HomeMy WebLinkAboutMINUTES - 03141989 - T.1 THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Adopted this Order on March 14, 1989 by the following vote:
AYES: Supervisors Powers, Fanden, McPeak, Torlakson
NOES: None
ABSENT: Supervisor Schroder
ABSTAIN: None
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SUBJECT: Crack/Cocaine Problem in Contra Costa County
As previously requested by the Board, Mark Finucane,
Health Services Director, presented a report on the crack/cocaine
problem in Contra Costa County (a copy of which is attached and
made a part of this order) . He noted that while there has been a
dramatic increase in the incidence and prevalence of cocaine abuse,
there is a lack of information about the extent of the problem.
Mr. Finucane commented on the need for a comprehensive approach to
confront the crisis, which should include the Health Services,
Social Services and Probation Departments.
Supervisor Tom Powers commented on the tragedy of drug
exposed infants, and referred to the Therapeutic Nursery School
program which works with such children in West County. He stated
the the program is currently operating at a deficit, and requested
that the matter be referred to the Finance Committee to review
funding options.
Supervisor Sunne McPeak noted that to date the major
emphasis has been on law enforcement. She stated that while the
increased law enforcement has been effective, there is a need for
more comprehensive treatment and prevention efforts. Supervisor
McPeak commented on the lack of resources to address all aspects of
the problem, and recommended that an action plan be developed for a
ballot measure to be presented to the voters next year.
After further discussion by Board members, IT IS ORDERED
that the following actions are APPROVED:
1. ACKNOWLEDGED presentation by Health Services Director on
crack/cocaine use in the County;
2. REFERRED to the Finance Committee the issue of funding
for the Therapeutic Nursery School program in Richmond;
and
3. REFERRED to the Internal Operations Committee the
development of an action plan and options for a ballot
measure to fund the War on Drugs in Contra Costa County.
cc: Finance Committee
Internal Operations Committee Ihr,,rebycert1iy, t atthisisatrue-anCccrre tcopyof
Health Services Director an action tai.erb and 011107"-'d On no - ,' r;s':es cf t"e
Social Services Director Board of Supervisors on the elate shown.
Probation Officer ATTESTED. -
County Administrator Pr,-fit_ 13ATCKEt_D[1, Gwl-a k cf tt=l gf:Urd
of Supervi;^,ors and Ccju aty Adim r s-trator
By 6 , Depuly
T.
THE CRACK/COCAINE PROBLEM
CONTRA COSTA COUNTY
HEALTH SERVICES DEPARTMENT
ALCOHOL/DRUG ABUSE/MENTAL HEALTH DIVISION
DRUG ABUSE PROGRAM ADMINISTRATION
MARK FINUCANE, DIRECTOR
INTRODUCTION
The mission of the Contra Costa County Health Services Department is to provide
cost-effective quality health care services to all eligible residents of the
county. These services represent a broad spectrum of care ranging from the
chronic to th;; acute. The Health Services Department is called upon for the
diagnosis and treatment of chronic medical conditions, such as coronary artery
disease, to the treatment of acute medical conditions, such as trauma resulting
from automobile accidents. However, the comprehensive nature of our mission is
not the only challenge - we are also challenged by the rapid evolution of health
care and the explosive medical technological advances . Today's landscape is
vastly different from that of a decade ago, and much different from what we will
see in the Year 2000. The infectious disease epidemics of the late 1800' s and early
1900' s have been attacked by medicine through the use of basic sanitation
methods and, eventually, through the development of antibiotics . The community
epidemics of today, such as the CRACK/cocaine epidemic, will require different
strategies, adaptations, and innovative responses . This report details some of
the characteristics of the CRACK/Cocaine problem and suggests a few preliminary
steps twoard its reduction.
To assess the cocaine "epidemic" and its impact on the Contra Costa County
Health Services Department and its clients, a task force was appointed by the
Health Services Director in September 1988 to examine the impact of CRACK or
smokeable cocaine. The task force specifically focused on the problem of
CRACK because this particular form of drug use is destroying individuals,
families, and whole communities at a shocking rate. Even the most experienced
among us have been stunned by the speed and extent to which CRACK has infil-
trated our communities . Since the first meeting of the task force over 50
interviews have been conducted with key individuals, including community
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members, elected officials, and health care professionals. Information
gathered from these interviews, as well as information gathered from the
Probation and Social Service Departments, has been utilized by the task
force to fulfill its mission and to prepare this report. The information
included from the Proba+ +on and Social Services Department reports is presented
in an abbreviated form; however, their work and participation has been essential
to this report. Ms . Wilhemina Johnson of the Social Service Department and Mr.
