THE WYOMING METH INITIATIVE

         Promise, Progress, and Unfinished Business

By Steve Erickson and the Citizens Education Project, October 2004

“People still have the bias that if we could all be good parents and everyone would follow Nancy Reagan’s ‘Just Say No’ approach to drugs and addiction, the problems would go away.  If that were true, we’d all be skinny.”  Linda Acker, Executive Director, Southwest Wyoming Counseling Center

“I estimate that 80% of the crimes in Casper referred to detectives are meth-related.”  Tom Pagel, Chief of Police, Casper, Wyoming.

KEYS TO SUCCESS OF THE METH INITIATIVE

Educating the public, garnering public support for comprehensive solutions.

Tom Pagel is a cops’ cop.  Smart, experienced, articulate, a no-nonsense leader.  Tough on crime.  At first blush, he seems an unlikely candidate to spearhead a campaign to reform Wyoming’s approach to drug abuse. But in 1992 through 1994, when detectives and narcotics officers alerted him as the head of the Wyoming Division of Criminal Investigation to a rapid rise in methamphetamine-related crimes, he realized “we can’t arrest our way out of this problem’.

“We started seeing so many young men and women, adolescents, even school children, getting hooked on meth, people from all social strata, we knew we had a new phenomenon to deal with, that to get on top of it would require more than traditional law enforcement,” Pagel recalls. 

In the early 1990’s, clandestine meth labs began popping up all across Wyoming, and lab busts skyrocketed. Later, meth started flooding in from Mexico as well, distributed through established gangs, moving west to east through rural western communities.  Production and transportation costs were low, profits huge.  For the user, meth delivers more bang for the buck – it’s cheap and the high lasts many hours longer than that of cocaine, then the drug of choice of serious drug users.  Meth is highly addictive.  There are no “casual users” says Pagel.

Pagel chaired the Governor’s Substance Abuse and Violent Crime Advisory Board, and he shared his alarm at the rising numbers of meth arrests with board members.  His concerns were echoed by representatives of the state health department, corrections, and family services.  The Board recognized that Wyoming had a worsening meth problem, and determined to develop a strategy to confront it.

“We knew we didn’t have good, solid data on the extent of the problem, and that until we had that, we couldn't make informed policy recommendations,” Pagel says.  Getting better statistical picture of substance abuse in the state was the first step.

Promise

With federal funding, Wyoming contracted with the PAXIS Institute of Tucson to collect data and conduct a number of surveys between 1996 and 1999.  PAXIS CEO Dennis Embry and Bernard Ellis, an epidemiologist and health professional with 25 years of experience in drug abuse research, became major players in the process that became the Meth Initiative.  What they found was disturbing, and compelling.

Methamphetamine arrests as a percentage of all drug arrests jumped from 18% in 1993 to 57% in 1998.  Total drug arrests tripled.  Meth lab cases increased from 3 in 1997 to 20 in 1999.  Estimates in 1998 were that meth users needing treatment numbered nearly 6000 – more than 1% of the population.  Only 1 in 10 received it.  Treatment centers were reporting that the drug of choice for over half of their clients was methamphetamine, and that 63% of drug addicts were victims of sexual abuse.  One in ten high school juniors and seniors could be classified as drug dependent.

While Embry, Ellis, and other researchers were compiling the evidence, Pagel hit the road, traveling to all corners of the Cowboy State to educate – and learn from the locals – about the threat of methamphetamine to their families and communities.  “I don’t know how many thousands of miles I drove in the late ‘90’s, but I’d drive anywhere to meet with people about the meth menace,” Pagel says.  “It didn’t matter if there were six or sixty people, so long as we got the word out.” 

Pagel had the standing, the credibility of a tough cop, and when he talked about the need for treatment as well as law enforcement, people listened.  Gradually, the awareness of the gravity of the meth problem grew, and communities started to look for solutions.

One key trip for Pagel and other members of the Governor’s Advisory Board was a visit to Center Point, a respected therapeutic community offering intensive residential treatment services in San Rafael, California.  They were impressed by Dr. Sushma Taylor and her staff, and by the success of the program.  They also realized that Wyoming had no similar long-term residential treatment options for Wyoming addicts.  Pagel and the Board became committed advocates for improving and expanding drug treatment.

