The Biggest Drug Story You’ve Never Heard
Jason Flom & Russell Simmons
April 20, 2010
What would happen if drug use were decriminalized? We’ve heard the horror stories: more drug addiction, more broken families, and crime run amok. We’ve also heard the opposite – that none of those awful things would happen and that we’d actually be better off for not criminalizing what’s really a health issue (and a personal choice).
So who’s right? You might be surprised to hear that this isn’t just about hypotheticals and what if’s anymore.
In 2001, Portugal decriminalized the possession of small amounts of all illicit substances. Having small amounts of drugs is no longer a criminal offence. It’s still against the rules; it just won’t get you thrown in jail or prison. It’s a civil offense – like a ticket. Portugal continues to punish sales and trafficking of illicit substances.
It’s been ten years. Ever wonder why you haven’t heard about the sky falling in Portugal? About out-of-control drug use? About a lost generation of young people? About record crime rates? Well, that’s because – the over-active Icelandic volcano notwithstanding – the sky didn’t fall.
That’s right: Portugal decriminalized possession of all drugs and the sky didn’t fall. Nor does it show any signs of faltering a decade later.
Here’s what did happen: drug use rates remained basically unchanged (like the rest of Europe), while fatal overdose from opiates (like heroin) fell by nearly half, new HIV/AIDS infections in people who inject drugs fell by two-thirds, and the number of people in treatment actually increased.
Decriminalization helped reduce the stigma around drug use (without increasing it) and made drug use less politically difficult to talk about. It encouraged better collaboration between law enforcement and service providers, and allowed law enforcement to focus on large-scale traffickers, resulting in increased seizures of commercial quantities of illicit drugs.
In Portugal’s thoroughly re-envisioned drug policy, police officers now issue citations – but do not arrest – persons found in possession of small amounts of illicit substances. People who receive these citations are ordered to appear at a “dissuasion commission,” an administrative panel that operates outside of the criminal justice system. The panel, with two health practitioners and one legal practitioner, examines the individual’s circumstances and determines whether to make treatment referrals, issue fines or impose other non-criminal penalties.
Portugal has an important story to tell and it’s not just about decriminalization. It’s about a post-criminalization approach to drug policy. Portugal’s 2001 policy shift was much more than just a legal change. It was a government-wide shift to a health approach to drug use, centered on expanding access to prevention, treatment, harm reduction and “social reintegration” services.
In 2001, Portugal’s explicit aim was to adopt an approach to drugs based not on dogmatic moralism and prejudice, but on science and evidence. Portuguese lawmakers recognized that the criminalization was not only failing to effectively control drug use; it was a barrier to protecting individual and public health.
The U.S. should be looking to Portugal and asking not can we replicate their success here? But how can we replicate their success here?
On the health front, the health care legislation that President Obama signed late last month promises to make drug treatment much more widely accessible within the mainstream health care system. (Insurers will be required to cover alcohol and drug treatment as they do treatment for any other chronic condition.) If done right, this could be a major advancement in creating a health approach to drug use in this county.
On criminal penalties, some states are already moving in the right direction by attempting to roll back the most punitive drug sentencing policies. Many of these measures aim to shorten the length of time served for drug law violations or reduce probation and parole revocations for drug use. In New York, the repeal of the worst of the 30-year-old Rockefeller Drug Laws late last year represents an important achievement in this national trend. In California, voters in November will decide whether to legalize marijuana.
These U.S. reforms are all significant, but they fall short of what is needed – and what is possible. Thanks to Portugal, the way forward is a little clearer today.
Tuesday, April 20, 2010
Friday, April 16, 2010
The Punishment Legacy: Criminalization, Healthcare Reform and Prop. 36
By Margaret Dooley-Sammuli
The healthcare legislation President Obama signed late last month promises to bring sweeping changes to California’s alcohol and drug treatment system. Not only will more people have access to insurance; heath insurers will be required to cover alcohol and drug treatment as they do any other chronic health condition (aka “parity”). Drug treatment – which currently exists largely outside the mainstream healthcare and insurance systems – may finally be allowed to come in from the cold.
As we work to make that treatment access a reality in California, however, we need to address the state’s existing contradictory policy responses to drug use. Our State Legislature is on record as supporting parity, having passed legislation several times (the governor’s veto notwithstanding). And the electorate is on record as supporting expanded access to treatment, both for alcohol and drugs (Proposition 36 in 2000) and for mental health (Proposition 63 in 2004).
California gets that drug use and addiction as well as co-occurring addiction and mental health issues are fundamentally health problems. And yet we punish.
About 30,000 people are in a California prison for a nonviolent drug offense; they make up over 15% of the prison population and cost $1.5 billion per year to incarcerate (or $49,000 each). A whopping 28.4% of new felony admissions to prison and 32.7% of parolees returning to prison with a new term in 2008 were for drug offenses. That doesn’t include drug-related technical parole revocations. The vast majority of these commitments were for drug possession, not sales, manufacturing or transport.
In 2008, over 270,000 Californians were arrested for a drug offense. In contrast, only 174,000 people accessed treatment that year – just a fraction of the estimated 3.3 million Californians with an alcohol or drug use disorder. Over half of those in treatment in the state came through the criminal justice system, giving rise to the belief that you have to get arrested to get treatment. Unfortunately, fewer and fewer people arrested for a drug offense actually receive such help.
In the last three years alone, state funding for Proposition 36, California’s landmark voter-approved, treatment-instead-of-incarceration law, has been cut by 90% – from $145 million in 2007/8 to just $18 million this year. It’s a simple equation: the less funding available, the less treatment offered and the longer the waiting lists (months long in some cases).
Ten years after voters overwhelmingly passed Prop. 36, calling for treatment rather than incarceration, the governor has proposed eliminating funding for the program. Never mind that, according to UCLA, Prop. 36 saves $2.5-4 for every dollar invested, diverts 36,000 people into treatment a year (when adequately funded), has helped reduce the number of people incarcerated for personal drug possession by 40% (or 8,000 people), and has had no negative impact on crime trends.