Larry Leal , representing Probation , have been extremely helpful in this effort .
Also, Messrs . Gerald Buck and James Rydingsword have been vitally interested
in and sympathetic to our work . Chuck Deutschman and Adanna Henry, Drug
Program staff, have been the key executives for the Department in this effort.
Ms. Henry, who conducted the interviews and all in all was our primary staff
resource, is to be commended.
Our knowledge about cocaine use and CRACK/cocaine in particular is still scanty
and largely anecdotal; however, it would be irresponsible to wait for complete data
before responding to the crisis . This report, therefore, includes recommen-
dations for an initial response to the CRACK/cocaine epidemic of the 1980's.
BACKGROUND
° HISTORICAi
The Spanish first discovered the use of coca leaves by the Incas in the
16th Century. The natural evolution of coca evolved very little until
cocaine itself was first synthesized in 1859. From 1885 until 1905
cocaine was praised by physicians as a wonder drug and was regularly
prescribed for the treatment of morphine, opium and alcohol addiction .
Its use for pleasure also grew rapidly as the patent medicine manufac-
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turers made cocaine hydrochloride widely available and advertised this
drug as the perfect elixir for an industrious America. Cocaine was
peddled from door to door and was often sold as an ingredient of alcoho-
-lic beverages as well as soft drinks such as Coca Cola. At the turn of
the century, medical circles became aware of the dangers of cocaine use.
A study completed during that time reveals that only 3-8 percent of
cocaine sold in New York , Boston and other metropolitan areas was uti-
lized for direct medicinal and/or dental reasons . Articles began to
appear expressing concerns regarding the non-medical use of cocaine by
many citizens. Federal and State governments passed numerous pieces of
legislation which made the non-medical use of cocaine illegal . By the
1920' s the use of cocaine had declined dramatically. The first epidemic
of cocaine use abated and the United States no longer was a free market
for the using and selling of cocaine.
The next epidemic of cocaine use did not begin until nearly 50 years
later in the 1970s; a lifetime span which erased society' s memories of
the tragedy of the first epidemic. Unlike the first epidemic, the
current epidemic of cocaine use is not a result of a free market place
for cocaine and a societal innocence as to the hazards of psychoactive
toxins. The current cocaine epidemic is due to the public and institu-
tional lack of knowledge concerning cocaine and its effects to the
increasing popularity of smokeable cocaine, known as CRACK. The natural
evolution (or mutation) of this drug provides a cruel twist to the
already legendary effects of rampant stimulant abuse caused by both
cocaine and methamphetamine.
4
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° RECENT TRENDS
There are several warning signs of an epidemic of cocaine dependency.
The most common signs are a marked increase in the number of
persons having the condition; the spread of this condition into subgroups
which were previously immune to the conO ;tion; a marked increase in the
number of users having problems resulting from their drug use, and
lastly, the significant increase in the use of smokeable cocaine known as
freebase or CRACK. The route of administration, in the case of smoking,
has a great deal to do with the severity of addiction and the addictive
potential of any drug . The smoking of CRACK has created yet another tra-
gic twist in the deadly evolution of cocaine. There seems to be general
agreement that an epidemic of cocaine dependency is occurring in the
United States , but, because it is emergent it is difficult to measure the
scope and magnitude of the problem.
The present CRACK crisis has developed over four separate sta-
ges .
1 . Dramatic increases in all drugs of abuse throughout 1960' s &
70' s and 80' s with a generally permissive societal attitude
toward drugs along with pervasive ignorance as to the hazards of
drugs.
2. The meteroic rise in the casual or, so-called recreational , use
of cocaine which began in the mid-1970' s and continues to this
day. The public initially viewed cocaine as a relatively benign
drug that could be used socially.
3. The synthesizing of free-base cocaine from cocaine hydrochloride
began in the early 1980' s. The new form of smokeable cocaine was
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much more addictive than the traditional powdered form, but rela-
tively few people knew how to convert cocaine powder to the smo-
keable cocaine called "rock ."
4. In the mid 1980's smokeable cocaine began to be mass produced and
marketed in places which were sometimes called "rock houses."
The price: violence, gang involvement, enormous profits, and the
profoundly addictive properties of this n;.w form of cocaine are
all factors in this volatile situation. Now, we see smokeable
cocaine, or CRACK, taking a tremendous toll on society through
perinatal substance abuse and the addiction of our younger
generation . It is also evident that the health care system is
being severely strained.
In California we have witnessed dramatic increases in the incidence and preva-
lence of cocaine abuse. This information is partially illustrated through the
use of client admission and discharge data from drug abuse treatment programs,
through hospital data, and through coroner' s reports . The following graphs
illustrate the magnitude of this serious problem.
