Serving the People of Hawaii Since 1960        

At what point do we stop caring about our kids?

At what point do they stop filling us with pride as we watch them grow and face new challenges and learn?  At what point do we stop being sheltering and supportive in order to give them the best chance to develop fully and realize their promise by contributing in a meaningful way to the life of the community?

At what point do we begin to reject and label and demonize our kids so that we may feel as if somehow they are not us?  That we are not like them.  What price do we pay for this rejection of our blood and of ourselves?

The price we pay is confusion, disorientation, we lose our way.  We don't know what to do.  We try to become detached.  Tell ourselves that the problem is something other than it is.  We try to explain to ourselves how it "just happened".  That no one is to blame.   That it couldn't be helped and we don't know what can be done about it.

"Banishment" must be the answer.  Out of sight - out of mind.  Until the bill comes due.   Does it cost more to build a University than it does to build a Prison?  Does it cost more to build new community medical centers, on all of the Islands, than it does to add jail space?  Does it cost more to heal the pain of a child of trauma than it does to maintain her son on life support?

It seems as if every day we see stories about the young boy who was severely brain damaged at the hands of his own Mother.  This is a terrible, unbelievably sad thing.  I think that any human being with the slightest bit of compassion would agree.

In my work I see this case over and over and over.  Only, somehow, the children survived.  Against incredible odds, through years and years of sexual abuse, physical abuse, emotional abuse and neglect, they managed to survive.  Horribly distorted, severely damaged, frightened and lost, but somehow they managed to hang on.

They managed to hold on long enough to stop being children.  That was their mistake.  That is what allows us to judge them, that is what allows us to reject them.  That is what allows us to tell ourselves that we are not them and that they are not us.  Because, by doing so, we can tell ourselves that we are not responsible.  The sad truth is that we are responsible.  Denying that fact only divides us against ourselves.

The majority of the human beings we are treating today for drug problems are those lost children who were being tortured and abused by our friends, our neighbors, our family members and no one saw and no one stood up for them and no one made it stop.

The people we are treating today are our parents, our kids, our brothers and sisters, our wives and husbands, our best friends, that we never really knew because they hid the pain so well.  They have been in a terrible accident that has taken place over a long period of time and they need real help to finally find peace.

Unfortunately, it's easy to become fixed on the symptoms of the disease of addiction ... view the behaviors and miss the suffering, lost human being at the center.  Consistent bad behavior must mean the person is just no damn good, not that the person must be really lost and have a serious problem.

Dr. Chandler and CPS have been doing a heroic job in attempting to disrupt this horrendous inter-generational cycle of abuse and neglect that marks the most significant developmental years of too many of our children.  CPS workers are tired, they are overworked and understaffed, assigned caseloads that no one could manage and they have seen it all for so long. 

Prevention Programs are going into our schools and letting our kids know that they are entitled to a certain type of childhood experience and that there are more effective ways for dealing with life situations than perhaps have been modeled for them at home. Programs in our schools are rescuing more kids every day as children of trauma are identified or come forward for help.

It's easy to love kids.   It's easy to fund programs for kids.  They are innocent.  It's not their fault.  We are responsible.  Let's not let this terrible abuse of our children go on another day.  It's wonderful that we are all so informed now and ready to roll up our sleeves and get involved.  Demand the best for the young ones. 

The terrible toll that our past inattention and inaction is taking on this community can be seen in the faces of the children whose parents have been lost and in the faces of the parents whose children have been lost.  It can be seen in the faces of the loved ones catching a ride, taking the bus, doing whatever it takes to make it to the jails on visiting day.

At what point do we stop wanting the best for our kids?  At what point does the human heart turn cold and judgmental?  I believe we need to open our eyes, our minds and our hearts and do our best for the kids that we let down before we became so enlightened, concerned and involved.

What about the survivors? The ones that we missed years ago.  The ones that ultimately turned to drugs for relief from the pain and confusion and suffering they didn't ask for, didn't understand and couldn't escape. 

We weren't there for them, then ...

Will we be there for them, now?

That which We Share is Greater than That which makes Us Different

I have been fortunate to have had the opportunity to work with a wide range of ethnic and racial groups during my years in Hawaii.  I have learned valuable lessons from each and this has greatly enriched my view of the possibilities for perception and interaction as a human being.

The first group to take me "under their wing" was the Samoan community.  I was shown a level of warmth and welcome, of friendship and caring that continues to influence me to this day.

Each group with whom I've become familiar has educated me in the variety of manifestations of basic, decent, civil social intercourse and family structure.  The rich tapestry of aloha created by the respectful coexistence of these various groups does make our island home a paradise.

Unifying concepts, that draw us all together, provide a framework for that respectful coexistence and allow us, as a community, to join together and resolve situations which impact the quality of our "shared" experience.

Respect and affection within the family is one of those important unifying concepts.

This concept allows us to bring children into the world and encourage them to feel safe and valued as human beings ... capable of adventure and learning that will benefit them, their families and the community.

The unifying concept of the honorable and industrious application of labor in a way that benefits the individual, the family and the community is another area in which we see a convergence of cultures.

A sense of purpose, self worth and dignity is instilled through adherence to this principle.

The concept of respect and attentiveness to those who are older and more experienced allows for the transmission of wisdom, with wisdom being that blend of intelligence and compassion which allow us to "heal" situations rather than just "solve" problems.

The lessons we learn from our Elders speak as much to our hearts as to our heads.

Gratitude, which allows us to see our many daily blessings as the "gifts" that they are from whatever conception of a divine being we might embrace. 

That sense of gratitude that keeps our hearts, our minds and our hands open to help one another so that we might be used as an instrument for the delivery of those blessings to others.

The concept of dignified perseverance in the face of hardship.  That quality of character which allows human beings to retain their honor when faced with difficulty and demonstrate that which is indomitable in the human spirit.

That response to hardship which has moved entire ethnic and racial groups away from the flawed perceptions of others to their rightful place of equality and partnership in the life of the community.

The concept of forgiveness of past hurts through our understanding of the frailty of the human spirit which can cause some among us to do harm to others.  That frailty of spirit to which we are all susceptible over the course of our lives.

Forgiveness, which allows us to end the hurt of a past wrong rather than continuing to inflict that hurt upon ourselves through angry or vengeful reflection.

Such shared concepts form a core of  values and beliefs that transcend ethnic and racial distinctions and bind us all together in the spirit and the life of the community.

In my time, working with our fellow citizens suffering from drug related disorders, my estimation of the value of these shared beliefs and concepts has grown as my understanding of their meaning has deepened.

I have come to believe that the most natural state for a human being is to be "at peace" and that conforming one's life to these types of principles is important in securing that "peace".

The patients we are serving represent all of the various ethnic and racial groups in Hawaii and, in most cases, manifest a shared inability to integrate these concepts and principles into their approach to daily living.

The indescribable sense of alienation and hurt that these human beings feel as a result of this disconnection from the driving spirit of their own ethnic or racial groups, and the community as a whole, carries with it a sense of loss and sadness that is truly profound and overwhelming for them.

In many cases the use of illicit drugs has been an effort to "feel" that which in their "spirit" they knew they should be able to "feel".

The use of chemicals to block the pain, the shame and the fear which accompanies an unbalanced view of life, and participation in life, has been a means of survival for many of these human beings.

As this sense of alienation and disconnection persists over time we see these feelings of loss and sadness replaced by frustration, anger and resentment.

It has been in this state of distortion, frustration, anger and resentment that the bulk of our fellow citizens drug related antisocial conduct has taken place.

Simply removing the chemicals does nothing to address the underlying issues of perception and conduct.  When little or no effort is made to understand and "heal" this pain in the spirit we will always see a return to the use of chemicals to provide a psychic "shield" against the persistent disorientation, pain and sense of loss generated within a poorly lived disconnected life.

Through legitimate, effective and responsive treatment we can allow these human beings to finally "feel" acceptance in a group that is moving toward the flow of the spirit of the community.

We can help our fellow citizens rediscover the "inner compass" that will guide them toward the principles and concepts that bind us all together in successful, productive participation within society.

We can help these fellow human beings experience the value of the concepts and beliefs that they have so consistently rejected in the past and give them an honest and an honorable opportunity to begin to feel, naturally, that which they have so desperately sought.

Through legitimate, effective and responsive treatment we can welcome home those who have been lost and we will at last be able to enjoy the benefits of the enlightened participation of these incredibly strong and sensitive miracles of creation.

They are Us.  They are a representation of the importance of that which we share.  They are an opportunity for us to demonstrate that in which we believe.