As Prop. 36 is cut back, more people are headed to jail and prison for their drug use, even as behind-bars treatment becomes unavailable. Under new California Department of Corrections and Rehabilitation (CDCR) regulations, moderate- to high-risk offenders will have priority placement in drug treatment in the state’s prisons. Ironically, drug offenders – most of whom are deemed low risk to public safety – will not receive treatment behind bars or on parole, even if they have a serious drug problem.
The passage of federal healthcare legislation, the repeated passage of parity legislation in this state and even the state’s corrections bureaucracy have all come to the same conclusion: drug use is primarily a health issue, not a high risk to public safety. And yet the state’s penal code continues to criminalize drug use.
Until California can reconcile the discrepancy between health statute and penal code, the Democratic majority in the State Legislature has a responsibility to reduce – in every way that it can – the criminalization and incarceration of people for drug use and addiction. This year that means rejecting the governor’s proposal to defund Proposition 36 treatment programs.
The healthcare legislation President Obama signed late last month promises to bring sweeping changes to California’s alcohol and drug treatment system. Not only will more people have access to insurance; heath insurers will be required to cover alcohol and drug treatment as they do any other chronic health condition (aka “parity”). Drug treatment – which currently exists largely outside the mainstream healthcare and insurance systems – may finally be allowed to come in from the cold.
As we work to make that treatment access a reality in California, however, we need to address the state’s existing contradictory policy responses to drug use. Our State Legislature is on record as supporting parity, having passed legislation several times (the governor’s veto notwithstanding). And the electorate is on record as supporting expanded access to treatment, both for alcohol and drugs (Proposition 36 in 2000) and for mental health (Proposition 63 in 2004).
California gets that drug use and addiction as well as co-occurring addiction and mental health issues are fundamentally health problems. And yet we punish.
About 30,000 people are in a California prison for a nonviolent drug offense; they make up over 15% of the prison population and cost $1.5 billion per year to incarcerate (or $49,000 each). A whopping 28.4% of new felony admissions to prison and 32.7% of parolees returning to prison with a new term in 2008 were for drug offenses. That doesn’t include drug-related technical parole revocations. The vast majority of these commitments were for drug possession, not sales, manufacturing or transport.
In 2008, over 270,000 Californians were arrested for a drug offense. In contrast, only 174,000 people accessed treatment that year – just a fraction of the estimated 3.3 million Californians with an alcohol or drug use disorder. Over half of those in treatment in the state came through the criminal justice system, giving rise to the belief that you have to get arrested to get treatment. Unfortunately, fewer and fewer people arrested for a drug offense actually receive such help.
In the last three years alone, state funding for Proposition 36, California’s landmark voter-approved, treatment-instead-of-incarceration law, has been cut by 90% – from $145 million in 2007/8 to just $18 million this year. It’s a simple equation: the less funding available, the less treatment offered and the longer the waiting lists (months long in some cases).
Ten years after voters overwhelmingly passed Prop. 36, calling for treatment rather than incarceration, the governor has proposed eliminating funding for the program. Never mind that, according to UCLA, Prop. 36 saves $2.5-4 for every dollar invested, diverts 36,000 people into treatment a year (when adequately funded), has helped reduce the number of people incarcerated for personal drug possession by 40% (or 8,000 people), and has had no negative impact on crime trends.
As Prop. 36 is cut back, more people are headed to jail and prison for their drug use, even as behind-bars treatment becomes unavailable. Under new California Department of Corrections and Rehabilitation (CDCR) regulations, moderate- to high-risk offenders will have priority placement in drug treatment in the state’s prisons. Ironically, drug offenders – most of whom are deemed low risk to public safety – will not receive treatment behind bars or on parole, even if they have a serious drug problem.
The passage of federal healthcare legislation, the repeated passage of parity legislation in this state and even the state’s corrections bureaucracy have all come to the same conclusion: drug use is primarily a health issue, not a high risk to public safety. And yet the state’s penal code continues to criminalize drug use.
Until California can reconcile the discrepancy between health statute and penal code, the Democratic majority in the State Legislature has a responsibility to reduce – in every way that it can – the criminalization and incarceration of people for drug use and addiction. This year that means rejecting the governor’s proposal to defund Proposition 36 treatment programs.
UK Talk Show on U.S. Incarceration Rate
US Prisons
http://www.youtube.com/watch?v=8E7wgFcCefE&feature=related
http://www.youtube.com/watch?v=8E7wgFcCefE&feature=related
Tuesday, April 13, 2010
ACLU Forum Wed. April 21, 7 pm: Drugs: Legalization, Civil Liberties, and Incarceration
ACLU presents: A PUBLIC FORUM ON THE ISSUE "Drugs: Legalization, Civil Liberties, and Incarceration”.
ADMISSION: FREE
TIME: 7:00 PM, Wednesday, April 21, 2010,
PLACE: Faulkner Gallery, Santa Barbara Public Library, 40 E. Anapamu St.
This location is wheel-chair accessible.
WHAT IS HAPPENING:
Experts from law enforcement, from UCSB, and from the community will discuss the legal, constitutional, moral, health, education, and civil rights issues raised by a “War on Drugs” that isn’t working, and by prisons full beyond capacity. The issues discussed will include such topics as drug policies that criminalize youth and people of color, how the drug “War” impacts other countries, the wastes of drug prosecution, and community responses to these educational and social problems.
There will be an audience question and answer period.
WHO IS ON THE PROGRAM:
The speakers include:
· Damien Schnyder, post-doctoral fellow in the UCSB Department of Black Studies, researcher of the U.S. prison industrial complex.
· Kyle Kazan of LEAP, Law Enforcement Against Prohibition (www.leap.cc) a former Torrance, California police officer.
· Suzanne Riordan, founder of Families ACT, a non-profit organization that advocates for treatment rather than jail for people with drug problems and mental illness
The moderator will be Cathy Murillo, Santa Barbara ACLU Program Committee Chair
Damien M. Schnyder is a University of California President’s postdoctoral fellow in the Department of Black Studies, at the University of California, Santa Barbara. Having received a BA and MA from Stanford, he received his Ph. D. from the University of Texas at Austin. He has conducted research on the relationship between the public education system, the prison industrial complex, and Black masculinity in Southern California.
