County coalition touts 'carrot-and-stick' system for drug treatment
Judges who sentence drug users and psychologists who treat them need to work together to make sure addicts can kick the habit successfully, says a work group of the Yavapai County Substance Abuse Coalition, a compilation of the Methamphetamine Advisory Task Force (MATForce), Youth Count and Advocates for Positive Choices.
Members of the coalition have been working for three years to find out what really works in treating drug users.
"It takes a blend of carrot and stick," said Don Ostendorf, director of social services at the Yavapai Prescott Indian Tribe.
Ostendorf and Billie Grobe, chief probation officer for Yavapai County Adult Probation, presented the work group's ideas during a public meeting at the Yavapai County Administrative Services Building this past Thursday.
In the past, Ostendorf said, treatment for addicts was separate from their legal punishment. But scientific studies on drug addiction show that the most successful outcomes for addicts come from a combination of treatment and punishment.
Ostendorf said he hears long-time addicts say over and over again, "If I had not been arrested, I wouldn't have gotten treatment and if I hadn't gotten treatment I would still be getting arrested."
The goal of fewer addicts is one the entire community should get behind because it means the public will be safer, Grobe added.
Ostendorf said the work group divided its efforts into three sections: Evidence-based research on addiction treatments, emerging research, and treatments over which experts have no consensus.
Evidence-based research involves treatment that over the long term has produced good results that experts generally accept. Emerging research involves newer treatments that have not been around long enough for proper study. No consensus treatment involves aspects of drug addiction over which no one consistently agrees, such as the optimum length of time to keep an addict in residential treatment.
Some aspects of successful recoveries stood. For example, Ostendorf said, therapy and the recovering addict's assessment of his or her own progress are essential.
"Clients should have a way to evaluate their own progress," Ostendorf explained, so a therapist will not assume that everything is going fine. If the patient thinks he or she is not making progress, the therapist will know to try something else.
Other successful efforts include giving the recovering addict rewards, such as community approval or even gift certificates at local stores.
"The community needs to surround them with
support," Grobe said.
The work group also learned that an addict may need medication during their recovery, especially if the addiction masks other disorders.
"As people begin to get clean, they very often hit a psychological wall and get depressed," Ostendorf said.
"It's always a challenge for the psychiatrist to know when depression is part of a mental illness or part of just coming off drugs," said John Schuderer, a clinical supervisor at West Yavapai Guidance Clinic. "There's a lot of art involved with the science of getting clean and sober."
Some areas the work group is undecided about are how to reduce cravings in recovering addicts and how much drug testing is necessary.
Eventually the coalition hopes to create an "academy" of sorts to be a one-stop location where the people who deal with addicts can receive training in the most up-to-date methods of drug intervention and treatment.
"Some people don't even know what drug court is," Ostendorf said.
Drug courts are voluntary programs for drug offenders that serve as an alternative to regular criminal courts. Drug courts have been in use in Arizona since 1992 and in Yavapai County since 1997.
Also discussed this past Thursday was the need for monitoring halfway houses to make sure they help recovering addicts and the need for more prevention programs involving children.
One such program recently kicked off in Yavapai County, said Penny Cramer, is the Busted Program, which encourages school children to report gang activity or anyone who brings drugs onto school property. The Busted Program began about a month ago and is part of the county's Silent Witness Program, Cramer said.
The Good Gun Foundation of Prescott donated $2,500 and large gun wholesaler Davidson's gave $10,000 to the program, Cramer added.
Cramer said the name of the program is temporary until organizers can conduct a contest so school children can pick a permanent name.