Mobile Care for Drug Users Affected by Katrina

The Postscript of Our Trip: Behind the Scenes

2005-10-06T12:12:00.000-07:00

Baton Rouge Treatment Center was not even extending its usual hours to deal with the influx of patients. We had talked with Carl Kelley, the clinic director – he knew we were driving down from Chicago with a specially designed, DEA-approved mobile methadone van – but when we arrived Friday the 16th at 1:13, the place was locked up and deserted. Well, deserted except for the desperate evacuees who kept driving up and asking us “where can we get our methadone?”

One patient from a NOLA clinic who arrived 10 minutes after quittin time (1PM) on Friday the 9th was told by staff that, if she wanted to be sure to be medicated by 1PM, she should be in line by 1AM (yes, that's one o'clock in the morning). This even after she told them that she and her husband own a trucking company and were working for FEMA. She said she drove past the clinic at 3 the next morning, and there was indeed a line in the parking lot. At 3AM. Carl Kelly, director of BRTC, told us "we hope the evacuees find health and happiness -- BACK IN NEW ORLEANS. Frankly, we don't want them here"

In LaPlace, Joanne Brown, owner of Choices of Louisiana, told us "we're going to rebuild New Orleans as the world's first drug-free city – the bad elements just won't be allowed back in". At her clinic, which was also closed up tight promptly at quittin’ time, she had actually lost some census, as some of her patients were from New Orleans and had evacuated to Houston.

She wasn’t even interested in looking at the mobile van. A DEA agent was visiting her facility and we invited him to look it over (he was very interested and stayed almost an hour asking questions). Joanne pulled me aside and said “do you really want him on there? I mean… you don’t have drugs on the van, do you?”

Well, some methamphetamine and exstasy, but those are just for personal use, Joanne, not to worry. (I don’t think she realized I was joking).

There were monies sent from SAMHSA to hurricane-affected states, and they were allocated thusly, according to H Wesley Clark:

•Alabama and Mississippi used their respective $150,000 and $100,000 for mental-health services
•Texas used its $150,000 for methadone services for storm evacuees.
•$200,000 was sent to Louisiana, who budgeted it all to provide mental-health counseling for police, firefighters, and other first-responders

In Baton Rouge I spoke personally to the physician in charge of the Red Cross shelter at the Civic Center (5,000 evacuees), to Dr. Dunham of the Baton Rouge Office of Addictive Disorders, to Brenda Lanz, State Methadone Authority, to Carl Kelly, director of Baton Rouge Treatment Center, and to Joanne and Roy Brown, owners and directors of Choices of Louisiana treatment center. All of them said exactly the same thing: Everything is under control. All the patients are taken care of. The emergency is over with. There’s no problem here, we don't need your help, Yankee go home.

Samantha Hope-Atkins was unable to help us connect with any facility that would be interested in letting us help provide methadone to opiate addicts. Dr. Mooney (who was told by the Red Cross that he could not do detox in the shelters; he set up a table across the street – yes, really) said his philosophy was abstinence-based so he wasn’t interested in working with us.

The one exception was New Orleans Narcotic Treatment Center, where owners and directors Diana and Alex John were still working to medicate patients 6 hours after "closing time" on Monday the 19th, the first day they were open after the storm. We talked to several of their patients (patients at all other clinics refused to talk to us, saying they were afraid of being identified BY THE CLINIC). NONTC patients were universally grateful to the Johns, saying they had gone out of their way to get patients medicated and give them exceptions for emergency carries before the storm, and to see patients at their other clinics at any hour of the day or night. The Johns told their patients: ‘don’t worry about the money now, just get in here and get your methadone’.

Back in Chicago

2005-09-26T11:21:00.000-07:00

Hello Everyone
It is good to be back in the Chicago area, although I think we are feeling quite drained from our excursion.
Spoke with Dan and Sarz they both say they feel quite shell-shocked, I quite agree.

I was so happy to see my clinic and see the clients, they were all very much interested in what was happening in LA. I feel they were frightened as to what would happen to themselves if something tragic happened in the Chicago area.

I have included some pics of the BBC, it is not your "ordinary" methadone clinic and I am very proud of it.

