Fw: News.Youth

Bruce D. Burleson (anvil@quik.com)
Tue, 28 Apr 1998 21:31:46 -0400


Forwarded from Smart Recovery email list.

----------
> From: Becky Dornon <becky@INAME.COM>
> To: SMARTREC@MAELSTROM.STJOHNS.EDU
> Subject: News.Youth
> Date: Tuesday, April 28, 1998 7:34 PM
> 
>                Treatment options are limited for younger addicts
>                  (Fort Worth Star-Telegram; 04/26/98)
> 
>    After five years of addiction, Jennifer K. was living on the streets
and
> sustaining herself on Snickers candy bars and the heroin she pumped
through the
> veins in her bony arms. The 22-year-old Colleyville woman had lost 45 of
her
> 120 pounds and had even been hospitalized for two days after she
overdosed and
> stopped breathing.
> 
>    Within a week, she had begun shooting heroin into her veins again.
> 
>    She was a heartbeat from death, pushing her father into a frantic
search to
> get her back into treatment. Chuck K. canvassed area drug treatment
centers and
> hospitals. Dead ends. In desperation, he started calling throughout Texas
and
> the country. All the while, he knew that time was running out.
> 
>    "It was a scary, gut-wrenching, hurtful thing," he said. "I lost 30
pounds.
> I could not sleep. Whenever the telephone rang, I cringed."
> 
>    He found an inpatient, 30-day detoxification program in Hunt. Jennifer
> refused to enter - but then she was busted on drug paraphernalia charges
and
> faced the choice of jail or rehabilitation. After the month of rehab, she
was
> transferred to a private residential center in California.
> 
>    Her father hopes that this time she can escape heroin's curse. He
knows
> there is no certainty.
> 
>    "It's now up to her. I've done all I can," Chuck said.
> 
>    Today's teen-age and 20-something users may be the most difficult
heroin
> addicts to save. They are more intensely addicted to heroin than the
"ghetto"
> junkies of the past, but treatment options have been sharply reduced
throughout
> Texas. Even when treatment exists, young users are the least motivated to
get
> clean.
> 
>    "Kids feel invulnerable because they haven't had 15 years of negative
> consequences from heroin use," said David Helton, director of case
management
> for the Tarrant Council on Alcoholism and Drug Abuse. "We don't see them
until
> they are in a lot of trouble. They are dragged in kicking and screaming
by
> their parents, or sent to us by the juvenile justice system."
> 
>    The young addicts need extended treatment away from their
drug-infested
> environments and ongoing support, studies show. But what most will get in
the
> Metroplex are only short bursts of treatment - unless they can pay $8,000
to
> $10,000 and more out of pocket.
> 
>    Treatment options are limited for adult heroin addicts, scarce for
> adolescent heroin addicts - and nearly nonexistent for adolescent heroin
> addicts who don't have insurance or another way to pay.
> 
>    "There is zero, nada, nothing for the greatest number of the
population.
> There is no publicly funded inpatient chemically dependent treatment for
> adolescents in Tarrant County," said Bob Josch, director of addiction
services
> at Cook Children's Medical Center in Fort Worth. "If you don't have the
ability
> to pay, there is nothing available."
> 
>    With the area's dramatic increase in heroin deaths in the past two
years,
> agencies are scrambling to stretch resources and create programs. But
they
> aren't sure that they can do it soon enough to save the wave of young
heroin
> addicts.
> 
>    And, they say, there hasn't been a public clamor for the services.
> 
>    "What I keep hearing from the politicians about drug abuse is, let's
save
> our kids, say no to drugs. But there seems to be a lot of talk, not
action. I
> don't see the money coming down for services," Helton said.
> 
>    "We don't have kids beating down our doors or parents beating down
doors for
> services."
> 
>    Too often, officials say, parents either are ashamed, aren't involved
with
> their children - or use drugs themselves.
> 
>    "The demand for treatment from parents is not a loud voice in the
county,"
> said Eric Niedermayer, chief of addiction services for Tarrant County
Mental
> Health-Mental Retardation Services.
> 
>    Only now, as addiction tears through communities, has the void hit
close to
> home.
> 
>    "It is happening to a number of young people from all spectrums of
society.
> People can no longer sit back, ignore it and say, `Those kids over
there,' "
> Tarrant County Commissioner Dionne Bagsby said. "Drugs are killing
everybody's
> kids."
> 
>    Tom Gillum took drastic action to try to save his teen-age son. When
James
> Daniel Gillum passed out one night last year, his father put him in an
> ambulance and sent him to Baylor/Richardson Medical Center for detox.
Worried
> that his son would skip out, he demanded that the hospital not release
him.
> 
>    "When a child is 17, they can write themselves out and say, `I want to
go
> out on my own,' " Tom Gillum said.