Kyle Kazan is a former Torrance, CA police officer and an expert in gang and drug identification and eradication. As a foot soldier in the “War on Drugs”, he has important insights into the futility and waste of drug prohibition, having seen the same people come through the system again and again. He is associated with LEAP (Law Enforcement Against Prohibition), and is a graduate of the University of Southern California.
Suzanne Riordan is founder and executive director of Santa Barbara-based Families ACT, a non-profit organization which advocates for compassionate treatment rather than incarceration for people with mental health and substance use disorders (www.familiesact.org). It helps families navigate the complexities of the criminal justice system and the meager treatment resources and it seeks to educate the community about the need for new approaches to the complex issues surrounding co-occurring disorders. She holds a BA in International Relations from the University of Washington and an MA in Education from UCSB.
ADDITIONAL INFORMATION
For additional information and/or public relations materials about this or other ACLU events, including photographs, Contact:
P.O. Box 30645, Santa Barbara, CA 93130, Phone to 805-252-3012 , Email: cathymurillo@cox.net,
ADMISSION: FREE
TIME: 7:00 PM, Wednesday, April 21, 2010,
PLACE: Faulkner Gallery, Santa Barbara Public Library, 40 E. Anapamu St.
This location is wheel-chair accessible.
WHAT IS HAPPENING:
Experts from law enforcement, from UCSB, and from the community will discuss the legal, constitutional, moral, health, education, and civil rights issues raised by a “War on Drugs” that isn’t working, and by prisons full beyond capacity. The issues discussed will include such topics as drug policies that criminalize youth and people of color, how the drug “War” impacts other countries, the wastes of drug prosecution, and community responses to these educational and social problems.
There will be an audience question and answer period.
WHO IS ON THE PROGRAM:
The speakers include:
· Damien Schnyder, post-doctoral fellow in the UCSB Department of Black Studies, researcher of the U.S. prison industrial complex.
· Kyle Kazan of LEAP, Law Enforcement Against Prohibition (www.leap.cc) a former Torrance, California police officer.
· Suzanne Riordan, founder of Families ACT, a non-profit organization that advocates for treatment rather than jail for people with drug problems and mental illness
The moderator will be Cathy Murillo, Santa Barbara ACLU Program Committee Chair
Damien M. Schnyder is a University of California President’s postdoctoral fellow in the Department of Black Studies, at the University of California, Santa Barbara. Having received a BA and MA from Stanford, he received his Ph. D. from the University of Texas at Austin. He has conducted research on the relationship between the public education system, the prison industrial complex, and Black masculinity in Southern California.
Kyle Kazan is a former Torrance, CA police officer and an expert in gang and drug identification and eradication. As a foot soldier in the “War on Drugs”, he has important insights into the futility and waste of drug prohibition, having seen the same people come through the system again and again. He is associated with LEAP (Law Enforcement Against Prohibition), and is a graduate of the University of Southern California.
Suzanne Riordan is founder and executive director of Santa Barbara-based Families ACT, a non-profit organization which advocates for compassionate treatment rather than incarceration for people with mental health and substance use disorders (www.familiesact.org). It helps families navigate the complexities of the criminal justice system and the meager treatment resources and it seeks to educate the community about the need for new approaches to the complex issues surrounding co-occurring disorders. She holds a BA in International Relations from the University of Washington and an MA in Education from UCSB.
ADDITIONAL INFORMATION
For additional information and/or public relations materials about this or other ACLU events, including photographs, Contact:
P.O. Box 30645, Santa Barbara, CA 93130, Phone to 805-252-3012 , Email: cathymurillo@cox.net,
Tuesday, April 6, 2010
International Chiefs of Police, Sens. Webb, Hatch, Specter & Graham Urge Senate Vote on National Criminal Justice Commission Act
Excerpts from: International Chiefs of Police, Sens. Webb, Hatch, Specter & Graham Urge Senate Vote on National Criminal Justice Commission Act
March 9, 2010
Washington, DC— Members of the International Association of Chiefs of Police (IACP) from across the nation today joined Senator Jim Webb (D-VA) and leading Judiciary Committee members, Senators Orrin Hatch (R-UT), Arlen Specter (D-PA), and Lindsey Graham (R-SC), to push for final passage of the National Criminal Justice Commission Act, S. 714. The legislation, introduced by Senator Webb on March 26, 2009, was voted out of the Judiciary Committee January 19, and awaits a vote on the Senate floor.
The National Criminal Justice Commission Act of 2010, which would create a blue-ribbon commission charged with comprehensively reviewing the nation’s criminal justice system and offering concrete recommendations for reform, has gained the bipartisan support of 35 members of the Senate and endorsements from over 100 organizations representing a broad spectrum of the criminal justice community.
The IACP is the oldest and largest non-profit membership organization of police executives, with more than 22,000 members in over 100 countries. For more than 20 years, the IACP has advocated for the creation of a commission that would follow in the footsteps of the 1965 presidential commission on law enforcement and the administration of justice.
“I am very grateful to the International Association of Chiefs of Police for having entered into a dialogue with us about how to improve our approach, and for throwing their support behind this important legislation,” said Senator Webb. “We started with two pieces of reality: we have by far the world’s largest incarceration rate—with 5% of the world’s population and 25% of the world’s prison population—and, at the same time, Americans will tell you that they don’t feel any safer today than they did a year ago.”
To read more about the National Criminal Justice Commission Act, please visit:http://webb.senate.gov/issuesandlegislation/Criminal_Justice_Banner.cfm
To download photos of today’s event, visit:http://webb.senate.gov/photos/photogallery/S714_Rally_for_Final_Vote.cfm
To read the February 13, 2010 New York Times editorial, “A Blue Ribbon Look at Criminal Justice,” visit:http://webb.senate.gov/newsroom/newsarticles/02-13-2010-01.cfm
To watch a highlight video from today's event, please visit:http://www.youtube.com/watch?v=5niWyJ_uttE
March 9, 2010
Washington, DC— Members of the International Association of Chiefs of Police (IACP) from across the nation today joined Senator Jim Webb (D-VA) and leading Judiciary Committee members, Senators Orrin Hatch (R-UT), Arlen Specter (D-PA), and Lindsey Graham (R-SC), to push for final passage of the National Criminal Justice Commission Act, S. 714. The legislation, introduced by Senator Webb on March 26, 2009, was voted out of the Judiciary Committee January 19, and awaits a vote on the Senate floor.