I wanted to include some background info about the mobile van and how this collaboration between CRA and BBC began.

TOPIC: The Bobby Buonauro Clinic (BBC) and Chicago Recovery Alliance (CRA) working together to implement a mobile clinic.

Beginning: In the fall of 2003 Mr. Dan Bigg (CRA) contacted Elizabeth Buonauro (BBC) regarding any interest the BBC might have in a mobile clinic. Mr. Bigg explained that he and CRA had been working with Family Guidance Centers, Chicago, IL regarding this proposed mobile clinic. Negotiations between CRA and Family Guidance Centers had broken down and CRA was looking for another MAT program to partner with.
The BBC was interested and work was started. Policies/Procedures were drawn up and sent to the Illinois Department of Human Services/Division of Alcoholism and Substance Abuse (DASA). The negotiations with DASA then consumed the next year. After several meetings, several changes on drafts, and several changes on plans for operating the mobile clinic, the BBC received the final approval on January 14, 2005 from DASA.
The BBC has been granted a new DEA license for operating the mobile van and approval from CSAT.
It is our sincere hope that this facility will be available to the Chicago area public during the month of October, 2005.

I am including some background info about the mobile van. The following are the specs for the van itself.
The drawing was completed by Sal Sottile, Architect for BBC.

BBC
The Bobby Buonauro Clinic, Inc

1029 West Howard Street

Suites 301 & 303

Evanston, IL 60202

Phone (847) 869-1808

Fax (847) 869-1950

MOST
Mobile Opiate Substitution Treatment

400 East Ohio Street, Suite 3103

Chicago, IL 60611

Phone (312) 797-2223 or (773) 569-899

Fax (773) 561-2499

Mobile Care for Drug Users Affected by Katrina

2005-09-22T06:46:00.000-07:00

Army convoys heading north:

Got Pain??

Tuesday 20 September 2005 4:37 PM

We’re heading home.

It’s hard not to feel defeated. Cos, you know, we kind of have been.

Today we talked to everybody in the whole world, and the upshot from the Feds was that there is no authorization for me to prescribe Suboxone in LA, and no waiver of the 30-patient limit. I guess Katrina doesn’t qualify as a REAL emergency. Ask again Friday, maybe after a second hurricane Louisiana will be a true disaster area.

We’re not sticking around to find out.

I am personally convinced that CSAT and SAMHSA did their level best. I put the blame on the Louisiana state authorities, who have a stranglehold on MMT. I also blame those MMT programs who are more concerned with making money and keeping the wrong sort of patients out of their nice clean clinics than they are with taking care of opiate addicts. I’ll tell you, this trip has made us really appreciate Illinois. Liz says next time she sees Richard Weisskopf (our SMA in Illinois) she’s going to give him a big fat kiss. Give ‘im one for me too, Lizzie. Nothing like a trip back in time to make us realize how progressive things really are at home.

Dan has a short video of a NONTC patient who was dosed in LaPlace… I’ll figure out how to post it when we get home. It’s very telling. We were told that LaPlace (Choices of Louisiana) is also the program that, when they had the providers’ conference call, led the vote to totally blackball us. Yankee, go home. Jesus, you’d think we’d arrived whistling “Marching through Georgia”.

We can’t distribute harm reduction materials ourselves either, even if we could get around the Draconian paraphernalia laws. In Baton Rouge there aren’t any established heroin marketplaces – YET! – remember, Terri said the dealers in town have loads of heroin that they’re holding until the markets are consolidated in the trailer parks they’re moving the shelter people to. The shelters aren’t great for dealing, too many men with Uzis around. Besides, every day the price increases.

But there’s no established heroin marketplaces now. Terri does outreach mostly with CSWs (commercial sex workers, if you’re unfamiliar with that particular acronym) and, as I’ve said, Baton Rouge is a crack town, not a heroin town (yet!). Anyway, all this is in aid of saying that there isn’t really any particular places for us to set up harm reduction outreach sites in BR. We’re pretty sure Baton Rouge Treatment Center would call the cops on us in a heartbeat if we set up exchange services in their parking lot… and the shelters are, as I think I mentioned, surrounded by men in jungle fatigues carrying automatic weapons. Did I mention the paraphernalia laws in Louisiana are a bit strict? I think I could bull my way through distributing needles under my medical license, and naloxone is legal for me to prescribe and dispense anywhere, but cookers and cottons… we were definitely getting the idea that the locals were looking for an excuse to hang something on us in Baton Rouge. We weren’t their kind of people at all, nope.