> 
>    "I told them that if they let my child out and he hurt himself or hurt
his
> family, that I'd sue them."
> 
>    The Allen teen-ager was kept at Baylor until he was fully detoxed.
Then his
> father gave him an ultimatum.
> 
>    "I said, `Well, you've got the choice, commit yourself or we'll commit
for
> you,' " Tom Gillum said. "If he had not, I would have filed charges
against him
> for drug possession."
> 
>    After a week at a state facility in Wichita Falls, James committed
himself
> into a three-month rehab program at Homeward Bound, a public adult
treatment
> center in Dallas. At 18, he was the youngest addict enrolled in the
program.
> 
>    "They had one guy there who was 60 years old and had been there five
times,"
> Tom Gillum said.
> 
>    James told others that he felt safe in rehab but was ready to come
home,
> even though he was scared, said Jason Beck of Plano, a 22-year-old
cousin.
> 
>    James' sister, April Sennhauser, recalls the weeks after his February
> release.
> 
>    "He got out of rehab and he was doing OK," said Sennhauser, 22, of
Garland.
> "But you can't really compete against the drugs - getting that rush."
> 
>    Eight days ago, the baby-faced teen died after shooting up at a
friend's
> home.
> 
>    When the wave of young heroin users began showing up for treatment two
years
> ago, Stevie Hansen, acting director for addiction for Tarrant County
Mental
> Health-Mental Retardation Services in Fort Worth, knew that they would
find
> little help.
> 
>    The agency's detox centers had programs only for people 18 and older,
she
> said. Without licensing and funding, the centers couldn't serve the
younger
> addicts.
> 
>    "We are trying to get more money to start an adolescent detox program.
More
> adolescents need to be detoxed. It's heartbreaking," Hansen said.
> 
>    Lena Pope Home, a private nonprofit agency, once provided 24-hour
daily
> residential drug treatment for indigent 13- to 17-year-olds. But the
program
> was shut down in 1995 because local and state funding sources kept
getting cut.
> It cost $232 per child per day to run a 13-week program for 40
adolescents, but
> the state offered to reimburse the home only $101 per child per day.
> 
>    "If the funds were there, you would have treatment programs
available," said
> Ted Blevins, executive director.
> 
>    Daytop Village, a program in Dallas and Palestine, is one of the few
area
> residential treatment centers for adolescents who have no insurance.
> 
>    "There is almost no treatment in the state for adolescent substance
abuse,"
> said Brad Smith, assistant program director for Daytop Village. "At
times, we
> have a waiting list of three to four months."
> 
>    Even for young addicts with insurance, area treatment options are
limited.
> Most insurance policies either exclude or severely restrict the length
and
> types of drug treatment.
> 
>    Huguley Memorial Medical Center closed its adolescent programs in
Arlington
> in December. All Saints Episcopal Hospital in Fort Worth closed its
adolescent
> outpatient program in August. Harris Methodist-Springwood in Bedford
closed its
> 20-bed adolescent unit in 1996.
> 
>    Santa Fe Adolescent Services in Fort Worth is the only publicly funded
> chemically dependent treatment center in Tarrant County for adolescents
as
> young as 12, but it doesn't provide residential care. Children are given
> intense daytime individual therapy and counseling on how to live with
their
> drug addictions.
> 
>    Cook Children's Medical Center has an intensive outpatient programg as
13
> for treatment.
> 
>    "It's not for the addict who is shooting every day," Josch said. "He
is
> going to relapse. I will not be able to keep him clean."
> 
>    The Excel Center, a private treatment program in Fort Worth, has 10
slots
> for outpatient day treatment and 15 for outpatient evening treatment.
Charter
> Behavioral Health System of Grapevine has 20 beds for adolescents who
need
> psychiatric or chemical dependency treatment. BHC Millwood Hospital in
> Arlington has 30 swing beds.
> 
>    "It's very challenging when you can't get them into treatment
anywhere,"
> said Charles Parks, assistant director of Tarrant Community Outreach in
> Arlington and a recovering heroin addict. "Sometimes, waiting for the
child to
> get into trouble and end up in juvenile detention is the only way to get
help."
> 
>    The situation isn't much better for addicts 18 and older.
> 
>    For indigent users, the few existing counseling programs have
months-long
> waiting lists because of limited funding and space.
> 
>    One notable exception is the nonprofit Cenikor Foundation Inc. in Fort
> Worth, which offers a three-year inpatient program for addicts 18 and
older.
> Cost is not a barrier. Clients pay $25 for an interview and $100 for
admission.
> The more than $16,000 annual cost of care per person is covered through
grants,
> donations and fund-raisers.
> 
>    But the addict must be completely detoxed before entering Cenikor.
