Drug Rehab

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Drug rehab: Getting rid of drug addiction mainly addict's responsibility

Dear Readers: Remember the letter from Lincoln Warkocz, the drug addict who is now incarcerated in Bowling Green, Fla.? He wrote to say he has been trying without success for 15 years to get help for his addiction.

Lincoln went to jail at age 17 and has been in and out four times since then. He claims that although he has pleaded with prison authorities to be rehabilitated, he was never placed in a drug treatment program.

I asked to hear from someone in the Florida state prison system about this man's situation. The secretary of the Florida Department of Corrections, Harry K. Singletary Jr., sent me this prompt reply:

"Mr. Lincoln Warkocz has been incarcerated four times by the department. He was offered an opportunity to participate in a drug program while assigned to a community centre but chose to escape before he was able to participate. In August 1990, he was returned to the department with a new sentence and enrolled in the auto mechanics course and the GED program. He dropped out of both programs within two weeks. Since his latest incarceration in October 1991, Mr. Warkocz has been placed on the waiting list for the drug rehabilitation program."

And now for some additional comments from readers:

Dear Ann Landers: I am a recovering drug addict and have been a fan of yours for 20 years. Two years ago, I became a member of Narcotics Anonymous. When I read that letter from Lincoln Warkocz, I had to write and tell him there IS hope and not to give up on himself.

I lost my leg because of drugs. Both my brothers were murdered over drugs. I know something about the subject. At 40 years of age, after more than 20 years of drugging, a friend took me to a meeting of Narcotics Anonymous. The 12-step recovery program saved my life. I hope Lincoln sees this. It could save his, too. - Judy from Detroit

Dear Judy: Thank you for an inspiring letter. I hope Lincoln sees it and picks up on your suggestion. Here's more:

Dear Ann Landers: When I read that letter from Lincoln Warkocz, I was irritated. His attitude is typical of addicted people - and this includes food addicts.

These whiners have a common failing - unwillingness to assume responsibility for their lives. Blaming someone else (in this case, the Florida prison system) will never get that guy clean and sober. Placing blame is a cop-out.

I was in a jail where there was no drug program and no Alcoholics Anonymous meetings. A few of us got ahold of the A.A. Big Book and held our own meetings.

I was in four treatment centres before I ended up doing time. Nothing worked for me until I got with the 12-step program of A.A. It works because it puts the responsibility where it belongs - on the user. I've been clean and sober for six years. If Lincoln wants to do it, he can. - Drug-Free in Atlanta

Dear Atlanta: Amen, brother.

Dear Ann: You were mistaken when you said, "Parents do not owe their children a college education."

In Illinois and some other states, if the child is capable of benefiting from a college education and the parents are financially able to provide it, they must do so. - Hugh Schwartzberg

Dear Hugh: Thanks to you and 34 other lawyers, I now know.

Drug rehab: Fight against drugs begins with users

Simply throwing money into the fight against drug kingpins won't win the international war on drugs, says the former commissioner of the RCMP.

Robert Simmonds, now a consultant with the United Nations Fund for Drug Abuse Control in Vienna, said that despite stepped-up law enforcement, the illegal trade will continue unless the North American appetite for drugs abates.

Simmonds, who headed the Mounties for a decade until 1987, said every option in the fight must be thoroughly studied - including the legalization of some drugs.

Simmonds said legalizing drugs has "certain attractions," but many questions still remain unanswered.

"Because of the problems that we face today, I think there should be a great deal of intellectual debate and research into all the options. But that doesn't mean the right option is necessarily legalization," he told Southam News in a telephone interview from Vienna.

He also said: "We're never going to solve the problem in the coca fields in South America or the poppy fields in Asia."

"The poor peasants will always grow it, there will be lots of criminal organizations ready to move it and do anything they have to make sure it moves about the world because it's worth a lot of money.

"The approach to go after the demand side at home is the right one. That does not mean there isn't room for work in the production areas, but fundamentally the problem's got to be solved at home by our own people cleaning out their own problems in terms of demand."

Although tremendous resources have been spent in recent years hunting down and prosecuting drug kingpins, they continue to flourish, said Simmonds, who has been working for the UN agency since April 1988. If the drug problem could be solved through law enforcement alone, it would have been solved "long ago," he said.

"It takes much more than just enforcement, it takes a whole change of attitude and comes right down to the user. (The traffickers) help create the demand a little bit, but fundamentally, it's the demand that keeps the rest of the business going.

"We've tended to look upon the user as some poor misguided character who shouldn't be disturbed too much. But the fact is that every time they buy the junk on the street, they are aiding and abetting the murder and the mayhem that's going on in some of the production areas. That's why it's happening - because of that demand."