And in New Orleans? Well, I think I mentioned, there’s another fucking hurricane on its way; they’re evacuating the poor damn town again. We’d have to do outreach out of a humvee. Or an ark. That poor city. Maybe Rita will give them a break. At least when Rita hits Texas, FEMA’ll be prepared. Funny, for the past however-many-years, FEMA was the one federal program you could depend on: efficient, compassionate, on-the-spot, effective. Then Homeland Security takes over and all of a sudden it takes FEMA half a week to fucking recognize a disaster situation, and another week to figure out that a disaster area may need food and drinking water.

No worries, though. Katrina was a trial run, and luckily the people were the expendable sort. Now that Rita is going to hit an important state (two important states, I hear Florida’s governor has connections, unlike Louisiana), they’ve had some practice and they know what to do. Like rescue the folks, and give ‘em a drink of water.

Texas even has addictions care set up. SAMHSA sent a $150,000 grant to Texas, and all of it is going to MMT. How d’you like them apples? So it is possible to get things done for opiate addicts. As long as they’re not unlucky enough to be in Louisiana.

We’ve met some amazing people. Vernon J Shorty stopped by NONTC. Vernon is executive director of Desire Narcotics Rehabilitation Center (and I just have to say I purely adore the name), one of the MMT clinics on the East bank that was pretty much wiped out. He hopes to re-open next week, actually… Rita allowing. He wanted to reopen sooner, but for the latest evacuation. He was a very cool guy.

We said goodbye to Alex and Diana John, bought a bunch of Subway sandwiches for the clients that were still inundating the clinic at 1:30 PM, an hour and a half after ‘closing time’. The Johns are great people, really great. We’ve met some amazing people on this trip.

I want to say a bit about a place in Mobile Alabama called Applied Pharmacy Services. They make a sublingual form of generic buprenorphine, in a wax-based sublingual troche, in varying doses. At this point, of course, this generic buprenorphine is not approved for use in treating addiction, only pain. The price, however, is very different from Suboxone: an 8mg tablet of Suboxone costs between $5 and $7, depending on what store you buy it at. The generic 30mg troche costs $6. Applied Pharmacy Services also offered to us that they would match any amount we bought with an equal donation, essentially bringing the price down to $3 per 30mg troche. That’s $0.10/mg for the generic versus approximately $0.75/mg for Suboxone.

I don’t know what ever happened to the Suboxone that Reckitt-Benckiser was supposed to donate. On Friday the 9th the Feds said they would send some of that allegedly donated Suboxone to Liz’s clinic in Chicago. On Tuesday the 13th the Feds said there were problems with conditions that Reckitt-Benckiser was putting on the donation, and the Feds still had not been able to authorize its distribution, but they would send it to Baton Rouge Treatment Center and we could meet it down there. We left Chicago Wednesday the 14th. Friday the 16th we arrived in BR after hours for the BRTC (1:15), but on the phone Carl said only that the Suboxone had not arrived. The Feds told us at about 4:30 on Friday that they were still trying to get the Suboxone to us. .

Tuesday the 21st, the Feds tell us that Suboxone can only be distributed from an MMT under methadone rules, that I can’t be authorized to prescribe or dispense Suboxone in Louisiana, and that they couldn’t waive the 30-patient rule in any case.
&%*$& me.

You know, it seems to me that, in a disaster situation, there ought to be a way for federal jurisdiction to override State barriers. But I guess that’s just me.