The unifying concept of our wish for "peace" in the lives of others should guide us as we learn to see the "pain" and see the "confusion" of our brothers and sisters ... to see beyond the behavior that this pain and confusion fuels ... and commit ourselves to legitimate attempts to truly end their suffering.

Our Continuing Responsibility

The year 2000 began pretty much as 1999 had ended ... Our phones started ringing early and the new demands for help kept us hoppin' all day. 

The problem of addiction hadn't been solved by some miraculous intervention and it didn't just go away.  It's now nearing the middle of March and there's no let up in sight. 

Yesterday was Sunday and I took a little time to evaluate the Foundation's current position and to develop some initial areas of focus for the coming week.

As I was allowing the different forces and factors that impact the operation of the Foundation, and my life, to roll around in my consciousness, my method for letting things find their own level and balance, I remembered that a very important day was coming up.

March 14th would mark 10 years since the death of Sid Kline, the last of our Founders.

For a while nothing else seemed important and I just let myself "feel".

Dick died first ... He died in December of 1988 and Sid called me right after he found out.

He said "Dick's dead" ... neither of us spoke for about 10 minutes.

The following Spring Jimmy the Hop was diagnosed with cancer.  He fought hard until September, but in the end the cancer won.

Six months later Sid had a heart attack.  He'd had heart problems for some time and had already had one by-pass operation.  Sid said the by-pass had helped for a number of years but that he was just real tired.

He died in the operating room on March 14th, 1990.

I miss him ... He was the best man I've ever known.

I got to work with these fellas for roughly six years ...

In the span of a little more than a year they were all gone.

I was very lucky to have had the chance to be around men of this generation ... the generation that fought to preserve our Freedom.  Men like Sid and Jimmy (the Hop) Hopkins and Dick Welsh.

These were good men who took me, like a child, and "raised" me through the sharing of their life and of a couple of hundred years of truly remarkable life experience.

I had a chance to learn about what they were like as kids and about all of their "rascally" actions which clearly showed that "free thinkers" were loose in the World and would not be "bent" to someone else's notion of how a life should be "spent".

They shared the trials they faced as young men during the war and how those experiences, soaked in blood and hate and brutality, had broken their hearts and, through that process, shown them how to truly feel "love" for their fellow man.

They said it was important for me to know about the fear and the desperation everyone experiences from time to time, no matter what kind of "front" they might put up ... They taught me about the fragile nature of human beings and how important it is to be strong "for" them and kind "to" them.

I wondered after they were all gone ... Why? ... How had it happened? ...Why had I listened? ... How had these men "gotten to me"? ...

I now know that there are things unseen by the eye, and words unheard by the ear, that affect the spirit ...  I had been exposed to the truth and the part of me that is powerless against the truth was touched, and I was changed.

I realize more now about the power and the "gifts" of this generation.

If they had done no more than simply "defeat worldwide tyranny and oppression" and then allowed "us" to enjoy the benefits of the Freedom "they" had preserved ... that would have been enough ... but they didn't stop there.

They came home ... they came home and kept working to make things better for us.

Most importantly, they allowed us to "know" them after they had walked through the fire.  The lessons they shared, by the way they have lived their lives, bring us closer to being the people we should be, by our wanting to be more like them.

Every day we're losing more of our generation of Heroes ... All mine are gone.

If you are fortunate enough to have one of these special people near you ... go to them ... be with them ... nothing has to be spoken ... just be in their presence.

When you have "felt" that which you needed to "feel" from the spirit that makes them so special ... thank them ... really thank them ... and then try, for the rest of your life, to live in as decent and worthwhile a fashion as the examples they have shown us.

That is our continuing responsibility ...

Drug Use, on the Taxpayer's Dime.

As I've stated before, I have no problem with members of the community who want to ingest beverage alcohol, or use other drugs, in order to experience altered states of consciousness. Such use usually amounts to no more than periodic perceptual masturbation, with side orders of impaired motor functioning and decision making.

The point at which I become interested in another person's contact with these substances is at that point at which the "choice" to manipulate their brain chemistry begins to negatively impact the quality of life being experienced by folks other than themselves.

As a citizen, I'm offended by public displays of intoxicated behavior but I am outraged when such self indulgent behavior leads to loss, injury or death on the part of innocent members of the community.  As an evolving human being, I feel a measure of sadness for those who require disorienting chemicals, at any level, in order to experience existence in a manner that is acceptable to them.

As an involved taxpayer, I wholeheartedly agree with the use of public monies to assist our fellow citizens who wish to move beyond this reliance.

As a person who has been involved with the phenomenon of chemically altered states of consciousness for nearly 40 years, the last 25 years having been devoted to assisting individuals move beyond the need for drugs, I understand the processes, and the flow, of drug seduction, entanglement and, for the lucky ones, transcendence.

Most folks who "experiment" with drugs or alcohol don't experience the "melt down" in functioning that characterizes addiction.  They simply allow themselves to experience the disorienting and distorting effects of these substances, find the experience unsatisfying or disquieting and then choose to refrain from further usage.

Of those who "experiment" with drugs or alcohol, a significant number find something that they "like" about these disorienting and distorting effects.  As kids they probably enjoyed the effects of spinning in circles until they were dizzy and then falling down on the grass and letting the world continued to spin.

Many of them probably remember hearing the words of caution, "You'd better stop that or you're going to fall down and split you're head open."  Words of caution that seldom proved to be accurate or true.   It could be that it was in situations such as these that the "skepticism toward words of caution", which so aids in the development of addictive disorders, began to settle in for many of these folks.

Now, a lot of the people in this group will go through their entire lives doing no more than periodically impairing their ability to manifest dignity, restraint and good motor skills.  They develop a real "friendship" with their "recreational" chemicals.  No harm ... No foul.

As long as they confine the fallout of this consciously self-induced impairment to themselves, or in settings where others have chosen to share in their periods of chemically induced distortion and disorientation, the exercise of Liberty wraps their conduct in the warm folds of "the pursuit of, whatever they choose to identify as, happiness."

I find no fault with these types of folks.   I know many of these types of people who lead good and productive lives.

Then we come to the portion of that group who have "experimented" with chemically induced disorientation and distortion and they feel like they've "come home".

We're talking about that group of people who "dearly love" the "distance" that these chemicals put between them and the reality of their existence.

They don't want their spirits to be "buoyed by periodic convivial interaction".  They want a reality that is fundamentally different from the one their life experience has brought them.

Alcohol or other drugs have done something for them that no person, object or other experience has been able to accomplish ... The disorienting and distorting effects of these chemicals have allowed them to "feel", in many cases for the first time in their lives, as if they are "ok".

Manipulation of their brain chemistry has provided them with a survival mechanism that extracts an extremely heavy and, over time, debilitating toll in functioning, socialization and the appropriate processing of life experience which is essential for advancement and growth as a human being. 

All of this they sacrifice gladly ...  Cost be damned ...  Damage suffered, ignored ... or distorted out of the range of comprehension through the "dog chasing its' tail" cycle of drug seeking - ingestion of chemicals - satisfaction with the "feeling" of "not feeling" - the intrusion of "life" as the chemical effects lessen - further drug seeking.

Now, a person with unlimited resources, and sufficiently focused "keepers/handlers", can climb right onto that corkscrew into oblivion and ride it right on down to the bitter end without impacting anyone else.   I'm ok with that ... it's a lifestyle choice ... this is America.

For folks who are not independently wealthy ... well, they end up having to scramble around disoriented, suffering from the onset of withdrawal, oscillating between delusional states and harsh reality, increasingly agitated and desperate and willing to roll the dice on their life. 

As these people spin through our neighborhoods, there's a likelihood that innocent uninvolved members of the community will get mangled as these people seek a chemically molded reality.

They have been "seduced" by the "comfort" of unperceived pain and "entangled" in a protective web of delusion which allows them to live increasingly unsatisfying lives.  The nature of addiction ensures that they will continue to medicate out of the range of comprehension the elements of distorted perception and maladapted conduct which drives their descent through fear, frustration, hopelessness and anger to additional drug exposure.

These are the ones I'm concerned about.   These are the folks who require a strong and clear defensive intervention from society.

But, how do we separate the social butterflies from the sociopaths?  How do we separate the innocent appreciation of botanical splendor from the desperate seeking of relief from reality ?  How do we separate the dignified sipper of peach brandy from the kleptomanical crack-head?

Simple ... You will know a tree by the fruit that it bears.

It is at that point at which a human being "inflicts discord or damage upon the community, or another human being", as a result of their proclivity for manipulation of their brain chemistry that "society" must "just say no".

