless. She attends
five Narcotics/Alcoholics Anonymous meetings a week to fill the
time.
"I get
bored really, really easy," she says. "That is the problem.
Then I start feeling fat, or useless, or anything. It's dangerous."
It is early
July, and Williams still is waiting.
 Getting into
treatment is a slow road in Butte County. It is impossible for addicts
to get into residential treatment the day they call. First, they
must pass a skin test for tuberculosis and a head lice check. Then
they have to find a way to cover the $200 medical expense fee. Most
take care of it by signing up for general aid. All that takes two
days, at least.
Butte County
has no official wait. Moltrum keeps a log of who called and acts
as moderator. She knows when there is space and when there isn't,
and she plans accordingly.
At 3:14 p.m.,
Moltrum picks up her last call for the day.
"Hi, this
is Carol . . . Hi, Joseph. What is the problem? . . . So the crank
is bothering you more than the pot or alcohol? . . . Are you going
to any 12-step meetings . . . What have you been doing recently
besides going to church?"
Joseph is not
signed up for any of the county's outpatient programs. No one gets
into residential without at least trying the groups first, Carol
explains. She tells him where to sign up in Chico.
"After
you have been doing that a couple weeks, if you are still having
a really serious problem staying clean and sober, you talk to your
counselor and call me back."
She hangs up
at 3:25 p.m. In all, she has taken eight calls. Six people told
her methamphetamine was their drug of choice. She scheduled three
appointments, told two to call her, told another two she would call
them and referred one to outpatient care.
"The calls
stop now," Moltrum says, "but the work doesn't stop now."`
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