When the time came to approach the Legislature for a comprehensive response to the meth crisis, Rodger McDaniel emerged as the key political strategist and advocate.  A remarkable man with an impressive resume, McDaniel’s devotion to the cause was highly personal and unwavering.  An ordained minister, former trial lawyer, and former member of both the Wyoming House and Senate, he was well known and respected, and he knew how to make the legislative wheels turn.

“I felt that the campaign had to be run like a trial.  Trial lawyers think backward from the result they want to achieve, then pursue each step in the case toward that end result,” McDaniel says.  “Teamwork at the top was critical to reaching that ‘tipping point’ where we could be successful, and we had that.  But grass roots support was also key to getting legislative support, so we took the campaign to parents, schools, churches, and had heavy involvement from treatment clients.”

McDaniel and Pagel made a formidable team of leaders, and their mutual admiration and friendship is apparent.  With support from the Governor, the Advisory Board, and the state departments of corrections, health and human services, a proposal was developed to establish pilot programs in drug treatment, intervention, and prevention programs statewide and in selected counties.

KEYS TO SUCCESS OF THE METH INITIATIVE

Developing solid data on the extent of the problem and need for effective interventions.

Progress

The team approached legislative leaders and found a dedicated sponsor in Representative Doug Osborn (R-Buffalo).  Osborn served on the Labor, Health, and Social Services Committee (which he now chairs), and was a strong proponent of tobacco cessation and prevention.  Together with McDaniel and Pagel, and armed with Ellis’ data, Osborn met with and enlisted the aid of Senate Appropriations Chair Tom Kinnison, Senate leaders Schiffer, Hanes, and Scott, and House leaders Wasserburger and Paraday throughout 1997.  Pagel recalls one particularly powerful legislative hearing.  “We brought six girls from the Wyoming Girls School to speak to three legislative committees.  I asked them how long it would take them to score meth at school.  They answered immediately or by the end of the class period.  It shocked and scared legislators.”

Despite the tight budget, a $3.2 million appropriation launched the Meth Initiative in 1998.  A year later, the Legislature extended the Initiative through 2001 with another $5.2 million.

With this seed funding, the state’s first drug court was established in Uinta County and two more drug courts were later added, a long-term residential treatment program was opened in Sheridan, outpatient programs were created for drug offenders on probation and parole, educational literature for parents and families was distributed, and a program monitoring and evaluation system initiated.

By the end of 1999, the initiatives were showing promise and progress, the new drug court especially, and the advocates decided it was time to go back to the Legislature with new proposals.  Pagel approached the Labor committee during the 2000 legislative session and convinced them to create a five-member subcommittee to meet during the interim to prepare strategies and bills for the 2001 Session. 

The subcommittee did its homework, spending four days in Cheyenne and Sheridan meeting with front line treatment staff and their clients, law enforcement officials, and citizens. McDaniel and Osborn, with backing from the administration, courts, corrections, and treatment providers, won the unanimous support from the subcommittee for expanding the drug court system and developing a long-term, comprehensive plan for dealing with substance abuse.

That support carried over into the 2001 Legislature, which passed by overwhelming margins HB 82, funding a $1.7 million expansion of drug courts statewide from three to17, and HB 83, providing $300,000 to the Health Department to develop a comprehensive blueprint for substance abuse interventions.  McDaniel and Embry, with significant contributions from Rep. Osborn, DOH Director Gary McKee and Substance Abuse Division Director Diane Galloway, authored the 300-page “Reclaiming Wyoming” plan, and presented it to the Labor Committee in November.

McDaniel understood “we had to be careful about not over-promising the Legislature.

We kept them informed as full partners in the planning.”   Legislators were sent bullet points on various studies, research on treatment issues.  “We made them knowledgeable enough to talk to their constituents about the subject,” McDaniel recounts.  “We also stressed accountability, applied equally to providers and to addicts, creating standards and expectations for all to follow.”

Plan in hand, the challenge for the 2002 Session was finding the money.  There was strong support in the Legislature and its leadership for implementing the blueprint, but it was another tight budget year.  The heavy lifting fell to Osborn, who proposed using Tobacco Settlement Funds to finance the proposal, HB 59, the Addicted Offender Accountability Act.

