‘Call Back Tomorrow’ Provides Little Solace : Making It Through the Weekend Can Be Tough for Drug Abuser in Search of Help

Saturday is no day to have a drug crisis in San Diego--especially if you are broke. In fact, you need to schedule drug and alcohol crises weeks in advance.

On a recent Saturday, a woman we have known for several years tearfully told us that she had a problem with methamphetamines--crystal meth, in the language of the streets--a drug for which San Diego County is well-known. In the past, she had tried to kick a cocaine habit on her own. Instead, she traded it for a cheaper drug.

This time she sought help at a community recovery center, which assigned her a peer counselor and a professional counselor. She saw each once a week. But, she asked, “What do I do the other five days?” It wasn’t a rhetorical question. Her counselors told her to go to meetings of Narcotics Anonymous.

That was good advice, but on most days depression was keeping her from meetings and in bed crying, in a darkened room. She had attended only four meetings and didn’t get fully into the program when she did go--and she knew it.

She had lost her job and her ancient car was on its last wheels. She had no family in San Diego. She had only $500, and her rent was due.

Suicide had crossed her mind. Haltingly, she said maybe she needed to be in a hospital. Maybe it would be better to spend the money on help instead of rent, she said. But, without insurance, $500 won’t get you into a private residential treatment program, which can cost $10,000 for a 30-day stay.

We suggested that she try a county-funded program, where a month in a recovery home might cost her only $200-$300. She started making phone calls.

But call after call to drug and alcohol residential treatment programs netted the same response: Call back on Monday. Not even the Crisis Team Hotline could suggest help on the weekend.

While it is true that she would need more than 48 hours of resolve to kick her habit, drug and alcohol abuse counselors say that addicts’ or alcoholics’ ability to face their disease can sometimes dissolve in a few minutes. It’s difficult to schedule crises only Monday through Friday, between 8:30 a.m. and 5 p.m.

The weekend was the least of her problems, however. Not only would she have to call back Monday, but she was told there were waiting lists of several weeks to several months, and that she would have to call back nearly every day to convince the program directors that she was sincere.

Just say no to drugs?

The program directors who have to deliver this grim news say the callbacks help keep the addict’s or alcoholic’s hopes up as well as prove motivation and likelihood of success. They acknowledge, however, that those most in need of help may be those least able to be persistent.

The plain fact is that there are too few beds for too many people needing them.

In San Diego County, officials estimate that there are 364,000 people for whom drugs or alcohol has become a problem, but there is room for only 623 of them in county-funded residential programs. Officials say there should be at least twice that many.

Private hospitals treat alcoholics and addicts together, but the county keeps them apart, because of state funding requirements and because of philosophical differences in treatment.

While the style of treatment may be debated among health care professionals, one thing that seems to be generally well-accepted is that many alcoholics and drug addicts, especially those with little or no support network, need several months of residential treatment so they can regain financial as well as mental health.

However, with stays frequently of three to six months or more, turnover is slow and waiting lists long. It can take as long as six months to get into one of the 575 spaces in long-term programs.

But, because there are more beds in recovery programs for alcoholics, many of the people our friend spoke with that Saturday told her to lie and say she was an alcoholic. Not just plain lie, mind you, but lie convincingly to an alcoholism professional. Three counselors we talked with later gave the same advice.

One person even suggested that she drink a few beers before applying so that she would smell of alcohol. While many addicts also abuse alcohol, and recovery means abstinence from both alcohol and drugs, this woman was offended at the prospect of lying.

The paradox is striking. Both Narcotics Anonymous and Alcoholics Anonymous stress “rigorous honesty,” and lying about one’s problem is exactly what both programs abhor. It is a cold reality, indeed, that prompts counselors to tell their patients to lie to get help.

No one knows how many people who seek help are lost in the waiting. As one recovery home director put it: “Our supply is such a fraction of the demand that we don’t sit around and count.”

The shortage of treatment facilities for addicts and alcoholics is part of a larger picture in San Diego County. For years, the county says, it has received less per capita in state funding than almost every other county in California.

State distribution formulas have not kept pace with population growth, and San Diego legislators have lacked the clout to change them. For example, San Diego County receives $1.45 per resident for drug abuse programs, compared to $2.21 per person in Orange County, $2.75 in Los Angeles and $5.56 in San Francisco. The state average is $2.35 per person.

The county has sued the state three times to redress this imbalance. All three suits are still pending.

Meanwhile, our friend made it through that weekend and the next. She paid her rent and picked up a few days’ work. She applied to two treatment programs, and was calling them every day. But then her car died, and with it most of her hope. Routine tasks such as laundry or mailing a letter overwhelmed her. How was she going to wait three months? She was just a short step from living on the street.

This story may have a happy ending, however. Our friend was accepted into a long-term residential program more quickly than predicted. The rest won’t be easy, but her chances of recovery look brighter.

With the system as overcrowded as it is, however, not everyone is so lucky.

“Just say no” is not realistic for the alcoholic or an addict who is broke, desperate and shaking too badly to hold a cup of coffee.

“Call back tomorrow” isn’t much solace either, especially when it may have taken years just to admit a need for help.

If the helpers are forced to say no, we shouldn’t be surprised that so many addicts and alcoholics continue to say yes.