CONFRONTING ADDICTION ENACTING DRUG-TREATMENT LAW A CHALLENGE.

Byline: Arthur R. Vinsel

LEADERS of Los Angeles County's alcohol and drug abuse recovery program infrastructure face a perplexing challenge with Proposition 36 - that brave, new experiment in hope and law that offers multitudes of addicts treatment over jail.

Despite the fact that it passed handily, many people don't understand Proposition 36 and how it addresses society's massive problems of drug abuse.

Proposition 36 allocates $600 million over five years to offer treatment rather than jail or prison to addicts who qualify.

But how do we define progress in treating diseases of addiction to drugs (or alcohol), afflictions literally imprinted in the genetic codes of we who have them? These maladies cannot be cured, only treated and managed.

One can endure withdrawals, attend 12-step meetings twice a day, pray, embrace yoga or wade in the sacred waters of Lourdes. There are no guarantees. We don't all get well. We can only get better, through abstinence and learning to handle our issues.

My struggle with alcoholism, compounded by chronic clinical depression, dragged from 1975 to 1990, a downward spiral from award-winning newspaper reporter to convenience store graveyard shift clerk to itinerant window-washer, then unemployable and technically homeless. Thank God and Mom for her spare room and patience.

Yet I understand - now - why she should have turned me out. She was killing me with kindness, when the addict or alcoholic needs to learn hard lessons sooner. Sometimes attitudes have to be changed as well as ways of doing things.

Here in Los Angeles County, Proposition 36 is supervised by treatment and health officials, rather than courts and the legal system. Cops and prosecutors traditionally regard addicts as criminals rather than sick people, while health professionals understand the process better.

Other counties are struggling to choose who runs this suddenly expanding care network, often giving the job to courts and law enforcement in less urban areas. Rural outposts where livestock outnumber people simply have inadequate human resources.

Drug addiction and alcoholism are not crimes in themselves. However, we alcoholics and addicts have a deserved image. Drunk or stoned, most of us do things we shouldn't. The sheriff is better equipped, however, to run a jail than a clinic for the sick.

This should be the criterion everywhere: put treatment in the trained hands of treatment specialists.

Perhaps most difficult is the issue of sick people doing criminal things and being eligible for treatment, rather than punishment. Remember, this plan does not excuse crimes. Violence is not exempted, nor are most felonies. To qualify for treatment rather than incarceration, the addict seeking it must fit a profile.

Some rather hard new ground is being broken here, because this voter- mandate passed by a 61 percent majority. But if we can't be cured, is just ``getting better'' sufficient?

What happens, or should happen, if a Proposition 36 client subject to random drug testing relapses?

Treatment professionals understand relapse is common in recovery. If nothing else, it helps convince the uncertain client exactly what he or she is: an addict/alcoholic.

However, some authorities want to penalize relapsers. Damaging consequences may result.

Law enforcement and addiction counselors will interpret relapse differently. I once knew a probation officer who said it just ``made her day'' to lock someone up.

Clearly, while Proposition 36 has been launched, the shakedown cruise will take time yet.

``We need people to help the public understand exactly what recovery involves,'' says Lydia Becerra, an analyst and public information officer in the planning wing of the county's Office of Alcohol and Drug Programs Administration.

Recovery - as it turns out - is a term not always easy to define, especially when a relapse or two is typically part of the process. Is an addict or alcoholic who stumbles, then abstains again marked for life? Do some find it harder than others to quit drugs and flourish in recovery? Definitely.

Sixty days after Proposition 36 took effect, Becerra said, county officials had 2,500 applications in for treatment and 1,300 processed into the evaluation system. These initial figures will change rapidly, but the greater the help needed, the fewer resources to meet demand.

Three treatment levels exist. The first involves moderate supervised outpatient care. The second level is more rigid, with certain day care services. The third level is intensive, residential care such as that of the Beacon House Association of San Pedro, a licensed, nonprofit, 105-bed facility that takes men from throughout the county.

Meeting needs won't be cheap. Although $600 million over five years has been allocated for care, the volume of drug prosecutions has almost overwhelmed California's legal system.

In the final analysis, it's all about money. How much should we spend, or not spend, on care vs. incarceration?

More of one or the other is imperative. History shows recovery is by far the cheapest and best.

``We already have great concerns over how these people are all going to be handled,'' Becerra said.

Guidelines are still being developed to distinguish ordinary drug addicts, for example, from the dually diagnosed, that large percentage who have a mental illness that complicates their specific treatment for addiction.

California may have jumped the gun offering widespread care for drug addicts so soon - because the money was there - even if the infrastructure and planning were not.

Still, we're headed in the right direction.

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Many fighting addiction relapse multiple times, like Robert Downey Jr., on the road to recovery.

Nick Ut/Associated Press