From The Oregonian, April 30, 2012

The heavily redacted mental evaluation report on Daniel Butts, the accused killer of Rainier Police Chief Ralph Painter, contains very little information not revealed in court during his aid and assist hearing earlier this year.

READ – the not-redacted Aid & Assist judgement from Columbia County Judge Ted Grove, February 2, 2012

But the report—released today by Columbia County Judge Ted Grove after The Oregonian filed motions a year ago that the reports be made public—does shed new light on the 22-year-old man’s behavior in the Columbia County Jail. [This document was not made available to the public beyond The Oregonian - and not posted by The Oregonian.]

Butts was arrested on Jan. 5, 2011 after police say he wrested Painter’s gun away and then shot the chief in the head at a Rainier stereo shop.

A Columbia County grand jury indicted Butts on nine counts of aggravated murder, which could carry the death penalty, and other charges including attempted aggravated murder, robbery, burglary, theft and unauthorized use of a vehicle.

Last December and again in January, Judge Grove heard expert testimony from mental health professionals, as well as police officers, on Butts’ behavior before and after the shooting.

The hearings weren’t held to determine Butts’ mental state at the time of the shooting, but whether he is able to assist his defense attorneys during a trial. In the past year, Butts was evaluated several times both at the Columbia County Jail and at the state hospital in Salem, where he stayed for 20 days last July.

Grove ruled that Butts could assist his attorneys in his defense, saying he believed Butts was “gaming the system.”

But earlier this month Grove ruled that Butts be returned to the Oregon State Hospital in Salem for additional mental health evaluation. Grove made the decision during a hearing on a writ of habeas corpus filed by Butts’ attorneys, said Columbia County District Attorney Steve Atchison.

The writ stemmed from the treatment of a self-inflicted wound Butts suffered when he stabbed himself in the forehead with a pencil in January. The wound became infected, but Butts refused treatment, officials said.

While by all accounts Butts was a difficult inmate, almost a year to the day after he was arrested for Painter’s murder, jailers observed Butts standing near the toilet in his cell “striking himself in the head, neck and face.”

The officers ordered him to stop, but when they approached Butts he ran and slid under his bunk. When he refused to come out, officers shocked him with a Taser. During the scuffle, officers fell on the “slicked up floor” as Butt kicked at them. He was stunned again, handcuffed and stunned a third time.

Despite their efforts, Butts continued to resist. He was then placed in a restraint chair, and again “he remained uncompliant,’’ according to a letter from Dr. Jerry Larsen contained in the report to Butts attorneys, Patrick Sweeney and Dianna Gentry. Officers placed a “spit hood” over Butts head to keep him from spitting at the officers.

Corrections deputies noted three pencils stained with blood. The following day, paramedics examined the wounds and told officers they were superficial.

According to another jailer, during an interaction with Butts he stuck his penis in the pass through of the cell door, and “almost threw it towards me.”

Several days after he was shocked with a stun gun, Butts (who by then had been moved to special holding cell) asked to be returned to his regular cell.

An officer asked him if wanted to hurt himself and he told them no. When the officer told Butts he was concerned that he might have to use his Taser on Butts, Butts said “That will not be necessary. I’ll be good.”

Oregon State Bar members share their stories of dependency and addiction — and recovery
By Melody Finnemore – for the Oregon State Bar Bulletin

“Elaine” was born into a family of alcoholics and watched her father, also an attorney, battle the disease for many years while growing up in the Midwest. “My father had a lot of great intentions that never seemed to happen until he got sober when I was 14,” says the Portland attorney.

“I was desperately afraid I would have problems with alcohol, so it wasn’t until I was 18, the legal age in my state, and a freshman in college that I started drinking,” she adds. “I took to it like a duck to water. I was a daily drinker almost immediately.”

A self-described perfectionist, she maintained strong grades throughout college though she drank on a regular basis. Her drinking grew steadily worse as she completed her first year of law school, while working at a law firm during the day and taking law courses at night.

“For the first time in my life, I wasn’t the smartest one in the room, and that scared me,” she says. “I was a functional alcoholic. I kept up and got good marks, but inside I was falling apart. I felt like alcohol was the glue that held my life together at that point, and I was afraid I couldn’t stop drinking or, if I did, that my life would fall apart.”

She turned to her father who, by that time, had been sober for nine years. He advised her to join Alcoholics Anonymous. She initially entered a 30-day, outpatient treatment program and joined a state lawyer recovery group modeled after the Oregon Attorney Assistance Program (OAAP) of lawyers concerned for lawyers. She attended a meeting each week and stayed sober for a couple of years. She began drinking again after her life got better and she convinced herself it hadn’t really been that bad.

Elaine graduated from law school in 1982 and married her first husband the following year. She moved to join her husband in New Orleans, which she called a “drinker’s paradise.” There her drinking worsened.

“I held it together for about six months, but the loneliness of leaving my family to move to a new city where there was a completely different culture was too much,” she says.

A move to Portland proved no easier. She was in another new city with no friends. Her drinking was causing problems in her marriage. And she was hit with another emotional blow when her mother was diagnosed with cancer and died in early 1985.

“She was concerned about me, but I kept the truth from her because I didn’t want her to worry,” she says. “The six weeks after she died were the most difficult time of my life. She was my closest friend.”

The decision to sober up for good came during an evening soon after that. She remembers drinking wine out of a box at the kitchen table and arguing with her former husband. When she went into the bathroom to clean their cat’s litter box, she found her father’s A.A. sobriety medallion, which he always carried in his pocket, behind the litter box. She can only surmise that the medallion accidentally fell off the bathroom counter during her father’s visit shortly after her mother’s death.

After reading the serenity prayer on the back of the coin, she says, “I just looked up and said to Mom in heaven, ‘I give up. I’ll get sober again.’” She sought help through OAAP 21 years ago and has remained sober ever since.

“Since then, I’ve put my life back together. I divorced in 1988 and remarried in 1994. I have a thriving law practice and the respect of my colleagues. My life is full, and I can weather the ups and downs of life with grace,” she says.