“I was a leading proponent of anti-tobacco programs, and had argued that we put the settlement money, about $20 million a year, into a trust fund so that it wouldn’t get spent on roads or other needs like it has in some states,” Osborn says.  “So when I proposed that we split the money between tobacco initiatives and the substance abuse initiative, I got a lot of heat from my anti-tobacco friends.  I had always been skeptical of the CDC’s recommendation that 100% of the money should be used for tobacco control.  It made sense that some of that money should be used for substance abuse prevention and diversion programs – there was a rational nexus.  Eventually we won over the anti-tobacco advocates.”

Legislators also had to overcome objections from the Wyoming ACLU.  “There were some onerous provisions in the original bill, some serious due process issues,” according to Linda Burt, Wyoming ACLU director.  “One I recall would have made it illegal for pregnant women to buy cigarettes or alcohol.  We support treatment programs, dealing with drug abuse as a public health problem.  And Wyoming has a real problem with overcrowding in the prisons.  Probably 70% are in for drug-related crimes – we can’t just keep stuffing people in jails.  Once we got the bad stuff out of the bill, we supported it,” Burt recalls.

Osborn calls McDaniel as “the spark” behind HB 59, and credits treatment providers and law enforcement and corrections officials for their efforts in helping pass the bill.  Burt agrees. “Rodger brought about a change in thinking about how to deal with drug problems.”  Osborn says “there wasn’t a lot of constituent pressure or calls, but leadership recognized the problem and were supportive.  It was always a nonpartisan issue.  It was personally my most satisfying effort in the Legislature.”

HB 59 appropriated $25 million ($12.5 million per year) for the biennium, with $18.2 million to the Division of Substance Abuse, $1.77 million to Corrections, and $4.9 million to Family Services.  Nineteen existing publicly funded mental health centers got boosts in funding and staffing to address substance abuse, four new residential treatment centers (three for women and children) were established, and two new programs were created in Rock Springs and Sheridan for long term treatment.

Corrections expanded its treatment programs in the prisons, adding 14 staff, and is set to open a new 100-bed privately run therapeutic treatment center in January 2005.

Corrections’ intensive treatment capacity will grow from the 28 new men’s beds funded by HB 59 to 240, and by 2007, women’s treatment beds will double from the current 16 to 32, according to Deputy Director Steve Lindly, the point man for the department throughout the evolution of the Meth Initiative.

More than just the money for new programs, the Act changed Wyoming’s fundamental approach to substance abuse.  Substance abuse assessments for all convicted drug felons were required prior to sentencing, and judges were required to order treatment in most cases.  There was more than an expansion of treatment, there was a change in treatment philosophy.

“Wyoming had long underestimated the need for residential treatment, for new treatment modalities,” says Linda Acker, director of the Southwest Counseling Center in Rock Springs.  “Outpatient treatment was the emphasis, and that just doesn’t work well for meth addicts”, she says.  Mike Huston, director of Casper’s Central Wyoming Counseling Center concurs.  “There was a 28-day limit to inpatient treatment, mostly built on a model for alcoholism treatment and insurance limits.  Best practices, what works best for meth addicts especially, usually means 18 to 24 months of intensive, residential treatment.  HB 59 forced that change to occur,” Huston says.

Uniformity of assessments, use of the same addiction severity index and placement criteria, shared data collection software, and treatment standards are also key reforms, says Lindly.  Corrections’ will now begin using contractors to do all of the substance abuse assessments, according to Lindly.  “The funds will be shifted there - $1 million plus one new position to coordinate.  The interagency coordination and cooperation has been remarkable; there have been few turf issues.”

KEYS TO SUCCESS OF THE METH INITIATIVE

Committed, complementary leaders and interdisciplinary teamwork.

Unfinished Business – The Future of the Meth Initiative

So, two years into the major system reforms fostered by HB 59, what are the results?

By all accounts, it is still too early to tell.

The outcome data isn’t there yet.  The Department of Health has just recently contracted with the state’s Statistical Data Center and the University of Wyoming Survey and Analysis Center to compile numbers and conduct longitudinal studies.  The first evaluation, of the drug courts, should be completed by the end of 2005.  Longitudinal studies of the impact of treatment services may take several years before the data is reliable.