I can’t help but think that R-B fucked around with that ‘donation’. My experience with them is that they are not the most compassionate firm around. I mean, is there any other medication for any chronic condition where the drug company has NO patient assistance program to allow for indigent patients?? None that I’ve ever heard of, not for any medication for any chronic condition. I guess I’ve been spoiled by the psychotropic firms in the US. When the SSRI antidepressants came out and were so much more expensive than the tricyclic antidepressants, Lilly and Pfizer and each of the companies immediately set up extremely generous patient assistance programs, not to mention all the samples we could use. When the atypical antipsychotics first came out, and were prohibitively expensive, it still was clear they were clinically superior to the older antipsychotics… and any patient who needed Zyprexa or Geodon or Seroquel or whatever was NEVER prohibited from getting the medication just because they couldn’t pay for it. But Suboxone?? Honey, if you ain’t got the big bucks you are just plain shit out of luck. Not to mention the 30-patient limit. No, I am not going to mention the 30-patient limit. Do NOT get me started, just don’t.

So… we’re heading home. It’s very obvious that the major impact we’ll be able to have is for the future. We can make our findings public, make them known to people who might be developing emergency management guidelines for addictions treatment programs. And, who knows, we may help to expose the execrable condition of addictions treatment in Louisiana.

We were able to leave a huge load of harm reduction supplies with the people in Baton Rouge. Their little outreach packet with the single syringe was so touching… and rather frightening. We left enough stuff that they can give out packages of syringes… boxes… cases!! Lots of condoms, loads of lube, other injection equipment, naloxone, naloxone training videos, not to mention boxes of canned goods and about fifty gallons of bottled water. They’ll share all that with the harm reduction programs in NOLA, as soon as those programs are up and running again. We never did make connection with Danita from the NOLA harm reduction program – talked with her several times, made plans to meet a couple of times, she never showed up.

Wednesday 21 September

Got a call just as we were leaving New Orleans from a Dr. Nancy Johnson, who’s in private practice in Shreveport LA. She had heard about our Mission… Quest…. Thing, and wanted to know how she could help. We suggested a revolution, but short of that couldn’t really come up with anything.

She was so nice, said she’s often very frustrated by the archaic Louisiana attitudes. “Thanks for coming down here,” she said. “Thanks for trying to help our poor patients, and our poor state.”

Well, here’s the last that Louisiana saw of us:

Lizzie's rear end (again)

Mobile Care for Drug Users Affected by Katrina

2005-09-20T14:11:00.000-07:00

John and LizzieB:

Liz with Carl Kelly at Baton Rouge Treatment Center:

Mobile methadone? NO! Mobile insurance? HELL YES

Church of Scientology to the rescue:

Choices of LA, MMT clinic in LaPlace, owned by Joanne and Roy Brown:

Inside at Choices of LA:

Medication booths -- when you're ready, you push the little bell, and they buzz you in... kind of nice system for privacy

Dan with Roy Brown at LaPlace clinic:

People trying to get back to normal:

Sloooooooow traffic moving toward checkpoints as people start moving back into NOLA (of course, this is the day before they decide everyone should move out again, thank you Lovely Rita)

traffic's moving slowly enough that John decided to walk beside the van and catch a smoke:

Police checkpoint to get into New Orleans:

Obligatory shots of the devastation in New Orleans:

New Orleans Narcotic Treatment Center, the only MMT program in New Orleans that wasn't virutally destroyed, opened Monday morning for business. The posted hours are 5AM to 12Noon

Alex and Diana John, still working at 5:30 PM on Monday.

Healthcare in Louisiana:

Monday 19 September 9:51 AM

Got to Baton Rouge Treatment Center around 7AM. Security guard greeted us with “New Orleans?” but let us thru when we said we had an appointment with Mr. Kelly.

Carl Kelly is a perfectly nice guy, seems to want to run a good program. CRC is a corporation. They have lots of rules. Like, they have a general policy that they don’t give split doses. Not even for pregnancy or medical reasons. We discussed Hepatitis C inducing cytochromes and stuff, but it’s corporate policy. It’s also corporate policy to get serum methadone levels if patients want to go over 130mg. It used to be they had to get levels to go over 180 mg, but they thought people were taking too much methadone, so they changed the policy to 130, and now most people don’t ask for doses over 130 because the serum levels are expensive. I’ll tell you, methadone programs have managed care beat all to hell for having administrators tell doctors how to practice medicine.