The National Criminal Justice Commission Act of 2010, which would create a blue-ribbon commission charged with comprehensively reviewing the nation’s criminal justice system and offering concrete recommendations for reform, has gained the bipartisan support of 35 members of the Senate and endorsements from over 100 organizations representing a broad spectrum of the criminal justice community.
The IACP is the oldest and largest non-profit membership organization of police executives, with more than 22,000 members in over 100 countries. For more than 20 years, the IACP has advocated for the creation of a commission that would follow in the footsteps of the 1965 presidential commission on law enforcement and the administration of justice.
“I am very grateful to the International Association of Chiefs of Police for having entered into a dialogue with us about how to improve our approach, and for throwing their support behind this important legislation,” said Senator Webb. “We started with two pieces of reality: we have by far the world’s largest incarceration rate—with 5% of the world’s population and 25% of the world’s prison population—and, at the same time, Americans will tell you that they don’t feel any safer today than they did a year ago.”
To read more about the National Criminal Justice Commission Act, please visit:http://webb.senate.gov/issuesandlegislation/Criminal_Justice_Banner.cfm
To download photos of today’s event, visit:http://webb.senate.gov/photos/photogallery/S714_Rally_for_Final_Vote.cfm
To read the February 13, 2010 New York Times editorial, “A Blue Ribbon Look at Criminal Justice,” visit:http://webb.senate.gov/newsroom/newsarticles/02-13-2010-01.cfm
To watch a highlight video from today's event, please visit:http://www.youtube.com/watch?v=5niWyJ_uttE
Sunday, April 4, 2010
Uninsured Mental Health Patients Face Service Cuts
Uninsured Mental Health Patients Face Service Cuts
March 29, 2010
By Lara Cooper, Noozhawk Staff Writer
Alcohol, Drug and Mental Health Services reduces available beds and other assistance to save money
Uninsured people suffering from mental illness have fewer places to seek treatment after a set of decisions made two weeks ago by Santa Barbara County Alcohol, Drug and Mental Health Services.
More than 400 patients per year are transported to Vista del Mar, a psychiatric hospital in Ventura, to be checked in involuntarily because of a lack of facilities in Santa Barbara, but ADMHS has reduced the number of its contract beds with the hospital to save money.
Reducing the beds from 12 to five for uninsured patients would save about $800,000 a year for ADMHS.
ADMHS has provided services to more than 1,300 patients who are medically indigent, meaning they have no health insurance. That cost of care amounted to nearly $3.5 million, just within the first six months of the 2009-10 fiscal year. It also funded outreach services to 400 indigent adults who were deemed to be a danger to themselves or others because of mental illness.
But looking ahead, things look much worse for the department’s 2010-11 funding, which is expected to be affected by dwindling state and general fund revenues.
According to documents from the department, ADMHS has determined it needs to shave off at least $2 million in spending for services for the indigent.
In addition to capping the beds at Vista del Mar for the uninsured, services also will be discontinued for 600 to 900 indigent people receiving treatment services through Fund 44.
The department will keep “very limited medication management support” for 300 of the 900 indigent adults who are currently served, and the priority will go to those most affected by mental illness.
According to ADMHS documents, the changes were effective March 15, which for some raises the question of why the change wasn’t approved by the Board of Supervisors.
“They’re implementing policies before they’ve been approved,” said Roger Thompson, who sits on the Mental Health Commission and who leads the Consumer Advocacy Coalition.
If beds continue to be capped, Thompson predicts a dramatic increase in people flooding emergency rooms.
“We’re going to get huge backlash from the hospitals, and that’s going to cost us more in the long run,” he said. “This is a direct immediate threat to this community on so many levels. We’re facing a potential catastrophe.”
One of the first places most likely to be affected by the change would be hospital emergency rooms.
Santa Barbara Cottage Hospital sees 250 to 300 people per month enter the emergency room for issues involving substance abuse and mental health, spokeswoman Janet O’Neill said.
She said that since the cap was put in place only two weeks ago, it’s too soon to say whether there’s been an increase, but she added that the hospital has seen a steady increase in patients seeking psychiatric and substance abuse help during the past five years.
“We do feel that this cap is probably going to have severe impact on the length of stay,” she said.
ADMHS Director Ann Dietrich acknowledged that there’s a great need for beds for involuntary care, but that the department just doesn’t have the money.
She said that in the past, the department has amended its contracts with Vista del Mar when money has been an issue or demand changes. In this case, the demand is still high, but the department has reached what Dietrich called its “contract capacity.”
“We’re seeing very clearly with the budget situation that we really can’t exceed that,” she said, but she wasn’t clear about why the decrease in beds this month hadn’t gone before the Board of Supervisors for approval.
Dietrich is expected to go over the details of the 2010-11 budget at Tuesday’s Mental Health Commission meeting, from 2 p.m. to 4 p.m. in the Ball Room of Hotel Corque, 400 Alisal Road in Solvang.
— Noozhawk staff writer Lara Cooper can be reached at lcooper@noozhawk.com.
http://www.noozhawk.com/noozhawk/article/032910_mental_health/
March 29, 2010
By Lara Cooper, Noozhawk Staff Writer
Alcohol, Drug and Mental Health Services reduces available beds and other assistance to save money
Uninsured people suffering from mental illness have fewer places to seek treatment after a set of decisions made two weeks ago by Santa Barbara County Alcohol, Drug and Mental Health Services.
More than 400 patients per year are transported to Vista del Mar, a psychiatric hospital in Ventura, to be checked in involuntarily because of a lack of facilities in Santa Barbara, but ADMHS has reduced the number of its contract beds with the hospital to save money.
Reducing the beds from 12 to five for uninsured patients would save about $800,000 a year for ADMHS.
ADMHS has provided services to more than 1,300 patients who are medically indigent, meaning they have no health insurance. That cost of care amounted to nearly $3.5 million, just within the first six months of the 2009-10 fiscal year. It also funded outreach services to 400 indigent adults who were deemed to be a danger to themselves or others because of mental illness.
But looking ahead, things look much worse for the department’s 2010-11 funding, which is expected to be affected by dwindling state and general fund revenues.
