Bert Klavens

March 24, 2008

United States Senate Judiciary Committee hearing on "The Rise of Drug-Related Violent Crime in Rural America: Finding Solutions to a Growing Problem."

March 24, 2008

Bert Klavens MA LADC
Coordinator of Outpatient Substance Abuse Treatment Program for Adolescents and Young Adults
Washington County Youth Service Bureau/Boys & Girls Club

Senator Leahy, Senator Spector: Thank you very much for the opportunity to speak here today.

Personal and Agency Information

I am a licensed drug and alcohol counselor. Currently I run an outpatient treatment program for youth age 12-22 at the Washington County Youth Service Bureau. I have been working with issues around substance abuse, families and young people for 17 years and I've been at the Youth Service Bureau for 8 years.

The Bureau's Substance Abuse Treatment Program offers a continuum of prevention, intervention, and treatment that is geared specifically to the needs of adolescents and young adults ages 12 to 22 years old.

The Bureau has been helping area youth and families thrive for over thirty years. We began in 1974 operating several teen centers and a substance abuse counseling program for teens. Today, we provide youth and family counseling, crisis intervention, support services, and out-of-school time programs to nearly 4,000 Washington County residents each year.

For the last year and a half we have been operating a re-entry/transitional living program for young men returning from jail known as Return House. This 6-to-12 month program for 18-22 year old males begins before participants are released from jail, provides 24-hour support to accompany them through their re-entry, and provides aftercare services following completion of the program.

The Demand Side Approach to the Substance Abuse Problem
Looking at the title for this hearing, the words "drugs" "violent" and "crime" jumped out at me. These words tend to bring one's thoughts to law enforcement and corrections system responses to a problem. The other word that jumped out at me was "solution".

While I greatly respect and appreciate the work done by law enforcement and the corrections system in keeping our communities safe, I do not believe the ultimate solution to the problems of drug-related violent crime can be accomplished with a reliance on these systems alone. The diversity of this panel reflects what I take to be a sharing of this belief.

The current rise of drug related violent crime is most likely tied to the cyclic nature of drug issues - that it is a persistent problem that continually changes forms. Different substances seem to have different sub-cultures, which manifest different sets of problems in our communities. Drugs like cocaine or methamphetamine are stimulants and seem to arrive along with much greater violence. In the Central Vermont communities that my program serves, increased cocaine use started showing up on the drug histories of our clients at almost the same time increased violent crime started appearing in our community. It's not hard to remember the 1980's when widespread cocaine use coexisted with an explosion of violent crime in communities all across America. While it is necessary to deal with the short term public safety issues that arise from this current cycle we must also recognize the bigger picture, the cyclic twists and turns of the drug problem in America. These are not a series of separate problems but different expressions of the same basic problem. Losing sight of this keeps us in a continually reactive stance, chasing the latest worrisome drug problem or symptoms of its sub culture.

The other reality demonstrated by the decades of fighting the drug problem, is that efforts to address this issue on the supply side only - reducing the amount of drugs flowing to our communities - again while necessary, have not been successful in reducing the scope of the problem. It is rare that I hear my clients tell me that they want to use drugs, but they just can't find them. To have greater success in reducing the amount of drug use and its accompanying violence in our communities, we have to start doing a better job of addressing the demand side of the equation and ask: why are so many people eager to use drugs and become dependent on them, despite all the information that has been disseminated regarding their harmful affects?

The Larger Problem of Co-occurring Disorders

Recent research about co-occurring disorders sheds some light on this. Substance abuse problems very often come in a package along with mental health disorders. Estimates put the number of substance abusing people with a co-occurring mental health disorder at upwards of 60%. In the corrections system this number rises to between 75% and 80%. Serious substance abuse problems usually occur in a package that includes one or more diagnoses such as Major Depressive Disorder, Bipolar Disorder, PTSD, different anxiety disorders, Conduct Disorder and so on.

I have worked with many clients in the corrections system over the years, the population most likely to be involved with drugs and crime and violence. In almost every case these clients have extensive histories of substance abuse and dependence, at least one if not more diagnosable mental illness, and past histories of abuse or neglect. They are struggling and wounded young people, often with undiagnosed or untreated psychological and physiological problems, and it is rare their problems began with substance abuse. As we seldom see the beginning of regular substance use before 11 or 12 years of age, and more usually at 13 or 14 years old, there are plenty of years for neglect, abuse and failure to take root in these young people.