Oops. I just called methadone maintenance medical practice. Silly stupid me.

Anyway, even with that 130-mg-serum-level rule, Carl said their average dose was 120mg. I’m having trouble following the math on that one but I never was so good at arithmetic.

Louisiana state legislature passed a moratorium on new methadone programs – that’s the reason (one of the reasons) why BRTC isn’t going for a mobile program, it would count as a new program. ‘Course, the SMA didn’t tell us that. I told you it was just ONE of the reasons. The moratorium is in effect until 2007. Meantime, it will literally take introducing a bill to the state government to change it.

There were cars everywhere when we arrived at the clinic. Parking lot full, waiting room packed. Liz and I went in and talked to Carl while Dan and John worked the parking lot. The clinic is a perfectly nice little clinic, clean enough, very plain (no cows anywhere). Only two of three medicating windows were open, one for BR people, one for NO people. John’s observation from the parking lot was that people were waiting an hour or more to be dosed. Carl said that the waits were so terrible in the first weeks after Katrina that at this point people think it’s pretty good.

They had ~400 patients pre-Katrina, and have taken in 250 more, which is pretty astonishing. There is no FEMA money, nothing set aside to pay for methadone treatment. A lot of patients (we’re not sure how many) are being dosed for free. No one seems to be turned away, except the ‘pain management’ patients (see below where we visit the LaPlace clinic).

When Carl was able to contact the parent NOLA program, he was able to give patients their same dose with uninterrupted pickups. Most of the NOLA programs have been good about getting in contact with BRTC and other nearby clinics where their patients may have gone. One program however, he’s been unable to contact, and that program has made no attempt to contact him, so he’s been unable to give full service to those patients.

This is all because, BTW, Louisiana has no state registry for methadone patients. When a new patient comes to a clinic, the only way to see if he’s already registered at another clinic is to pick up the phone, dial the other clinics, and ask them, one by one.

In the week after Katrina, two of the BRTC nurses left the area, and one of the doctors died…there were no nurses to be found anywhere in the area to do methadone (all being used for medical relief) so CRC muled in a couple of nurses from elsewhere in the country – they’ve since gone home. So it’s been a bit stressful there. BRTC has, we believe, really made an effort to take care of the patients who showed up at their door. No outreach, of course, but that’s a foreign concept in MMT anyway. And they sure don’t want to take us up on our offer to DO outreach. Patients are being taken care of, but they’re not what you’d call welcome for the long haul.

Average counselor caseload at BRTC is 50, though LA recently passed a law that it can go as high as 75 without being out of compliance with accreditation. Carl hopes his counselors won’t need to carry caseloads that high for too long – but he needs to hire new people, and maybe expand the physical plant, to accommodate the new influx of patients.

Speaking of which, Carl was pretty clear that he wants all those New Orleans people to prosper, be well and happy, BACK IN NEW ORLEANS. Carl likes to visit New Orleans, but he doesn’t want to live in New Orleans, and he doesn’t want New Orleans living in his town. NIMBY, you know. And the class of patient that’s coming in from NO isn’t really the sort they like in BRTC. BR is, as I’ve said, a cocaine town, not a heroin town. Opiate addicts tend to be white, middle class, prescription drug users who drive nice cars and pay their bills on time. Less than 3% of the BRTC clinic population is African American.

Dan and John talked to a couple who were staying at the River Center with their baby. They said they had spent about 3 hours taking buses and other public trans to get to the clinic, and would take another 3 hours to get back. They said that, to their knowledge, there are about eight or nine people from the River Center who are coming to BRTC. They said there was talk of a van to transport people from the River Center to the BRTC, but it hasn’t been running.

The Red Cross doc had specifically told me that transportation had been arranged to take patients back and forth between River Center and BRTC – it’s the reason she gave that she didn’t need our help.