In her professional life, clients often seek her help for legal difficulties that may go hand in hand with drug and alcohol problems of their own. When appropriate, she shares her battle against alcoholism with clients. “I will share with a client that I know what it’s like to hit rock bottom and that life can get better when you face your problems,” she says.

In addition, she serves as an A.A. sponsor for others struggling with alcohol addiction. “It makes it all worth it. A.A. allows you to take your worst experiences and share them with others to show you’ve been there and to offer hope,” she says.

She says the key to maintaining her sobriety is to deal in a constructive way with the emotions that led to drinking, such as a compulsive need for achievement and perfection, into healthier channels such as running, golf, work and volunteer work, as long as she doesn’t overdo those, too.

She believes that she is genetically different than non-alcoholic drinkers and therefore can never safely use alcohol again regardless of how long she is sober or how well she functions.

“I continue to go to A.A. meetings because I’ve seen too many times what can happen to people who don’t go. I don’t ever want to drink again. Besides, I like meetings — it’s a place to stay honest with myself about my alcoholism and have a chance to help others. I’ll do whatever it takes so I never drink again.”

COMMITTING TO SOBRIETY

Susan Gerber also began drinking in high school, although alcohol was not part of her conservative, Jewish upbringing.

“My brother and I say everyday that we have the best two parents on the planet – it was like the Brady Bunch. There was never a drop of alcohol in the house,” she says. “I always felt different, though, so I had my first Miller Genuine Draft and felt funny and more comfortable. I started drinking to get drunk every time.”

Gerber continued to drink through college, law school and private practice as a trial lawyer. The problem grew worse when she accepted a job as an assistant district attorney in Chicago.

“It’s so stressful and disgusting, because you see so many victims who have had horrible things done to them,” she says. “It was the biggest relief to drive home and have a beer to take the edge off.”

Gerber says her decision to quit drinking wasn’t instigated by any external crisis. Like so many alcoholics, however, she suffered a shattering crash at rock bottom.

“Nothing horrible went wrong. I didn’t have any DUIs or anything like that. It just eventually got to the point where I felt what they call utter and complete demoralization,” she says. “You look in the mirror and hate yourself, and you just want to die. I’d gotten to that point where I thought I’d rather kill myself than live the way I was one more day. I didn’t like who I was or how I was treating my family or my co-workers.”

Gerber joined A.A., where the newfound clarity that came with being sober gave her some perspective on her life. She realized she wasn’t happy with her work as a private practice attorney. After three years of sobriety, she decided to quit her job, sell her house and volunteer for the American Bar Association’s Central and Eastern European Law Initiative (CEELI). The program promotes a worldwide exchange of ideas and programs that include training for foreign lawyers and other professionals.

As part of the program, Gerber moved to Albania for a year to teach law students there how to serve as lawyers and judges, preserve civil rights and recognize the downfalls of corruption.

“It was a really depressing experience, but an amazing experience,” she says, adding she lived without a phone and only occasional access to the Internet. “It was very spiritual not having contact with a lot of other people.”

Upon returning to the United States, Gerber obtained her license to practice in Oregon in 1999 and began working for the state’s Department of Justice in 2001. Now an assistant attorney general for DOJ’s trial division and sober for eight years, Gerber attends three or four A.A. meetings each week and sponsors two other members. Her commitment to the recovery program is essential to her sobriety, she says.

“The longer you remain sober, life becomes more routine, and when it’s routine it’s easy to become complacent. Your memory goes and you begin to think, ‘Okay, maybe I can drink like other people,’” Gerber says. “Helping other people helps me out of myself. It’s literally the one thing that keeps me sober.”

WHAT MONEY CAN’T BUY: SELF-ESTEEM

Like many boomers, “Mark” grew up in an atmosphere where drugs and alcohol were readily available. Drinking was perceived as a positive pastime in his family even though several generations of his male relatives had battled alcoholism.

“My father took care of our family, and I think he was a pretty typical businessman for the 1950s. He drank socially, and when I was nine or ten he would give me an occasional beer,” he says. “I started drinking more in high school as well as smoking pot and doing other drugs that were prevalent during the late ’60s and early ’70s.”

While attending law school at Willamette University, Mark drank and smoked pot daily. He quit smoking pot gradually, finding it interfered with his legal practice. He continued to drink, however, and was involved in an alcohol-related accident in the early ’80s.

“I was fortunate that one of the paramedics convinced me to take a ride in the ambulance to have my broken arm looked at because it stalled off the police,” he says. “I would have had a DUII because I’d had five martinis.”

Despite the near miss with the police and potentially more tragic consequences, he continued to drink through the termination of his legal partnership and the birth of two children in the late ’80s and early ’90s.

“Through all of that the drinking just steadily progressed, and there are parts of that time that I’m not at all proud of because I did some pretty shameful things,” he says. “Why it took so long to reach out and get help, I don’t know. It’s the nature of the disease, I guess. My wife asked me time and time again, ‘Don’t you think you should get some help?’”

He found excuses not to get help or face the problem head on. Instead, he focused on managing his practice, and says working as a sole practitioner actually enabled his drinking because he didn’t have to answer to other partners. In addition, chronic anxiety added to the problem.

“I’m a nail biter to this day, and alcohol always took the anxiety off. When the drinking gets out of hand, alcohol not only eliminates the anxiety but, over time, exacerbates it,” he says. “Over time it goes from drinking to feel good to drinking so you don’t feel so bad.”

He sought help through OAAP in 1992, intending to get his drinking under control but not necessarily stop.

“With time I realized I needed to stop altogether, because my mental and physical health were deteriorating quickly,” he says. “Drinking took more than my health, and recovery has given me more than just not drinking. My drinking took something that no amount of money could buy — my self-esteem. Recovery has restored this and more.”

He now serves as a sponsor for others in recovery and works with impaired attorneys through other bar programs. He continues to attend several support meetings each week. “I did most of my daily drinking at lunch, so I find lunch meetings work well for me,” he says.

Though it took time to rebuild his economic stability, he found that many other aspects of his life improved dramatically soon after he made the commitment to stay sober.