> 
>    In a structured 24-hour program, residents have curfews, must work,
build
> savings and obtain a high school equivalency diploma.
> 
>    Many addicts refuse to apply for the program and commit for such a
long
> term, said Gloria Tudon, a recovering crack addict who graduated from the
> program and works as its public relations director.
> 
>    "People who come here have already lost everything. It's therapeutic,
> confrontational and tough," Tudon said. "It's not people sitting on their
> behinds."
> 
>    For adult users with insurance, only very short stays at the private
> treatment centers are covered.
> 
>    "The length of average stay four years ago was 18 days. The length of
stay
> today is five days," said Robin Biege, program director for psychiatry at
Cook
> Children's.
> 
>    Controversy, the switch to managed care and changes in state
priorities
> drained money from residential treatment programs.
> 
>    Insurers cut back sharply after a nationwide psychiatric hospital
scandal in
> the early 1990s, when it was revealed that some facilities paid a bounty
for
> insured patients and hospitalized them until their insurance was tapped
dry.
> 
>    The change to managed care also reduced after-care programs and
counseling,
> treatment specialists say.
> 
>    The Texas Commission on Alcoholism and Drug Abuse, which doles out
much of
> the state's federal grants for treatment, sharply cut funding after a
state
> investigation revealed that some treatment providers had improperly
billed the
> agency for millions of dollars. The state already had begun channeling
its
> treatment dollars for adult addicts in the criminal justice system, said
Stacey
> Trayler, program director of Nexus Recovery Center in Dallas, a private
> nonprofit treatment center for indigent women.
> 
>    Today, more money is spent on addicts within the Texas criminal
justice
> system than on drug users who voluntarily enter programs, said Adam
Velez,
> director of the nonprofit Red River Council on Alcohol and Drug Abuse in
> Texarkana.
> 
>    "I've been turned away because of money, case load," said Robert
Shockley,
> 47, a recovering Fort Worth heroin addict who has been in and out of
treatment
> since the early 1980s. "Sometimes the help just isn't there."
> 
>    Kay, a Sansom Park mother, searched for three weeks to find a slot in
> treatment for her 16-year-old son before he was admitted to Santa Fe
Adolescent
> Services. He was smoking marijuana and feared that it would lead to
stronger
> drugs.
> 
>    "You feel like banging your head against the wall, especially when a
kid is
> telling you, `Mother, I want to get into treatment,' " Kay said. "I hate
to
> think about what could have happened in those weeks. It should not have
taken
> that long. There are not a lot of options."
> 
>    The junkies who have broken free of their addictions in years past
have
> three things in common, researchers say.
> 
>    They were disgusted with their lives and wanted out. They knew that
they had
> to break away.
> 
>    They stayed in treatment an "adequate" amount of time - six months, a
year
> or more.
> 
>    They had ongoing support.
> 
>    "It's not magical," said Dwayne Simpson, director of the Institute of
> Behaviorial Research at Texas Christian University and a leading
treatment
> research scientist who is taking part in a national study of treatment.
> 
>    An addict must want treatment before it is likely to be successful,
> according to the ongoing study, which is jointly researched and analyzed
by the
> University of California at Los Angeles and the National Institute on
Drug
> Abuse.
> 
>    "How motivated, how ready they are for treatment when they come in is
> related to how well they engage in treatment," said Simpson, who has been
> studying treatment of drug addiction for three decades.
> 
>    Most young people lack such motivation because they can't imagine what
10
> years of addiction will do to them. They dupe themselves into believing
that
> they can handle their addictions and mock the benefits of treatment,
counselors
> say.
> 
>    Jennifer K. recalls standing over a friend who was overdosing as she
kept
> shooting up.
> 
>    The only emotion she remembers is anger that the overdose might bring
> police. "I was mad," she said, "because I didn't want to get in trouble."
> 
>    Teens 16 and older cannot be forced into treatment against their will
unless
> they end up in the juvenile justice system and are ordered into treatment
by
> the courts.
> 
>    "Parents can bring their kids in, but if the kids don't want
treatment, we
> can't do anything," said Eric Apple, a spokesman for Charter Behavioral
Health
> System in Grapevine.
> 
>    That's why it's vital to respond when a young user says, "I'm ready, I
need
> help,' " said Richard Spence, manager of research and technology at the
Texas
> Commission on Alcohol and Drug Abuse.
> 
>    "People can get on a waiting list, but they don't bother," Spence
said.
> "Drug addicts can't wait. There is a window of willingness to enter
treatment."
> 
>    "Adequate" treatment varies according to the individual's need,
researchers
> say. That's why screening is important before treatment, Simpson said.