Effectiveness of new prevention and education programs will be difficult to assess.

Huston cautions that the majority of users are 20-30 year old males – oil and gas workers may be the nucleus of users – and they’re often transient, hard to track.

Without question, there have been some very positive impacts.  Lives have been turned around through treatment and support systems.

The nineteen new social workers focused on child endangerment and the new treatment options for women with children have undoubtedly made a difference for dozens of children and families.  “There has been a significant improvement in quality and capacity of services,” says McDaniel.  “We are seeing some initial success through the drug courts, which have the most solid data so far,” Lindly says. 

Linda Acker notes that there has been a huge increase in community awareness.  “People now recognize that they are in danger of losing their communities [to meth addiction],” she says.  The new Sweetwater County Meth Initiative has held three meetings in the past few months, with over 80 people attending each one. “There is a readiness now in southwest Wyoming, supported by the County Commission, that we need to pass a sales tax increase to fund a new building for treatment.”  Pagel organized a statewide meth conference last year that over 700 people attended, and is getting overflow crowds and heavy media coverage for local meth awareness meetings.

The ACLU’s Burt says “we’re not getting complaints, not even one, on either drug courts or the meth initiatives.

Rep. Osborn believes that the Legislature is committed to continue funding and supporting the treatment focus. “I think that funding will grow slowly.  Treatment has moved up in priority, we know we need to boost juvenile treatment and that we’re still short on residential beds,” he says.  “There’s a new direction in corrections to reduce recidivism and establish re-entry programs, we’re talking about expanding drug courts, we’ve just opened the first family court and want to build six more.  We’re studying a children and families initiative, looking at realigning case management, assessing redundancies and gaps in services, involving all social services in state government.

It’s hard to know just yet where our successes and failures are – we’re in continuous monitoring mode – but it helps to have a wonderful budget surplus.”

Yet “the meth problem is bigger than ever,” McDaniel says.  “Caseloads for family services are going up. Huston agrees that “the meth train isn’t slowing down – we haven’t turned the corner yet.”  In Casper, where Pagel is now chief of police, “meth drives 80% of the crimes referred to detectives, and meth was involved in all five murders here last year, “ he says.

It will take time for the system to adjust to the rapid growth of HB 59-driven reforms.  System capacity remains the biggest problem.  More funding for more facilities to serve 

the varied segments of the drug affected population will be needed.  Acker states that there are still waiting lists for treatment, and we haven’t really addressed the problems with adolescents yet.

“All the treatment centers are having difficulty in recruiting qualified treatment professionals – it takes us six months to a year to fill positions,” according to Acker “There’s a psychiatrist deficit nationwide, and it’s hard to attract people to small town Wyoming.”  An exodus of college educated Wyomingites doesn’t help.

Federal drug intervention funds at the local level are drying up as the emphasis has shifted toward homeland security.

Lindly notes “there has not been a reduced need for additional prison beds yet.  We expect there will be over time, but we are projecting a gradual increase in the number of beds needed for the next several years.  We’re in our biggest growth term now, but that should plateau as the population ages and the treatment options come on line.”

In many respects, the battleground in the meth wars shifted to the local level.  The Health Department’s Substance Abuse Division launched new prevention/education materials and programs   McDaniel on schools….

Can other states learn from Wyoming’s experience?  The consensus of Wyoming’s leaders is that there is nothing unique about their approach.  In Osborn’s view, “Any state would benefit from a comprehensive approach.”   Wyoming may have started out farther behind the curve philosophically and in resources and capacity relative to other states, but may also have benefited from its smaller population, less complex governmental structures, and the fact that the major players were more familiar with each other and able more quickly to establish trust and cooperation.  As Steve Lindly says, if we can‘t succeed here, then maybe it can’t work anywhere.”

Linda Burt hopes “we don’t get discouraged.  There will be relapses and failures.  Just like an addict needs to make a lifetime commitment to sobriety, there must be long-term support in communities to achieve the goals of the meth initiative.”

METH INITIATIVE MILESTONES

KEY ELEMENTS OF THE METH INITIATIVE

KEYS TO SUCCESS OF THE METH INITIATIVE

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