CALIFORNIA
COCAINE OVERDOSE DEATHS
204
200
160
120
0
ao
55
40
0
1981 1968
NCKASE - 270.9%
Source: State Department of Alcohol and Drug Programs
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Medical Examiners throughout the State of California reported an increase in
cocaine overdose deaths of 270.9 percent in the five year period from 1981 to
1986. The smoking of cocaine has become a much more frequent route of admi-
nistration. Toxic levels of cocaine are reached much more quickly when cocaine
is smoked. The compulsion to continue the high leads to extremely toxic levels
of cocaine which may result in death.
CALIFORNIA
COCAINE RELATED DEATHS COCAINE ER MENTIONS
450 3.5
437 3,451
40CY
3
35
V 2.5
30or
o
25 2
'\
200 0
F 1.5
150
W 1
10
69 527
0.5
5
01 0
1981 1986 1981 1986
INCREASE = 533.3% INCREASE = 554.8%
IN 5 YEARS IN 5 YEARS
Source: State Department of Alcohol and Drug Programs
Additional statewide indicators which illustrate the magnitude of the cocaine
problem are illustrated above. The Federal Drug Abuse Warning Network (DAWN)
reports that, within the three major metropolitan areas in California (Los
Angeles, San Diego, and San Francisco) used in their national sample, cocaine-
related deaths increased 533.3 percent over the same period. In the same three
metropolitan areas, cocaine-related emergency room mentions increased approxima-
tely 554.8 percent.
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CALIFORNIA
COCAINE ADMISSIONS
13-
12-
11-
10-
9-
15-
z
3 12111098Z w
O
V1 : 7
N o
6
Q
5 4,719
4-
3-
2-
1 321
0
1983 1987
INCREASE 168.8%
IN 4 YEARS
Source: State Department of Alcohol and Drug Programs
There has been a statewide increase of 168.8% in the number of people being
admitted for cocaine dependency in the four year period from. 1983 to 1987.
Persons entering treatment facilities for cocaine dependency represent approxi-
mately 14 percent of all treatment admissions. The number of persons admitted
for smoking CRACK cocaine is increasing at a dramatic rate as illustrated in
the following graph .
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CALIFORNIA
COCAINE: ROUTE OF ADMINISTRATION
TRENDS 1983-87
TOTAL OF ALL ROUTES
12-
10-
z
210z a-
0
N
p C
Q D
0 c 6 SMOKING
M i.
D %" INHALATION
z
4- i
2
j
!NJEC'!0N
0 ...................................................................................... ORAL AND OTHER
1983 1984 1985 1986 1987
SOURCE: CAL—DADS
SOURCE: California State Department of Alcohol and Drug Programs
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ADMISSIONS FOR COCAINE TREATMENT
Contra Costa County. 1983 and 1987
240
222
z 200
Z
U
O
U
0 160
4.
z
O
vNi
120-
C)
W 80
M
z
40 38
0
1983 1987
INCREASE = 484% IN 4 YEARS
Source: State Department of Alcohol and Drug Programs
In Contra Costa County we have seen a 484 percent increase in the number of
treatment admissions to our drug treatment programs for cocaine dependency from
1983 to 1987. We have also witnessed a startling increase in the number of
alcohol dependent patients who also have major CRACK/cocaine dependency
problems . An ever increasing percentage of these clients are dependent on CRACK
cocaine. While this treatment data is indeed dramatic, it does not begin to
portray the overall impact that the cocaine crisis has had on other sectors of
the Health Services Department and the Social Service and Probation Depoartments
as well . As documented in the following section, which is based on interviews
of those most closely associated with this crisis, the impact is vast and
changing rapidly.
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4
CONTRA COSTA COMMUNITY ANALYSIS
To prepare for these changes, the Contra Costa County health care system
must examine major environmental trends and their implications. This is par-
ticularly true with respect to the volatile and dynamic nature of crack use
which has not only increased dramatically in the last few years, but the
effects of this drug, in each case, has had profound effects on the individual
user, the family and the community. The following community analysis is based
in large part on an in-depth survey of over 50 community members, elected offi-
cials and health care professionals as well as extensive, invaluable information
provided by Probation and Social Services Departments .