Allowing individuals ... those who have crossed this line ... to continue to ingest mind/mood altering substances, without strong negative societal intervention places the community at risk for increasing loss as this individual vacillates between social responsibility and a selfish disregard for the rights and safety of others.

Allowances could be made for youthful indiscretion or inexperience ... but only 1 time. Provide these folks with a comprehensive education on social responsibility as it pertains to intentionally self inflicted impairment and then hold them responsible for future conduct.

After that ... Sorry Pal, you've lost your privilege to artificially manipulate your brain chemistry .  You don't know how to act.  There is no right to self inflicted impairment, leading to loss on the part of innocents, in the Constitution.

This is known as "early intervention" but it has to have "teeth" if it's going to work.

In viewing addiction as a disease ... a legitimate treatable medical condition, we cannot allow a maudlin perception of the individual suffering from this disorder to prevent society from dealing effectively with the havoc generated by individuals who insist on continuing in an addicted lifestyle.

In my work I have seen individuals, with extended periods of time away from drug exposure, "choose" to return to usage because that's what they "wanted" to do.

These people had participated in educational sessions, focal group psychotherapy, support group meetings, daily process groups, individual and family counseling, they had affirmed their commitment to recovery in public, but then "chose" to use again.

They "chose" to use drugs again because it was what they "wanted" to do.

They felt free to make this "decision" to use drugs because the "benefit" that they felt they would receive from this usage outweighed any "penalty" or "consequences" that they might "suffer" as a result of this usage.

This decision was based upon experience and is no different than the belief of the bank robber, who has experienced insufficient negative social feedback, that "Yep, I oughta' rob that bank."

We have to eventually see that it's not the fact that they suffer from a substance related disorder, it's the mindset of the person engaging in any particular act of antisocial behavior.

What is the difference between the bank robber who commits his crime to finance a comfortable lifestyle in Miami and the addict who robs a bank to finance drug use and drug dealing?

Both are seeking to experience a lifestyle that is acquired through socially unacceptable means, but for some reason we have come to believe that the individual who intentionally limits his ability to make appropriate decisions, through drug use, should somehow be viewed in more sympathetic terms.

What's up with that?

Fair and square the bank is just as robbed!

The strong volitional element of continuing addiction should disallow blanket absolution for antisocial acts committed while under the influence or to finance further usage.

I see addiction as a learned response to life pressures.  It is only through the receipt of sufficient negative feedback that conduct will be modified.  The important element here is the "mindset" of the individual engaging in the inappropriate conduct.

At the point that an individual is deemed to be a "risk" to the community in connection with the use of disorienting and distorting chemicals, we must ensure that strong ... very strong negative social feedback is administered for any subsequent ingestion of these substances.  It is most often during the states of intoxication or withdrawal that the damaging actions related to drug use take place. 

Alcoholics and addicts, with some period of time away from substance contact, are generally more timid and thoughtful about their participation in life ...  Nothing like the cartoon character - all things are possible - Hi-yooo Silver approach of the drug influenced "desperado".

We have to understand that continuing drug use is a conscious act based upon perceived benefit and cost.

If someone, who uses drugs, robs a bank ... punish them as a bank robber is punished.

If someone, who uses drugs, beats a loved one ... punish them as an assaultive person is punished.

If someone, who uses drugs, breaks into a house and steals ... punish them as thieves are punished.

Please .... Stop acting like addiction is an excuse for "anything".

Help these people, by holding them accountable for their actions, including voluntarily inducing poor decision making through the use of drugs.

By shifting our focus to enforcing abstinence from the usage of these chemicals we will short-circuit the "liberating" impulses which allow these folks to take repeated and escalating actions against the rest of us. 

The mindset that allows an addict to continue to chemically self limit is based upon society's "bleeding heart" attitude toward the individual suffering from addiction.  This societal response is based upon "our" past trust of, and reliance on, spin-dry drug treatment programs.

The failure of these types of programs to perceive and address the true nature of the addict's problem, had failed to equip the recovering person to protect abstinence.

Responsibility, for the failure of these programs, had been shifted to the poorly served addicts with a societal response of acceptance and allowance of relapse and a sense of awe and dread of the persistence with which these folks damage themselves and generate suffering among innocents.

Society needs to wake up and simplify this deal if it ever intends to get this "mess" under control.

On-going attempts to justify the failure of these spin-drys, to allow for their "normal" relapses, has cost the community an unimaginable amount of blood, suffering and money.

See these spin-dry programs for what they are ... greatly expanded and very expensive versions of simple detox which do nothing in terms of advancing an individual's ability to deal effectively with life.  The job can be done cheaper and much better when incorporated with targeted effective and responsive treatment.

Get rid of these spin-drys ... Put the money into long-term treatment geared toward assisting these folks with the development and integration of methods of operation that will allow them to be successful, reduce the stress associated with the operational deficits or distortions ignored by the spin-drys and eliminate the "need" for chemically induced escape from reality.

Once effective treatment systems are in place, we have to quit being "saps" about continuing drug usage by these folks.

It was the bogus treatment, not some inherent feature of addiction, that was generating all of those "normal" relapses.

We have to start spending our resources much more wisely.

Following legitimate, effective and responsive treatment we have to "ENFORCE" the maintenance of abstinence. 

Don't play with these people 'cause they will just go on laughing at us "suckers" while they continue to rob us, maim us and kill us.  All the while society will continue to sincerely try to understand these poor souls and all of their trials and tribulations.

B------t!

These folks need for us to look them in the eyes and tell them, with a steely resolve, "You're a "menace" when you use and if you use again, you're going to the "CAMP" for 2 weeks. 

Not if you do anything bad while you're using ... no ... those days are gone ... they're over.

Now, all you need to do is "use" ... that's the problem ... that's what "allows" you to "consider" doing other harmful things.

Abstinence is where the line must be drawn in the sand.

As long as we believe that weakness and failure is indicative of anything but poor treatment, or obstinacy on the part of the addict, this problem is going to get worse and worse and worse.

Yesterday I was speaking with a Probation Officer.  She's a really nice lady and has served our community in Child Protective Services and Adult Probation over the course of her career.  She truly and genuinely cares about our community.

Well, she told me about a conversation she had with a drug addict who was not complying with the terms and conditions of his probation.  Apparently he didn't like being held accountable by this woman.

He told her that he was going to put a contract out on her ... he was going to have her killed ... that they would find her dead body face down in a cane field.

Think about that for a minute ...

How much longer can we, as taxpayers, support a system which breeds such arrogance on the part of people intent on destroying anything and everything that gets in the way of their self indulgent headlong rush into oblivion?

By allowing these folks to willfully reinitiate the addictive cycle, with no appreciable penalty attached, we will continue to feed the drug addict's artificially induced sense of entitlement ... that sense of entitlement that was bred by the attempts of the spin-drys to escape responsibility for ineffective services and by "our" allowing them to get away with it for so long.

We have to start being strong for these folks while they are learning "how" to be strong for themselves. 

We can't afford to let failure continue to be an option so that we can avoid admitting that we got "sucked in" by the spin-drys.  We need to go on and admit it and accept the fact that we've been "bamboozled".

We then have to realize that conscious antisocial conduct is best addressed cleanly and without sentimentality.

We have to open our eyes ... provide solid treatment, that is responsive to the needs of the patient ... and then hold the individual RESPONSIBLE for any subsequent drug use.

Keep it Clean ... Keep it Clear ... Keep it simple.

As informed and aware Citizens ... the ones who are footing the bill ... we should "demand" this and "accept nothing less".

No Room at the Inn?

A few years back I was attending a meeting of Directors of Non-Profit treatment agencies in Hawaii.  As is usually the case, the meeting quickly deteriorated into plaintive wails and a gnashing of teeth regarding funding

Plans were being finalized to approach the State Legislature for supplemental funding requests, to bolster the regular money provided through the year, to fund substance abuse treatment for Hawaii citizens.  As I recall the meeting someone, out of the blue, said that a request for $385,000.00 in supplemental funding was being submitted for my agency's benefit. 

Well, that was news to me ...

I started by saying that we didn't need the money.

This information was met with stunned silence ... followed by rapid panicked chatter ... clearly an attempt, by the others at the meeting, to cleanse their minds of this heretical and, frankly, frightening concept.

Don't  -  Need  -  More   -  Money?

I went on to say that, sure, we could spend an extra $385,000.00 but that we didn't need it.  We were operating at max capacity and had at least $1.00 left over at the end of the year to keep us in the black.   That $1.00 extra is all the Board has ever required in order to balance the books at audit time.