> 
>    Most teen-age addicts first need to be detoxed - taken completely off
heroin
> under medical supervision, as they experience the gut-wrenching effects
of
> withdrawal: cramps, fevers, shakes, racing pulse, aching bones and
coughing.
> 
>    Then, to help addicts change their behavior and stay off heroin, they
need
> intensive counseling and support groups.
> 
>    Another key is getting the addicts away from the temptation of old
> relationships and places, counselors say.
> 
>    Nick, a 20-year-old Richland High School graduate, was desperate to
get
> clean after three years of addiction. He entered four treatment programs
in
> Fort Worth and Dallas but dropped out of each and went back to using
heroin.
> 
>    "Every time I've ever said I was going to quit I've meant it," Nick
said.
> "Then, I'd find myself going right back, and I would sit there and ask
myself
> why."
> 
>    Today, he is living at Addiction Treatment Centers Inc., a residential
> treatment center in Arkansas. His parents loaned him $1,000 to enter the
> program, and he plans to pay the rest of the cost, an additional $1,300,
after
> he gets out and begins working.
> 
>    "There are obviously plenty of drugs here, too," he said. "But I don't
have
> to worry about running into people I know or seeing places I used to go
to."
> 
>    Communities as a whole will benefit if addicts can be saved through
> treatment, said Lois Chatham, associate director of TCU's Institute of
> Behavioral Research.
> 
>    Research has shown that for every dollar spent on treatment, $4 to $7
is
> saved by keeping people off the streets, employed and out of the criminal
> justice system.
> 
>    "Most studies show that if we don't pay for it now, we're really going
to
> pay for it down the pike," Simpson said.
> 
>    Still, although research shows that diligent medical treatment works
against
> drug addictions, the public believes that jail is a better response,
surveys
> show.
> 
>    "In this country, we believe that addiction is a sort of a sin. We're
really
> quick to criticize," Chatham said. "We hardly have a public consciousness
and
> public consensus on what addiction is about and how we go about solving
it."
> 
>    Treatment has to be sculpted to fit the problem, Simpson said. "Let's
make
> sure that we have an array of treatment and we keep services in place,"
he
> said.
> 
>    But there must be a public outcry before the system changes.
> 
>    "Not until they start dropping like flies do people start paying
attention,"
> said Virginia Hoft, executive director of Santa Fe Adolescent Services.
"We the
> consumers haven't stood up and said loud enough, `If I'm paying for
premiums
> and my kid needs treatment, services need to be available.' "
> 
>    The resistance to supporting treatment may be changing as middle-class
> families struggle to get heroin treatment for their children.
> 
>    "The medically indigent population is growing. It is not just poor
people
> anymore," Hoft said.
> 
>    "We are getting more calls from the suburbs from families that have
> exhausted their benefits or do not have coverage that is adequate to
treat
> their kids."
> 
>    Jennifer K. counts herself among the fortunate, because her father was
able
> to pay for her care after the family exhausted its insurance.
> 
>    "My mom sent me some newspaper clipping of friends who had died. It
made me
> upset," she said by telephone from the Palm Springs center she re-entered
after
> a relapse. "I had a chance to change, and they didn't. I would probably
be dead
> or on the street if my dad had not gotten me into treatment."
> 
>    Her father said the choice is clear.
> 
>    "If addicts don't get treatment and continue to use, they die," Chuck
said.
> "It's not negotiable, especially with heroin."
> 
> Evaluating an inpatient treatment program
> 
> Questions to ask:
> 
>   What does the program do to screen or assess the patient?
> 
>   Do they detox?
> 
>   What is the staff-to-client ratio?
> 
>   What are their credentials?
> 
>   How long have they been in business?
> 
>   How many of their staff members are recovering addicts?
> 
>   Do they accept your insurance?
> 
>   What is their success rate?
> 
>   Are there resident physicians on staff?
> 
>   Is it a lock-down facility?
> 
>   What is the average length of stay in the program?
> 
>   Where do the clients live?
> 
>   Do they have an outpatient facility for transition?
> 
>   What follow-up care do they provide?
> 
> What to look for on a tour of the facility:
> 
>   How does it look? How do the clients look?
> 
>   Would you want to stay there?
> 
>   Ask clients what they think of the place.
> 
>   How did other clients get there?
> 
>   How long have they been there?
> 
>   What other facilities have they been in?
> 
> Source: researchers and parents Susan Gill Vardon contributed to this
report.
> 
> Carol Lewis, (817) 685-3957 carollewisstar-telegram.com Marisa Taylor,
(817)
> 685-3819 marisataylorstar-telegram.com
> 
> PHOTO(S): Olaf Growald;Susan Goldman
> 
> (Copyright 1998)
> 
>                     _____via IntellX_____
> 
> 
> {A5:FortWorthStarTelegram-0428.01934}   04/26/98