Editor's note: The illicit drug trade is undergoing a seismic shift, with Utah in the middle of the deadly impact of opioids. This is another in an ongoing series of stories about this modern-day plague. Today, a possible solution.
SEATTLE — Huddled behind a line of cars in a parking garage in the Belltown neighborhood of Seattle, Turina James and a friend hurriedly unpacked spoons, foil, a needle and a precious parcel of white powder. Sometimes they smoked the heroin and sometimes they injected it. That day in 2014, they decided to do both.
Outside, it was summer in Washington, the singular time of year when Seattle residents enjoy sunny weather and relief from relentless gray skies. But nothing could compare to the warmth that heroin brought. With each hit, James sunk further into the familiar feeling. She didn’t use enough to get her high, just to get well. All the 45-year-old single mother needed was enough to get through another night of homelessness.
On their way out of the garage, James suddenly stopped. She was struck with reflexive fear as two bicycle cops rolled in. “Here comes the bikers,” she warned her friend.
But as the officers approached, it became clear that they weren’t there to arrest anyone. They started chatting with the pair about a program where instead of throwing drug users in jail, they are paired with a social worker who helps them get treatment and housing. It's called LEAD — Law Enforcement Assisted Diversion — and James had heard about the program from friends on the street.
“What do I have to do to get into LEAD?” James asked.
The only way to get in was to get caught committing a crime, one of the officers said. “Do you have a crack pipe on you?”
Normally, turning over drug paraphernalia to police would mean being locked up for several nights in jail. But James trusted the officer. And she was tired. Tired of sleeping on concrete, tired of scrounging for drug money, tired of living in fear. She considered what he was asking her to do, and what her life would look life if she didn’t make a change. She retrieved her small glass pipe and presented it to the police.
Is LEAD a solution?
When it comes to helping heroin addicts on the street kick the habit, Seattle has come up with an innovative, albeit controversial approach.
Instead of sending low-level drug offenders to jail, police can refer suspects to LEAD, which provides them with intensive long-term case management and a chance to change their lives.
Since 2011, more than 500 people have been enrolled in Seattle’s program, which has been replicated in 11 cities across the country from Santa Fe, New Mexico, to Albany, New York.
According to a peer-reviewed study that looked at 318 people suspected of low-level drug and prostitution crime in downtown Seattle, participants in the program were 60 percent less likely to be arrested, 89 percent more likely to have a place to live and 46 percent more likely to have a job in the six months following enrollment.
Unlike other diversion programs, LEAD does not force clients into addiction treatment. The individual dictates what kind of assistance they want to receive, and there is no timeline for recovery. Case managers become their clients’ personal advocates, offering legal assistance and helping them access social services like housing, health care and therapy with the goal of getting them to a point where they can live drug-free.
Last year, Salt Lake City opened a community resource center downtown where people in need can meet with social workers and get help with anything from signing up for Medicaid to getting a legal ID. It’s called the Community Connection Center, and it is the closest thing to Seattle's program in Utah because police can choose to refer someone to the center instead of taking them to jail.
From 2013 to 2015, Utah ranked 7th highest in the nation for drug overdose deaths, according to the Utah Department of Health and nearly 1,213 people in the state died from opioid overdose from 2014 to 2015, according to the Utah Department of Human Services. Opening the downtown resource center isn’t the only thing Utah legislators and police have done to ensure people suffering from addiction get help instead of being punished.
The Justice Reinvestment Initiative, which began in 2015, reduced certain drug crimes from felonies to misdemeanors and is projected to save $542 million in corrections spending over the next 20 years, which can then be reinvested in treatment.
Although other diversion programs also offer case management and therapy, Seattle's program has distinguished itself because of how long it sticks with people in addiction. When a Salt Lake City police officer decides to drop someone off at the Community Connection Center instead of taking them to jail, there’s nothing to stop that person from leaving, and typically little effort is made to follow-up with them.
LEAD, on the other hand, is a collaborative approach that brings police, social workers and prosecutors together to make sure they don’t lose track of any clients, even when they relapse.
It is not a perfect solution and does not work for everyone, but for Turina James it was a new chance at life. And for Salt Lake City, it may be a model to learn from.
Drugs and trauma
James will never be able to forget the image of her deceased infant son’s face. It was the traumatic and accidental death of her baby boy in 1986 that spurred her first foray into heroin and cocaine at age 17.
James fought her way back to sobriety after giving birth to a premature baby girl in 1989. Terrified of losing another child, she slept in a chair in her living room with the baby clutched to her chest, instead of putting her in a crib, for nearly a year. Off of drugs, James was able to launch a successful career as a property manager, in addition to starting her own construction and home repair business. At the height of her company’s success, she was making more than $70,000 a year and providing a comfortable life for her family in the Queen Anne area of Seattle.