Although he advocates increased drug counselling and education, Simmonds said it may also become necessary to get tougher with "the user in our own streets."

"Every time I see another good person, a judge or policeman, lose his life as a result of dealing with the trafficking side, I just get mad at the people down down on the street corner buying, because after all that's why they're trafficking.

"When people decide to go and use what are clearly illegal products, then I think they should be prepared to pay the price."

This week, U.S. President George Bush unveiled a $7.9-billion plan that envisions slashing drug abuse in the U.S. by 50 per cent over the next decade with a combination of tougher street-level law enforcement, including stiffer penalties for casual users, and slightly more spending on drug treatment and education programs.

The anti-drug strategy also increased from $57 million to about $260 million the amount of economic and military assistance to Colombia, Peru and Bolivia - prime cocaine-producing countries.

Family key, drug-rehab

A family atmosphere that the Portage drug-rehabilitation centre says is one of its most powerful tools was very much in evidence at a graduation ceremony yesterday at Place des Arts.

Quebec Lieutenant Governor Lise Thibault handed out certificates to the 120 adults and adolescents recognized for passing certain stages of Portage's rehab program.

Thibault - who made no political comments - praised the centre for its openness and family atmosphere.

Portage president Peter Howlett said support is the key to the Portage program, which claims an 85-per-cent success rate.

``We are a family,'' Howlett said as he greeted former members long after the ceremony was over.

``People who have been in the program have experienced the same problems as those going through the program now,'' he said.

During the ceremony friends, family and former Portage members gave loud support to tearful speeches from administrators and graduates.

Portage recently heightened its focus on the family when it successfully convinced sponsors to help create a program that keeps mothers with their children while trying to break a drug addiction.

Normally, parents going through a drug-rehabilitation program are forbidden from caring for their children by court order. In the Portage program, specialists watch the children in daycare as mothers progress through the rehabilitation process.

Portage also works with the provincial child-protection agency.

One mother receiving a diploma yesterday had lost custody of her two boys because of her drug addiction. She got both back through the Portage program within nine months.

Once the mothers have their children back Portage tries to introduce both mother and child to a family life without drugs.

``It's intense, but mothers find it is worth it,'' said France Landry, director of the 2-year-old program.

Portage members say a family atmosphere has always been the key at Portage, created in 1970 and located in in the Laurentian mountains north of Montreal.

Buddhist temples to serve as drug rehabilitation centres

More than 3,000 Buddhist temples in Thailand will act as drug rehabilitation centres in a new strategy to combat a national addiction crisis. About 2.7 million Thais out of a population of 62 million use drugs, with about 2.4 million of those addicted to cheap methamphetamines. The program will start next month at a temple near Bangkok.

New drug rehab model here?

An innovative Italian drug treatment model with a remarkable success rate is being eyed by regional officials for possible introduction to the Lower Mainland.

San Patrignano is a residential drug rehabilitation centre in northern Italy that began with one man, Vincenzo Muccioli, who welcomed a group of young drug addicts into his home in 1978.

Today, Muccioli's dream has grown into the largest drug rehab centre in Europe, serving 1,800 "guests."

The services at San Patrignano are free of charge and without social, political or religious discrimination. The only condition to enter the program is a desire to face and overcome drug addiction.

San Patrignano is a long-term social and education program focusing on dignity, honesty, responsibility and respect. Some guests stay as long as three to four years.

Approximately 50 per cent of the funding necessary to run the centre comes from internal economic activities such as agriculture and food production, crafts, and breeding and training race horses and show dogs. The balance comes from donations.

The centre boasts 50 job training sectors in which guests learn the professional skills necessary to return to society and a normal life.

San Patrignano has the on-site services necessary to run as a small town of 2,000, including a kindergarten for the children of staff and guests, a hospital and a small village where families live.

Most of the 180 staff and volunteers working at the centre (half are former addicts themselves) also live in the community.

Perhaps the most remarkable thing about San Patrignano is its success rate. After having left the community for at least three years, close to 73 per cent of former guests had a house, a job, a family and were no longer addicted to drugs.

Studies indicate many drug rehab programs in North America have success rates of between 40 and 60 per cent.

While drug rehabilitation is not a Greater Vancouver Regional District (GVRD) mandate, a report from regional officials who visited San Patrignano suggests the model could work in the Lower Mainland.

GVRD deputy chief administrative officer Delia Laglagaron, who toured San Patrignano this summer, said regional district officials are impressed with the program and want to gauge whether there is interest from government and non-government bodies to begin a similar program in Greater Vancouver.