According to documents from the department, ADMHS has determined it needs to shave off at least $2 million in spending for services for the indigent.
In addition to capping the beds at Vista del Mar for the uninsured, services also will be discontinued for 600 to 900 indigent people receiving treatment services through Fund 44.
The department will keep “very limited medication management support” for 300 of the 900 indigent adults who are currently served, and the priority will go to those most affected by mental illness.
According to ADMHS documents, the changes were effective March 15, which for some raises the question of why the change wasn’t approved by the Board of Supervisors.
“They’re implementing policies before they’ve been approved,” said Roger Thompson, who sits on the Mental Health Commission and who leads the Consumer Advocacy Coalition.
If beds continue to be capped, Thompson predicts a dramatic increase in people flooding emergency rooms.
“We’re going to get huge backlash from the hospitals, and that’s going to cost us more in the long run,” he said. “This is a direct immediate threat to this community on so many levels. We’re facing a potential catastrophe.”
One of the first places most likely to be affected by the change would be hospital emergency rooms.
Santa Barbara Cottage Hospital sees 250 to 300 people per month enter the emergency room for issues involving substance abuse and mental health, spokeswoman Janet O’Neill said.
She said that since the cap was put in place only two weeks ago, it’s too soon to say whether there’s been an increase, but she added that the hospital has seen a steady increase in patients seeking psychiatric and substance abuse help during the past five years.
“We do feel that this cap is probably going to have severe impact on the length of stay,” she said.
ADMHS Director Ann Dietrich acknowledged that there’s a great need for beds for involuntary care, but that the department just doesn’t have the money.
She said that in the past, the department has amended its contracts with Vista del Mar when money has been an issue or demand changes. In this case, the demand is still high, but the department has reached what Dietrich called its “contract capacity.”
“We’re seeing very clearly with the budget situation that we really can’t exceed that,” she said, but she wasn’t clear about why the decrease in beds this month hadn’t gone before the Board of Supervisors for approval.
Dietrich is expected to go over the details of the 2010-11 budget at Tuesday’s Mental Health Commission meeting, from 2 p.m. to 4 p.m. in the Ball Room of Hotel Corque, 400 Alisal Road in Solvang.
— Noozhawk staff writer Lara Cooper can be reached at lcooper@noozhawk.com.
http://www.noozhawk.com/noozhawk/article/032910_mental_health/
ADMHS Fiasco
Dog Daze in the Afternoon
Angry Poodle Barbecue
Thursday, April 1, 2010
by NICK WELSH
DON’T CALL ME, I’LL CALL YOU: It seems that the folks running the county’s Mental Health Services — officially known as Department of Alcohol, Drug, and Mental Health Services — have embraced their inner “Never Explain, Never Complain” modus operandi, first popularized by former auto magnate Henry Ford II, who allegedly coined the phrase while drunkenly driving through Santa Barbara and crashing his car — not a Ford, by the way — while in the company of a woman conspicuously not his wife. A car wreck, it appears, is an apt metaphor for Mental Health Services, which despite the heroic efforts of many dedicated employees over the years, has long been the poster child for bureaucratic euthanasia. In recent years, the situation there has gone from bad to unbearable. The rate of turnover among top managers is enough to induce whiplash, and money flies out 20 times faster than it comes back in. Even without the convenient excuse of the state budget meltdown, Mental Health has had its own independently generated fiscal nightmare — to the tune of $25 million. This stems from hyper-optimistic billing practices that allowed delusional department managers to think the state would be paying them a whole lot more than they were entitled to. Actually, it’s even worse than not getting money that you expected. It’s having to pay back what you did get. If that wasn’t bad enough, Mental Health executives announced — halfway into this year’s budget — they had sprung a $3.3-million budget leak. Somehow, costs had to be controlled. If I were running that show, I certainly wouldn’t want to talk about it. And even less would I want to talk about new treatment protocols I’d devised for the poorest of the poor — chucking them overboard. Presumably, if these can float, then they’re cured. And if they can’t, I guess we won’t have to listen to them screaming and hollering up and down State Street anymore.
With a conspicuous lack of fanfare or even a modicum of public notice, Mental Health executives enacted a series of cuts two weeks ago designed to save the department $2.4 million. They did not ask. They did not tell. And certainly, the county Supervisors never approved these cuts. In the process, up to 900 indigent mentally ill found themselves either cut off from services they’d previously received or had those services curtailed in significant fashion. Lara Cooper of Noozhawk did an excellent job reporting how Mental Health administrators cut the county’s allocation to secure desperately needed mental health beds in Ventura’s Vista del Mar facility by more than half. Normally, Santa Barbara reserves 12 beds for Santa Barbara residents in desperate need. Translated into actual lives, that means 236 of the 400 people whom Santa Barbara typically sends to Vista del Mar every year will now be at loose ends when they reach their breaking point. Where do you suppose they will go when that happens? If we’re lucky, they’ll have the good sense to check themselves into the Cottage ER. But if we’re not, the SWAT team could be busy.
Likewise, Mental Health has put a serious lid on treating people with both substance-abuse and mental disorders. Or, as one county social worker put it, “If you blow numbers, they won’t do 5150 assessments anymore.” The code 5150 refers to the state policy allowing involuntary psychiatric holds on individuals who pose a threat either to themselves or to others. “Blowing numbers” refers to testing positive for drugs or alcohol. Given that people in extreme distress are inclined to medicate themselves into obliteration, this new policy is clearly problematic. It’s not so much a case of closing the barn door after the horses have gone as it is of locking the barn door with the horses inside, while the barn is burning down. Last time I spent any time hanging around the Cottage ER, it seemed plenty busy and plenty eccentric already. Beyond that, Mental Health Services officials have decided to stop providing services for low-income people too messed up to apply for Medicaid assistance. This is a universe of several hundred troubled souls.