“There’s been a lot of family growth and changes in that time. There have been some really wonderful gifts that have come out of being sober,” he says. “Besides having my health restored, I have grown emotionally. I have found joy in living and a sense of who I am. My life has purpose, and I find satisfaction in what I do. I am convinced that today I am a better father, a better lawyer and a better member of my community.”

He advises others who feel they have dependency problems to reach out for help so they, too, can regain what they may have lost along the way.

“I do not doubt for one minute that anyone who has lost control of their drinking can have everything I have received and more, if they are willing to ask for help,” he says. “If you think you have a drinking problem and need help, please pick up the phone. It is a call that will save your life.”

SHATTERING THE DENIAL

Ted Grove has faced addiction nearly every day for the last 11 years in his role as a Columbia County Circuit Court judge. Raised in the Midwest, Grove started drinking as a teen. He began drinking heavily with his older teammates when he joined the Des Moines Rugby Club while still in high school.

“I was a daily drinker and sometimes a binge drinker. By the time I was 21 I would say there weren’t many days I didn’t drink, and once or twice a week I drank a lot,” he says.

Grove attended law school at Lewis & Clark College, where his drinking continued. He graduated in 1978, but worked in the woods as a tree planter and logger for a couple of years after graduating while some legal issues were resolved.

“I would get drunk and get belligerent. I would upset people and law enforcement would cuff me and take me away,” he says.

He had marital and physical problems by the time he was 30. Still, he refused to admit that alcohol was controlling his life.

“Basically, you function in life for the continued right to drink. You tell yourself that as long as you’re able to make it work, you don’t really have a problem,” he says. “After one substantial drunk, my wife warned that she wouldn’t be around much longer. It was pretty clear that alcohol was kicking my butt.”

Grove contacted Don Muccigrosso at the Oregon Attorney Assistance Program in 1982, but admits the initial effort was half-hearted. “I called Muccigrosso to show my wife I was serious about quitting drinking. I immediately regretted it and, as the day progressed, I was planning my first after-work drink,” he says. “Just before 5 p.m., Don called and asked me to meet him.”

Grove started attending OAAP and other recovery meetings outside of the small Columbia County town where he lived and practiced law.

“Like most alcoholics, we have this myth or perception that other people don’t realize how much we drink or how big of a problem it is,” he says. “It wasn’t long before I recognized that I needed to get involved in meetings in my community.”

Grove says he quickly gave up on the notion of anonymity in a small, rural community. As a circuit judge, he has openly shared his story from the bench.

“Over the years you touch an amazing number of families, whether for good or not,” he says, noting 85 percent of the people in his court system battle chemical dependency problems. “I am still active in the recovery community, attending open meetings and have held hands during the closing prayer with people I’ve sent to prison, mothers who have had their parental rights terminated and parents whose children I’ve sent to prison. I’m always surprised that I feel no anger from them.”

At 53 years old, Grove has been sober for 23 years and now serves as a mentor for others in recovery. The experience benefits him as much as those he sponsors, he says.

“It causes you to reconnect with the program at a more basic level because you try to assist someone who is new to the recovery process. It reminds you of the problems, experiences and insecurities you felt during the early stages of recovery,” he says.

His job also brings the issue front and center on a near daily basis. “I have these people who come before me who are suffering from the same disease of addiction, so it’s a bit of a 12-step call on a daily basis for me.”

His message to other recovering alcoholics is simple: Everything you lose when you’re drinking is restored to you in your sobriety.

“It’s an amazing transition when you think of it. One day you’re drinking yourself to death and the next you’re not taking a drink at all and are taking the first steps as a recovering alcoholic,” he says. “It’s all about letting people know there is life after recovery and it’s a damned good life.”

THE DANGER OF CROSS-ADDICTION

Heroin was the drug of choice for “James,” an Oregon attorney who has practiced law for nearly 20 years at some of the most well-known law firms along the West Coast.

James’ drug abuse began in the early 1970s when he was a seventh grader and started smoking pot. “It was so prevalent and easy to obtain, and it was accepted. In the crowd I ran around in, it was pretty much the social norm,” he says. “I’ve probably used about every drug that’s been available at some point in my life until I got into recovery.”

While he experimented with LSD, cocaine and other drugs, James didn’t begin drinking until college. Then, he would binge on beer during the weekends. He continued to drink, smoke pot and use other drugs throughout law school and during the start of his legal career. A job with a high-profile firm on the West Coast exacerbated his drinking problem.

“It was common to go out after work and share war stories and drink,” he says. “It came from the top, and I think partners need to realize they have a tremendous influence over the younger associates who want to succeed in the firm.”

James says his addictive personality eventually led him to try heroin, which at first was inexpensive, pure and easy to obtain.

“It was a very solitary practice for me. I never used that drug with anybody else,” he says. “The reason it was a good fit for me, if you could call it that, was because it was an instant stress reliever. And unless you knew what to look for, you wouldn’t know I was high because it was odorless and it didn’t make me doze off or look stoned.

“However, the whole process of getting, using and functioning made me one of the busiest, hurried persons I knew,” James adds.

Initially he smoked it during the evenings to relax after a long day at work. It wasn’t long before he did heroin in the mornings before work and during his lunch breaks.

“It escalated quite rapidly. Inevitably – and it is inevitable that this will happen with this drug – I used more and more and took greater risks to obtain it,” he says.

James eventually was arrested for possession of heroin and placed in a diversion program. He relapsed and, thanks to the skills of his defense lawyer, was allowed back into the diversion program.

“I had no life, and I was chained to buying and using that drug. I had to feed my habit,” he says. “It eventually resulted in the loss of my marriage and, while I never received a complaint from a client, I actually took myself out of practice for a couple of years.”

James stopped smoking heroin six years ago when his connections dried up and he could no longer obtain it. He replaced heroin with alcohol and found the impact on his life was just as negative.

“That’s the danger of cross-addiction. For an addict, and I consider alcoholics to be addicts, any drug can start the cycle again,” he says. “I gave myself permission to use alcohol and cigarettes, and the result was just as disastrous.”

James sought help after realizing that he eventually was going to do great harm to somebody else or himself. He entered a recovery program and has been clean and sober for several years. James moved to Portland, remarried and now has a young child. His legal career is thriving, yet there are no more 15-hour work days, and he is able to enjoy time with his family. James continues to be active in the recovery community and has sponsored other recovering addicts.