Laglagaron said the regional district may look at providing land to begin a similar program on a smaller scale.

"Being a catalyst is something we can do," she said, adding staff will study the program and measure support from potential partners.
THE PAYOFF FROM DRUG REHAB

It's cheaper than jailing criminals

It has long been common wisdom that drug addiction is linked to criminality. During the 1990s, however, public policy focused more on putting criminals behind bars and less on drug treatment.

But a study suggests that spending more money on treating drug addicts would pay off as well. Mireia Jofre-Bonet and Jody L. Sindelar, faculty at the Yale School of Public Health examined data on 3,500 inner-city drug users entering treatment in the Philadelphia area between April, 1985, and May, 1998. The data recorded criminal behavior as well as the change in the use of different drugs, such as heroin, during treatment.

The authors found that treating drug abusers reduced the crime they committed by 51%. Jofre-Bonet and Sindelar also note the cost advantages of drug treatment over prison. A year in the jug costs $23,000 per inmate, compared with a $3,000 annual tab for methadone treatment of heroin addiction.

Drug rehab: Trying to kick the habit: Emotions run high in Addington House when addicts try to change their lives

When William walked through the doors of Addington House in early October, his arms were covered in scabby needle craters and his skin had the sickly gray-green pallor of a far-gone junkie. The sobriety he had carefully nurtured for 2 1/2 years had slowly eroded under the stresses of a failed relationship and life on the straight and narrow. And when he finally surrendered again to his twin obsessions of cocaine and alcohol, giving in to the desires that had been tormenting him like an unscratchable itch, he sank further and faster than he had before.

``I didn't care and I just wanted to escape. It's the lie that every alcoholic and drug addict believes - that it will all go away,'' says William, who has been fighting a losing battle with drugs for two decades. ``But it doesn't. You still have to face your problems the next day.''

Last Friday, after 56 days of therapy, counseling and self-reflection, a healthy and refreshed William graduated from the N.D.G. drug-rehabilitation centre, ready to embark on what he hopes will be a lifelong recovery. Even though it's the 38-year-old's second visit to Addington House, and the fourth time he's been through rehab, he's confident that this time he will succeed. And he credits the centre's staff and program with finally making him understand what he has to do.

``I've been given everything I could be given here,'' he says between hauls on a cigarette in the centre's basement rec room. `` I can't go through this again.... For me it's not an option. It's recovery or death.''

William's words echo the philosophy Addington House's director, Gerry Sidel, who says he is in the business of changing people's outlooks and personalities. He says the private, 10-bed treatment centre has produced 300 graduates during its seven-year history with a success rate of 65 per cent.

Centre Started in 1989

Sidel started the centre in 1989 after a 15-year career as a marriage counselor and sex therapist. He says he became interested in drug and alcohol addiction after encountering it again and again as the root of so many family problems.

Located in an unassuming house near Sherbrooke and Decarie, the centre offers both men and women an English-language recovery program based on the 12-step method developed by Alcoholic's Anonymous, in a comfortable, homey setting.

Patients spend a minimum of two months in the house's highly structured environment, undergoing individual counseling and participating in an average of six hours of group therapy and support meetings each day. After graduation, clients return to the centre at least once a week for two years for after-care follow-up.

The idea behind the intense nature of the program, Sidel says, is to break down the false self-image addicts have created to justify their dependency and force them to recognize that they are powerless before their addictions.

A day spent at Addington House reveals an almost oppressive atmosphere of emotion. Residents, fueled by endless chains of cigarettes and bottomless cups of coffee, quickly swing between peaks and valleys, opening up to express years of unexamined rage, sorrow, desperation and happiness.

And some addicts have a tougher time ``buying in'' than others.

`Things get tense'

``Things get tense in here,'' says Len, a federal inmate who is doing the program as a precondition to his parole as he nears the end of a three-year sentence for armed robbery. ``I don't like people constantly digging in my head, and that's what it is in here for 56 days.''

Halfway through his stay, he's wrestling with the AA concept of abstinence and avoidance, and can't accept that he can never have another beer even though his problem is primarily cocaine. At 27, he's spent almost a third of his life in prison, and says he grew up in a climate of addiction.

``A beer bottle was like a baby bottle to me.''

Len says he's going to stay clean and take it one day at a time, but Sidel and other counselors say he won't make it unless he changes his attitude.

``There has to be trust and, because it's a warm, loving environment, it's usually there and developing,'' Sidel says. ``But you can't save everybody.''

Healing mind and body doesn't come cheaply - in-house patients pay $3,000 a month to get clean - but Sidel says he isn't getting rich. The majority of Addington House's clients are federal prison inmates, taking their first tentative steps at reintegration into the community, and Corrections Canada pays a much cheaper rate. The centre also reserves one bed for people on welfare who can't afford to seek treatment elsewhere.