Attempts were made to help me "come back to my senses".

It was explained that this "extra" money would allow us to put patients into our "empty" beds ... beds that were "empty" because nobody was paying us to provide treatment.

I had to ask them to repeat that last statement.

They said, once again, that the "extra" money would allow us to put patients into our "empty" beds ... beds that were "empty" because nobody was paying us to provide treatment.

Now, I sat there and thought about that statement for a minute ...

Either I had completely lost touch with reality ... or ... they had just indicated that they believed that I had "empty" beds because nobody would "pay" me to provide treatment.

Well ... from where I was sitting there was only one way to approach this matter ... I had to ask the question.

I asked, " Are you telling me that you think that unless "somebody" will "pay" us, to provide treatment, we will turn a person away ... even if we have "empty" beds?

"Well ... sure", was the response.

By now my mind was racing and I couldn't prevent myself from going that last step ...

I asked, " Do "you" have beds that are "empty", not because your fellow citizens haven't asked for help, but because nobody will "pay" you to treat them?"

"Absolutely", was the response to this question, accompanied by vigorous nods all around the conference table.

I said, " That's the "coldest" damn thing I ever heard."

Well, from that point on there was no reasoning with me.  I told 'em to get our name off of that list.

Now here's where it gets "real" squirrelly.

Somebody then asked me if I would go to the Senate and ask that these other agencies be given additional money to fill "their" empty beds ... beds that they had denied to sick Hawaii citizens because nobody would "pay" them for treatment?

Man ... I was stuck!

On the one hand I was looking at what I considered to be an immoral policy of denial of services due to "lack of full payment" a policy I was now being asked to validate and support before the Senate ...

On the other hand I was looking at a situation where fellow citizens were being turned away from treatment at their most vulnerable point, and also at the point where they presented the greatest danger to innocent members of the community due to drug related desperation coupled with this passionless rejection.

It was calmly explained to me that, given the fact that we were not asking for any additional funding for ourselves, our request for additional funding for these "other" agencies would be all the more compelling.

They were very very comfortable with their policy of rejection and serious about this request.

So, as you can see, I was stuck.

The same kind of "stuck" that our legislators have to experience, way too often, as they try to help our fellow citizens and move our State forward.

I sat there and thought for a while ... I remembered that for the first 13 years of the operation of the Kline - Welsh Behavioral Health Foundation, there was "no" funding at all for our services.  The whole idea was to "get" people while the "gettin' was good", like ... "when they asked for help."

When men like my "teachers" began helping others there was no money to motivate or support their efforts, they were moved to act by a "gut level" caring for the people who were suffering.  These men committed themselves to the work, began helping others and worried about how the bills were going to be paid as an afterthought. 

The fact that they had personally experienced deliverance from the condition being addressed allowed them to approach the work with the confidence and enthusiasm that successful first hand experience brings.

That they were from the generation that had fought and won W.W.II, there was no obstacle or deprivation that could deter them from fulfilling their mission.  These were hardened, focused, caring men who would not accept defeat and who would not give up on, or sell short, another human being.  The defining moments in these men's lives had to do with service to others, and to a higher cause, regardless of the cost in personal terms. 

The intensity with which they "felt" for their fellow man, that "no holds barred" kind of devotion that can only be acquired on the battlefield, where a man and his "buddies" struggle to protect one another, and pull each other through served as the bedrock and the foundation of their commitment to helping others.

These men had crawled through the mud and the blood and the s--t to secure freedom from oppression for their generation and for generations to come.  When these men returned from the war, we welcomed home a generation of Heroes.  Men who could see things clearly, formulate solid plans and get things done. 

As we all know, by the impact these men had on Hawaii, there was much good work to be done.

So, how had things gotten to "this" point?   How had the "heart" gone out of helping?

One of the greatest sources of shame to be brought down upon the field of addictions treatment, by the treatment "industry", has to do with the morally bankrupt practice of leaving taxpayer subsidized treatment beds "empty" when no source of funding can be found to pay top dollar for those beds.

I understand the argument that bills have to be paid and that agencies need to remain viable but it's important to remember that we are talking about the operation of Tax-Exempt Non-Profit entities.

These Non-Profit entities are subsidized by the taxpayers so that their operation can be more flexible, and avoid many of the "hardball" considerations that drive for-profit enterprises.

Non-Profits, it would seem, should acknowledge a "responsibility" to the public granting these "tax breaks" rather than just maximizing the "benefits" of Tax Exempt status.   It is my view that non-profit treatment entities, and the licensed beds they administer, are owned by the community ... by the people they serve ... by the people who are sacrificing a legitimate corporate benefit through the granting of tax-exempt status.

When one is talking about agencies sitting on land, owned by the State, in facilities built with millions of dollars of taxpayer money, the obligation to maximize services to the community, to go that extra mile, is that much greater and even easier to identify ... and, in a world that makes sense, much more difficult to avoid.

The licensed treatment beds under the stewardship of these types of agencies  are already "bought and paid for" by the community ... the community "owns" them, not the agency.  It is incomprehensible that these treatment beds would be left "empty" so that they could be used as bargaining chips in attempts to extract more funding. 

It is fundamentally unsound public policy to leave these resources in the care and control of an administrative structure intent on distancing itself emotionally from the people they are intended to serve, through the denial of the moral obligation implicit in the granting of tax exempt non-profit status and the fact that the taxpayers have already "purchased" every brick, desk, pillow and pencil under their control.

We, as a community, cannot allow the administration of such a public trust to become a "monopoly" game for a Board of Directors determined to overlay exclusionary for-profit concepts upon a system freed, through the bestowing of this tax-exempt status, from many of the cost considerations faced by other "businesses."

Well ... I went to the Senate anyway and I asked that those other agencies be given "additional" money so that those "empty" beds could be filled by our fellow citizens in need of help.  I felt real compromised and complicit in this extortion until I remembered Sid and Dick and Jimmy.

There was nothing these guys wouldn't do to help someone in need ... they had no shame when it came to helping others recover ... people were suffering.

I did the right thing.

I don't know if the Legislature gave those guys more money ...  I don't keep track of that kind of stuff.

I do know that they still have "empty" beds ...

I know that all our beds are full.

I don't think money was the problem ...

I don't think money can alleviate a "poverty of character".

A couple of months ago I received a phone call from the CEO of another treatment agency.  He wanted to know, in detail, how we could afford to provide treatment for patients after funding had ended or even in the absence of "front end" funding support.

I started into my "spiel" on caring for the patient, at which point he interrupted saying that he wanted his "Executive Assistant" to get his "Business Manger" so that I could explain our policies to the "Business Manager".

As I waited for the "Business Manager" to come on the line, I clearly saw the problem and the solution.

Fire the CEO ... Fire the Executive Assistant ... Fire the Business Manger ... Hire a "real" CEO that can do the job ... Dismiss the Board of Directors that approved such a top-heavy redundant administrative staff structure ... Recruit a Board that genuinely "cares" about the suffering being experienced by our people ... Hire 2 more "competent" counselors, from the savings realized on a trimmed top end and make sure your counselors receive a level of pay that is commensurate with the service/benefits they are providing to the community ...

and Fill Those Damn Beds! ... Now!

Or, do as we do.

Help the person standing right in front of you ... move forward in faith ... value each human being that asks for help ... finish what you start ... believe that if you stay close to Him and do His work well, He will provide everything you need.

Oh ... one more thing.

check out "Karma" in the dictionary.

The "Treatment" of Addictive Disorders

What our People Deserve.  What our People are Getting.

Part I.  What It Was Like

The treatment of addictive disorders has gone through a remarkable evolution since money began to be available to fund those services in the early '70s.  In order to begin to understand the systematic reduction in the effectiveness and responsiveness of the treatment services provided to our fellow citizens some background would probably be helpful.

Prior to the availability of funding, "treatment" was organized and delivered by private citizens. Programmatically based in the 12 Steps of Alcoholics Anonymous, these structured and supportive activities were geared toward assisting other alcoholics with the arduous process of honest, thoughtful self-examination and change.

These "programs", being structured and operated by "true believers" in the ability of the alcoholic to recover, set realistic goals for each individual that included increasingly comfortable abstinence, remission of the symptoms of addiction, growing serenity and improved levels of functioning across the full spectrum of inner and outer life.

Kind of sounds like something you'd want for yourself or for your loved one, doesn't it?

Being motivated by gratitude, and an "inner need" to be of "genuine" service to those still suffering, the people operating these programs worked very hard to ensure that everything that could be done to improve an individual's chances of recovery was done.

