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Domino Effect

The immediate impact of successful treatment and recovery services for those adults who abuse drugs on their children is self-evident. For families to rebuild, for children to return to their homes, the caregivers must no longer be substance abusers. They must be on the road to recovery. Children of addicts wish only to return to their families of origin, free of the chaos and turmoil extant when substance abuse was their parents' way of life. For the kids, the parents, and society the stakes couldn't be higher.

Yet, for reasons that are complex and often defy understanding, Oregon does not front load services that will greatly effect the eventual cost of substance abuse. Put simply, the state seems more inclined to build prisons at the back end, at costs running into the billions, rather than offer treatment and social programs at the front end. Reported data shows that for every $1 spent on prevention and treatment, $5 to $7 dollars are saved in related costs ranging from health care, emergency room visits, law enforcement, and criminal justice. Still, experts in the field say Oregon has lagged in putting resources where they will be prophylactic and not reactive.

According to "The Domino Effect," a report prepared for Gov. Ted Kulongoski on alcohol and drug abuse, drug and alcohol prevention, as well as treatment and recovery services have been among "the most deeply eroded..." The results of these cuts are evidenced in higher crime and soaring child welfare caseloads, lost health and diminished economic productivity.

"Eighty percent of women who are incarcerated have a history of alcohol and other drug use while 66 percent of men in the prison have substance abuse problems," the report states.

As well, the report reveals the population of women inmates has grown by 128 percent and the Department of Corrections identifies meth as "the primary drug of abuse for 63 percent of women and men in treatment in Oregon prisons. Sixty-six percent of women in prison have children they were parenting prior to incarceration. The increase in property crime by 279 percent committed by women since 2000 is driving the increase of women inmates."

The report also establishes linkage between the increase in foster care demand and the meth epidemic in Oregon.

"There are growing foster care costs as parents, mostly women, are unable to complete the substance abuse treatment required to get their children back within the one year time frame allowed by the Adoption and State Families Act."

Treatment

As to the efficacy of treatment programs, case workers acknowledge getting clean can be a long and torturous process. The council's report pointed out that one aspect of chemical dependency that is least understood is relapse.

"Many equate relapse with treatment failure. An episode of congestive heart failure in a patient with heart disease is not a treatment failure. We intervene to correct the problem... Likewise, we do not treat a rise in blood sugar in a diabetic as a treatment failure."

The report states that relapses can occur at any point in recovery. Parents, educators, child welfare workers, and legislators need to intervene with the disease of chemical dependency as they would any other disease.

A cold breath

Treatment can, for many, be life changing and the only viable alternative.

Despite the setbacks, some are indeed helped.

Take Michael (not his real name), 31, a successful local business man with a family. He is someone who crawled out of a very dark abyss. Michael grew up in a broken home, his mother was abusive, and, he says, neglectful. Already at the age of 11 he was becoming hardened, angry, but still, he recalls, fundamentally a good kid; however, at 15 he was smoking pot, which, he discovered, "eased the pain." It was at this point, at his pot dealer's house, along with his girl friend, that he tried meth for the first time and got immediately sick. When he tried it a second time he was hooked.

"The drug demonized me," he said. "When you take it, you feel like you can do anything. You don't feel average. When you do it you are so cool, like you could have sex forever. I was defiant. It was wrong. It was the worst thing I could ever have done. Though my life was already chaotic, the drug made me numb. I didn't care about anyone. I had no remorse when I was high. I felt big and strong and paranoid. At the age I was, it was the worst thing I could ever have done because I was so susceptible to influences."

At 17, Michael began hanging around with what he refers to as terrible people.

"They became my new family. Everyone used meth, and so you get this false sense of family being with other users."

But he emphasizes that it is a false reality. At the same time he started getting arrested. He had been caught giving meth to a minor child. He was so detached, he convinced himself that he wasn't the one who had committed the crime. He was sent to a boys' home. Though he got his GED, immediately upon being released he was back on the street using, back with his old friends. the age of 20 he was living in Jackson County, stealing cars, burglarizing homes, committing petty crimes, dealing in drugs, feeling, as he put it, in the grip of grandiose behavior.

"I was a narcissistic personality. I used, I dealt, I considered myself a high class dealer," one of the largest, he said, in Jackson County. He was cooking meth and he was selling it.

In his 20s he went to prison for 22 months.

"I guess the judge had had enough. When I was in prison I met a lot of people who shot up meth. When I got out I 'slammed it,' I shot up. I was with this girl, she pulled out this rig, and I shot up. It was this incredible high, helicopters flew in, it was like a different drug than smoking or snorting it.

"It was like a cold breath."

When Michael became a father, things began to change for him.

"I always thought I loved my kids, but in prison they say if you can't stop using, you don't love your kids."

Again he was arrested for theft.

"I stole some CDs, woke up in jail and it killed me being there. I hated my life, hated where I was, hated my situation. I called my wife, my P.O. and it was then I went into a program at Genesis. I went through their intensive outpatient program, did AA, NA (Narcotics Anonymous), went to 90 meetings in 90 days, and at that point it was my purpose to get clean. I went out and looked for a job. I credit the love of my kids. Once I fell in love with my kids, that opened me up. Loving your kids more than the drugs is what it's all about. It opened my eyes."

Michael is now clean, and has no use for drugs or the drug culture.

"For some time, now, I haven't had a dream about using. When I had those dreams I hated them. I despise everything that has to do with meth. I hate the drug. I hate the fact that people are suffering from the drug. It infuriates me that people are involved with it."

A tough road

However, as stated in "The Domino Effect," cuts over the last three biennia have significantly affected the infrastructure of drug treatment.

There is a critical need for additional services across the full continuum including prevention, outpatient, intensive outpatient, day treatment, residential detoxification, corrections treatment, case management and recovery services. During the past four years, treatment programs have nearly succumbed to the epidemic of methamphetamine use. As well, younger adolescents are drinking more and finding it increasingly easy to obtain alcohol. Such trends place an inordinate burden on state agencies and local providers.

Yet, despite the demonstrable need, and savings of taxpayer dollars, the "Domino Effect" reports that treatment access in Oregon has been reduced by 18 percent. Alcohol and drug prevention activities in schools and communities have decreased. Forty percent of substance abuse treatment professionals are considering leaving the field. There are 30,000 individuals on supervision or probation outside of Oregon correction facilities. The Department of Corrections states that a minimum of 20,000 need treatment or recovery support services. Only 20 percent receive treatment while incarcerated.

"A prime opportunity to make a sustained and cost effective difference is being lost by not treating impaired individuals while incarcerated with formal treatment and recovery services in place."'The Domino Effect' report recommends the following as a way of addressing Oregon's growing substance abuse problem:

— Increase capacity for public substance abuse treatment by 20 percent in the 2007-2009 biennium.

— Double the state prevention investment by allocating 4.5 million dollars during the next biennium.

— Increase rates paid for substance abuse treatment services by 15 percent.

— Support and increase the number of state police officers in order to impact the drunk driving rate.

— Support an increase in drug free housing by at least 2,000 beds.

— Conduct a workforce training initiative to elevate counselor expertise in evidence-based practices beginning with the 2007-2009 biennium; repeated every two biennium.

— Support a 20 percent increase of substance abuse treatment for prison population and recovery services for those released.

As the report concludes, it is time for Oregon to "stop shoveling up the wreckage of substance abuse and addiction and begin funding prevention and treatment in order to build a healthier, more hopeful tomorrow."

The children of addicts would certainly agree.