“I attend several meetings every week and I probably will for the rest of my life, and it’s not a burden. In fact, any time I start to think it’s a burden I know it’s time to get to a meeting,” he says.

RECLAIMING HER DIGNITY

“Joan” has battled a series of addictions ranging from gambling to smoking crack. She began experimenting with alcohol and pot in high school. Her use in college escalated to drinking binges that lasted entire weekends.

Several years later she began her insidious battle with cocaine. “I’d been out drinking when someone passed me a crack pipe, and without hesitation, I took a hit. I was hooked instantly. I found what I had been searching for my entire life – complete escape — in seconds.” She would chase that first euphoric feeling for many years.

Joan was living a double life — law student by day, junkie by night. She ventured into the worst areas of town to feed her addiction, noting, finding that she actually starting feeling comfortable in crack houses.

“Although I wasn’t a daily user, it affected me on a daily basis. Trying to keep up the façade to hide my addiction was exhausting. I entered into a self-induced schizophrenic state when I used; nothing mattered more to me than getting that next hit,” she says.

It didn’t take long for Joan’s increased drug use to cause problems. Her class attendance dropped. She was so stressed about a final exam that she had to get stoned to take the test.

She also fell behind in her rent and faced phone and electricity disconnections.

After graduation Joan prepared to take the Oregon bar exam. Although she didn’t jump right back into using cocaine, she reports that drinking and smoking pot took priority over attending bar review classes. She failed the exam and was soon smoking crack again. Within weeks her addiction was in full force

“The first time it occurred to me that I might have a problem was when I saw a T.V. program with a toothless heroin addict who was sharing how her addiction led to homelessness and prostitution. I thought, ‘Oh my God, that could be me,’” Joan says. (But, that epiphany evaporated as soon as the next craving hit.)

She finally asked for help after being threatened at knife-point by a dealer. “My sister pleaded with me to tell her what was wrong. Fortunately, she caught me in a moment of sheer panic and desperation, and I confessed,” Joan recalls. “I called a recovering alcoholic attorney I knew, and he took me to my first 12-step meeting at the OAAP.”

Over the next five and a half years Joan dutifully attended meetings, but she couldn’t accumulate more than several months of continuous sobriety. “I’d go 30 or 60 days, start feeling better, and the next thing I knew I had a beer in my hand — and from there it was a short road to the crack house,” she says. “I understood that smoking crack was a problem, but just couldn’t grasp the idea that I couldn’t drink alcohol. I couldn’t use any mind-altering substance without suffering severe consequences.”

Next, Joan attended inpatient treatment, but that still wasn’t enough. She used several more times before she would hit bottom. The end of her use came when she was living with some friends and smoking crack in their basement. She was car-less and unemployed. “It was 3 a.m., I was out of dope and down to my last $50. Panicked, I thought that if I could just take one more good hit, I’d be able to figure everything out,” she says. “All I could do was pace back and forth and watch the clock. At 5 a.m., I headed out to catch the first bus of the day to purchase more drugs.”

Joan says that as she headed back to the basement with her new stash, she was extremely paranoid. “I was sure I was being watched and followed. But then I thought, what’s the worst that could happen? I’d get arrested and go to jail. That calmed me down. Crack cocaine had become more important to me than my freedom. I had hit bottom.”

She checked herself into an intensive, outpatient treatment program and has slowly pieced her life back together. She attends recovery meetings almost daily and works with other alcoholics and addicts in recovery. She worked various low paying jobs for a couple of years before joining a law firm as a paralegal for the past year.

Although Joan passed the Oregon bar exam several years ago, she withdrew her previous application to work on strengthening her recovery. She re-took the exam in the summer of 2006. “I just didn’t want to rush into re-applying for admission; my sobriety had finally become more important to me than having to re-take the bar exam,” she says. In October, Joan will have been clean and sober for three years.

“Sobriety allows me to reclaim my dignity on a daily basis. The constant feeling of impending doom has been replaced by hope. I finally really believe I will get to practice law someday,” Joan says exuberantly.

She feels that she owes an enormous debt of gratitude to the OAAP staff as well as the other OAAP support group members, noting: “Without their love and support I would not have made it.”

ABOUT THE AUTHOR
Melody Finnemore is a Portland-based freelance writer. She is a frequent contributor to the Oregon State Bar Bulletin.

From the South County (Scappoose) Spotlight, April 25, 2012

State struggles with rising number of heroin overdoses, availability of illicit narcotics

It was meant to strike a hefty blow to the region’s heroin supply.

A two-month Columbia County Narcotics Team investigation led to a large-scale bust Feb. 24 at the Gresham house of suspected drug dealers Maribel Sebastian-Evangelista, 31, and Amadeo Lupercio-Quezada, 32.

Along with an assortment of narcotics and paraphernalia in the couple’s home, police reported finding candles burning at a shrine to Mexican folk hero Jesus Malverde, the unofficial patron saint of drug traffickers.

And while police say the arrest cut off a large amount of drugs flowing through the region, the effect may be temporary.

Officers are well aware of a sobering reality – where there is demand, there is always supply. Heroin will find a way.

“There is always somebody higher up the chain,” said St. Helens Police Detective Sgt. Phillip Edwards.

Though it seemed 10 years ago that the Northwest’s thirst for heroin had been washed away by a tide of cheap, home-brewed methamphetamine, these days police say it’s becoming more common to find black tar heroin on the streets.

Just like in Columbia County, officers in Washington County have been dealing with the low-cost, readily available narcotic.

“Heroin’s pretty cheap right now, and they can get a three-day high for $20,” said Forest Grove Police Officer Jennifer Smith. “I would say, other than marijuana, it’s the second-most popular drug that I’m seizing off people. When it comes to hard drugs, heroin is definitely number one.”

Rise in overdoses

It’s not just police who are seeing an uptick in the use of the illicit opiate.