The Founders of these various programs around the country studied the problem on a daily basis.  Each human being who came to them for help was important.  Having experienced recovery in their own lives they knew that the process of "change", described in the book Alcoholics Anonymous, was vital in maintaining abstinence and allowing a person to "grow" beyond their addiction.

They were also aware that each person was unique and would require time and the attention of someone further along on this pathway of change to help point the way.  This was the beginning of  "addictions counseling".

They had also learned that environmental support was necessary to allow the individual to benefit from a shift away from an alcohol consuming peer structure to an abstinence and growth based peer structure.   This environmental support also allowed for the application of external behavioral controls.  These behavioral controls were intended to assist the newly "dry" individual with the inevitable "craving" which would occur and had, in the past, resulted in relapse.  This was the concept behind the establishment of "residential treatment centers and therapeutic communities".

The aspect of "anonymity", one of the key underlying principals of Alcoholics Anonymous, tended to shield these agencies and recovering individuals from becoming too much of a topic of conversation within their respective communities.  Principally shame based due to the stigma attached to alcoholism, it is likely that this was the beginning of the concept of  patient "confidentiality" within the treatment field.

Through the '50s and '60s these "programs" were pretty much left alone to help their fellow citizens recover from alcoholism.  There was no money to pay for the services so the operation of these organizations didn't attract much attention.

Through the efforts of highly motivated and deeply committed private citizens, there had been established an agreed upon "Curriculum" for recovery from alcoholism, the field of "Addictions Counseling", "Residential Treatment Centers and Therapeutic Communities" and the concept of "Patient Confidentiality".

So what was wrong with this setup?  Nothing!  That's the problem.  It worked.  People were seeing formerly hopeless alcoholics returning to productive community life.   People wanted to know about this breakthrough.  People wanted to support this remarkable rescue of previously lost loved ones.

During the early years a few medical doctors, with their hearts in the right places, had begun to offer their services, at no charge, to the new "treatment" programs.  In the Kline - Welsh Behavioral Health Foundation's beginning we were fortunate to have the support of Dr. H.Q. Pang, Dr. Larry Winter and Dr. Frank Glaser.

Generally there had not been much effort expended on research or medical education dealing with alcoholism.  Although some early work had been done, by physicians mentioned in the book Alcoholics Anonymous, this work accelerated when stable settings were established that would allow for more in-depth study over longer periods of time.

These concerned physicians were helping their fellow man and building a base of knowledge and experience directed at providing treatment for the physiological consequences of the recovering individual's past consumption of alcohol.

Given the "reflective" nature of the 12 step program of Alcoholics Anonymous, there had also been an interest in the psychiatric community for determining the recovering alcoholic's potential degree of responsiveness to traditional psychotherapeutic approaches.

Based upon my contact with the Founder's of various programs around the country, there was no reason to believe that the medical community's involvement, in those early days, was motivated by anything other than a genuine desire to help their fellow human beings with a painful, degrading and life threatening condition. 

In our case, Dr. Glaser had spoken with his colleagues in the medical profession, and in the State Health Department, about the pioneering work being done at Sand Island.  A consensus  developed, over time, that the community should provide more direct and consistent support for these efforts.  This translated into money and this is where the problems started.

Apparently the State of Hawaii made a "grant" of some amount of funding to support the work at Sand Island but, rather than giving the funds directly to the Foundation, it was decided that the program should be monitored and the funds administered by a local community health center.

This decision was probably influenced to some degree by the fact that the program had been established and was operated by recovering alcoholics.  Again we see a not so subtle example of the stigma of alcoholism lingering for years after the establishment of abstinence and in spite of the good works being accomplished by the Founders. 

Of course, with a "more trustworthy" intermediary, there would be an "additional" administrative cost for the job of monitoring the program and administering these funds.  Bingo!  That's where it started.  Individuals, irrelevant to the recovery of the alcoholic, found a way to insinuate themselves into a functioning process and reduce the amount of funding available for the "real" work.

All of a sudden that which had been working, that which had been returning loved ones to their families, that set of actions and environment that had provided the breakthrough was, now, not good enough.  We now needed "experts", we now needed "college graduates" involved in the process.

We now had to start having team meetings with multiple uninformed and inexperienced administrative and "clinical" types jockeying for position at the "blackboard" to chart treatment and justify their "cut" of the funding.

As these extraneous "hangers-on" began to see that they could access considerable funding, without actually having to be involved in the "dirty work" of treating alcoholics, there was a dizzying sense of glee accompanied by a stroke of brilliance that illuminated the potential future of addictions treatment.

The buzz went through various elements of the "professional" community that, if we can convince the funding sources that top-heavy layers of administration and clueless clinical   "professionals" are actually necessary for the recovery process, just maybe we can convince them that the job could be done much better in a "Hospital Setting".

The "Treatment" of Addictive Disorders

What our People Deserve.  What our People are Getting.

Part II.  What Happened?

Glad You Asked

In recent weeks I've been asked why I have been critical of the operations of some of the other entities within the "treatment industry".  This is a legitimate question and one that deserves to be answered.

The principle reason, I suppose, is because this is not an "industry" to me. 

The work we do is about helping human beings reclaim their lives.  From my earliest exposure to helping people suffering from alcoholism/addiction this has been about ending the misery desperation and insanity that follow along with these conditions.  The good men who taught me about helping others would never let me view the work in any other way.

When men like my "teachers" began helping others there was no money to motivate or support their efforts, they were moved to act by a "gut level" caring for the people who were suffering.  These men committed themselves to the work, began helping others and worried about how the bills were going to be paid as an afterthought. 

The fact that they had personally experienced deliverance from the condition being addressed allowed them to approach the work with the confidence and enthusiasm that successful first hand experience brings.

That they were from the generation that had fought and won W.W.II, there was no obstacle or deprivation that could deter them from fulfilling their mission.  These were hardened, focused, caring men who would not accept defeat and who would not give up on, or sell short, another human being.  The defining moments in these men's lives had to do with service to others, and to a higher cause, regardless of the cost in personal terms. 

The intensity with which they "felt" for their fellow man, that "no holds barred" kind of devotion that can only be acquired on the battlefield, where a man and his "buddies" struggle to protect one another, and pull each other through served as the bedrock and the foundation of their commitment to helping others.

These men had crawled through the mud and the blood and the s--t to secure freedom from oppression for their generation and for generations to come.  Only a fool could have believed that the honor, courage, sense of purpose and compassion for their fellow man, forged in combat, would end when the shooting stopped.

When these men returned home from the war, we welcomed back a generation of Heroes.  Men who could see things clearly, formulate solid plans and get things done.  As we all know, by the impact these men had on Hawaii, there was much good work to be done.

As in all wars, some of our Heroes were deeply scarred by their combat experiences in North Africa, Europe and the Pacific.  The unimaginable suffering and loss to which they had been exposed had dealt a crushing blow to the spirits of some of these men.  Some had turned to alcohol to deaden the impact of the jarring, screaming horror they had been required to endure, for our sake. 

When the war was over, it wasn't over for some of our men.

This was the case with the principal Founder of the Kline - Welsh Behavioral Health Foundation.

Sid Kline was a decorated American combat Hero who had received the Silver Star, the Bronze Star and Purple Heart.   His valor was not in question.  Sid Kline was a good and decent man who had fallen victim to Alcoholism.  He was a casualty of war with a desperate need to make peace with himself and with his past before he could move forward in life.

For 9 years, after the end of his involvement in WWII, Sid Kline attempted to return to normal living.  First in Oregon and then Hawaii, he tried to move his life forward while at the same time trying to drown the memories of that which he had seen, and been required to do, in the service of his Country. 

In 1956, Sid Kline found Alcoholics Anonymous and met Dick Welsh.  A bond of fellowship was established that would last until Dick's death in December, 1988.

Upon getting to know Sid, Dick Welsh saw that Sid's honor, courage, sense of purpose and compassion for his fellow man were still present but had been rendered diffuse and ineffective as a result of his alcoholism. 

Dick knew that "serving others" would be a key element in Sid's victory over his condition.  Dick also knew that time, moral support and the availability of practical advice on the application of the 12 Steps and other recovery principles would be vital in "steering" Sid along a pathway of recovery.

Through several years of "in your face" AA support from Dick, and other like minded members of the fellowship, Sid made steady progress in solidifying his commitment to abstinence and change. 

Years later Sid would express his gratitude for the tough and disciplined manner in which he had been assisted in his early recovery.  He would speak of weakness and failure as having not been an option.  He would go on to demonstrate his caring through the sacrifice of "personal popularity" in favor of clarity of communication and an aggressive advocacy of the recovering person.