Then, after being clean for 17 years, several unsuccessful pregnancies and a series of surgeries that followed got her hooked on pain medications and catapulted her back into the throes of heroin addiction in 2007. Eventually, she would lose her business, her marriage, her house and all her savings.
By 2014, she was homeless and broke. One night in the spring of that year, she decided to leave the tent encampment where she had been staying under a bridge downtown by Pike Place Market, unable to stand another moment in that filthy place where rats crawled over people who were sleeping or too high to notice. She wandered the streets without a destination in mind, her arm was swollen and throbbing from an infection that started with a spider bite and was now eating away at her bone. All she wanted was a safe place where she could be alone.
Eventually, she came across an alley and a doorway in the Pioneer Square neighborhood, no more than 3 feet by 3 feet. Small and frail, she fit easily in the space. Placing cardboard underneath and around herself to keep warm, and using her backpack as a pillow, she slept.
It would be her home for the next three months before she joined LEAD.
How it works
LEAD started in 2011, covering just the Belltown neighborhood of Seattle with four case managers. In the first year, the program cost $435,000 and was funded by grants from private foundations, such as the Ford Foundation and the Open Society Foundations. Since then, the program has expanded to cover most of the city and employs 14 case managers who each handle about 25 clients. The city and county stepped in to provide additional funding, and the budget now exceeds $2.5 million.
Case managers are employed by a nonprofit called Evergreen Treatment Services and work closely with police, often riding along with them in a patrol van to talk to people in need or look for clients who may have stopped showing up to appointments.
When police come across someone with a nonviolent history who they have reason to arrest, they offer LEAD as an alternative to jail and prosecution. If the person refuses to participate, they are charged with the crime they were caught committing.
After the program started in 2011, police encountered many people like James, who were willing to confess to a crime just to get in. Since then, program leaders have changed the rules to allow police and community members to refer people to to the program without witnessing illegal activity.
“Not everyone belongs in jail,” said Seattle police officer Felix Reyes. “(Before LEAD) I was arresting the low-level drug offenders, the people shooting up in alleys. It was never the actual bad guys I wanted to: the predators and big dealers.”
According to Reyes, drug addiction is not a problem that police can “arrest our way out of.” LEAD offers an alternative solution that is both necessary and effective.
LEAD meets you where you are
After joining the program, James was paired with a case manager named Najja Morris, a woman with a smooth voice, shaved head and the Egyptian symbol for life tattooed on her arm along with the names of her three children. Eventually, James would call Morris “my savior.”
Morris immediately arranged for James to move from the alley where she was sleeping to a small motel room on Aurora Avenue in North Seattle, paid for by LEAD funds.
At the time, James recalls stopping by the LEAD office to get coffee, but not much else. She was in the program for about a year before she decided she actually wanted treatment for her addiction. At that point, Morris helped her enroll in a methadone program where she started getting daily doses of medication to curb her heroin cravings.
By Morris’ estimate, less than one-third of people referred to the program are ready to seek addiction treatment or counseling right away. Most are not emotionally or mentally ready to stop using drugs.
James had a lifetime of trauma to work through: abuse as a child, teen pregnancy, her son’s death, two failed marriages, illness and finally homelessness. She wasn’t ready to tackle it all on day one.
That’s why, instead of requiring abstinence and forcing clients to follow a one-size-fits-all treatment plan, LEAD uses a “meet you where you are” approach to provide individuals with the help they actually want. A lot of participants start out by getting food and clothing, or trying to get a job or housing, before they can commit to getting clean, according to program manager Cathy Speelman.
The only condition for remaining in the program is that participants keep in touch with their case manager and accept some kind of service, which could be anything from signing up for Medicaid to simply stopping by the office every few weeks for a cup of coffee, like James did.
Later, when James was in and out of the hospital for various surgeries because of the bone infection in her arm, which had also spread to her neck, Morris accompanied her to doctor’s appointments and sat by her hospital bedside. She brought snacks and toiletries when James needed them, and listened as she talked about her fears, anxieties and plans for the future.
On another occasion, Morris drove James across the state to her hometown of Yakima, a five-hour round trip, to see if she could take care of her grandmother and rent an apartment there.
“I don’t think I’ve ever had someone in my life who was there for me like Najja was,” James said.
According to James, it was Morris’ patience, understanding, consistent outreach and keen ability to tell when James was lying about her drug use, that kept her engaged in LEAD services until she was ready to get clean.
Seattle police on the street
It’s an overcast November afternoon and officer Felix Reyes abruptly pulls the police van to the curb in front of a Starbucks a few blocks away from Pike Place Market, one of Seattle’s most popular shopping destinations. He and two other officers spring out of their seats and onto the sidewalk.