Budget cuts of these magnitudes easily qualify simultaneously as “turd-in-the-punch-bowl” and “skunk-at-the-garden-party.” At a minimum, people should have been alerted that they’re happening. Better yet, maybe somebody should have been consulted before the fact. The cuts were implemented effective March 15. One day later, the county’s Mental Health Commission convened somewhere in the Santa Ynez Valley, mutually inconvenient to almost all the stakeholders involved. Strikingly, the issue never came up. The advisory commission appointed by the county Supervisors to give advice on mental health concerns was never told or asked about the cuts. Is it possible that was an oversight? This Tuesday, the Mental Health Commission met again, also in the Santa Ynez Valley. I don’t know what happened. But the timing couldn’t have been more piquantly propitious. It turns out that at the same time, the Santa Barbara City Council had scheduled a discussion of some 12-point program to deal with the aggressive panhandlers, the chronically obstreperous, the habitually inebriated, and others disinclined to go quietly into anybody’s long good night. Given that the indigent and mentally ill feature prominently in this population, many of the key mental health stakeholders found themselves intensely conflicted as to where they should be. Was it possible that was a scheduling oversight, as well? Some in the mental health advocacy community don’t think so. But of course, they could just be paranoid. And unfortunately, with all the not-so-quiet cuts being made to Mental Health Services, it’s not likely they’ll be getting the treatment they need. And when that happens, the least of our problems will be aggressive panhandlers. In the meantime, how ’bout spare change for the mentally ill?
Angry Poodle Barbecue
Thursday, April 1, 2010
by NICK WELSH
DON’T CALL ME, I’LL CALL YOU: It seems that the folks running the county’s Mental Health Services — officially known as Department of Alcohol, Drug, and Mental Health Services — have embraced their inner “Never Explain, Never Complain” modus operandi, first popularized by former auto magnate Henry Ford II, who allegedly coined the phrase while drunkenly driving through Santa Barbara and crashing his car — not a Ford, by the way — while in the company of a woman conspicuously not his wife. A car wreck, it appears, is an apt metaphor for Mental Health Services, which despite the heroic efforts of many dedicated employees over the years, has long been the poster child for bureaucratic euthanasia. In recent years, the situation there has gone from bad to unbearable. The rate of turnover among top managers is enough to induce whiplash, and money flies out 20 times faster than it comes back in. Even without the convenient excuse of the state budget meltdown, Mental Health has had its own independently generated fiscal nightmare — to the tune of $25 million. This stems from hyper-optimistic billing practices that allowed delusional department managers to think the state would be paying them a whole lot more than they were entitled to. Actually, it’s even worse than not getting money that you expected. It’s having to pay back what you did get. If that wasn’t bad enough, Mental Health executives announced — halfway into this year’s budget — they had sprung a $3.3-million budget leak. Somehow, costs had to be controlled. If I were running that show, I certainly wouldn’t want to talk about it. And even less would I want to talk about new treatment protocols I’d devised for the poorest of the poor — chucking them overboard. Presumably, if these can float, then they’re cured. And if they can’t, I guess we won’t have to listen to them screaming and hollering up and down State Street anymore.
With a conspicuous lack of fanfare or even a modicum of public notice, Mental Health executives enacted a series of cuts two weeks ago designed to save the department $2.4 million. They did not ask. They did not tell. And certainly, the county Supervisors never approved these cuts. In the process, up to 900 indigent mentally ill found themselves either cut off from services they’d previously received or had those services curtailed in significant fashion. Lara Cooper of Noozhawk did an excellent job reporting how Mental Health administrators cut the county’s allocation to secure desperately needed mental health beds in Ventura’s Vista del Mar facility by more than half. Normally, Santa Barbara reserves 12 beds for Santa Barbara residents in desperate need. Translated into actual lives, that means 236 of the 400 people whom Santa Barbara typically sends to Vista del Mar every year will now be at loose ends when they reach their breaking point. Where do you suppose they will go when that happens? If we’re lucky, they’ll have the good sense to check themselves into the Cottage ER. But if we’re not, the SWAT team could be busy.
Likewise, Mental Health has put a serious lid on treating people with both substance-abuse and mental disorders. Or, as one county social worker put it, “If you blow numbers, they won’t do 5150 assessments anymore.” The code 5150 refers to the state policy allowing involuntary psychiatric holds on individuals who pose a threat either to themselves or to others. “Blowing numbers” refers to testing positive for drugs or alcohol. Given that people in extreme distress are inclined to medicate themselves into obliteration, this new policy is clearly problematic. It’s not so much a case of closing the barn door after the horses have gone as it is of locking the barn door with the horses inside, while the barn is burning down. Last time I spent any time hanging around the Cottage ER, it seemed plenty busy and plenty eccentric already. Beyond that, Mental Health Services officials have decided to stop providing services for low-income people too messed up to apply for Medicaid assistance. This is a universe of several hundred troubled souls.
Budget cuts of these magnitudes easily qualify simultaneously as “turd-in-the-punch-bowl” and “skunk-at-the-garden-party.” At a minimum, people should have been alerted that they’re happening. Better yet, maybe somebody should have been consulted before the fact. The cuts were implemented effective March 15. One day later, the county’s Mental Health Commission convened somewhere in the Santa Ynez Valley, mutually inconvenient to almost all the stakeholders involved. Strikingly, the issue never came up. The advisory commission appointed by the county Supervisors to give advice on mental health concerns was never told or asked about the cuts. Is it possible that was an oversight? This Tuesday, the Mental Health Commission met again, also in the Santa Ynez Valley. I don’t know what happened. But the timing couldn’t have been more piquantly propitious. It turns out that at the same time, the Santa Barbara City Council had scheduled a discussion of some 12-point program to deal with the aggressive panhandlers, the chronically obstreperous, the habitually inebriated, and others disinclined to go quietly into anybody’s long good night. Given that the indigent and mentally ill feature prominently in this population, many of the key mental health stakeholders found themselves intensely conflicted as to where they should be. Was it possible that was a scheduling oversight, as well? Some in the mental health advocacy community don’t think so. But of course, they could just be paranoid. And unfortunately, with all the not-so-quiet cuts being made to Mental Health Services, it’s not likely they’ll be getting the treatment they need. And when that happens, the least of our problems will be aggressive panhandlers. In the meantime, how ’bout spare change for the mentally ill?
Drugs and Prison: The American Disgrace
For years, drug policy discussions have foundered on a fundamental dilemma: If illegal and addictive drugs are freely available in the nation’s prison system—and there is no one who says otherwise—then how can we as a society expect to control the consumption of drugs outside the prison walls? Moreover, should people be jailed at all for simple possession?
