Sunday, December 4, 2011

Downtown dilemma: Giving people aid in their darkest hours


Reserve Officer George Gozelski of the Juneau Police Department checks on an inebriated local man at Gunakadeit Park (also known as Pocket Park) on Franklin Street last July.   Michael Penn / Juneau Empire
Michael Penn / Juneau Empire
Reserve Officer George Gozelski of the Juneau Police Department checks on an inebriated local man at Gunakadeit Park (also known as Pocket Park) on Franklin Street last July.
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Several institutions and individuals are tasked with dealing with Juneau’s chronic inebriates. Here is a look at three of them:

The Juneau Police Department
Last summer, for the first time, the Juneau Police Department, after pressure from the Downtown Business Association, assigned an officer dedicated to the downtown area to monitor inebriates and to manage any problems that might arise. Downtown shop owners appreciated the efforts of the first liaison, Officer Tracy Murphy.
Murphy moved south, and this winter, Officer Thomas Penrose has stepped into his shoes. Penrose is still learning the job. He said that one of his main goals is enforcing Title 47, which is concerned with personal welfare, social services and institutions. Basically they administer public assistance for adults in need, which are often people who have passed out from alcohol abuse or are in medical danger.
“They really want me to be boots-to-the-ground to interact with business owners, inebriates, homeless, customers or citizens on a positive level, to try and figure out how we can move,” said Penrose.

Rainforest Recovery Center
“One in every 10 people in this country has troubles with alcohol or drugs,” said Sandy Kohtz. Kohtz is the director of Rainforest Recovery, a 16-bed facility that’s an offshoot of Bartlett Regional Hospital. She has been working in the substance abuse field since 1977, first as a social worker, then director, of a 175-bed statewide treatment center in Nebraska.
She said clients arrive at the door of Rainforest in different ways, but often their clients are picked up because they’re considered a public nuisance. Besides getting calls from the community, Rainforest actively looks for individuals who are obviously drunk. If an individual refuses services, they may be held for 12 hours at Lemon Creek Correctional Center.
That 12-hour stay, or “sleep-off”, is considered the first stage of a five-stage recovery. “Most people in sleep-off are in the pre-contemplative stage,” said Kohtz. Stage two is contemplation, stage three is preparation, stage four is action, and stage five is maintenance.
Kohtz says no two people arrive at sobriety the same way. Sometimes it’s like a revolving door.
“Relapse is part of the disease. The lucky ones are the ones that come back”, said Kohtz. “Unfortunately sometimes they die.”
Though many seem treatment resistant, Rainforest’s staff never gives up on a client. For example, one person had 76 admissions, and on the 76th he stayed sober for the rest of his life.
Kohtz said she never knows what is going to be effective.
“They have to be sick and tired of being sick and tired. And they have to do some recovery on their own,” said Kohtz. She has seen many people recover in her 35 years in the field, and she knows one thing for sure; if the outreach people are working harder for the sobriety than the client is, it’s not going to work.
Kohtz said the workers have to have a broad attitude. She doesn’t like the term “chronic inebriates,” as she thinks the term implies hopelessness.
“I would rather them be called a person who has a disease and aren’t ready to change,” she said. “If you don’t treat them as if its treatable, and if I didn’t believe that some of these people can get straight and sober, then there is no point.”
“For the most part I’ve been doing alcohol and drug treatment because you can see people get well. Even if it is 1 out of 10, it’s that one that keeps people going.”
This is one of the things that keep doctors and nurses going as well.

Bartlett Regional Hospital
Rose Lawhorne, a registered nurse, has been the Emergency Department manager at BRH for two years, after working for many years as an emergency room nurse. Lawhorne says inebriates are in the ER almost every day.
“Inebriates are one of the highest risk populations because there are so many things that can behave like intoxication. Blood sugar problems, strokes, low oxygen from heart problems, lung problems or infection,” said Lawhorne. Sorting out the problems can be tricky.
Every nurse feels differently, but some find their patience tried, especially when they see the same person twice in one day, or have to deal with violent behavior caused by drugs like methamphetamine. Consequently the hospital has security watching potentially violent people.
Frequently inebriates picked-up downtown must pass through the emergency room for a medical clearance before being transferred to Rainforest Recovery or Lemon Creek Correctional Center.
“We have to watch them at the hospital if security isn’t available, and it starts to take up time,” said JPD patrol officer Sarah Hieb.
Lawhorne says individuals average blood alcohol levels between 0.2 and 0.3, but there are many who blow 0.4, 0.5, and even above 0.6 because of their tolerance. A level of 0.08 is presumed by Alaska law to be too drunk to drive. Sometimes they are given medication to help relieve withdrawal symptoms before being released. Some simply get a sandwich and a warm blanket before being sent to Rainforest.
“At the same time we are seeing heart attacks and strokes, traumas, sick children, injuries,” said Lawhorne. “People come to us in their darkest time and the thing that keeps the nurses going is being able to meet them in their hour of need and support them.”