Before anyone on the busy corner of Pike Street and 3rd Avenue recognizes what’s happening, the officers have stopped four young men gathered around a brand new Sonicare toothbrush, still in the box. To the officers’ trained eyes, it’s clear the item was shoplifted and the men are trying to sell it for drug money.
Mikel Kowalcyk, a LEAD case manager, is riding along with the officers. She has purple hair and wears black gloves with the fingers cut off. She has her own history with drug abuse but has turned her life to helping others with addiction. Kowalcyk immediately recognizes one of the men as a LEAD client.
“That’s one of our guys,” she says before the van even comes to a stop.
The police bring the men to stand on the curb. “What is your name and date of birth?” they ask each one.
Grant is a 23-year-old, originally from Cedar City, Utah, who has been homeless in Seattle for four years. He has a shaggy mess of black hair and wears jeans that are baggy on his slim frame. He’s already been referred to LEAD, and Kowalcyk asks if he wants to see his case manager, Hector.
“I actually really want to talk to him,” says Grant. Within minutes, Hector arrives from the LEAD office, just five blocks away. Grant has only been in the program for two months but speaks highly of it. “It's given me a plan, like something to do instead of nothing out here," he said.
One of the officers addresses another young man, Julian, whose scab-marked face peeks out from underneath a dark blue hood. He is notorious for shoplifting. But he’s not the bad guy on these streets, according to the officers. Just last week, he was the victim of an assault they explain, looking at his police record.
“Everyone knows that you’re a likeable guy that’s in a bad situation,” says officer Chad Winfrey, who is firm but kind. “If you get in the LEAD program, that’s your chance.”
Kowalcyk, the case manager, explains to Julian how the program works. She will do a brief intake interview and then he has 30 days to show up at the nearby LEAD office for a full assessment. Once he does that, he’ll be officially enrolled. If he doesn’t show up within 30 days, the caseworkers and officers will go out and look for him. Then, if they can’t find him after awhile, or if he refuses to come in, he will be charged for the crime of selling stolen goods.
Julian agrees meekly, and the officers part ways with the men.
No one is sent to jail.
Though most police officers in Seattle are happy to work with LEAD, some are critical of of the program’s “harm reduction” philosophy, which aims to reduce the negative consequences associated with drug use, rather than trying to stop drug use altogether. Because clients are not forced to get treatment, some never do.
Not everyone in the program is a success story, and despite all the support the program offers, some clients continue to commit crimes and end up in jail or prison anyway, according to Reyes.
“I’ve seen epic failures, but I’ve also seen monumental successes,” said Reyes, who was skeptical of the program at first but quickly became a fan after seeing how it helped people.
Reyes and his colleagues in law enforcement do not consider LEAD a perfect solution but see it as a necessary alternative to arresting someone.
“Ultimately, it’s another tool in our belt,” he said.
LEAD is not a “get out of jail free card,” Reyes is quick to note. Clients who continue to get caught committing crimes will have to face the criminal justice system. But that doesn’t disqualify them from the program either. LEAD case managers often accompany their clients to court appointments and arrange to meet them when they are released from jail.
Reyes describes the program as a speed bump in the cycle of drug use and incarceration that many get caught up in. It doesn’t automatically stop them. But instead of letting people cycle out of control, police and case managers offer them services at every juncture.
“We’ve inserted a program where every time they cycle, they keep hitting this bump and slowing up,” said Reyes. “People eventually stop on that bump. And they get their lives back together.
Turina James now
Today, James has been clean for two years. Thanks to LEAD, she has stable housing and is going back to school. She contributes to the community by serving on several public committees, including as a board member for the Public Defender’s Association.
Wearing a black beanie and blue eyeliner on a recent Thursday afternoon, she appears completely comfortable in the room of younger students at Seattle Central Community College. She grips a mechanical pencil in her previously infected right hand, which is still in a brace and likely will be for the rest of her life.
Because she got pregnant as a teenager, James never made it past the eighth grade. But now, at age 48, she’s studying to get her GED and meeting with a tutor, 30 years younger than herself, twice a week to practice basic math skills.
The titles of her worksheets read, “finding a percent of a number,” “rewriting percents as decimals,” “learning to use a calculator.”
“It’s really simple when you figure it out, but it’s really hard when you don’t understand it,” said James.
Tutor Hailey McGill, 18, sweetly encourages James and corrects her mistakes. “Good job, you’re getting it!”
James’s goal is to get a degree to become a chemical dependency counselor and then go back to work for LEAD.
In the meantime, she works part time watering flowers at Pioneer Square, an area she used to frequent when she was homeless. She uses it as an opportunity to reach out to people she knows, caring for them as she does the plants. She wants to show others that with help, it is possible to revive a withering life and start again.
“If I can do it, they can, too. And that’s what I try to tell them,” she said.