Also, the low number of patients in River Center who need methadone jibes with the reports we’ve had from several sources that patients are being put out if they use. Saturday night we walked past the River Center a little past midnight… there was a woman sitting on the curb with her husband and all her possessions, said she’d been put out for fussing with her brother. She said she was trying to get a cab to a hotel. We advised her that she wasn’t going to find a hotel room closer than, like, Atlanta. When we walked back past around 1:30 AM she was still there. She was quite intoxicated, cocaine and alcohol would be my guess. We would have given her a ride to wherever she wanted to go, but there was nowhere TO go, and we figured she was safest there, with a police and National Guard cordon around the River Center.

BTW, the Red Cross is not allowing 12-step meetings in the shelters. Yes, you heard that right.

***

Choices of Louisiana is a program run by Joanne and Roy Brown in LaPlace. Beautiful physical plant, very new and clean and medical, staff were fairly friendly to us. Joanne was busy and had only a few minutes to talk to us… in fact was downright brusque. Then again, she’s been busy. Roy chatted a little while longer… in general the message is the same: “We have the situation under control, we know how to manage our opiate addicts, Yankee Go Home.”

I have been suggesting to them the strategy of “don’t waste your disaster” – use this situation to point out the flaws in the LA addiction treatment system, use the momentum of Katrina to drive systems change.

BTW, the program in LaPlace is 91% white as well. Don’t any African Americans in Louisiana use heroin? Very odd.

Their census pre-Katrina was 300-odd, swelled by at least 150 – though their clinic also lost some patients who had lived in NOLA and evacuated to Texas. They’re not requiring any patients to pay, though they’d like to be paid… Roy said ‘this could drive us to bankruptcy’.

The potential for disaster is pretty bad here. The AA addicts coming out of NOLA are very much ‘undesirables’ everywhere they go…. And the treatment system is already set up to exclude and marginalize them. The culture shock that BR will undergo when they realize these undesirable people are going to stay in their neighborhood… well it ain’t going to be pretty, and addictions is gonna take it on the chin… “we didn’t have these problems before those people came up from NOLA”, etc… racism feeding anti-addict sensibilities, re-feeding the racism in a downward spiral.

As we arrived at the LaPlace clinic a young woman was leaving quite profanely… she was a ‘pain patient’, with a prescription for 90 40mg diskettes of methadone a week, and the clinic didn’t feel comfortable just writing that prescription… which I can understand, I’d have a bit of trouble with that myself. This ‘pain clinic’ situation is quite a problem here in LA. We see billboards on the highway for “Pain Management”. Evidently there was a big ‘pain clinic’ prescription mill in BR… half a dozen docs, each doctor saw 700 patients/month; when DEA infiltrated they found that the agents would go in, be seen for less than 60 seconds, and walk out with an average of three prescriptions, for schedule II narcotics and schedule III benzodiazepines. Patients were bringing in an MRI of someone’s knee – the name on the MRI didn’t even need to match their own.

The reason for these ‘pain clinics’, of course, was to address the enormous need left by the huge inadequacies of the methadone treatment system. The solution, of course, is to arrest the ‘dirty doctors’ – and the patients; when they made the sting a lot of patients got scooped up as well.

OH!!! I almost forgot to tell you the really good news! Louisiana has a goal of making all its cities Drug-Free, and New Orleans will be the pilot project. They will be very careful about not allowing the criminal element to re-enter when New Orleans is repopulated… Babylon has been destroyed, let’s rebuild Jerusalem in its place.

Although in this case I think it’s more Epcot Center than Jerusalem. I mean – New Orleans as the pilot project for New Drug Free Cities??? New Orleans???

Bzuh?

1:52 PM

we’re driving over the Spillway at Lake Pontchartrain now. Very wet, but it always was… lots of trees down.

6:13

quite a fucking afternoon. It was a challenge just to get close to NOLA… had to go through several Army checkpoints, where the Power of the CRA Identification Badge was once again manifest hooray! Anyway, we got past… drove thru several areas, including the Garden District, saw lots of … well, sights. I’ll put up a couple of pics just to prove we were there, but CNN does a better job of giving you pics of what it looks like in New Orleans.

The big news is that finally we found New Orleans Narcotic Treatment Center, and after the other programs we’ve visited today, it was very refreshing. The hours posted on the door are 5AM – 12noon. We arrived at 3:15, stayed till six, and they were still medicating people when we left… a nice contrast to BRTC and LaPlace, where the hours were NOT extended. Of course, this was NONTC’s first day back in business since Katrina… and now they may have to evacuate again tomorrow for Rita. Jesus.

