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Street Wise

How the Contract with America just said no to drug and alcohol treatment programs

By Dylan Bennett

In better times, heroin addict Johnny Jones lived with his wife in a trailer park. To placate his addiction, he received treatment at a methadone program. With methadone--a synthetic narcotic that helps decrease or eliminate the craving for heroin--he escaped a low life of shooting dope to ease chronic back pain, a jaw-clenching reminder of two major spinal injuries incurred in the military and in a car accident. All things considered, Jones--molested and abused as a child, and prone to explosive, violent behavior--was doing OK.

Today, Jones bivouacks in the urban landscape, homeless, sleeping in the back of a messy, cluttered old car on the streets of Santa Rosa. He works odd jobs, despite the constant pain from both his back injuries and hunger. "It's killing me," he says of his situation.

The government money he once received for his disability is gone, cut off by a new law, and with it the additional money that paid for methadone treatment.

When the last dose of methadone runs out, the future of the burly, unwashed Jones is a prescription for death. Without treatment he could easily return to cheap vodka, a $100-a-day heroin habit, and a steady gig pushing heroin.

Jones is one of hundreds of drugs addicts and alcoholics in Sonoma County whose Supplemental Security Income also brought Medi-Cal-paid drug treatment and counseling. Now, they are back on the streets without money, and without access to drug treatment since federal legislation implemented on Jan. 1 left them ineligible for the benefits.

The new law, part of the Contract with America ushered in by the Republican-led Congress, promises to increase crime, spread disease, siphon the county budget, and push deserving, well-intentioned people out of drug treatment, according to local officials. They say the funding cuts shift a significant financial burden from the federal government to the county as those slashed from cash benefits and treatment return to homelessness, drug abuse and dealing, theft, and prostitution, and ultimately end up in local hospitals and jails and on local economic relief.

"We've got hundreds of people who were in some kind of treatment, and now they are not," says Sonoma County drug administrator Gino Giannavola. "I think it's a tragedy. The problem didn't go away. The people are still out there."

In the past seven months, at least 73 heroin addicts countywide have lost funding for treatment at the two local methadone clinics. "I'm sure that the majority, if not all of them, are out there using heroin," says methadone program director Brian Piercy of the Drug Abuse Alternative Center in Santa Rosa, which has lost 23 clients.

At the Santa Rosa Treatment Program, director Lee Tillman counts 50 heroin addicts no longer in treatment. Many of the addicts, he says, suffer from hepatitis and tuberculosis and are sure to spread their diseases via shared syringes and prostitution.

"I don't think [Congress] really thought it through," reflects Andrea Learned, executive director of Face to Face-Sonoma County AIDS Network. "They harmed a group of people who are entering recovery and need the income to make a change in their life. And they did it because they were angry about the infamous percentage of people who take advantage [of SSI programs].

"They also didn't look at the long-term health cost of denying a large group of people preventative health care or access to treatment. If you can't get SSI, you can't afford private treatment. What are you to do? You are encouraged to continue to use drugs and alcohol."

Both addicts and drug counselors predict increased crime as a result of the changes. "Those are persons out there and they are addicted," says Giannavola tensely. "So if they don't get the methadone, they are going to go out looking to score. They get into breaking into cars, houses . . . to feed the habit. Selling the body, whatever. Whatever it takes to get their fix."

Jones echoes that analysis: "If the government thinks taking people off SSI is going to change something, it will," says the street-wise addict. "The crime rate is going to go through the roof. More dealing, petty theft, and strong-arm robbery than ever before. People who cannot go out and work have to do something."

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More SSI cuts leave people out in the cold.

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Lori McElroy of Santa Rosa, an alcoholic, was scheduled to lose her Social Security Disability benefits this August. A timely letter asking for reconsideration has postponed the cutoff date. The looming cut, she says, would seriously jeopardize her family.

McElroy, 34, says she has been "clean and sober" for eight months, attends numerous support groups, sees both a psychotherapist and a psychiatrist, and is signed up for vocational rehabilitation. Unemployed since her alcoholism compromised her job performance, she has sclerosis of the liver and hepatitis. She and her 7-year-old daughter get $818 a month in SSI payments, plus about $100 in food stamps. Rent on their one-bedroom apartment is $560. With the change, she pays the PG&E bill and buys some food.

But McElroy says she needs more time to find a job that pays at least $9 per hour. By her reckoning, the cost of child care and loss of medical insurance would offset the benefits of a low-paying job. In addition, the fear of losing her daughter to Child Protective Services if she becomes homeless brings daily anxiety for the former Safeway meat department worker.

"I agree that some people are out there and they just don't want to get sober and they just use their check [for drugs and alcohol], and that's reality," argues McElroy. "I know it's hard to screen them, but there are people out there like me who really need help and would be devastated [by the cuts]. Their whole family would be torn apart."

According to Mike Humphrey, executive director of Community Resources for Independence, a non-profit independent living center, drug addicts and alcoholics are not conveniently moved "from welfare to work," regardless of popular political beliefs.

"Alcoholism and drug addiction have been known to be just that, an addiction," asserts Humphrey. "People don't have the ability to just say, 'No, I don't want to do it.' They have to eventually go into treatment and get some assistance. It might have been more appropriate to have some kind of time limit where a person could be eligible, rather than [imposing] cold turkey and kicking everybody off."

As the law went into effect, public agencies scrambled to help clients keep benefits by reclassifying them to a different disability, usually a physical or mental classification. In Sonoma County, two thirds of those cut failed to get reclassified, a daunting bureaucratic process for many disabled people who often don't have complete medical records, access to doctors and transportation, or coping skills to negotiate the review process.

Disabled SSI recipients and treatment advocates say individuals faced brief reviews from Social Security doctors who appeared determined to purge the rolls of the disabled toward a predetermined outcome. "They ran us through like cattle just to get rid of us," grumbles Jones.

Of 693 Sonoma County residents receiving SSI under the drug and alcohol classification, 438 had their benefits terminated. Of those appealing the cuts or seeking reclassification, 261 were denied. In all, 177 recipients simply never contacted the Social Security Administration.

The latter group, many fear, may be the most disabled of all. Drug addiction and alcoholism often mask other serious maladies such as post-traumatic stress disorder among war veterans, depression, manic-depression, schizophrenia, HIV, back problems, heart conditions, and liver and spinal disorders. About 50 percent of all the mentally ill have substance-abuse problems stemming from their efforts to medicate themselves.

"The big thing here is that a lot of people have fallen through the cracks," says Humphrey. He relates the story of a woman with a multiple personality disorder who came to his agency after three or four months of being homeless. She didn't remember getting the letter of termination.

Ironically, Humphrey says, over the last decade getting disability for psychiatric reasons was very difficult and many mentally ill people were advised to apply for disability under a drug or alcohol classification.

Looking to a solution, Andrea Learned of Face to Face argues that Medi-Cal eligibility should be separated from SSI, so low-income people can get funding for treatment, but not necessarily cash support. "I don't like the way they did it, but I also understand the presumption that because someone uses substances, many of which are illegal, the government should agree to pay for their daily expenses isn't great public policy either," she says. "You don't want to be sending this population the message that we'll support you in this, unconditionally.

"But I would argue that, in the case of this law, the harm outweighs the help."

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From the July 24-30, 1997 issue of the Sonoma County Independent.

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