According to the Oregon State Medical Examiner, the drug was involved in 143 of the 240 deaths in Oregon last year that involved heroin, cocaine and meth. Methamphetamine was involved in 107 deaths, while cocaine was involved in 33 deaths.

There were two reported drug-related deaths in Columbia County in 2011, one from heroin and one from meth.

Overdoses from heroin have been on the rise in Oregon for years. Between 2010 and 2011, the medical examiner’s office reports a 59 percent jump in heroin fatalities.

While police say heroin use appears to be up in Columbia County, based on drug-related arrests, meth remains king. In 2011, the Columbia County Sheriff’s Office arrested 41 people for methamphetamine possession and seven for heroin. Two people were arrested for possessing cocaine.

Why now?

What’s spurring some drug users’ switch to heroin isn’t entirely clear.

Users can be introduced to the drug through a friend network or by a boost in availability.

Sgt. Edwards said most of this region’s drug supply flows from Portland.

“That’s usually the stopping point for all the drugs,” he said.

Portland’s drug activity impacts other communities as well.

“In the past, whenever Portland has seen a spike, we’ve seen a spike in overdoses,” said Lt. Michael Rouches, spokesman for the Hillsboro Police. He said two of three overdoses reported to Hillsboro police in the past 15 months happened in the last two days of March.

Police also speak of the influence a single dealer can have in small areas like rural Columbia County. Once someone’s selling the drug, users get hooked and start searching it out.

On top of that, users can quickly gobble up a flood of cheap drugs.

Some say a rise in the use of pharmaceuticals like OxyContin and Methadone – both opiates – might be introducing people to a high similar to that of heroin.

The Oregon Medical Examiner’s office is also seeing more deaths related to pharmaceutical opiates. In 2011, 100 people died from Methadone overdoses, 56 died from OxyContin overdoses and 37 died from overdoses of hydrocodone, a drug commonly known by the brand name Vicodin.

All three drugs are used to medicate persistent and temporary pain stemming from injuries. But they also wind up on the street, being peddled by dealers for about $30 a dose. At street prices, a fix of heroin costs around $10.

Pharmaceutical opiates are prepared in doses, but black tar heroin – the most common on the street – is not.

Batches of heroin can range in potency and intravenous users who are used to a certain amount of one batch of the drug can accidentally overdose when they hit a more potent supply.

“When there happens to be a strong batch out there,” Rouches said. “that’s when we see problems.”

April 29, 2012, from AP.com

Telecare caused quite a stir in 2010 when it opened two residential homes in northeast Bend. Neighbors feared their property values would drop and worried that some residents of the mental health facilities might be dangerous. They later complained about residents’ tendency to smoke on neighborhood sidewalks.

The debate put a magnifying glass on the treatment of mental illness, which is delivered much differently in Central Oregon today than it was even a decade ago.

Before the 2005 opening of the Sage View Psychiatric Center near St. Charles Bend, anyone who experienced a psychiatric problem requiring help faced a long trek. Adequate care was available in the Willamette Valley and Pendleton, but not here.

Sage View administrator Molly Wells remembers very well what services looked like back then. “Before, we had two hold rooms on the fourth floor (of St. Charles Bend) and we had to send all of the clients to Pendleton or (Salem) or Portland.”

Mental health care has changed dramatically thanks largely to a 1999 U.S. Supreme Court decision, which coincided with local officials’ desire to create more options for the mentally ill and with the state’s push for deinstitutionalization.

As a result, Central Oregon today provides a greater spectrum of care for people struggling to cope with schizophrenia and other mental illnesses.

The 1999 Supreme Court case, commonly called the Olmstead decision, determined that it is discriminatory to keep the mentally ill in institutions if they can reasonably be placed in community settings instead.

According to a February 2011 memo from the Oregon Department of Human Services/Oregon Health Authority, “To achieve the intent of the Olmstead decision Oregon intends to move healthy people to independent housing that promotes recovery, resiliency, independence and wellness in a system that is consumer driven and assists people in obtaining ‘a key to their own door.’ ”

That means cutting the length of time people stay in the Oregon State Hospital in Salem and expanding “independent living environments” around the state.

A study completed in 2010 by Accumental Health, a nonprofit contracted by the state, found that about 60 percent of people in some form of mental health facility could be placed in less restrictive facilities or could conceivably live independently.

However, a 2010 state memo discussing the Oregon Health Authority’s plan to honor the Olmstead decision noted that Oregon’s system was “under stress because the state had relied on creating a facility-based approach to service delivery” reliant upon large hospitals. As a result, “the mental health system at present is meeting less than 50 percent of the need for public services for adults and children.”

The problem was evident in Central Oregon. Because the area lacked the necessary homes and community-based facilities, the mentally ill either remained in the state hospital much longer than necessary or were released to other areas of the state.

“We didn’t have nearly enough resources,” said Deschutes County Mental Health Director Scott Johnson. “I’d hear from a mom, ‘I’ve got a daughter (receiving care) in Medford and I want to bring her home,’ and we realized we needed to do more to keep people in our community.”

Bob Joondeph, president of the advocacy group Disability Rights Oregon, says it’s better to place the mentally ill in smaller facilities for several reasons.

“In a big state hospital there’s huge bureaucracy,” he said. “If you just look at our state hospital, there are all kinds of problems. . It is clinical, and supervision becomes more difficult with more and more wards and doctors. The tradition at the state hospital in Salem is that wards are these independent little fiefdoms, so there are difficulties (for patients) in transferring to different levels because of the politics within these institutions.”

Smaller facilities, he said, avoid many of those problems.

“They tend to be more relaxed environments,” he said. “The staff (relationship) to the patients is steadier and more direct, more long-term, and that’s good for folks.”

Joondeph said Oregon’s treatment model has long involved the transition of the mentally ill to smaller facilities as they recover. The model hasn’t worked perfectly, he said, but he believes the state is trying to revive it.

“For many years the system that was originally designed to be a step down became sclerotic,” Joondeph said. “It became clogged. And our mental health system is designed for people to move, and so once any part of the steps in movement become clogged, it backs up, and you end up with folks staying (too long).”