These men were uniquely prepared to tackle this problem.  Having served in a Wartime Army, they were used to disrupted supply lines, Jimmy had been a part of the RedBall Express.  They were used to impossible missions, under unlivable conditions, where survival equated to victory, Sid had served under Patton.  These men knew that if you had a logistical or tactical problem you had to seize that problem by the throat and squeeze ..... until it stopped being a problem.

Sid and Dick and Jimmy had no patience with mealy mouthed dissemblers who used weasel words to justify and rationalize lack of right action, and ultimately, failure.  This was a horrible and degrading condition for any human being to experience and these men would not accept defeat no matter how neatly wrapped and heartfelt half-measures might have appeared on the surface.

These men were intimately familiar with the nature of the disease ...

They knew, from first hand experience, how this disease robbed a person, and their loved ones, of their basic human dignity and their ability to move forward as individuals and as families...

They also knew the remedy for this condition ... and God help anyone who tried to get in the way or subvert the process.

These men, and other private citizens like them, fired the first shots in our Country's war on drugs.

The battle was joined.  The fight was on.  Passion and a firm conviction in the rightness of their efforts and in their ability to solve this problem sustained these remarkable people in the early years.   Full blown recovery was being seen more and more often. 

"Solid supportive treatment" was shown to be the answer for this problem. 

Success was being seen where relapse and despair had been common.

So ...... What Happened?

Someone ... somewhere ... driven by greed and ego ... decided to try to ride on the coat-tails of those early treatment pioneers and, in so doing, brought about the circumstances that would lead to the creation of a vast, self protecting, self serving "Treatment Industry" in this Country.

The people who had first entered the battle, and had brought us an unprecedented level of victory over this condition, were supplanted by "rear echelon" types.

The warriors were outflanked by clueless under-employed "degreed professionals", Hospitals desiring a revenue boost, political schmoozers and bean counters.

In a way you could say that the "point" of the spear was sacrificed by the people who gave us the "shaft".

So, what has America gotten for it's capitulation to "more trustworthy" and "more reliable" intermediaries and more "professionally competent" hospital based treatment services?

What has the "Treatment Industry" done, since that capitulation, to foster such skepticism within government, the community and the Insurance Industry?

What has the "Treatment Industry" become when millions of our fellow citizens must be imprisoned and receive "treatment" while incarcerated?

How long can this Country tolerate the policies of the people who have done this, to that which once worked?

How long will we, as a nation, swallow the lie of the "Inevitability of Relapse" to explain away the actions of people who either don't know what they're doing - or worse - have known all along and have never cared about the human cost of their actions?

It's time for all of us to think very seriously about this.

The "Treatment" of Addictive Disorders

What our People Deserve.  What our People are Getting.

Part III.  What It's Like Now

This past summer I attended an Executive Program at the Kennedy School of Government at Harvard University.  I was impressed with the range of talent pulled together by Phil Heyman  and Will Brownsberger.  The speakers were pretty much at the top of academic investigation and opinion in relation to the drug problems we're facing.  The team performed at the level one would expect from a Harvard activity.

Over a 2 week period, "Merging Perspectives In Drugs and Crime - A Cross Agency Approach" provided an amazingly clear, coherent and comprehensive analysis of the interrelated nature of  America's current response to the drug issue.

The 30 individuals accepted to participate in this executive program were a good mix of domestic and international supervisors and executives currently involved in Government Funding, Policy Development, Law Enforcement, Research, Treatment and Community Action/Harm Reduction.

Sitting together, day after day, were representatives of the Office of Management and Budget, the Drug Enforcement Agency, the National Security Agency, the United Nations, the Justice Department, the Department of Defense, various State and regional Law Enforcement and Corrections entities, front-line State Prosecutors, Treatment providers and leaders of Nationally recognized Community Action/Harm Reduction organizations.

There was much shared during this program that gave me confidence that this Country has committed its' best and brightest to solving this problem.  I must say, however, that the enormity and the complexity of the response necessary to "inadequately" address this Country's drug problem was staggering.

To attempt to communicate the substance of this experience would require too much space and to be honest, I'm still processing the many implications of the operational philosophy driving our collective drug response.   I think one of the most important aspects of this experience for me was in recognizing the solid linkage that has now been established, in everyone's mind, between "drugs" and "crime".

Do you remember when it wasn't so?

What has taken place in this Country in the last 25 years or so that could have had an impact on the increasing virulence of our fellow citizen's substance related disorders?

What has happened in the last 25 years or so that could help explain the increasing levels of drug related disruption and violence being seen in communities all across America? 

Why are we all at greater risk of being victims of substance related criminal conduct, both property and personal injury, than at any other time in our history?

Why are more and more of our children killing, and dying violently, as a result of drug related gang activity and the disintegration of the traditional family structure?

In my view a linkage can be drawn between the rise of ineffective non-responsive spin dry drug treatment programs and the beginning of this Country's descent into drug related social mayhem.

In the 70's, hospital based programs began pitching the idea that brief terms of in-patient treatment, with a concurrent referral to unmonitored unregulated community based support group meetings, was the answer to the treatment needs of our fellow citizens.

This "pitch" made the spin dry's a lot of money but initially angered many "old-timers" in those support groups.

The "old-timers" believed in - Attraction Rather Than Promotion - and weren't happy about "pillheads" and "dope fiends" showing up in their meetings.

Many of these "old-timers" believed that treatment wasn't even necessary.  Shoot, "Just don't Drink and Go To Meetings"   - "90 Meetings in 90 Days"  -  that's all anybody really needed.

This anger lasted until they started seeing that these new "referrals" were required to attend meetings regularly and that they would usually "drop a dollar" into the basket that goes around during these meetings. 

Hey, "new money"!  Maybe these "treatment" folks ain't so bad after all.

The spin dry's also learned that by employing/recruiting support group Bigshots/Beloved Group Icons and making nice, plush hospital accommodations available for new meetings that they could further ingratiate themselves with the "fellowship" and gain community and, in some cases, political support for their ineffective, non-responsive treatment programs.

When you look closely at this alliance you see that it was all gain and no pain for the parties involved and that they actually had much in common.

Attending these types of support group meetings had traditionally yielded about a 10% recovery rate for individuals seeking abstinence and a solution for their problem.

The Spin dry's co-opted this recovery rate and began to proclaim the inevitability of relapse for individuals seeking recovery.   This approach allowed them to convince insurance companies that the problem wasn't that their services were ineffective and totally non-responsive to the needs of the patient but that "Gee Whiz Guys, these people relapse".

The support groups meanwhile were getting an infusion of new bodies, many carrying wallets, and with the compromised influence of their group Bigshots/Beloved Group Icons, they were also getting the opportunity to identify more and more closely with the Spin Dry's, which tended to add an aura of social acceptability to these organizations that had formally been so elusive.

Spin dry's, more and more, were simply "pimping" for these unmonitored community based support groups.  They were carrying on a defacto trade in the sale of meeting schedules for thousands of dollars. 

The "fellowship" of these self-help groups suffered through the establishment of little fiefdoms and power bases, within their midst, based upon who could or would sell out most thoroughly and effectively to the Spin drys.

Basically those that had, sold out the people looking for help.

So here you have the self proclaimed and vigorously self promoted authorities on highly responsible, reliable, trustworthy professional health care services charging thousands of dollars for providing treatment to people suffering from substance related disorders and then abdicating the most significant portion of that responsibility to groups of unstructured, unmonitored, uncontrolled addicts and alcoholics in environments thick with rampant dysfunctional conduct and a generally recognized rate of recovery of about 1 in 10.

Anybody else see anything wrong with this picture?

The dynamics of the approach employed by the spin drys bears an unsettling resemblance to the old "con" game known as the "hump and bump".

While this, in and of itself, is not responsible for the intolerable rise in drug related criminal activity, this subversion of professional and volunteer community based assistance to our fellow citizens provided the environment for that growth.

In order to understand the larger picture we have to look at "disease", "quackery" and "appropriate effective care".

Addiction is not a disease of ignorance.   Addiction is not a disease of being unaware.

If it were, one would simply need to inform the suffering patient that alcohol and other drugs were having a negative impact in their lives, the patient would then make minimal behavioral adjustments concerning the ingestion of certain substances and all would be well.  

The truth is that addiction is a disease characterized by incredibly strong beliefs in a doomed approach to living.

Individual addicts are firmly committed to their own world view and to the continued use of illicit substances to support the distorted beliefs and perceptions governing their conduct.

The approach the spin-drys took to solving this problem was to dump as much miscellaneous "clinical" information about addiction on the patient as possible in the shortest period of time for the greatest sum of money. 

