By Angeli R. Rasbury
Wednesday, February 15, 2012
Women who suffer drug addictions often experience other disorders, such as mental illness or childhood trauma. Few treatment programs address all their needs, but a holistic drug-court program in California shows how it can be done.
Female participants receive a wrist watch when they enter the program. Little charms are added when the women reach milestones, such as 90 days without any drugs or the day they secure a job.
The graduation rate for the program, which began in 2000, is 60 percent for the last two years. Nineteen of those 32 graduates were women with children, some with multiple kids.
In an e-mail Meynardo Mendoza, a coordinator for the Drug Court, said participants who did not graduate at least went through an "episode of treatment" that would improve their chance of becoming clean and sober in the future.
Barbara Bonsignori, a registered nurse, works with mothers over 18 and their children through Rx for Kids, a program of Ventura County Public Health. The treatment goal is six months in-patient followed by six months out-patient and in some cases additional out-patient treatment. Bonsignori says she provides everything from health assessments to guidance to accessing care to providing infant massage.
In addition to the court and Ventura County Public Health, other agencies involved in the program include CalWORKS, California's welfare to work program, and providers of transitional housing.
The inclusion of mental health professionals is significant.
"Addiction treatment has historically not dealt well with mental health problems or traumas," Amaro said, "and people who deal with issues like domestic violence don't deal with or are not trained with substance abuse. Everybody's dealing with their part of the problem but not comprehensively. As a result, issues aren't addressed in a comprehensive manner."
Large, coordinated programs like the one in Ventura, however, are hard to maintain and duplicate, added Amaro, hindered in great part by a shortage of clinicians trained to treat drug addiction's common co-occurring disorders.
Amaro says her own Boston programs are held back by low payments from Medicaid, the public health program for low-income people.
People who might need intensive services can be limited by Medicaid rules to one or two out-patient services, or number of days in a program.
"The level of payment is usually very inadequate," she said. "Reimbursement for the services is quite low. You never end up having enough money to have a program if you rely on reimbursement."
Budget cuts are another limitation, she says.
"There are more cuts coming," Amaro said. "That means more programs will have fewer spots or will have to close."
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Angeli R. Rasbury is an educator, artist, lawyer and writer specializing in women, girls and culture. Her 2006 article for Women's eNews, "Out of Jail, Mothers Struggle to Reclaim Children," won an award from the National Council on Crime and Delinquency.
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