Why does drug use then become so appealing? Drugs and alcohol are remarkably effective in the short term at accomplishing what is for the substance abuser their primary purpose: they change the way he or she feels. It is the most natural of human impulses to seek relief from pain. People explore the possibilities in their environment to try to find something that works to this end. Drugs, despite our best efforts, are widely and relatively easily available in our communities. Young people struggling with the early onset of clinical conditions, an unhappy home life, feelings of loneliness and alienation discover that this or that substance can magically provide relief. Balanced against all the exhortations to not use drugs and information about their negative effects, they now have the first hand experience that a drug experience made them feel better even if only temporarily.

Once they do start using substances, of course, a whole new set of problems and consequences come into play. Each drug comes with its own short- and long-term negative effects. But overall, drugs are a negative sum proposition. In exchange for whatever short-term relief they bring, their overall affect over time is clearly negative. Existing problems with mental illness, or school or family will be exacerbated. Cognitive functioning and the ability to make good decisions will be further eroded. And legal problems, either due to the drug use or associated behavior presents an additional layer of obstacles.

I want to say clearly that I do not think that any illnesses or past difficulties excuse violent or other law breaking behavior. But if we are not simply going to lock substance abusers up in jails (and at least in Vermont it has recently become clear that this is no longer an economically viable strategy) then we have to start doing a better job of helping them become healthy contributing members of society.

This is exactly why we cannot focus only on the supply side of this problem Even if we could prevent these young people from having access to drugs, they would still be searching for outlets to relieve their misery. And they would still have little guidance in finding healthy ways to do this. In our work with substance abusers at the Youth Service Bureau, our goals for our clients are for them to be not only drug free but also healthy and happy.
Solutions: Practical Applications at the Washington County Youth Service Bureau.

I would like to share with you some of the positive work happening at my agency that touches on these issues. The Return House Program, I mentioned earlier, now one and a half years old, provides a structured, supervised, supportive environment for inmates re-entering the community. Working in concert with the Bureau's mental health and substance abuse programs as well as other community resources, co-occurring issues of the residents are being addressed in a comprehensive way.

In the substance abuse treatment program I run, we have found teaching our clients tools for emotional regulation to be very useful. Difficulty in dealing with challenging emotions and thoughts lies at the core of the day-to-day struggle that substance abusers have in trying to eliminate drugs from their lives. Tools like Cognitive Behavioral Therapy, Mindfulness Based Therapies and Health Realization have proved very effective in giving our clients useful skills that are available in the moment to help them maintain or restore their own mental balance and healthy functioning. Teaching skills like these and other basic components of a healthy life like exercise and healthy diet have been very well received. They have the further benefit of adding an experiential component to treatment that is very useful when working with teens and young adults.

Successful therapeutic intervention begins with strong relationships. Research that has been done on resilience in young people has found that an enduring positive relationships with a healthy adults is one of the greatest predictors of future success. At the Bureau we are fortunate to have the flexibility to work with young people in this way and thus have been able to form just these kind of enduring relationships with young people, who come to realize that they can continue to rely on our support even after a particular service is no longer necessary.

Conclusion

My hope in giving this testimony is to raise awareness of the key role that treatment programs can play in reducing substance abuse and substance related violent crime in our communities. The recognition that substance abuse frequently occurs within a web of other problems and challenges suggests different approaches as we try to reduce or eliminate its presence in our communities.

While I think committing ourselves to the health of people with substance abuse problems could lead to the more efficient use of resources currently available, more support would, of course, be helpful. After a year and a half our Return House Program is still not fully funded, and many more such facilities are needed. Increased availability of treatment programs (i.e. in prisons) and better salaries to continue to attract good people to the field would be helpful. More flexible funding for treatment programs that would support the integration of emotional regulation tools into the lives of clients would also be useful. And overall, an equal commitment to address related issues such as mental illness, child abuse and neglect and domestic violence would go a long way toward making substance use and abuse a less prevalent choice for people now and in the future.

Thank you again for your attention on this issue and the opportunity to speak here today.