Kind of like simply informing the suffering patient about one narrow aspect of the manner in which alcohol and other drugs were having a negative impact on their lives  ... and then runnin' to the bank.

Again, where the monkey falls out of the tree is when we realize that the majority of the folks who presented for treatment had developed their addicted and distorted world views over significant periods of time.   These distortions were pervasive, well entrenched and not at all amenable to superficial didactic correction or clinical shell games.

So, let's play this scenario out from the unsuspecting patient's point of view.

Joe's got a problem. 

He's 30 years old, married and got three kids 14, 13, and 12.

He started beating on his wife, Vicki, after their first child was born and he and his wife haven't really been close since she got pregnant with the youngest.

Joe and his wife were high school sweethearts.  They both dropped out of school in the 10th grade.

Joe is functionally illiterate and underemployed.  He's managed to get by through a minimum wage job, additional hidden employment, borrowing from both sets of grandparents and selling a little marijuana and cocaine on the side.

Joe is also an alcoholic and he is addicted to the use of cocaine.

Joe's wife is also addicted to the use of cocaine.  That's what originally brought these two together.  Joe used to be nice.  He used to give her all the cocaine she wanted, but after the first baby it was like he didn't like her as much anymore.

She still likes cocaine as much as ever but now she has to get it from "friends" that Joe doesn't know about.  They seem to like her and they only ask her to do "favors" for them, and their friends, every once in a while and she has never let anyone take pictures. 

She thinks Joe suspects something is going on but he hasn't beaten her up really bad for a while so she feels safe to continue.

Joe just got arrested for drunk driving for the 4th time and now the Courts are telling him he needs to get some "residential treatment".

Joe's been to out-patient treatment twice already and was able to work it into his schedule ok. He didn't mind going to out-patient because he was able to make some really good new drug connections there.  He was even able to keep "using" because the "treatment professionals" had convinced everybody that they shouldn't do drug testing on people in out-patient programs. 

What a scam.  Joe was impressed.

Joe's worried though, he doesn't know how he's going to keep the ball rollin' if he has to go into "residential treatment".  He's also worried about the 14 year old.  She stays out all night and acts just like her Mom did when she was 14.

One of Joe's friends tells him about a 28 day drug "treatment" program he goes to every year.  It's at a "Really Nice" and "Really Plush" hospital where you just kind of hang out.  It's kind of like one of those "Spas" the rich people go to and your insurance company picks up the tab.

Joe decides he could use a break.   He has no intention of changing anything.  He just needs a vacation.

Joe is on his best behavior when he shows up at the "nice" treatment place.  He wants in and he just wants them to like him.  Nobody there really challenges him either.  They have empty beds.... he has insurance.

Joe enters "Treatment".

Joe is "booted" from "Treatment".

His insurance would only pay for 12 days.

Joe is untouched by the experience.

One good thing they told him, again, is that "relapse is normal".  Shoot, that's like a license to use.

One day they asked him to read out loud and he was so ashamed.  They had assumed that he could read.  He thought about that incident and was scared for the rest of his "treatment".  He just might kick some ass if he sees that counselor on the street.

Generally though it was ok.  He only cried once, the food was pretty good and he met a girl named Rebecca.

He and Rebecca "hook up" at the self help meetings the people at "Treatment" told him he should attend.  She's cool, she's nothing like Vicki.  No kids!  She's smart, she's had 6 abortions.

He's also going to Out-Patient Treatment, again, 3 hours a day - 3 days per week.  Not too bad, he's still using cocaine but he doesn't drink alcohol or smoke marijuana before he goes to Out-Patient Classes because somebody might smell something.  He learned that during his first two out-patient "treatments".

He's fed up with Vicki and he's getting tired of Rebecca because she asked him if he was still using cocaine and not telling her about it.  The way she's smoking marijuana, they're bound to "bust" her soon anyway.

Joe got his graduation certificate.   Now he's an Alumni.  He can come back for meetings and check out the new females showing up for "Treatment".

Joe and Vicki haven't seen the 14 year old in a month.  Joe thinks she's turning out just like her Mother.  Joe wonders if the 14 year old told Vicki about what he had been doing with her  while everyone else was asleep.

Last night Joe ran a redlight and hit a family of four on his way to score some more dope.

They're all dead.

Joe's dead.

When Vicki found out she cried.... until she figured out that she didn't know what she was crying about.  Now the "real" party starts.

The 14 year old's, 27 year old boyfriend is glad that he doesn't have to kill her old man.  He just wishes she didn't have such a huge appetite for Cocaine.  He's trying to get her to just drink beer while she's pregnant.

Her 40 year old "employer" wants to know who got her pregnant.  He stands to lose a lot of money if the number of "dates" she can handle in a day goes down too much.  He'll just have to keep the Cocaine flowin' and maybe she'll have a miscarriage, it's way too risky taking a 14 year old in for an abortion.

The people at the "Nice" and "Plush" treatment place are very upset. They're concerned about being connected to Joe and the potential negative publicity.  They had also counted on Joe to provide regular "relapse revenue" for at least a couple of years.

Well, there's always Vicki and the Kids.

How many issues could you identify that evolved from, or contributed to the perpetuation of, a family wide addictions disorder?   Pain and distortion are visible in every direction.  The sad truth is that in spin-dry treatment programs these issues would be "shoved off" to be dealt with by "someone else" at a "later date" if they were ever dealt with at all.

Relapse doesn't seem so surprising under those circumstances, does it?

Does anybody really believe that  a few weeks in a "nice" and "plush" environment is going to penetrate to the level necessary to begin dealing effectively with these types of issues?

Can you get a hint of the distorted world views being taught to the children and what Joe and Vicki must have been subjected to as children?

How much pain and trauma can we afford to have shoved aside in favor of quick fixes and the fast buck?

Is this how we want our fellow citizens helped?

Is this how we want our tax dollars spent?

Is this the type of help that you want if you, or one of your loved ones, ever need help with an addictive disorder?

Are you beginning to see how superficial treatment exposure is worse than no treatment at all?

A significant portion of the "Treatment Industry" has been consistently undertreating our fellow citizens for far too long.

Since "hijacking" the idea behind the original community based treatment systems these agencies have made a concerted effort to diminish genuine care and increase the cost of these diminished services. 

Over time they have perfected a flow of clinical deception that shoves the responsibility for non-responsive treatment services and failure off on the patient and unregulated and unmonitored community based self help groups while collecting hundreds of millions of dollars. 

We have "research experts" proclaiming the inevitability of relapse while their snake oil treatment professional co-conspirators collect thousands of dollars per patient for services that fail to identify or address the underlying factors bringing about these inevitable relapses with the predictable intensification of distorted thinking, maladapted conduct and further incidents of loss, injury and death on the part of innocent members of the community.

Can you begin to imagine the scale of, and the ripple effect on, our Country's drug problem when the situations experienced by Joe and his Family are multiplied by millions of patients over 25 years?

How many Joes ... How many Vickis ... How many kids raised in this type of environment would it take to fill our prisons and terrorize whole communities?

This brings us full circle only now we are stuck with an exploding prison population, spin-drys demanding "more treatment episodes per patient", billions of dollars squandered and millions of innocent lives lost.

In the 50's and 60's small clusters of committed private citizens recognized that attendance at community based support group meetings yielded an unacceptably low percentage of uninterrupted abstinence and growing sobriety.

These good and caring people identified the need for, and then began to provide, supportive environments coupled with monitored, focused and individualized assistance.

Funded entirely by the private sector these measures produced greatly enhanced results.

This improvement in success rates for participants generated a desire within the community to support these works more consistently.

Money became available.

Underemployed "professionals" and "more established" health care agencies smelled the money.

The rest, unfortunately, is history.

I'd like to appeal to your common sense for a moment.

If a person is suffering from an infection and is given an insufficient or inappropriate prescription for antibiotics does the person get better or does the organism causing the infection get stronger and the infection spread?

If a person is suffering from high blood pressure and is given an insufficient or inappropriate prescription for their high blood pressure does the person's condition improve or do they continue to experience the same types of health problems?

If a person is suffering from diabetes and is given an insufficient or inappropriate prescription for insulin does their diabetic condition cease to be a damaging factor in their lives or do they continue to suffer?

If a person has a broken leg and is given insufficient or inappropriate care for that condition does the person's leg heal or do they suffer increasing problems from that insufficient or inappropriate care?

If a person is suffering from appendicitis and they are given "clinical" information about the "dangers of appendicitis" and then allowed to "hang around" the hospital until their insurance is depleted, does their condition improve or does their condition continue to deteriorate due to innappropriate and insufficient "treatment"?

