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By Linda Martz, lmartz@nncogannett.com

News Journal

DEC 13/2004

Special Report: Hidden Deaths, A fatal fight with drugs

MANSFIELD -- People dealing with drug addiction -- family members or friends of addicted persons, treatment counselors, probation officers -- are frustrated the system isn't working as well as it could to curb drug addiction.

But many had ideas on how they might fix those problems.

And their ideas, which sprang out of first-hand experience, merit further public discussion:

Mentors to turn around kids at risk

Tom Bowers, 54, of Mansfield believes adult mentors in the community can make a huge impact in turning children at risk away from drugs.

In high school, he was good friends with two kids who died many years later of drug-related causes -- George Beymer and Terry Myers.

But Bowers said he began taking a separate path, after he was caught at junior high age breaking in- to two school buildings.

A principal at one of the buildings "took me un- der his wing," Bowers said.

The break-ins were a juvenile felony, but the principal kept it from police, he said.

"He probably could have lost his job over that. ... Maybe he saw something in me," Bowers said.

Instead, the principal, now deceased, began guiding him toward better choices.

"I view that man as just saving me. I view things as turning around then," Bowers said.

Unfortunately, his friends weren't so lucky.

Short round of treatment not enough

Treatment officials said the public needs to fully understand a single round of treatment paid for through insurance, sometimes lasting only a couple of days, may not be enough to help drug addicts get well.

Drug addicts don't just go through detox and automatically stop using, said Geron Tate, executive director of Urban Minority Alcoholism and Drug Abuse Outreach Program. They need to make permanent changes in their behavior, he said.

"You get a sponsor who is clean and sober and willing to tell you the truth," Tate said. "Recovery is about learning."

Make drug suppliers accountable for deaths

METRICH officials said people who illegally supply drugs that kill people deserve to be targeted with criminal charges -- whether heroin or prescription drugs were involved.

But police apparently were not involved in some local overdose deaths, judging by the lack of police incident reports.

Operations supervisor Michael Bammann said he would like police automatically contacted regarding more overdose cases.

Emphasize treatment, not punishment

Some believe America turned down a dead-end alley, when it shaped the "War on Drugs" by spending heavily on law enforcement, courts and prisons -- rather than putting those dollars toward treatment and prevention programs.

"A lot of experts would prefer to rephrase that," said Eric R. Wandersleben, public information officer for the Ohio Department of Drug Addiction and Alcohol Services.

"Instead of supply reduction -- where you go after the people who are growing and selling drugs -- instead focus on demand reduction," treating addicted people, he said.

State officials said targeted anti-drug campaigns have shown they can be effective.

"Four years ago we were seeing an increase (in use of Ecstasy) especially among youths in raves and clubs." But by 2003, abuse "was leveling off," ODADAS official Sandy Starr said.

Ads promoted by Drug Free Ohio emphasized that Ecstasy wasn't just a benign "love drug", but something that could kill, "the very first time" it was used, Wandersleben said.

Mansfield attorney Stephen Cockley, who serves on the drug court board, has approached the board with the idea of sponsoring an "amnesty" program that would allow parents to turn in their kids, to get treatment. If treatment doesn't work, only then might they go to prison, he said.

'Educated eyes' watching for signs of drug abuse

Treatment officials want to see lots more people around the community -- parents, teachers, health professionals -- learn the signs of drug abuse.

Tate, a former teacher, said schools should form crisis intervention teams, for early identification of children affected by drug abuse. The programs would "get them help and learn how to conduct themselves in the appropriate environments at the appropriate times," he said.

He doesn't believe those children should just be relegated to special behavior classes. "They don't really learn, so they end up dropping out of school. The prognosis is failure."

Increased payouts

for treatment

Many mental health professionals are frustrated by the fact that private insurance programs typically pay only a small percentage of a patient's bill for drug or alcohol addiction treatment, compared to what they'd pay for expenses in a medical plan.

"There is a big push for mental health treatment parity and to (have those services) paid for at the same level (as medical)," said Richland County Board of Mental Health and Recovery Services Associate Director Tom Chambers.

But that would require lobbying at the Statehouse -- since the parity issue is being approached "state by state," Chambers said.

Help for parents

Several parents or older relatives told the News Journal they were very uncertain where to go for help, once they discovered younger relatives were using drugs.

Parents who believe their own children might be using can get a list of useful information Web sites through Community Action for Capable Youth.

"We also sell drug tests to parents on a regular basis," so families can monitor activity, said CACY Director Karen Moody-Bierly.

Parents "need to be educated on what's out there," said Wandersleben. "Even at 7, 8, 9 years old, there's people out there that are approaching them, trying to sell them drugs," he said.

