Pubdate: Sun, 24 Dec 2006
Source: North County Times (Escondido, CA)
Copyright: 2006 North County Times
Note: Gives LTE priority to North San Diego County and Southwest 
Riverside County residents
Author: Sara Solovitch, Public Access Journalism


In San Francisco County Jail Number 8, the 21 orange-suited women in 
the SISTER program are getting a lesson in self-esteem from Jackie 
Gordon, a one-time heroin and crack addict who did 18 months in 
California State Prison and has been clean and sober for six years.

"What limits you?" she asks. "You go so far and then you go back to 
what is familiar."

A light-skinned Hispanic woman named Carolyn raises her hand. "I 
don't know if you guys know it, but I'm on my way out of here. It's 
my fourth time going into a program and I always relapse."

She takes a deep breath. "There's always an excuse: Someone tells me 
I can't smoke and I say, this program is not for me. People irritate 
me. I irritate myself. I'm scared because I can't keep doing this.

"I'm lucky," she adds. "I'm going into a good program, and I don't 
know what's going to pop up."

A few minutes later, a guard gives Carolyn a nod. Clutching a 
crumpled brown paper bag, she strides up the aisle, throws her arms 
around Gordon and rushes out to freedom and the unknown.

SISTER (Sisters in Sober Treatment Empowered in Recovery) is one of 
only a dozen or so comprehensive treatment programs nationwide for 
incarcerated women dependent on drugs and alcohol. Though there are 
hundreds of programs for male offenders, including an entire prison - 
the Sheridan Correctional Center in Illinois - dedicated entirely to 
drug treatment for men, resources for women are scarce.

America's 25-year war on drugs has taken an exorbitant toll, both 
human and economic. Drug arrests have tripled since 1980; as a 
result, the number of jailed drug offenders in 2000 equaled the total 
number of inmates in U.S. prisons and jails 25 years ago, according 
to The Sentencing Project, a research and advocacy group.

By most estimates, women have paid the highest price. Between 1977 
and 2001, figures from the Women's Prison Association show a 592 
percent increase in the number of women jailed, from 12,279 to 
85,031. According to the WPA, the growth "corresponds directly to the 
mandatory minimum sentencing laws in effect since the early 1970s. 
Since more women are convicted for nonviolent, drug-related crimes 
than for any other, these sentencing policies have had a particularly 
profound effect on women."

Though men still far outnumber women in arrests for drug-related 
crimes, women now represent the fastest-growing prison population 
nationwide for drug offenses. In 1996, the number of female state and 
federal inmates in jail for drug crimes grew at nearly double the 
rate of males. In New York State, whose Rockefeller Drug Laws are 
among the harshest sentencing laws in the country, nearly half of all 
women in prisons are serving time for drug-related offenses.

"It's increased dramatically. All the studies show it," says Elyse 
Graham, program manager of SISTER, a collaborative project of the San 
Francisco Sheriff's Department and Walden House, the largest 
therapeutic drug community on the West Coast. "We're seeing cycles 
and generations of women who are addicted and in our jails. We see 
mothers and their daughters, sisters, cousins and maybe now their 
children who are in foster care. The cycle is continuing and that's 
pretty disheartening."

"Women have become the silent casualty of the war on drugs," says 
Malika Saada Saar, executive director of The Rebecca Project for 
Human Rights, a national advocacy organization that works with 
low-income families on issues of substance abuse, criminal justice 
and the child welfare system.

In fact, 70 percent of women in jails and 65 percent of women in 
state prisons are mothers of minor children, according to the 
National Institute of Corrections. Not surprisingly, 80 percent of 
children in the foster care system are the offspring of incarcerated parents.

Four Cents for Prevention

When the National Center on Addiction and Substance Abuse at Columbia 
University analyzed the costs of alcohol and drug abuse in a 2001 
report, it concluded that the 50 states spent an incredible $81.3 
billion in 1998 alone. Of every dollar spent on substance abuse, it 
found that 96 cents went to "shovel up the wreckage" brought on by 
addiction and substance abuse, while only four cents went to 
prevention and treatment.

Today, with addiction now widely accepted as a public health problem 
- - among the nation's top 10 - experts question the value of 
imprisoning a chronically ill woman at a cost of $30,000 a year and 
placing her children in foster care for another $30,000.

"We are approaching a chronic illness as an acute model," says 
Michael Flaherty, executive director of the Institute for Research, 
Education and Training in Addictions at the University of Pittsburgh. 
"As if it were a cold."

Approaching addiction as a chronic illness like diabetes or 
hypertension upends the whole dialogue in the professional community 
about the relapse of drug abusers. Instead of seeing addiction as a 
moral failure, it becomes a disorder that requires continuing care.

"What we're trying to do is change the approach entirely," Flaherty 
says. "All the science says that if you don't give someone at least a 
90-day continuum of care, it's an economic and clinical waste. That's 
why the relapse rates are so high."

When, in 2001, the federal Center for Substance Abuse Treatment 
evaluated 50 residential treatment programs designed specifically for 
substance-abusing women who were pregnant or the mothers of infants 
or young children, the results were better than anyone had 
anticipated. The study showed an 84 percent reduction in the risk of 
low birth-weight babies and a 67 percent reduction for infant mortality.