Sidel says the house, which has four paid staff, barely breaks even and would die without the work of volunteers, most of them grateful former residents.

Even if Addington House's program doesn't always work, says one volunteer and recovering heroin addict, it plants the seeds of change in the drug-abuser's mind.

``Everyone comes in here with the impression that they can beat the system,'' he says. ``But no matter what they say, they change. They change.''

Special prayers and cold baths offer hope for drug addicts

Shivering in the early morning mist, recovering heroin addict Slamet prepares to start another day of Islamic prayer and meditation.

The 28-year-old man used to spend most of his time stealing and shooting up. Now, after eight months in an Islamic drug rehabilitation centre high in the hills of west Java, he is becoming a rare success story in Indonesia's often feeble war on drugs.

"Before, people used to look at me like I was trash. All I could think about was heroin. Now, I can eat, sleep and pray like a normal person. I feel good," he says.

There's an explosion of illicit drug use in Indonesia and some social activists believe the solution lies in Islam, a faith which some 90 per cent of Indonesia's 210 million people adhere to.

Slamet, along with 30 other ex-addicts, receives no specialized counselling or detoxification treatment at the centre -- just a steady diet of religious devotion. In the end, the centre claims a higher success rate than conventional clinics trying to combat the drug crisis.

The centre is run by a nearby Islamic boarding school, or pesantren. The school, named Suryalaya, is home to around 3,000 students, from kindergarten to university level.

There are hundreds of thousands of similar schools across Indonesia. Most teach a mixture of religious and secular subjects and are rarely inspected by state officials.

Fears that Indonesia is leaning toward Islamic extremism have been fanned by reports of pesantren where students are indoctrinated with hardline anti-western teachings. Some pesantren have been accused of having links to regional terrorists groups.

But Suryalaya is different. It specializes in the study of Sufism, the mystical form of Islam that stresses devotion to God and religious tolerance. Its 90-year-old leader is revered as a holy man who, according to tradition, can trace his teaching in a direct line back to Islam's prophet, Mohammed.

Suryalaya's 30 drug rehab centres are called Inabah, or "returning to the correct path." They revolve around three Islamic principles: communal prayer, the chanting of God's name and ritual bathing.

Each of the complexes, of which one is reserved for women and girls, is run by a husband and wife team. There are also branches in neighbouring Singapore and Malaysia.

The day starts at 2 a.m. with a cold shower. The first prayer of the day is then performed in the mosque followed by Arabic chanting of the phrase "There is no god but God" -- part of the Muslim profession of faith -- at least 700 times.

The recovering addicts then drink a cup of coffee before saying the dawn prayer, followed by more chanting. Apart from meal breaks and a couple of hours of rest or sport in the midmorning and afternoon, this combination is continued until bedtime early in the evening. Anang Syah, the religious teacher who heads the complex in Cibeureum, says faith alone is enough to break an addict's habit.

"We don't heal them, we don't even treat them. All we do is make them aware that they belong to God," he says.

The clinic's founders say that around 40 per cent of the addicts they treat go back to drugs when they leave, normally after about a year. No statistics are available to back up their contention. Skeptics doubt the claim, and point out that conventional detoxification and counselling centres admit to relapse rates of around 85 per cent.

The centres' wealthy clients, who have included the children of high-ranking politicians and police and army officers, subsidize those from poorer families. No one is turned away, Syah said.

Indonesia has approximately four million addicts.

Cheap heroin accounts for many of them, though the country has been awash with cheap Ecstasy and amphetamines since the 1990s. Thousands of nightclubs function as little more than drug dens, allegedly with the backing of corrupt security forces.

Critics say the Islamic clinics' lack of AIDS and HIV policies -- there is no routine testing or special counselling for those found out to be infected -- is irresponsible. Up to 40 per cent of injecting users in some parts of Indonesia are infected with the virus, health workers say.

Drug activists say the clinics should introduce programs to support former addicts once they return to society.

"The idea of religious-based treatment is a good one . . . but for them not to deal with (AIDS) is negligent," says David Gordon, a Californian who runs two detoxification centres on the southern outskirts of Jakarta.For the young addicts, getting clean is a lot easier than staying clean. But hope is in ample supply at the Inabah complexes.

Says 22-year-old Novi, two months into her stint at the female centre: "There was before and there was after. I feel like I've been reborn."

Mandatory Drug Rehab Unethical

Program for people on welfare takes away the right of informed consent

Doctors who comply with the Ontario government's mandatory drug rehab program for welfare recipients will be compromising their professional ethics, says an inner-city health expert.