In 1982, President Ronald Reagan inaugurated the “war on drugs." From 1980 to 1997, writes Glenn C. Loury in his book Race, Incarceration, and American Values, the number of people in prison for drug offenses increased more than 1,000 %. Only one out of five drug convictions involved any sort of distribution beyond simple possession, says Loury, although there is often dispute about these numbers and how they are derived.
In “Can Our Shameful Prisons Be Reformed?” which appeared in the November 19 issue of the New York Review of Books, David Cole argues that African-Americans “have borne the brunt of this war.” While white drug offenders in prison increased by more than 100 % from 1985 to 1991, the prison population of black drug offenders soared by 465 %. Citing figures from The Sentencing Project, Cole asks whether we are willing to accept “a system in which one out of every three black males born today can expect to spend time in jail during his life?”
America’s prison disgrace is everyone’s problem, however. Cole informs us that a new prison is opened in the U.S. every week, and that imprisoning someone costs $20,000 a year and up. We spend $7 billion on jails in 1980. Today, writes Cole, the figure is $60 billion.
Where are we going wrong? The answer is straightforward, and unavoidable: The War on Drugs. According to FBI crime statistics cited by Cole, the U.S. last year arrested 1.7 million people for drug crimes. “Since 1989, more people have been incarcerated for drug offenses than for all violent crimes combined,” writes Cole. “Yet much like Prohibition, the war on drugs has not ended or even significantly diminished drug use.” In addition, “about half of property crime, robberies, and burglaries are attributable to the inflated cost of drugs caused by criminalizing them.”
At the heart of the problem lies a long-standing dilemma. The American prison system does next to nothing for drug addicts, except assure them of a steady supply. The justice system does not systematically help drug addicts avoid prison, or reintegrate them into society when they get out. And, since a high number of chronic drug abusers also suffer from other mental disorders, the lack of consistent, well-funded, effective programs for ex-offenders virtually guarantees a revolving-door cycle of repeated incarcerations. For those drug felons who are not themselves addicts, and who are in prison due to simple possession charges, a program of mass parole would ease prison crowding significantly. There is really no reason why many of the prisoners in this class should have been locked up at all, but for draconian legislation passed in the heat of passion—like New York’s Rockefeller laws--about one drug “epidemic” or another.
In addition to converting the swords of the drug war into the ploughshares of job programs, education, and housing assistance, we need to recognize and act upon the obvious fact that young people who are in school are far less likely to end up in prison. Schools are a far more cost-effective solution than prisons. In addition, a RAND Corporation study cited by Cole concluded that treatment is "fifteen times more effective at reducing drug-related crime than incarceration."
In the end, the need for action is undeniable. As Cole writes, “The very fact that the US record is so much worse than that of the rest of the world should tell us that we are doing something wrong.”
http://addiction-dirkh.blogspot.com/2009/12/drugs-and-prison.html
****************
In 1982, President Ronald Reagan inaugurated the “war on drugs." From 1980 to 1997, writes Glenn C. Loury in his book Race, Incarceration, and American Values, the number of people in prison for drug offenses increased more than 1,000 %. Only one out of five drug convictions involved any sort of distribution beyond simple possession, says Loury, although there is often dispute about these numbers and how they are derived.
In “Can Our Shameful Prisons Be Reformed?” which appeared in the November 19 issue of the New York Review of Books, David Cole argues that African-Americans “have borne the brunt of this war.” While white drug offenders in prison increased by more than 100 % from 1985 to 1991, the prison population of black drug offenders soared by 465 %. Citing figures from The Sentencing Project, Cole asks whether we are willing to accept “a system in which one out of every three black males born today can expect to spend time in jail during his life?”
America’s prison disgrace is everyone’s problem, however. Cole informs us that a new prison is opened in the U.S. every week, and that imprisoning someone costs $20,000 a year and up. We spend $7 billion on jails in 1980. Today, writes Cole, the figure is $60 billion.
Where are we going wrong? The answer is straightforward, and unavoidable: The War on Drugs. According to FBI crime statistics cited by Cole, the U.S. last year arrested 1.7 million people for drug crimes. “Since 1989, more people have been incarcerated for drug offenses than for all violent crimes combined,” writes Cole. “Yet much like Prohibition, the war on drugs has not ended or even significantly diminished drug use.” In addition, “about half of property crime, robberies, and burglaries are attributable to the inflated cost of drugs caused by criminalizing them.”
At the heart of the problem lies a long-standing dilemma. The American prison system does next to nothing for drug addicts, except assure them of a steady supply. The justice system does not systematically help drug addicts avoid prison, or reintegrate them into society when they get out. And, since a high number of chronic drug abusers also suffer from other mental disorders, the lack of consistent, well-funded, effective programs for ex-offenders virtually guarantees a revolving-door cycle of repeated incarcerations. For those drug felons who are not themselves addicts, and who are in prison due to simple possession charges, a program of mass parole would ease prison crowding significantly. There is really no reason why many of the prisoners in this class should have been locked up at all, but for draconian legislation passed in the heat of passion—like New York’s Rockefeller laws--about one drug “epidemic” or another.
In addition to converting the swords of the drug war into the ploughshares of job programs, education, and housing assistance, we need to recognize and act upon the obvious fact that young people who are in school are far less likely to end up in prison. Schools are a far more cost-effective solution than prisons. In addition, a RAND Corporation study cited by Cole concluded that treatment is "fifteen times more effective at reducing drug-related crime than incarceration."
In the end, the need for action is undeniable. As Cole writes, “The very fact that the US record is so much worse than that of the rest of the world should tell us that we are doing something wrong.”
http://addiction-dirkh.blogspot.com/2009/12/drugs-and-prison.html
****************
Doctors are part of the problem, says US Deputy Drug Czar McLellan
In a March 15 cover story titled “The American Way,” Drink and Drugs News of the UK ran an insightful interview with America’s “deputy” Drug Czar, Thomas McLellan. Professor McLellan, deputy director of the Office of National Drug Control Policy, is not a cop, like his boss Gil Kerlikowske, or a retired Army general, like former Drug Czar Barry McCaffrey. McLellan is a rare breed, a treatment specialist, and brings an entirely different viewpoint to an office that has traditionally been strongly oriented toward law enforcement.