Even more telling, 60 percent of participants reported being alcohol- 
and drug-free during the six months following discharge, and only 7 
percent of participants arrested for alcohol-or drug-related offenses.

Long-Term Treatment Brings Results

The longer a woman stayed in treatment, the better her chances of 
recovery. There, the statistics also spoke volumes: 68 percent of 
those in treatment longer than three months remained clean and sober, 
compared to 48 percent of those who left within the first three 
months. And only 9 percent of those with longer stays were arrested, 
compared to 20 percent of those who left earlier.

Long-term care is cheaper, too. A California study found it costs 
seven times more to imprison and take children away from a 
drug-abusing mother than it does to break her of her addiction with 
long-term residential treatment.

Yet those programs are a rarity. In Washington, D.C., where thousands 
of women - and men - are addicted to crack cocaine, only one such 
program exists, the Community Action Group's Family Treatment 
Program, with 14 beds.

"Many women say it's easier to wind up in prison than to get 
treatment," Saar says. "Treatment programs are turning women away 
because they have children. Or they're pregnant. And if they do go 
into a single adult program, they're often unsuccessful because their 
children aren't with them. So they spiral down further and eventually 
wind up behind bars."

That's what happened to Lorna Hogan of Silver Spring, Md., two weeks 
after giving birth to her fourth child in 2001. By then, she'd had a 
13-year run with crack cocaine, had been in and out of jail, and made 
several attempts to quit. Her latest effort had been met with 
outright rejection from a six-month program that wasn't equipped to 
deal with children.

Women react differently than men

Drug treatment programs were designed with men in mind. For years, 
many refused to even admit women and those that did typically used a 
confrontational approach that drove many women away.

As the study of female addiction has come of age, one of its main 
tenets is that women have a different relationship with alcohol and 
drugs than men. For women, substance abuse all too often is bound up 
in a history of domestic violence, childhood sexual abuse or physical 
and emotional trauma. Symptoms of post-traumatic stress disorder are 
widespread. And that understanding plays a key role in the kinds of 
treatment that work - and don't work - with women.

"You take a female who has been traumatized and raped, and shame them 
for some infraction of the rules, they'll split," says Randy Muck, 
lead public health adviser for adolescent drug treatment at the 
federal Substance Abuse & Mental Health Services Administration.

Men are another big reason why women leave treatment.

"Relationships are the No. 1 issue that takes women out of 
treatment," Jackie Gordon tells the women of the SISTER project. "Right?"

A murmur of assent runs through the room.

"You get into a program, you feel good about who you are, you have a 
routine every day. And then the first time someone shows an interest 
in you, you get defocused."

In fact, many women not only choose relationships over treatment; 
they choose them over freedom. According to the National Advocates 
for Pregnant Women, women often incur long sentences because they are 
unwilling or unable to give prosecutors evidence about a husband's or 
boyfriend's crimes and connections.

The loyalty they show isn't necessarily returned in kind. 
Incarceration puts a special stigma on a woman.

"You see it when you go to the D.C. Jail," Saar says. "There are 
always far more family members visiting the men than the women. 
There's an attitude that because they are mothers, they have done 
something terribly wrong. They're stigmatized."

Children Can Be Scattered

The last time Hogan was released from jail, she discovered that her 
children had been dispersed to different group homes throughout the 
District of Columbia. She begged a social worker for help, admitting 
to almost everything she had ever done. Hogan was fortunate. The 
social worker referred her to a family treatment program for women at 
the Center for Mental Health in southeast Washington.

"She told me what I needed to do," Hogan says, "and that's exactly what I did."

For the next 18 months, she underwent routine drug testing; took 
parenting classes; and received individual therapy, domestic violence 
counseling, and training in jobs skills and life skills.

"But I think the thing that helped me most was hearing the 
accomplishments that the other women described in group meetings," 
Hogan recalls. "A lot of them had lost their kids and were getting 
them back. They were getting their own housing - not transitional 
housing, but real places to live. There were women going back to 
college, or maybe they had never finished high school and were 
getting their GED. It gave me encouragement."

Her story had a happy ending: she got her children back; she found a 
house, she got a job.

Today, as associate director of the Rebecca Project's parent advocacy 
group, Sacred Authority, she regularly goes to Capitol Hill to tell 
her story and advocate for comprehensive family therapy.

"I wanted to get my life together so bad, but when you don't have the 
right type of treatment, you feel hopeless," Hogan says. "That door 
was open for me. And I am so grateful."

- -----

Sara Solovitch is a freelance journalist and former Knight Ridder 
Newspapers reporter.

For more information, resources and interactive forums on substance 
abuse issues, visit Take the reader survey 

Editor's note: These stories are part of a series on drug addiction 
produced by Public Access Journalism LLC, an independent editorial 
company, and distributed by McClatchy-Tribune Information Services. 
The cost was underwritten by The Robert Wood Johnson Foundation, a 
philanthropy devoted to health care.
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