Dr. Philip Berger, chief of family and community medicine at Toronto's downtown St. Michael's Hospital, issued the warning in the latest edition of the Canadian Medical Association Journal.

"It's a complete contradiction to the ethics of the doctor- patient relationship," Berger said in an interview.

"People should be providing fully informed consent, and they have the right to refuse an investigation and the right to refuse treatment. They won't have that right, because the state's forcing them.

"What does the doctor do?"

The program also discriminates against people on welfare by implying that people on welfare are prone to drug use, said Berger, who is also the medical director of the hospital's Inner City Health Program.

He points out that the only other institution that can command a drug test and treatment program is the judicial system, and usually only in cases where the individual has been convicted of a drug- related offence.

"Welfare recipients are not criminals," Berger said. "They have not lost any of the civil rights that the rest of us enjoy; that's not true of someone who's been through the judicial system."

Ontario's Ministry of Community and Social Services is "well aware" of Berger's feelings on the issue of mandatory drug testing, said spokesman Dan Miles.

"I guess we will agree to disagree," said Miles, who added the government held extensive consultations on the program with more than 600 groups and individuals across the province.

"I won't say that we had the majority of support, but views were certainly mixed, and there was support for our approach."

Under Ontario law, doctors are the only people who are empowered to communicate a medical diagnosis to a third party, Berger said.

The drug testing program is scheduled to start on a limited basis in the new year and will be fully phased in over the next two years, said Miles. Where it will begin next year has not yet been decided.
Prison drug rehab just a Band-Aid, says study

Drug rehabilitation programs in Canada's prisons are mostly a waste of time and money unless officials can halt the increasing flow of narcotics to prisoners, says a newly released audit. "Until the issue of drugs in the institutions is seriously addressed, we do not believe substance abuse programs will be taken seriously as our investment in them warrants," concludes the 1994 federal audit. Corrections Canada directed about $5 million into drug abuse programs during the 1993-94 budget year.

The report, prepared for Corrections Canada, says the availability of drugs in prisons has always been a problem, but it's worse now that it has ever been. The authors call the drug rehab programs a Band-Aid treatment. "Case management staff are at their wits' end, not knowing what do about offenders they suspect or know are using drugs," says the 42-page study. "At each site we visited, when we told people we were there to conduct an audit of substance abuse programs, the first thing we heard was that the problem of drugs in the institution was critical. "It was the first thing on people's minds, and we were told it was having an impact in all kinds of ways." Wardens are wondering what to do about known drug users, whether they should be transferred to higher security prison. Case officers don't know if they can trust progress reports on prisoners in drug rehab programs.

Jacques Belanger, spokesman for the Corrections commissioner, said the federal government has taken measures to combat drugs in prisons over the past year. "We have introduced tracking dogs. We've been testing inmates at random, taking urine samples at random and it has had a good effect so far." Roughly 25 per cent of the prisoners tested showed positive signs of drug use. Belanger also said guards have made narcotics seizures, although he could not provide exact figures.

Meanwhile, another Corrections Canada audit reported there have been nine suicides by drug overdose in the past three years in federal prisons. "Drugs or alcohol were either consumed or suspected of being consumed in one-third to one-half of the suicides during the past two years; drug debts resulting in financial pressure ... were hypothesized to be a motivating factor in five of the 24 suicides in 1993-94."

DRUG REHAB PROGRAM A NECESSITY

"Judge calls for jail probe," Helen Dolik, Herald, Dec. 18.

Judge John Harvie`s inquiry into the drug-related death of Twila Alston reveals serious problems in Alberta`s prison system and the need for important changes to how we treat known drug users. Alston died of a drug overdose on March 22, 1993 at the Bow River Correctional Institute.

According to Harvie`s report, Alston was in the minimum security facility on cocaine and soliciting offences. As MLA for Calgary North West, in which the institute is located, I feel I must comment on this situation.

Rather than spending millions of dollars incarcerating drug users, we should be providing effective drug rehabilitation. While it is unfortunate, the reality is that drugs are readily available in the minimum security institution. So why are we throwing drug users into these situations? Even Harvie says the government must decide whether it is operating a prison or a drug-use facility.

Minimum security institutions are an important part of the prison system in Alberta and have a major role to play in facilitating the release of prisoners back into society. But we must also ensure that Albertans who require proper drug rehabilitation are given the necessary treatment so they can return to society and not put into institutions where drugs are available.

Harvie`s report must be made available to all interested Albertans, but despite requests, the government has yet to provide the Alberta Liberals with the report.