The state hospital, meanwhile, has had its share of problems. The hospital is famous for its role in the 1963 Ken Kesey novel and 1975 film “One Flew Over the Cuckoo’s Nest.” In 2008, the U.S. Department of Justice’s Civil Rights Division issued a critical report on problems at the hospital that violated patients’ rights. Among them, the report found the hospital wasn’t protecting its patients from harm, wasn’t providing proper assessments and mental health care, overused seclusion and restraints, and didn’t properly manage medication. The federal investigation into the hospital continues.

In 2010, Oregon began to implement the Adult Mental Health Initiative, which seeks to better use facilities already in place and to improve the coordination of care. The initiative aims to address a problem identified in a 2010 Oregon Health Authority memo: “Currently, too many Oregonians living with mental illness spend too much time in the wrong level of care and cannot access services that could help them become more independent.”

To combat the problem, the state decided to transfer responsibility for managing the residential services to local mental health organizations. The state’s large residential facilities “are less flexible and more costly than a community-based supportive housing system,” the memo states.

The Adult Mental Health Initiative provides funds directly to counties and other mental health organizations, allowing local government officials to determine — and pay for — the services their communities need. Deschutes County’s mental health department has used these funds for about a year to run its Assertive Community Treatment, or ACT, team. Each team member makes regular visits to a small number of people living independently or in supported housing, said Travis Sammon, the team’s supervisor. By making health checks, bringing medicine and ensuring the provision of needed services, team members help those dealing with mental illness live largely on their own.

“We can take people who have been in residential care for years, and what we’re able to do with the ACT team is put them in their own apartments,” Sammon said. “Some of them are 50 years old, and it’s the first time they’re on their own.”

ACT team members look for indications that their clients are struggling to manage their apartments and keep themselves clean and well-fed. They track police calls and visits by their clients to the emergency room.

Using local residential treatment homes, meanwhile, can prevent hospitalization for people in a downward spiral, said Sammon, though “sometimes it takes a while — a week or a month or three months.”

To Sammon, who worked in a state hospital before coming to Deschutes County, keeping the mentally ill in their home communities is vital.

“Being in a state hospital — it’s not very helpful to a lot of people to be in that situation,” he said. “It’s a very unappealing environment to help those who are not the illest of the ill. The units have people who are very psychotic, violent, aggressive. And that’s the last place you want to be if you’re trying to get help and recover.”

Sammon said the ACT team is cheaper, too. According to Oregon State Hospital spokeswoman Rebeka Gipson-King, the average cost for a patient to stay in the state hospital is $21,875 a month, or $262,500 each year.

“I can house a person for $6,000 for a full year,” Sammon said.

Much of this money is used to subsidize rent and provide housing vouchers for people who often receive less than $700 per month in Social Security Disability Insurance.

In 2010, nine people from Deschutes County were admitted for state hospitalization. In 2011, four were.

“I believe this is a direct result of having increased residential beds, which allowed us to divert a number of individuals instead of sending them to the state hospital,” Sammon wrote in an email.

The average length of hospitalization dropped as well over the same period. In 2010, locals committed to the state hospital typically spent 94 days there. In 2011, those stays lasted only 65 days.

Although the area has seen an uptick in the number and variety of placements available for people who are struggling with mental illness, many say there is a need for even more.

“We want lots of options. The state as a whole, they’ve made past development of structured residences more of a priority to meet the need,” said Kevin McChesney, who oversees Telecare’s Oregon operations. “Because of the budget we’re only serving 40 to 45 percent of people, so there’s a huge unmet need. We need those RTFs (residential treatment facilities) and RTHs (residential treatment homes), because people are backing up in the secure facilities. It’s a real need.”

In 1999, HousingWorks Director Cyndy Cook took her first step into supported housing for the mentally ill.

A pair of Deschutes County case managers showed up at her door that year and told her they couldn’t treat clients who didn’t have places to live.

“They were in crappy old motels,” she said. “Some were living in camps.”

Spurred by their pitch, Cook toured the Willamette Valley, talked to developers and mental health departments and checked out housing.

“I said, ‘We should be doing this, and we can do this better.’ ”

In 2000, HousingWorks opened Emma’s Place, an apartment community in which people with severe and persistent mental illness can live for as long as necessary. HousingWorks is also responsible for Horizon House, a two-year transitional housing facility in Bend, which opened in 2005; Prairie House, an apartment complex for people with mental illness in Prineville, which opened in 2006; and Barbara’s Place, an apartment complex in southwest Redmond for chronically homeless people with severe mental illness, which opened in 2010.

In 2010, Telecare Corp., in conjunction with the state, opened two five-bed residential treatment homes in northeast Bend. Those homes allow residents to come and go as they please, but provide structured times for eating meals and taking medicines and receiving various types of therapy.

“If you’re in a larger facility like the state hospital, you get three meals a day and housekeeping and all these things that make it so you’re at camp,” Joondeph said. “You go and all these things are taken care of. It’s not like living in the community.”

Months later, the Alameda, Calif., company opened a secure residential treatment facility on Poe Sholes Road in Bend. The locked facility has 16 beds and two staff members for every five residents. It also features a variety of oversight levels. Some residents earn the right to go out into the community on hours long passes. Others remain locked up, including some who are always in a staff member’s line of sight.

The goal at the secure facility, which opened in January 2011, is to help residents develop skills. Some, for instance, can earn a food handler’s card and work in the facility’s dining area and, eventually, a restaurant. Others work on hygiene and other coping skills like housekeeping.

“We try to get them to identify their hopes and dreams, then try to give them activities to move toward that,” said Emilie Dauch, the facility’s director. “If you’ve been institutionalized a long time, your hope has died to some extent. . Even the idea of an open kitchen can be a new thing.”

The region also has several adult foster homes to serve people with mental health issues.

Given the availability of many treatment options, a mentally ill person could conceivably suffer a psychotic episode and receive treatment without ever leaving Bend: starting at the emergency room or Sage View, moving through local facilities, and eventually returning to an apartment or family home. Those who present a danger to themselves or others can still go to a state hospital for help, as can those with significant needs. They return to the area when they feel better.

“We want people to move to lower levels of care, with more responsibility,” Johnson said. “If they deteriorate, they can move back up to a higher level. That continuum of care should go both ways.”

