On the front lines--the public treatment clinics to which cocaine and heroin users are flocking in unprecedented numbers--the President's war on drug abuse in Los Angeles County is not faring so well.
Space is short, dollars scarce and, despite a new outbreak this summer of tough anti-drug rhetoric from Sacramento to Washington, the future looks grim. Budget cuts in recent years have undermined the county's ability to cope with the treatment demand triggered by runaway drug use among the poor and now the middle class.
While high-priced clinics catering to upscale drug users seem to be opening on every corner, the road to recovery for those who cannot afford five-figure treatment programs is getting longer and longer.
The homeless, the poor and a growing number of middle-class users who lack the money or insurance for private care, now wait up to four months to enter county-contracted clinics, where treatment is free or provided at a reduced fee.
Since 1982, one-third of all publicly supported drug treatment services in the county have been cut because federal and state dollars--which finance 90% of those services--have not kept pace with program costs or needs.
Only 2 Centers for Teens
"The situation is serious. . . ," said Irma H. Strantz, director of the county's drug abuse office. "But politically, people don't feel they can cut services for children or the elderly to free up dollars for some nasty drug abuser. It is simply not high enough on some people's priority list."
Program shortages are particularly acute for the homeless, unwed pregnant mothers and adolescents. For example, only two centers, with 40 beds, are available for teen-age drug users in the entire county.
The cuts have come at a time when drug use among the county's down-and-out is on the rise.
Cocaine, in a new and highly addictive rock-hard form known as "crack," has never been cheaper or more plentiful on the streets. County heroin use and related deaths are also increasing, according to law enforcement officials.
"It's not hard to find cheap drugs," one narcotics investigator said, "and with a little initiative, a guy living on the street can finance a habit real easy."
Many street users steal or peddle drugs or even sell themselves to feed their personal habits. It is a debilitating cycle that eventually prompts some to seek help, but now help is almost impossible to find.
No longer are public drug clinics the private domain of the poor. Today the poor compete for a precious few public treatment slots with the middle class--the auto mechanics, housewives and even stockbrokers who have fallen to the power of cocaine in huge numbers in recent years but cannot afford to pay up to $20,000 for a six-week recovery program at a private institution.
Middle-Class Addict Favored
County officials acknowledge that when push comes to shove, the indigent drug user is sometimes passed over in favor of the middle-class addict who has the ability to pay for at least some care.
To weary clinic operators, frustrated by failures to keep many poor patients drug-free, middle-class users are a welcome sight. They are better-educated, usually have a shorter history of drug use and generally are more motivated to go straight. In short, officials say, middle-class users often have a head start when it comes to licking drug habits.
"Many of them had something before they discovered drugs--a family, a house and a career," said Rene Topalian, assistant director of the county's drug abuse program. "If you know what you've lost, you are willing to work harder to get it back. And to a counselor who has been burned, you offer him a candidate that has a good chance to succeed."
The treatment network, Topalian said, is "badly overloaded." As a result, he added, "it's forcing a lot of people to make some hard choices about who to treat first."
Scores of homeless and poor addicts are learning the new rules of the county treatment game the hard way.
Take one Los Angeles user named Richard, who declined to give his last name. He's broke and into heroin, a lot of it, and now he wants help. He's been on a waiting list for a bed at Cri-Help, a public drug clinic in North Hollywood, for two months but realizes that it will be weeks before his number is called.
"I'm using, and I've got to get off this stuff soon," he pleaded recently with a Cri-Help counselor in the clinic's lobby. "Can't you pull some strings? Please?"
"I'm sorry," the counselor replied. "The whole world is using. I can't help. You have to just keep coming back."