Tuesday, May 09, 2000
New program helps AIDS sufferers with drug abuse
By Tim Bonfield
The Cincinnati Enquirer
For most of the past 14 years, David White barely cared what would kill him first — AIDS or drugs.
Mr. White, 43, was diagnosed with HIV in 1986, not long after moving from Cincinnati to Chicago. “Back then, HIV was like a death sentence,” he said.
For no logical reason, the virus that caused friend after friend to wither and die hadn't made him very sick at all. Waves of depression helped push years of alcohol and marijuana abuse into full-blown drug addiction.
Snorting cocaine moved into free-basing then to smoking crack. But the brief highs couldn't chase away the pain. A year ago, after moving back to Cincinnati in 1998, he attempted suicide by swallowing a handful of pills.
“Thank God, it didn't work,” Mr. White said. “I hit rock bottom. In my desperation, I finally decided to seek serious treatment.”
Now, Mr. White is re building his life as one of the first four residents of the Caracole Recovery Community, a new program for people with AIDS and substance abuse problems.
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BRIEF HISTORY OF AIDS
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• 1981: First cases of a “gay-related immune deficiency” reported.
• 1982: Disease gets new name: Acquired Immunodeficiency Syndrome (AIDS).
• 1984: Human Immunodeficiency Virus (HIV), which causes AIDS, identified.
• 1986: Condoms shown to prevent the sexual transmission of HIV.
• 1987: First AIDS medication, AZT, gets FDA approval.
• 1990: AIDS has killed 100,813 Americans.
• 1996: AIDS has killed 315,928 Americans, and new infections grow among women and minorities.
• 1997: With growing use of multi-drug “cocktail” therapy, AIDS deaths drop 45 percent in a single year.
• 2000: AIDS has killed 410,800 Americans, including more than 1,200 Tristate residents.
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The program, launched in February, was funded by a three-year, $600,000 federal housing grant and about $36,000 in city funds.
“For a long time, people (with AIDS) didn't live long enough to consider treatment for substance abuse,” said Sue Butler, Caracole's executive director. “But as HIV drugs are improving and prolonging people's lives, addiction is more of a problem.”
Substance abuse runs high among people with AIDS and HIV. For some, the depression that comes from having the disease turns them to alcohol and drugs. Meanwhile, people who already have substance abuse problems wind up more vulnerable to catching AIDS.
Drug abuse, be it alcohol or illegal drugs, often goes
hand in hand with reckless sexual behavior. Some addicts become prostitutes to feed their habits. Meanwhile, people using injected drugs risk passing HIV and Hepatitis C if they share needles.
What started in America as a disease spread mostly among gay white men has spread increasingly to minority groups and women regardless of sexual orientation. In 1994, the federal Centers for Disease Control and Prevention estimated that as many as half of all new HIV infections were drug related. By 1997, officials estimated that 24 percent of all men with AIDS were drug users along with 47 percent of infected women.
Having an active drug problem makes it hard for people to stick to AIDS medication regimens. It also makes it hard to get social support, including help from Caracole. Since 1998, an estimated 86 percent of people referred to Caracole for housing support also had chemical dependency or substance abuse problems.
Caracole requires clients with active abuse problems to complete a treatment program then pledge not to use any alcohol or drugs while living in its facilities. Most haven't been able to do it, Ms. Butler said.
That means some get turned away. Others get kicked out.
Knowing that such people often wind up back with drug-using friends, in shelters or completely homeless prompted the agency to launch the program as a halfway house for addicts with HIV infec tions.
The apartment house has four residents and a capacity for nine. If successful, Caracole hopes to add another building.
Dwayne, who asked that his last name not be used, has been living at the Caracole Recovery Community for about a month. He has been fighting a crack addiction for about 11 years.
In his early 20s, Dwayne said he was drinking wine every day and smoking pot when he could get it. Then he got into crack. The more drugs he did, the wilder his sexual activity became.
Over the years, he bounced from Cincinnati to Birmingham to Louisville, then back to Cincinnati again. He has been in and out of de-tox centers, in and out of jail.
He was diagnosed with HIV in 1987, after his lover's ex-lover advised them to get tested.
Dwayne, now 39, said he tried joining a church to clean up his life. But he still couldn't break away from the drug culture. “At my friend's house, it was party time all the time,” he said
He was referred to Caracole's program by the director of a local drug rehabilitation center.
“When I came here, I wanted to die,” Dwayne said. “I'm still sick, but I've come a long way.”
Bob Keck, program director, said the goal of Caracole's recovery house is to help residents rebuild almost every aspect of routine daily life — keeping a regular schedule, cooking for themselves, replacing unhealthy activities with healthy ones, going back to work.
“People come here knocked flat on their backs,” he said. “Years of denial breaks down all at once.”
Increasing substance abuse services has been a growing priority for AIDS-related agencies, said Kathryn Thompson, education coordinator for AIDS Volunteers of Cincinnati. In fact, AVOC plans to hire its own substance abuse specialist this year.
“Addiction is just one of the issues. As this disease moves from an acute problem to more of a chronic one, we're seeing more intense need for all sorts of ongoing living resources,” Ms. Thompson said.
Mr. White came to Caracole after a month in substance abuse treatment and six months at Dana House, a transitional living center in Evanston.
While Mr. White has his own apartment, the building is staffed by social workers 24 hours a day. Residents must attend at least four counseling sessions a week at the house, plus regular Narcotics Anonymous or Alcoholics Anonymous meetings.
“I haven't relapsed at all. Not one joint. Not one beer. Not one sniff,” Mr. White said.
In recent months, Mr. White has used his own experience as a speaker for AVOC and the Central Community Health Board. But the journey isn't complete.
He expects to live at Caracole Recovery Community for at least a year (two is the maximum allowed.)
“This is just my first year of recovery,” Mr. White said. “My next move after this will be independence.”
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