° REGIONAL
Research has shown that drug preference is determined in part by
variables such as age, ethnicity, peer groupings and residency. In the
case of CRACK use, survey respondents consistently reported that the
smoking of cocaine is a particular problem in lower income areas of
Richmond and Pittsburg. This in no way diminishes the critical problem
with abuse of drugs in other geographical areas of the County, but it
serves to highlight the profound effect which this particular drug has
on these communities. The problems associated with the CRACK crisis
in these communities manifests itself not only through increased levels
of drug dependency but through increased levels of homelessness, child
abuse and AIDS. The resulting trafficking in cocaine also becomes a law
enforcement problem which further adversely effects these communities.
This area of concern was highlighted in the Drug Summit, sponsored by
the Board of Supervisors, held in February of this year.
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° DEMOGRAPHIC
CRACK abuse disproportionately effects ethnic minorities and youth.
Youth are adversely affected either because they make up a high propor-
tion of the cocaine dependent population or because they reside in fami-
lies where a family member may be cocaine dependent. In either case, the
destructive effect of this drug on children and youth is tremendous .
Survey respondents consistently reported that this epidemic is creating
severe hardships for lower income black communities . All communities
are at risk, but the black , lower-income communities are currently
bearing the brunt of this epidemic.
° USER PROFILE
- CURRENT
The profile of the CRACK user tends to be a young adult who has
been involved with some use of other drugs and who probably has
not previously received drug abuse intervention or treatment ser-
vices . During the initial phases of the cocaine epidemic, mid
1970' s to early 1980' s, the dependent person tended to be middle-
income and better educated. That profile radically changed once
"rock" cocaine, CRACK, began to be openly sold on streets for as
little as $5 per rock . This newly addicted, less affluent popula-
tion, can afford the drug, but cannot afford appropriate treatment
services . Additionally, prospects for a successful recovery
are lessened where education levels and income levels are lower.
Addiction to CRACK is a very rapid process . Users of this form of
cocaine report adverse physical , psychological , and
social/financial consequences within months of their initial use.
CRACK abuse disproportionately affects minority communities . A
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recent study by the National Institute of Drug Abuse's - Drug
Abuse Warning Network (DAWN) found that from a sample of 750
hospital emergency rooms and 87 medical examiners or coroners
around the country in 1986, Black patients accounted for more than
half of the emergency room overdose episodes related to cocaine
or heroin use.
° FUTURE
Many experts are predicting that the use of CRACK will spread to
suburban middle-class areas . In reality, it is already there, and
we delude ourselves if we do not acknowledge that fact. The high
risk population will continue to be young adults who routinely
engage in other high risk behaviors . The smoking of other types
of psychoactive substance may increase in popularity.
SOCIAL COSTS
° HEALTH SERVICES
- PERINATAL SUBSTANCE ABUSE
° It is estimated that of the approximately 11,000 births per year
to Contra Costa residents between 330-550 are cocaine exposed
babies .
- SEXUALLY TRANSMITTED DISEASES AND AIDS
° Crack is a major component in the County' s syphilis epidemic,
especially in West County as abusers turn to prostituion to
support their habit.
° It is reported that County wide there are nearly four times the
number of syphilis cases this year as compared to two years ago
(200/60) .
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° There has been a significant increase in the number of congenital
syphilis cases .
° Medical and Public Health officials predict that the syphilis epi-
demic will precede increases in AIDS cases.
- DUAL DIAGNOSIS
° CRACK and other drugs can mimic or cause mental illness
symptoms .
° For a significant number of clients admitted for treatment
as mental health patients, the psychopathology disappears once
detoxification from the drug is completed.
° Reports suggest that 20% of people in Napa State Hospital may not
need to be there if they were not using cocaine or others drugs
including alcohol .
- VIOLENCE RISKS
° County employees expressed concern about their personal
safety when dealing with drug users, particularly CRACK
users . They suggest that the Health Services Department develop
policies and training to assure their safety.
- YOUTH AND FAMILIES
° Substance abuse programs report counseling many more school aged
children who are (1) depressed because their parent uses cocaine,
(2) exhibiting unusual emotional problems because of parental drug
use, and/or(3) at high risk of running away from home because of the
negative home environment.
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° Child abuse and neglect resulting from parental use of drugs, as
observed by Public Health Nurses, Maternal and Child Health Care
providers, is of major concern due to almost daily referrals to
Child Protective Services.
° The High Risk Infancy Program reports that 60% of the referrals to this
program are drug related cases .
° Lack of Foster Care homes, lack of training for Foster Care
Parents in caring for difficult babies, i .e. CRACK born
babies, lack of adequate pay for caring for difficult
babies , are recurring themes on a countywide basis .
° Family members of cocaine users frequently present through
Emergency Rooms with stress related complaints.
° SOCIAL SERVICES
° At least 50% of homeless families are either drug/alcohol abusers
themselves or victims of same.
