Each month this year, KQED Public Radio's The California Report is hosting special statewide live discussions of health issues of importance to Californians. More than a dozen public radio stations statewide air these informative sessions, and many of them have added local programming of their own to this special project.

In March, the discussion focused on California Drug Treatment Policy, with particular emphasis on Proposition 36. Program guests included Stephen Manley, Superior Court Judge in Santa Clara County; Dr. Lonny Shavelson, an emergency room physician at Alta Bates Hospital in Berkeley and author of "Hooked," a book about California substance abuse treatment programs; Ryan Añonuevo, a drug rehabilitation client at Walden House in San Francisco; and Cheryl Branch, co-founder and chairperson of the African American Alcohol and Other Drug Council in Los Angeles. Our special broadcast was part of Health Dialogues, an ambitious two-year special effort to look at California health issues, funded by The California Endowment.

As a California civic and legislative leader, you have made a commitment to examining and addressing health issues. We thought you would want to hear a few of the comments, summarized below, made by callers some of whom are your constituents. I am also enclosing a compact disc recording of the entire program in case you or your staff might wish to hear the conversation in context.

Here are some of the issues that surfaced during the program, which we think can be further illuminated with your ideas, suggestions and comments:

1. San Franciscan Scott Lyons expressed concern about inadequate funding under Proposition 36. He and others said California's drug rehabilitation system has long been underfunded and understaffed. Indeed, our research indicates that Los Angeles County alone could use the entire $120 million state allocation under the Proposition and still not meet the needs of its population. And an influx of thousands of new treatment patients under Prop 36 can only make things worse. What can the state do to raise enough funds to properly treat the large numbers of addicts under Prop 36?
2. Robert, of Santa Cruz cited examples of potential harm reduction programs such as educating drug users and their associates about HIV and hepatitis and urging them to call 911 in case of overdose. Californians could be better served if Proposition 36's goal were harm reduction instead of absolute sobriety, according to Dr. Shavelson. He said few addicts are able to stay 100 per cent clean, but that rehabilitation could mean fewer incidents of domestic violence, higher employment and better educational opportunities for current drug abusers. Would you support evaluating the success of drug treatment programs by assessing harm reduction outcomes and not strictly by measuring drug use?
3. Ben from Poway in San Diego County said he is frustrated that most California courts do not approve of using methadone to treat narcotic addition despite evidence of its effectiveness. This is partly because of lack of funding but, Dr. Shavelson said, it is also an ideological issue where judges refuse to let addicts use a form of treatment that could help them get off drugs. Would you favor legislative action to make these forms of treatment available to drug offenders under Prop 36?
4. J.B. from San Francisco complained that substance abuse and mental health treatment providers are supposed to work together, but they really don't. Drug treatment facilities turn down patients with mental illness, and psychiatric facilities are rejecting patients with substance abuse problems, according to Dr. Shavelson. The "dually-diagnosed," those who have both mental illness and chemical dependency, get caught in between these camps and fall through the cracks. What would you advocate so that these individuals actually get adequate care under Prop 36?

These comments, along with other information about the program and the issue, will soon be available on our web site. We would be pleased to be able to add your observations to our web site -- particularly any responses to the questions above. I invite you to join this lively discussion.

The aim of Health Dialogues is to facilitate a statewide discussion on important health issues -- a conversation that brings to the table (on air and via the World Wide Web) policy makers, state officials, private sector organizations, non-profits and everyday citizens affected by health issues and policies. We believe that your observations and ideas would enrich that conversation.

Sincerely,

Raul Ramirez, Director
News and Public Affairs
KQED Public Radio