If any medical condition is inappropriately or insufficiently addressed what do we see?

Why have we let them convince us that addiction is different?

Could it be that the spindrys and their supporters are playing on that last scrap of "stigma" by subtly implying that our fellow citizens, suffering from addictive disorders, are "somehow different" and "just don't get it" and that they will relapse at astronomically higher rates than any other "treatable" medical condition?

It's time we called them on this ...

Do you think it's possible that a " by the numbers - don't go too deep - it doesn't matter, they're going to relapse anyway " approach to "treatment" has contributed to the horrendous escalation in the volume and severity of drug disorders being seen in our country?

Could it be that the spin-dry's "husbandry" of this painful and degrading condition has been a way of ensuring continuity and growth for an "Industry" that has consistently refused to effectively address the legitimate treatment needs of our people?

It's your Mother.

It's your Father.

It's your Brother.

It's your Sister.

It's your Son.

It's your Daughter.

It's your Husband.

It's your Wife.

It could be you, next!

One thing that the explosion in drug related crime, pain and suffering in America makes very clear is that "misery does love company".

What level of personal suffering do we, as members of this society, have to endure before we are willing to start asking the right questions and begin demanding legitimate, effective and responsive treatment services for our suffering fellow citizens?

I believe that it is absolutely essential, at this time, to remember the commitment and the intelligent compassionate response originally put forward by the "Founders" of structured addictions treatment in this Country.

The systems of aid and assistance that they developed to address this problem are as valid and effective today as they were when initially offered.

Unfortunately the greed, the deadening of compassion for the suffering human being and the malignant sense of entitlement of the spin-drys have been transformed from a bold and risky grab for assets and authority to an ingrained mindset that the "true servants" of this population have become afraid to challenge.

It's "your" life, and the lives of "your" loved ones, hanging in the balance.

It is no longer necessary to be an addict in this country to experience drug related pain and suffering and loss.

The non-addicted "victims", of those who have been poorly served, know this pain and suffering and loss all too well.

The "Treatment" of Addictive Disorders

What our People Deserve.  What our People are Getting.

Part IV:  Where Do We Go From Here?

Simply stated, addiction to illicit substances is America's greatest Public Health and Public Safety concern.

I don't believe a relaxation in our current drug laws would, or could, have any beneficial impact on the situation we are facing today or in the foreseeable future. 

Decriminalizing or legalizing the use of these substances would not reduce the number of individuals suffering drug exposure and a very good argument could be made that such a move would cause a nightmarish explosion of addictive disorders that is beyond our ability to imagine.

What we are required to face at this time is a decision about the manner in which we will help our fellow citizens currently suffering from addictive disorders.  We have to work to end that suffering and to prevent that suffering from creating pain and loss in the lives of the innocent victims of their drug influenced behavior.

Our past experience clearly shows that insufficient levels of treatment invariably lead to relapse.

While this may not be particularly distressing for the Boards and Administrators of programs that use the "inevitability of relapse" as a "bailout" position we, as a society, can no longer afford to blindly buy into their rationales for flawed treatment approaches.

In Hawaii last year we had too many examples of babies being killed by their own addicted Mothers and Fathers ...

People immediately focused their justifiable outrage on Child Protective Services.  People claimed that CPS was at fault ... That they should have known better ... That they should never have placed these children back with unfit parents. 

The general public missed a key target for the anger and contempt that they felt in connection with the obvious poor decision making leading up to these tragedies.

Where did these people go for treatment?  

What kind of treatment was it? 

How long was it? 

How comprehensive was it? 

How many times had they been referred to treatment? 

How many times had they been referred to that same place for treatment?

Did they "Graduate" from any of these programs?

How many CPS workers were lied to by these treatment programs concerning the legitimate treatment "needs" and progress of these addicted individuals?

How many CPS workers were "hypnotized" by these programs into believing that relapse was "normal" when in fact these treatment programs had just done a poor job of helping the addicted individual and should have shared in the public condemnation that was "heaped upon" our overburdened CPS workers and Dr. Chandler?

What's wrong with the public knowing about specific treatment successes and treatment failures of the various treatment services available in Hawaii? 

There is no way that anyone can say that these "cover-ups" are intended to protect the patient or serve the public interest.

If a treatment approach is "cranking out" psychopathic baby killers I believe that the public would like to know about that.

What about all of the other drug related crime taking place within our communities?

The rapes, the robberies, the assaults, the incidents of domestic violence, the drunk driving deaths involving innocents, the grandmothers beaten to death for their social security checks, the drive by shootings and all the rest of the horrific and increasing levels of violence that we hear about and the everyday simple inhuman acts of abuse and violence that never get reported.

Where have these people gone for "treatment"?

Who was paid, with taxpayer money, to "help" these people?

What the hell is goin' on?

As you can see, until there is some measure of openness in relation to these matters it will continue to be impossible to make legitimate decisions about which treatment services work and which services are on the wrong track.

Openness in these matters would allow addicted citizens and their families to make truly informed decisions about where they might find the "most effective" help in putting their lives back together.

The popular saying now is that "Treatment Works".

It's true.

Legitimate treatment, that is responsive to the individual needs of each patient, works exceedingly well.

Bogus treatment that "passes through" deeply troubled individuals, based upon financial considerations, serves no one and does real harm to the community.

I believe that it's time that we separated the wheat from the chaff.

One year of our news services reporting prior treatment experiences along with information concerning criminal conduct by an addicted individual, or where drugs are involved, should help the public to better gauge that which works and that which doesn't.

This would be a true public service and would allow society to choose how to allocate its' dwindling resources in the most effective way.

I am not advocating unwarranted attacks on treatment approaches or treatment agencies based upon philosophical or operational differences, but how long are we willing to give a "free ride" to agencies or approaches that are just not working for too many of our people.

Just report the "facts" and let the "facts" speak for themselves.

Our political leaders want to do the best for the people who elected them to office.  One of the major difficulties these political leaders face is the fact that they are heavily lobbied by agencies and individuals seeking to "protect their own rice bowls", many times at the expense of the community as a whole.

Let's educate the public.  Let's not engage in promotion and propaganda.

Speak the truth about treatment failures that lead to loss, violence, injury and death.

The public has a "right" to know these things.

Keeping the community "in the dark" will only prolong the problem and allow the "sickness" to spread and intensify.

It's absolutely true that "Treatment Works".

It is equally true that "Poor Treatment works Poorly".

When will the Suffering End?

Addiction is a disease marked by sad and poorly lived lives.  I know it ... You know it.

The suffering addict knows it, too.

Squandered potential, lost opportunity, failed relationships, disconnection from family and community, increased susceptibility to injury and disease, a higher incidence of criminal justice involvement and loss of Liberty through court supervision or incarceration, a much greater likelihood of homelessness, growing isolation and mounting feelings of insanity and despair provide hints of impending disaster for the addicts and for those who care very deeply for them.

The suffering being experienced by these troubled human beings creates such an atmosphere of pain and shame and fear and confusion that, in many cases, all involved become frozen ... they become numb to the pain and unable to see any way out of the nightmare that their lives have become.

A life driven by pain will seek to find relief from that pain.  For the addict this need is so terribly great and so terribly deep and so terribly urgent that they will blindly generate additional suffering in search of any relief from that pain.

Headlong desperation makes it so.

The constant background fear that the addict will overdose, or be killed in an accident, or be murdered, or contract an additional life threatening condition, or injure or bring about the death of another or commit some other action that will cause them to be imprisoned.  All of the fears that loved ones have for their suffering Father ... Mother ... Brother ... Sister ... Son   ... Daughter

The confusion that comes from not knowing whether, or how, to love and support this caring human being who has become a stranger.   The mixed signals ... do I help ... is helping wrong?

For the loved ones, the sight of this good and valuable human being being eaten up by forces that they just don't understand is often too much to bear.  The pain and the fear that is created by the slow grinding destruction of someone you love dearly can tear at the heart until a kind and loving person is driven to the point of uncaring. 

The shame that results from this emotional disconnection, the sense of having "let someone down", through efforts intended only to allow emotional survival, can scar a loved one in ways that remain long after the death or the recovery of the addict.

In the midst of addiction, there's pain and shame and fear and confusion enough to go around.  Enough to destabilize these individuals and families and almost guarantee that they will be unable, when left to their own devices, to find a way to restore harmony and balance in their lives.

Now, let's roll in on top of all of this the external sources of condemnation and deceit that society has decided to invest in the persecution and exploita