° In East and West County at least 80% of homeless and other
emergency assistance referrals are due to drugs . Often, clients
are evicted by their families because of failure to pay rent or
because they destroy property.
° About 70% of single homeless males may be substance abusers.
° Current statistics estimate that at least 25% of the Child Welfare
intake referrals are specified as drug related; the actual numbers
of drug related cases comprise one-third to over half of total
caseloads .
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° 81 Child Welfare clients were tested for drugs/alcohol in
December, 1988. This Health Services drug testing service
started last year costs about $3,000 per month.
° Drug abuse is the major reason that more infants are entering
the foster care system. goster Care rates and services have
not kept pace with the special needs of drug-exposed infants .
° PROBATION
° Statistical information regarding referrals to Probation for
cocaine offenses show a dramatic increase. For the first three
quarters of 1986 there was a total of 429 referrals and for the
same period of time in 1988, there were 726 referrals. This repre-
sents a 69% increase in cocaine referrals over the two year
period.
° Increased drug offense arrests and convictions have seriously
impacted Probation supervision workloads .
° The Probation Department has approximately 4,500 misdemenants, 500
drug diversion cases and 1 ,700 juveniles . The overall supervision
caseload has been increasing at a rate of approximately 5% a year.
° A study in 1978 showed that there were 1,637 adults on Probation
(misdemeants and felons) for specific drug violations, amounting to
approximately 22% .of the total supervision caseload.
° Probation staff estimate that 75% to 90% of the adult probationers
have had various degrees of involvement in illicit drug use.
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PROGRAMS IN PROGRESS
It should be made clear that Contra Costa County has already begun addressing
this problem. The 1988-89 Multi-Year Plan for the Provision of Drug Abuse
Services describes many of the publicly funded drug abuse services which are
currently being provided to our residents. Further, several innovative programs
focus specifically on the CRACK abusing population, among them are:
° ADAPT COMMITTEE - This is a multi -disciplinary group of professionals
which is focusing on identifying prevention, intervention, and treatment
strategies for the perinatal substance abusing population . ADAPT is an
acronym for Alcohol and Drug Abusing Parents Task Force.
° GIDE COMMITTEE - This is a group of professionals who are working towards
establishing uniform methods for all hospitals to utilize in identifying
drug exposed infants. GIDE is an acronym for Guidelines for Infants with
Drug Exposure.
° DUAL DIAGNOSIS SERVICES - Through a federal grant in West County residen-
tial services are currently being provided to area residents who are
severely mentally ill and who have substance abuse problems . CRACK abuse
in the severely mentally ill population is becoming of greater concern .to
mental health professionals .
° ALCOHOL SERVICES - Many clients who present with primary alcohol problems
also have very significant problems with CRACK abuse. While all alcohol
programs deal with the CRACK problem to some degree, a program of special
note is the RECTORY in WEST County which provides residential services
for alcohol dependent mothers and their children. Many of these mothers
are also addicted to CRACK.
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° DRUG ABUSE SERVICES - Increased outpatient counseling services are being
developed in West, Central and East Contra Costa County. These expanded
programs will target the CRACK abusing population through intensive out-
patient services.
° BORN FREE PROJECT - Is a new program which identifies high risk mothers
who deliver at Merrithew Memorial Hospital . The purpose of this program
is to provide intervention and counseling services to mothers who have
drug dependency problems . The drug dependecny problem which is most fre-
quent now is the use of CRACK.
These programs represent just some of the areas in which the Health Services
Department is attempting to address this tragic epidemic. Only through
increased resources and greater public involvement will programs such as these
be truly effective in the war on CRACK .
TASK FORCE RECOMMENDATIONS
The initial goal of the task force was to assess the impact of the CRACK epide-
mic on the Health Services Department and its clients and to make recommen-
dations for confronting this crisis . It soon became evident, however, that a
larger perspective was needed, one that included the Social Service and
Probation Departments as well , and addressed the impact on Contra Costa County's
health and human services generally.
It is with this larger perspective in mind and with the recommendations of the
many interviewees that the task force has identified five major areas in which
to concentrate resources in the short terms as we increase our efforts to erra-
dicate the CRACK cocaine problem.
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The five recommendations are:
Prenatal/Perinatal Services
° Develop improved assessment, interventioin and treatment services for the
perinatal substance abusing population .
° Institute universal blind toxicology screening of mothers to ascertain
the prevalence of drug use among pregnant women .
° Support Medi-Cal reimbursable case management services for pregnant
addicts .
Training and Education
° Improve educational efforts directed to women at risk for cocaine abuse.
° Provide increased levels of education and training for all human service
providers of the cocaine dependent population .
