PointsSouth: Articles 2007

When Metropolitan Charities decided to expand to include treatment for drug addictions, the staff knew the odds were steep. After a year of planning, they've learned that just getting addicts in the door may be their biggest challenge.

The St. Petersburg, Fla., nonprofit organization has a long and respected record of preventing AIDS transmissions and serving those infected with HIV.

Because there is a connection between the spread of HIV and drug use, it was a logical next step for the charity to expand its services, said Tonicia Freeman, administrator of the new program. Metropolitan got a grant in 2005 to spend $254,000 over five years counseling drug addicts. The money came from the U.S. Department of Health and Human Services through a program aimed at minorities.

In January, Metropolitan Charities opened the doors to the Minority Empowerment Through Risk Reduction and Outreach. For three months participants receive a combination of education, counseling, vocational support and health screening. The goal is to give addicts the tools and self-awareness they need to change their lives.

So far, progress is slow. Out of 30 people recruited since January to participate, just three have completed the program. That's far short of the goal of 90 a year.

"We can't change people if they don't have the desire to change," Freeman said. "The program doesn't change people. People change people."

The rules of the grant themselves create some challenges. Along with the grant, the federal government provides a list of methods for treating drug addiction. Metropolitan Charities chose the Holistic Health Recovery Program, which requires treatment sessions be conducted in groups, in 12 sessions, in the same facility.

But Metropolitan Charities has found it difficult to get drug users to come to their facility on Third Avenue North. Most of the prospective clients don't have cars, so rely on public transportation to get to the program, Freeman explained.

Drug addicts also need discipline to complete the program, Freeman said. The Metropolitan program, which is voluntary, requires participants to attend weekly two-hour classes for three months.

"I see our work as if you were having to move a mountain or tear down a house," Freeman said. "If you didn't have any construction workers you would start moving it piece by piece, like a puzzle."

These problems are not unusual for a start-up program.

"New programs generally take time to develop a strategy to retain participants," said Luis Rodríguez, a Miami-based clinical psychologist with 30 years of experience in addiction treatment. "It is not easy to attract patients but it can be done."

The programs that are most successful are those that are most intense, Rodriguez said: "In an intense course the patient disconnects from the problem faster."

Some treatment facilities require addicts to attend up to nine hours a week and involve patients' family members.

The Department of Health and Human Services says Metropolitan Charities is allowed to change the program in order to have better results.

"The Holistic program allows flexibility," said Dr. Charles Collins, behavior scientist at the Centers for Disease Control and Prevention, a federal organization that designed the Holistic Health Recovery Program.

Metropolitan Charities may make the program shorter than 12 weeks as long as it covers the topics suggested by the course's manual, Collins said.

Metropolitan Charities is using its outreach specialists, who offer free HIV testing, to recruit participants into the program. They also offer offering free hepatitis screening, gift cards, bus passes and gas coupons.

So far nothing has been a big success.

To have more of an impact, Metropolitan Charities plans to bring the program to the communities throughout Pinellas County by partnering with other nonprofit agencies. But first it must get federal approval.

"We want to be closer to people, but it takes time," Freeman said.

The need and urgency is clear.

Pinellas County law enforcement arrested more than 2,700 people on drug- related charges from Nov. 2006 to May 2007, according to the Sheriff's Office.

But even if Metropolitan Charities gets approval to bring the program to the community, the bigger problem is getting addicts to want to change.

"We need to find people who are at a point in their in life where they are thinking of changing," Freeman said. "They must want to have more information on how to protect themselves and have a better life."

María Torres, 39, has reached that point. She was one of more than 20 people who attended an informational meeting by Metropolitan Charities, but the only one who registered for the program.

She said she is tired of a lifetime of violence, insecurity and drug use. She stopped using cocaine a month ago, when she found out she was pregnant. She has a 24-year-old daughter and two grandchildren. Her two younger children, ages 6 and 4, have been living with relatives. Torres wants them back. She wants a relationship where she doesn't tolerate being beaten and humiliated. Mostly, she said, she wants a future.

So she walks 20 minutes every Tuesday to reach the center, where she attends a session with a therapist. Earlier this month, she was the only participant who showed up. Organizers would have liked for more than a dozen people to attend the session.

"They tell me they can teach me how to be a better person," Torres said. "I want to be normal, like everybody else."

The therapy sessions are held in a back room of Metropolitan Charity's one-story house. It has two sofas where participants may sit together, a desk and a projector the therapist uses to present his class and a CD player that generally plays restful music. Participants can read motivational and spiritual books displayed on a coffee table in front of the sofas.

At the end of each session participants do relaxation exercises in which they are asked to imagine a future free of drugs. They also analyze what situations in their lives make them vulnerable to keep using drugs or to be at risk to get HIV.

"The meetings helped me to realize I was hanging out with the wrong people," Torres said.

Program administrators want to reach more people like Torres. They said they will wait for a one-year evaluation of the program to know what adjustments should be made.

"If this doesn't work we try until we find something else," Freeman says. "We cannot help everyone in Pinellas County, so we start small and we help as little as we can. Eventually we will be able to have a larger impact."