Ultimately, the local expansion of mental health treatment reduces the likelihood that Central Oregonians will end up in the state hospital. In addition to reducing treatment costs, this can prevent disruptions for patients, who would have to head to Portland, Salem or Pendleton for treatment, Sammon said. Such upheavals can force the mentally ill into a frustrating cycle: rebuilding lives that are already fragile.

Here are a bundle of documents and historical photographs of the Oregon State Hospital. These come from a variety of sources, including the State Archives and the State Library (which are fairly unsearchable through Google or Bing or other search engines). Some of the items come from our personal collection.

Female inmates receive nurse’s aid training at the Oregon State Hospital in the mid-1960s. (Board of Control Records, Photographs, box 4, separated from State Institution Research Reports, box 76, folder 23)

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Nurses display handicrafts created by patients at the Columbia Park Hospital and Training Center in a 1968 biennial report. (Board of Control Records, Photographs, box 4, separated from State Institution Research Reports, box 76, folder 23)

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This color lithograph depicts the Circuit Rider statue in front of the Oregon State Capitol in 1924. The lithograph was included in theprogram commemorating the dedication of the statue. The Capitol was destroyed by fire in 1935 and the statue was moved to the east side of the current Capitol. (Board of Control Records, Circuit Rider Statue Dedication Program, box 82)

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This architectural drawing depicts a proposed Oregon State Building in Portland. The drawing was created in circa 1938. The Board of Control oversaw the construction and maintenance of numerous state buildings. (Board of Control Records, Photographs, box 1, separated from State Building Construction Records, box 17, folder 9)

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Roller skating at the Oregon State Hospital in the late-1960s. (Board of Control Records, Photographs, box 4, separated from State Institution Research Reports, box 76, folder 23)

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A boy surveys some of the damage on the grounds of the Oregon State Hospital in the wake of the Columbus Day Storm of 1962. The storm caused extensive damage on the hospital campus and throughout much of Oregon. (Board of Control Records, Photographs, box 1, separated from State Institutions Correspondence, box 46, folder 11)

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Civilian defense officials wanted to use various state institutions for housing in the event of an emergency during the war. Shown above is the exercise yard at the Oregon State Insane Asylum in about 1905. (Photo no. OSH0023, Oregon State Hospital Records, OSA)

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• Minutes from a September 1968 Oregon Criminal Law Revision Commission discussion about partial responsibility for crime by persons impaired by mental condition
• Minutes from an October 1968 Oregon Criminal Law Revision Commission – same subject
  (This is perhaps one of the formative conversations about creation of the Psychiatric Security Review Board.)
• Oregon State Hospital Superintendent’s Overview 1968, 1968. By Dean Brooks, MD.
• Oregon State Hospital Administrator’s Overview, 1968. By Ken Gaver, MD
• Oregon State Hospital Administrator’s Overview, 2009. Unknown author. This text has a lengthy history of the hospital and timeline, a bibliography and organizational chart.
• An alphabetical list of the cremated remains (called ‘cremains’ by the funeral industry) of over 3000 patients of the Oregon State Hospital. These patients either had no family willing or able to collect their remains when they died, mostly in the late 19th and early 20th century. Families who identify relatives on this list should contact Medical Records Services at 503-945-2976. You can also reach Medical Records Services by e-mail at oshcremains@state.or.us or postal mail: OSH Medical Record Services, 2600 Center St. NE, Salem, OR, 97301. See also Oregon State Hospital unites families with cremated remains of deceased patients.
• The History of the Oregon State Hospital from 1883-2012, an unsigned Western Oregon University student 2-page essay. Includes a table of causes of insanity reproduced from the Seventh Biennial Report of the Oregon State Insane Asylum, December 1894 and November 1896.
• Effects of Publicity on a Forensic Hospital, by Scott M. Reichlin, M.D., and Joseph D. Bloom, M.D.Bull Am Acad Psychiatry Law, Vol. 21, No. 4, 1993
• The 2011 union contract for nurses at the Oregon State Hospital.
• The Right to Refuse Treatment in Oregon’s State Hospitals. PowerPoint presentation. Presented at OHSU Grand Rounds by Joseph D. Bloom, M.D., Martin Epson, M.D., M.T.S. and Liban Rodol, J.D., M.D. in 2012.
• Post-Hinckley Insanity Reform in Oregon, by Scott M. Reichlin, MD; Joseph D. Bloom, MD; and Mary H. Williams MS. Bull Am Acad Psychiatry Law, Vol. 18, No. 4, 1990
• Using a Specialized Foster Care Community Treatment Model for Children and Adolescents Leaving the State Mental Hospital, by Patricia Chamberlain and John B Reid, from the Journal of Community Psychology July 1991.
• Oregon State Hospital, 1883–2008, from the American Journal of Psychiatry – February 2009

From the Salem Statesman Journal, April 24, 2012

A theft of patient information from the car of the Oregon State Hospital’s chief of psychiatry has created a confidentiality breach affecting approximately 550 current and former patients, the hospital reported today.

Patients at Oregon State Hospital received a hand-delivered letter today explaining the details of the April 13 break-in of Dr. Michael Duran’s car outside the 24 Hour Fitness health club at 4546 SE McLoughlin Blvd. in Portland, hospital spokeswoman Rebeka Gipson-King said.

A backpack containing hospital notes and records is among the items taken by the thief, Gipson-King said. The records include:

• A case load list containing the names of approximately 550 patients in the care of the hospital during the first week in March. The list also includes the patients’ hospital identification number, and the doctor and treatment program assigned to each patient.
• Approximately 20 progress notes of individual patients, randomly drawn by Duran as part of an audit he was conducting of his doctors’ work. These notes include dates of birth and could include health information like the patient’s diagnosis.
• A notebook containing Duran’s day-to-day work notes.

The Social Security numbers of the patients were not compromised, and no electronic patient information was involved, Gipson-King said.

Letters detailing the breach will go out to all 618 patients treated by Oregon State Hospital during the entire month of March, to make sure everyone who could be affected is notified, Gipson-King said.