Treatment
° Provide intensive outpatient services with emphasis on multidisciplinary
team approachs .
Policy Development
° Develop policies, procedures and training which address violence risk
factors to those providing services to the cocaine dependent population .
Data Collection
° Improve and incorporate better systems for collecting information
and reporting data.
° Insure consistency of reporting among various providers of services
to this population .
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Other Recommendations for Consideration
There were, of course, many suggetions beyond the five areas identified
above, and we intend to incorporate them in our long term efforts.
° Provide funding for residential facilities to include transitional living
homes for cocaine recovering addicts with emphasis on women and children
to ensure family preservation .
° Continue to develop drug specific prevention efforts through the use of
mass media and technical assistance to current prevention service
providers.
° Provide outreach and other services to the CRACK addicted homeless
population .
° Review and study compulsory treatment options .
This document is merely a starting point; much work remains to be done. We
expect to revise projections and change priorities as we gain more knowledge and
acquire better data. The task force will remain a vital part of this effort.
The members will serve as advisory to the Health Services Department, each
offering their various perspectives and expertise on the CRACK cocaine problem.
They will also be invaluable in the planning efforts for Drug Summit II sche-
duled for the fall of 1989.
Conventional wisdom is that recovery is a process not an event. So, too, can it
be said that the confronting of the CRACK epidemic is a process , not an event,
which will take considerable commitment of time and resources over the fore-
seeable future.
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APPENDICES
APPENDIX I
SAMPLE OF INTERVIEWEES' RESPONSES
"Two years ago the crack problem was not as hard and heavy in the Mental Health
population. The program saw clients who used marijuana, alcohol , or snorted
cocaine. In the last year crack has become on the rise and 85% of all
admissions to the program are crack users. In the Richmond area, clients are
now mixing crack with PCP, which is even more devestating."
Toki Bangoko, Program Director
Nyumba Chuki
"There is a qualitative change in Public Health Nurses' caseloads . They're
seeing more problems associated with crack"
Dr. Wendel Brunner, Asst. Health Services Dir.
Public Health
"Crack is a major component in the syphilis epidemic that is being felt in West
County. This epidemic, felt by medical and public health officials, is going to
presage major increases in AIDS cases . The vector seems to be that women, who
are addicted, prostitute themselves in order to support their drug habits ."
Dr. Kim Duir, Family Practice Physician
Richmond Health Clinic
"Health Services must develop policies regarding the safety of its employees
against drug users ."
East County
Public Health Nurses
"These children do not fit any pattern: can' t learn, fall apart emotionally,
they are learning disabled, and there is abstract reasoning. The problem is
too big for the Health Department to take on without connecting with the school
substance abuse programs ."
Joe Shippo, Special Educ. Day Care Teacher
County Office Of Education
"School personnel are beginning to panic because they are realizing that drug
effected children are now beginning to enter the school system and how to deal
with these children remain a mystery."
Nancy Torres, Special Educ . Day Care Teacher
County Office Of Education
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"Patients present with problems related to lifestyle. The Emergency Room sees a
lot of violence related to cocaine use such as gunshot, stab, and physical
altercation wounds ."
Dr. Tom Padgett, Director Emergency Services
Brookside Hospital
"There is a substantial increase in the number of pregnant women presenting who
are in premature labor, who are aborting spontaneously, who are being admitted
with placenta abruptio, and who are delivering premature babies. All of these
conditions are suspected to be due to cocaine use."
Sally Tueckes, R. N. , Obstetrics
Los Medanos Hospital
"Over the past 12 years there have been a continual increase in the number of
admissions with crack as a secondary drug of addiction . Even though the
admitting diagnosis is alcoholism, in a very short period the program assesses
that the real problem is crack, which is a manipulation for bed space."
Peggy Spitler, Counselor
Tri County Women' s Recovery Services
"The newest thing being seen here is children contacting this agency through
referrals from schools, requesting information about their crack using parents .
These youths are presenting with a number of problems such poor school perfor-
mance, nightmares, assuming parental roles in the family system and running away
from home."
Linda Schaefer, Program Director
Tri -Cities Discovery Center
"Programs that combine treatment, shelter, and children are needed, e.g. most
shelters will not accept battered, addicted women and most treatment facilities
will not accept an addicted, battereTwomen ."
Laura McKenna, R.N.
Battered Women' s Alternative
"85% of clients have crack/cocaine or alcohol problems . Drug problems increased
in the last two years . Financial assistance is counterproductive with this
population . Service needs include: transitional housing; work requiredments;
education; and strict enforcement of legal penalties; crack/cocaine users are
most manipulative and dishonest."