More drug treatment dollars?

Treatment officials said public and private dollars for treatment of drug addiction have dropped off or remained flat, at the same time experimentation with heroin has increased among young people.

Chambers said local treatment agencies that receive public funding had to raise their "triage" levels in recent years.

Today, they focus primarily on "people further down the road to destruction," and are less able to help moderately addicted clients' head off problems at an early stage, he said.

Take fewer 'wrong turns' locating help

CACY officials would like to see many more people around the community become knowledgeable on where to refer families grappling with a drug addiction issues.

Moody-Bierly said she got a call this summer from a person who was addicted, lived alone, had no family, and was employed in a low-paying job. The person qualified for help through Job and Family Services, but had made false starts, not knowing where to turn, "and just went back to using," she said.

The more people around this area who are aware of resources, the more they can point families toward help, Moody-Bierly said. "I think, as a community, we need to look at how we empower people."

Nina Clark of Mansfield would have appreciated guidance when she tried to get her nephew into treatment four years ago. Lacking good information, she called dozens of phone numbers, noting "I went through the whole phone book."

She couldn't find a long-term treatment program that would accept him. Now her nephew is in prison, after he shot someone while he was high, she said.

Shop around for best 12-step meetings

Mark Cox, who runs Mansfield Municipal Court's treatment court, believes judges make a sensible decision when they "force" someone to attend such meetings.

"My personal opinion is, everyone who goes to a 12-step meeting was 'forced' to, at some time or other. It's either 'My wife is going to leave me.' ... or 'I'm going to lose my house.' ... or 'I'm going to jail if I don't get it together.' ... or 'My doctor says I'm going to die, if I don't stop drinking. ...' "

The court system forces some defendants to meetings "before they're actually ready," he admitted. But resistant people still pick up knowledge that could help them recover later, he believes. "If they don't get sober this year, they know where to go next year."

However, not all 12-step meetings may be an equal help, Cox said.

Certain meetings may attract people who "aren't really serious." If the number of resistant substance abusers gets too high, and "there's not enough old-timers to lead them," the meeting is less effective," he said.

North central Ohio is rich in a large number of 12-step meetings, Cox said.

He has advised some defendants to travel further afield, if necessary, to find a good meeting with the best mix of attendees -- people like themselves just beginning recovery, those who have been sober for a year or so, and sponsors who have accumulated the wisdom to help others.

Sensible rules on medical confidentiality

Some people close to the issue of drug addiction say they're sometimes frustrated by tightened federal medical confidentiality regulations.

They'd like to see confidentiality rules adjusted to become more common sense.

Cox said police sometimes deal with suicidal people, and want to know whether and where they're already getting treatment. If asked, "The Center can't say whether she's a client or not," Cox said. "There are reasons why they've got confidentiality. But, I think there are times when it goes too far."

METRICH officials said the federal restrictions sometimes "hinder" investigations conducted by law enforcement.

Philip J. Klusmann, whose fiancee, Jane Lewis, died of a drug overdose, said some doctors allowed him to take part in Lewis' medical conferences. That gave him a more accurate idea what medications she was actually supposed to receive.

But the last doctor she saw before she overdosed "wouldn't even talk" to him, Klusmann said.

Cross-training

for professionals

Cox said he'd like to see much more training provided to various professionals who deal with the drug problem.

Doctors, social workers, teachers and police officers often comment that they had only limited hours of training, early in their careers, to help them recognize and deal with drug addiction issues, he said.

Additional training would help, Cox said.

Crossroads Center for Change Director Lynne Spencer agrees. She believes physician education is crucial for reducing prescription drug addiction.

"People who are drug-seeking are very good at getting what they need to get," she said.

Spencer knows of physicians who released patients from the ER after realizing they didn't actually need medicine they came in seeking. But other doctors get taken in, she said.

Cox also would like to see local "cross-training" sessions, to bring together professionals in the Richland County area, to discuss how they deal with drug addiction.

Those who approach the problem from different directions can help each other, he said. "Sometimes they come up with a solution."

Enough money for autopsies

If drug-related deaths, including prescription overdoses, are on the increase, more autopsies probably should be completed, Richland County coroner's investigator Paul Jones said.

But the coroner has hasn't had a large enough budget to keep up with increased cases, Jones said.

County commissioners provide funding to operate the coroner's office, but it's "not a lot," when ongoing expenses also must be paid, he said. "You have to make a decision -- do we do this autopsy?" he said.

Jones thinks some funding should be forwarded to coroner's offices through the estate tax, to help pay for services like pathologist's reports.

It also would be fair for insurance companies to chip in for the cost of autopsies -- since they use coroner's rulings to determine whether to issue a settlement on a death, he said.

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