About 290 of those patients will be further notified that they could be one of the 20 people whose progress notes were taken during the theft, Gipson-King said. Because Duran’s audit was random, that is as far as hospital officials can narrow down the list.

“We have no reason to believe the information has been misused, but we want to make sure our patients are aware and have the support they need,” OSH Superintendent Greg Roberts said in a prepared statement. “The state hospital takes patient privacy very seriously. We will take any and all steps necessary to ensure no similar incident happens in the future.”

The break-in occurred around 10:15 p.m., after Duran had put in a late night at the hospital’s Salem campus. On his way to his home in Portland, he stopped off at the gym to work out, Gipson-King said.

Gipson-King said Duran took steps to hide the backpack, but the thief rooted it out and took off with it.

From the Transition Projects April e-newsletter

Shelley Dixon is a name that is known well around Transition Projects. Clients, staff and volunteers who have had the pleasure of meeting her will all sing her praises. Shelley has served every role imaginable at Transition Projects and has knowledge of both sides of the social service experience. She is not shy about sharing her story and you will agree that she shouldn’t be when you hear how far she has traveled in her journey.

Shelley came to Transition Projects in 1988, then Burnside Projects, as a client. Referred from her parole officer, she had been previously been to detox and did not have success. Arriving at the shelter, she jokes, that she had no idea of what she was getting into.

“I had a t-shirt, pair of shorts, no shoes and a teddy bear,” Shelley explains. “I showed up and said: where’s my room?”

Shelley enrolled in the drug and alcohol treatment and corrections programs to get her life in order. Shortly after that she began her community service, serving as a volunteer aid helping other clients access showers and clothing at Transition Projects, as well as volunteering with the Blanchet House and Sisters of the Road Café.

In August of 1989, Dixon was hired on as a residential advocate. During that time she worked out of temporary administrative offices in Portland’s Union Station. She was tasked with entering in the handwritten records of clients into a computer database. This made it possible to track services that clients used and how many nights spent in the shelter, something that had not been possible to keep up with before.

During that time, Shelley also worked at our Street Light Youth Shelter. Working 13 hour shifts, she saw kids showing up at all hours looking for a place to stay. She would eventually serve as shelter supervisor working the swing, graveyard and weekend shifts. What stands out the most to her about that time was the struggle to care for as many youth as possible with limited resources.

“How are you going to tell a 12 year old, at three in the morning, in the snow, that they can’t stay here?” Shelley says. “We found ways to get them in.”

By April of 1994, Shelley had become a case manager. She worked very closely with the corrections program and support groups, fostering relationships that would help her clients thrive. She was one of the first case managers at Jean’s Place, our women’s residential program when it opened.

In 2004, Shelley began meeting with every client that was put on our shelter waiting list. This allowed her to house 175 people in six months, a record that still stands.

Another program Shelley has influenced is the current mentor program. The initial class of graduating mentors were all at one time Shelley’s clients. Ask any of them and they will attribute some of their desire to change the lives of others to the compassion Shelley had shown them.

Some of Shelley’s proudest accomplishments involve the amount of people she was able to help and the longevity of their stay in housing after being placed. To her, the number one priority was always clients. There was something about her that allowed clients to open up to her and share information and stories that they never had before.

“I don’t know how or why,” Shelley admits. “But they would come into my office and begin to tell me all of the things that they would never tell anyone. Sometimes things that they wouldn’t even admit to themselves.”

For all she had accomplished, Shelley credits her coworkers at Transition Projects. She can rattle off a list of names of current and former staff members that have helped make her success possible. Shelley is amazed by the ability of each individual to look past appearances and personal barriers and treat everyone with respect, something she role-modeled on a daily basis.

Shelley retired shortly after Transition Projects offices moved into the Bud Clark Commons. She was able to see the organization and its clients benefit from the new setting.

“I loved the surroundings. I loved it for the clients, because the building was built for them. Basically it came down to more space for everyone.” Shelley says.

Shelley’s work throughout the years should not be measure by how many individuals she housed or connected to services, but rather in the number of relationships she has created. Staff or clients, everyone has a story involving Shelley’s kindness and compassion.

“We see people fail on a daily basis,” says Shelley. “At a certain moment in some individuals’ lives they cannot move past those failures. But then, there are so many people who do well and that is what keeps you going.”

Curry County in far southwest Oregon has given up attempting to manage its public health, addiction health, mental health and developmental disability departments. Commissioners are seeking a independent nonprofit organization to manage the state contracts currently managed by the Public Health Department and Mental Health Departments.  Several other Oregon counties are in similar distress, including Lane, Josephine, Klamath, Coos, Douglas, Polk and Coos.

No prospective vendors for these services have been publicly acknowledged. The State of Oregon’s office of Addictions and Mental Health does not provide county-based service contract oversight.

County OKs tentative health budget – Curry County Pilot 4/17/2012

The Curry County Budget Committee has approved a tentative budget for the Health and Human Services Department, which the county hopes will not be used.

“The budget for Health and Human Services Department is a space holder,” Jan Kaplan, director of the department, told the committee last week.

The county plans to spin off the department to a nonprofit agency, hopefully by July 1, the beginning of the new fiscal year.

“We may not make that date,” Kaplan said. “But our future budget changes depending on the organization we become part of.”

Commissioners consider closing Curry health – Coos Bay World 4/1/2012

Commissioners told Health Department Administrator Barbara Floyd the news last Monday, when it was her turn to present her department’s plan at a budget meeting.

“I had no idea the commissioners were entertaining this idea,” said Floyd, who has managed the department for 13 years.

Floyd believes that no matter how the issue ultimately is resolved, residents will receive fewer health services.

“People need to know what is going on,” Floyd said Thursday. “This is about every single person who lives in this county.”

Curry County Rejects State Plan For Financial Stability – OPB.org, 4/19/2012

Curry County Commissioners have rejected the state’s plan to help put the county on a path to fiscal stability. The Commissioners say they can’t support spending $75,000 to pay for the committee that would work out a restructuring plan.

County Chair David Itzen says Commissioners aren’t denying the urgency of the situation. Round after round of layoffs have gutted basic services like public safety and the health department.