Malcolm Lee
Richmond Rescue Mission
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"Crack seems to be the perfect drug for young people. Unlike marijuanna, crack
is an easy to use, cheap, and consistently quick high . GA, Homeless , and other
financial assistance programs actually do more to enable addicts than to help
them. Current regulations have to be carefully explained and then strictly
enforced for this population ."
John Boylan
Social Worker
"Crack seems to have a more instant and profound effect; users lack motivation
to stop even though they love their children . More residential programs are
needed; we need a "methadone" for crack."
Linda Waddington
Child Welfare Division Manager
"In the majority of times crack is smoked; occasionally crack is taken orally or
drunk mixed with wine coolers called "crack coolers" , or sometimes it is drunk
in plain water."
Dr. Darryl Inaba, Pharmacist
Haight-Ashbury Clinic
"We've seen older people (40 to 70 years old) in this area who use drugs and who
deal drugs . Older people need contact with people because some of them are lonely
and they' ll do anything to keep contact with the real world."
Lillie Mae Jones, Resident
Richmond, CA.
"From an overall operational perspective, crack has not had a major devastating
impact on the hospital . From a clinical perspective, it' s had an impact on the
prenatal area. That is clearly where we are seeing an impact.
Frank Puglisi , Executive Director
Hospitals and Clinics
Merrithew Memorial Hospital
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APPENDIX II
COCAINE TASK FORCE MEMBERS
Mark Finucane, Director Health Services Department
Lorna Bastiar, Assistant to the Director
Gale Bataille, Deputy Director, Alcohol , Drug Abuse and Mental Health
Wendel Brunner, M.D., Director Public Health Division
Barbara Cross, Regional Mental Health Chief, West County
Chris Dailey, Associate Director For Patient Care, Merrithew Memorial Hospital
Chuck Deutschman, Drug Program Chief
Mary Foran, Coordinator, Maternal and Child Health Care
Adanna Henry, Chief Staff Person
Wilhelmina Johnson, Family Services Program Spec ., Social Services Department
Larry Leal , Adult Division Director, Probation Department
Stuart McCullough, Director, Alcohol , Drug Abuse and Mental Health
Jerry Nava, Alcohol Program Chief
Frank Puglisi , Executive Dir., Hospitals and Clinics, Merrithew Memorial Hospital
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APPENDIX III
INTERVIEWEES
NAME TITLE ADDRESS
Supv. Tom Powers District I 100 38th Ave.
Richmond, CA
Supv. Nancy Fanden District II 805 Las Juntas
Martinez, CA
Supv. Robert Schroder District III 1410 N. Main St.
Walnut Creek, CA
Supv. Sunne Mc Peak District IV 2301 Stanwell
Concord, CA
Supv. Tom Torlakson District V 300 E. Leland Ave.
Pittsburg, CA
Steve Allen, Ph.D. Regional Mental Health Director, 2025 Pt. Chicago
Central County Pittsburg, CA
Mercedes Anderson Public Health Nursing Staff, 100 38th St .
and Staff West County Richmond, CA
Sharon Bacon Child Welfare Worker 30 Muir Rd.
Martinez, CA
Toki Bangoko Director, Nyumba Chuki 3215 Nevin Ave.
Richmond, CA
Joe Barger, MD Emergency Room Physician 2500 Alhambra Ave.
Merrithew Hospital Martinez, CA
Gale Bataille Deputy Director, A/DA/MH 595 Center Ave., #200
Martinez, CA
John Boylan Social Worker 4545 Delta Fair
Antioch, CA
Wendel Brunner, MD Public Health Division Director 20 Allen St.
Martinez, CA
Jack Champlin Director, Horizon Center 2244 Pacheco Blvd.
Martinez, CA
Yvonne Chevalier Child Welfare Social Worker 4545 Delta Fair
Antioch, CA
Chris Dailey Associate Dir, of -Patient Care 2500 Alhambra Ave.
Merrithew Hospital Martinez, CA
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NAME TITLE ADDRESS
Marie Daniels Dir., San Pablo Discovery Center 1524 Rurill
San Pablo, CA
Steve Daniels, MD Pittsburg Health Clinic 525 School St.
Pittsburg, CA
Everett Davis, Ph.D. Chair, Richmond Neighborhood Oakland Naval Base
Coordinating Council
Mike Donnally Emergency Room Supervisor 2500 Alhambra Ave.
Merrithew Hospital Martinez, CA
Kim Duir, MD Richmond Health Clinic 100 38th St.
Family Practice Clinic-Martinez Richmond, CA
Hope Ewing, MD Medical Director BAART-Pittsburg 45 Civic Dr.