“In the US we’ve been thinking about addiction as just a lot of drug use,” McLellan told a group of addiction specialists and policy professionals at the Institute of Psychiatry in London. “And as a result we’ve been purchasing [treatment] stupidly. We can’t decide if addiction is a crime or a disease so we’ve compromised and given them treatments that aren’t any good.”
McLellan singled out doctors for special attention: “Most physicians are not trained in how to treat substance abuse. They don’t see it as a disease and don’t see why they should look for it.”
Treating addiction like any other medical condition is still a goal rather than a reality. “You may know that the relapse rates for diabetes, hypertension and asthma are almost identical to the relapse rates for any addictive disorder…. And no one puts their hands on their hips when a diabetic comes back and says, ‘I ate half a bucket of fried chicken and I forgot to take my insulin, and now I’m back here.’ They just treat them.”
If there are doctors who don’t believe in the disease model of addiction, we can’t be surprised if members of the general public—and addicts themselves--often feel the same way. McLellan said that less than 3 % of all referrals for addiction treatment and specialty care originate with doctors. Moreover, roughly half of 12,000 smaller treatment programs in the U.S. have no doctor, nurse, or psychologist on staff. And counselors, who make up the majority of treatment staff, suffer from a 50 % turnover rate.
In addition, McLellan took on the traditional British aversion to methadone treatment for heroin addicts: “That this has been a battle, that you are either on methadone or you are on the path of truth, beauty and light, is artificial and unfortunate…. I’m now officially wagging my finger and saying not just to Britain, but to the whole damn field; get past this, this is an artificial contrivance. People ought to have the opportunity to get the medications and other services they need.”
McLellan also had choice words for politicians and policy makers who see incarceration as the only acceptable response to drugs and drug-related crime. He referenced studies that “suggest very clearly that in a prison situation, when you release somebody with a drug problem, they are back and you’re going to do it all over again. It’s a bad business deal.”
Ongoing care—after prison, or after treatment—is essential to success. “I think residential care is important and necessary, but not sufficient,” McLellan maintained. “It is like having a very good junior high school education.”
Source:
http://addiction-dirkh.blogspot.com/2010/03/deputy-drug-czar-goes-his-own-way.html
******************
“In the US we’ve been thinking about addiction as just a lot of drug use,” McLellan told a group of addiction specialists and policy professionals at the Institute of Psychiatry in London. “And as a result we’ve been purchasing [treatment] stupidly. We can’t decide if addiction is a crime or a disease so we’ve compromised and given them treatments that aren’t any good.”
McLellan singled out doctors for special attention: “Most physicians are not trained in how to treat substance abuse. They don’t see it as a disease and don’t see why they should look for it.”
Treating addiction like any other medical condition is still a goal rather than a reality. “You may know that the relapse rates for diabetes, hypertension and asthma are almost identical to the relapse rates for any addictive disorder…. And no one puts their hands on their hips when a diabetic comes back and says, ‘I ate half a bucket of fried chicken and I forgot to take my insulin, and now I’m back here.’ They just treat them.”
If there are doctors who don’t believe in the disease model of addiction, we can’t be surprised if members of the general public—and addicts themselves--often feel the same way. McLellan said that less than 3 % of all referrals for addiction treatment and specialty care originate with doctors. Moreover, roughly half of 12,000 smaller treatment programs in the U.S. have no doctor, nurse, or psychologist on staff. And counselors, who make up the majority of treatment staff, suffer from a 50 % turnover rate.
In addition, McLellan took on the traditional British aversion to methadone treatment for heroin addicts: “That this has been a battle, that you are either on methadone or you are on the path of truth, beauty and light, is artificial and unfortunate…. I’m now officially wagging my finger and saying not just to Britain, but to the whole damn field; get past this, this is an artificial contrivance. People ought to have the opportunity to get the medications and other services they need.”
McLellan also had choice words for politicians and policy makers who see incarceration as the only acceptable response to drugs and drug-related crime. He referenced studies that “suggest very clearly that in a prison situation, when you release somebody with a drug problem, they are back and you’re going to do it all over again. It’s a bad business deal.”
Ongoing care—after prison, or after treatment—is essential to success. “I think residential care is important and necessary, but not sufficient,” McLellan maintained. “It is like having a very good junior high school education.”
Source:
http://addiction-dirkh.blogspot.com/2010/03/deputy-drug-czar-goes-his-own-way.html
******************
Saturday, April 3, 2010
Poor Communication In The Brain Linked To Schizophrenia
By Nadja Popovich
New evidence suggests that schizophrenia can be caused by a lack of synchronization between regions of the brain.
Mice with a genetic defect linked to schizophrenia had trouble navigating through a maze.
In a study, just published in the journal Nature, researchers from Columbia University compared mice bred to have a genetic mutation linked to schizophrenia in humans with healthy mice and found that mutant mice had more trouble completing spatial tasks -- like getting through a maze.
Though most people associate schizophrenia most strongly with hallucinations and delusions, the disease also impairs cognitive abilities, including working memory. The Columbia researchers found that the two regions of the brain associated with working memory in the mutant mice -- the hippocampus and the prefrontal cortex -- weren't communicating the way they do in normal animals.
The short circuit may lend a clue to the causes of schizophrenia in humans.
New evidence suggests that schizophrenia can be caused by a lack of synchronization between regions of the brain.
Mice with a genetic defect linked to schizophrenia had trouble navigating through a maze.
In a study, just published in the journal Nature, researchers from Columbia University compared mice bred to have a genetic mutation linked to schizophrenia in humans with healthy mice and found that mutant mice had more trouble completing spatial tasks -- like getting through a maze.
Though most people associate schizophrenia most strongly with hallucinations and delusions, the disease also impairs cognitive abilities, including working memory. The Columbia researchers found that the two regions of the brain associated with working memory in the mutant mice -- the hippocampus and the prefrontal cortex -- weren't communicating the way they do in normal animals.
The short circuit may lend a clue to the causes of schizophrenia in humans.
Subscribe to:
Posts (Atom)