Family Practice Clinic, Pittsburg 525 School St.
Director, Born Free Project Pittsburg, CA
Mary Foran Maternal & Child Health 595 Center Ave.
Coordinator Martinez, CA
Donna Harbaugh Eligibility Worker 30 Muir Road
Antioch, CA
Marge Harmon Foster Care Rate 2401 Stanwell Dr.
Program Analyst Concord, CA
Joseph Hartog, MD Medical Director, A/DA/MH Div. 2500 Alhambra Ave.
Martinez, CA
Don Holcum Social Worker, Psychiatry 2500 Alhambra Ave.
Merrithew Hospital Martinez, CA'
Darryl Inaba Pharmacist, Haight-Ashbury Clinic 409 Clayton
San Francisco, CA
Lillie Mae Jones Resident, City of Richmond 258 6th St.
Coronado Neighborhood Richmond, CA
Linda Kirkhorn, RN Director, E Ward 2500 Alhambra Ave
Merrithew Hospital Martinez, CA
Norman Kruse High Risk Infancy Program 595 Center Ave.
Martinez, CA
Malcolm Lee Director, 200 Macdonald Ave.
Richmond Rescue Mission Richmond, CA
Francesca LoPorto Director, BAART Richmond 2910 Cutting Blvd.
(Resigned) Richmond, CA
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NAME TITLE ADDRESS
Jeff Mandel , MD Medical Director, Martin Luther 101 Broadway
King Health Center Richmond, CA
Jewel Mansapit Program Analyst 2401 Stanwell Dr.
General Assistance Concord, CA
Iris Mazaroff, RN Manager, Perinatal Ser,.- ices 200 Vale Rd.
Brookside Hospital San Pablo, CA
Stuart McCullough Director, A/DA/MH Div. 595 Center Ave., #200
Martinez, CA
Laura McKenna, R.N. Director of Research and (Anonymous)
Program Development
Battered Women' s Alternatives
Steve Mitchell Director, Holloman Detox Center 208 23rd St.
Richmond, CA
Kareen Morgan Supervisor, Information and 1305 Macdonald Ave.
Referral Unit Richmond, CA
Soicial Services, West County
Beverly O'Halloran Director, Public Health Nursing 2450 Stanwell Cir.
Concord, CA
Larry Organ Asst. To Supv. Powers 100 38th St.
Richmond, CA
Tom Padgett, MD Director, Emergency Room Sercives 200 Vale Rd.
Brookside Hospital San Pablo, CA
Gayle Page Child Welfare Unit Supervisor 3055 Research Dr.
Richmond, CA
Steve Peavler Child Welfare Intake Supervisor 30 Muir Rd.
Martinez, CA
Stafanie Pfingstl Child Welfare Program Analyst 2401 Stanwell Dr.
Concord, CA
Jonah Powell Director, Fredrick Ozanam House 2931 Prospect St.
Concord, CA
Frank Puglisi Executive Director, Hospitals & 2500 Alhambra
Clinics , Merrithew Hospital Martinez, CA
Ed Sanchez Mental Health Treatment Spec. 232 Broadway
Richmond Adolescent Treatment Richmond, CA
Program
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i
NAME TITLE ADDRESS
Linda Schaeffer Director, Tri-Cities Discovery 3654 San Pablo
Program Dam Rd.
El Sobrante, CA
Michael Simens East County Alcohol Detox Prog. 500 School St.
and Staff Pittsburg, CA
Ted Signet Medical Records Manager 2500 Alhambra Ave.
Merrithew Hospital Martinez, CA
Peter Strauss Director, San Ramon Valley 350 Rose St.
Discovery Center Danville, CA
Sally Tueckes, RN OB/GYN 2311 Loveridge
Los Medanos Hospital Pittsburg, CA
Jan Tompkins Program Analyst for 2401 Stanwell Dr.
Homeless Assistance Concord, CA
Marc Usatine, MD Obstetrician Kaiser Hospital
Walnut Creek
Linda Waddington Child Welfare Division Manager 3055 Research Dr.
Richmond, CA
William Walker, MD Medical Director, Health Services 20 Allen St.
Martinez, CA
Carol Walsh Unit Supervisor 4545 Delta Fair
Emergency Response Intake Antioch, CA
Pat Walters Director, Shennum Detox Center 2090 Commerce Ave.
Concord, CA
Franz Wasserman, MD Director East County Mental 525 School St.
Health Pittsburg, CA
Laudemia Winniford Public Health Nursing Staff, 525 School St.
and Staff East County Pittsburg, CA
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