Anyway… Diana and Alex John run a very friendly, homey clinic. Their census is in the 300’s range, and they expect that to at least double this year, as they’re the only clinic on the West Bank… and all four East Bank programs were pretty much completely destroyed – they’re still closed and likely to remain so, especially with Rita coming through.

NONTC has a nice feel to it. Their average dose is only around 60mg, which I don’t like so much, but I suspect that the other programs actually have an average closer to that as well. I just can’t imagine that a clinic who has ‘nobody going over’ 130mg has an average of 120mg.

Patients at NONTC seem to like the program… after they’re medicated, people wait so they can say goodbye to Alex and Diana before they leave, stuff like that. John and Dan talked to a few folks in the parking lot, Liz and I to a couple in the waiting room, and they all said that, in general, they were treated well at BRTC while NONTC was closed. One guy said that BRTC was very clear with him when he medicated and picked up his bottle on Sunday that NONTC was going to open Monday, so he should move on from BRTC. That’s not unreasonable….

Anyway, here’s the good news: Diana and Alex know there are patients in several different shelters through Louisiana and Texas who are not being medicated, and they would very much like our help in getting methadone to them. They are aware that the Louisiana SMA has not been enthusiastic about us doing mobile methadone in BR, but think it’s possible we can work something out for NOLA… particularly with another hurricane moving in.

Tonight Liz and I are headed back to BR – we have to, we stupidly didn’t bring our bags with us – John and Dan are staying with Alex and Diana… unless traffic is totally impossible Liz & I will come back down tonight. Terri has been wonderful, and it’s time we got out of her hair. Traffic is totally impossible at the moment, but that’s headed OUT of New Orleans, which is the way everyone wants to go right now. Did I mention there’s another hurricane coming?

So we probably won’t stick around in NOLA to see a hurricane first hand… the Johns own several other clinics so we’ll probably be moving west with them to Lake Charles LA and maybe on to Houston. They know there are several people in the Lake Charles area shelters that haven’t been medicated, so maybe we can actually HELP, what a concept.

If there’s no pics with this post, well, I’ll get some up tomorrow…. Sorry, internet access is just kind of an issue around here. So is cell phone access, come to think of it.

Tuesday 20 September 10:30 AM

Well… Liz and I drove to BR, got our stuff, drove back down to NO, but Dan and John didn’t have any idea where they were, just the address of Alex & Diana’s house, which was in a gated community somewhere in Harvey Louisiana. Evidently Dan hadn’t been paying close attention as they drove there, said he had no idea where they were and couldn’t give us directions, and Diana and Alex had already gone to bed when we called (at about 9:30, poor people were exhausted).

Liz and I drove around Harvey Louisiana for about an hour and a half and couldn’t get any clue of where the address might be. It was pretty spooky, out after curfew, armed men cruising around in humvees… around 11:30 we gave up and drove back out of town to a Walmart we had seen. People in cars and trailers were camped in the Walmart parking lot, so we did the same; each of us took an Ambien and slept in the car.

Plans today look hopeful… maybe. First, a little background: On Thursday or Friday, there had been a conference call between Duffy, the Louisiana methadone authority, and the various clinics: BRTC, LaPlace, NONTC, and a few others. Basically, as we hear it, the programs were warned off from this group of crazy people coming down from the North to stir things up. On Monday the group talked again, and everyone but LaPlace wanted to see if we could help them; LaPlace was still very negative toward the idea, and that’s the way the decision went: the state would not support us.

LaPlace, BTW, actually lost some patients after Katrina, as they had several dozen from NOLA, and those patients were all affluent enough to evacuate out to Texas and other parts distant. So… looks like they definitely have a vested interest in keeping evacuees out of their clinic.

Here at NONTC this morning it’s a madhouse. Patients everywhere, Alex and Diana run off their feet. Evacuation order starts today, and everyone is supposed to be OUT by tomorrow evening, so patients are frantic to get their methadone. NONTC is giving out at least 5 days’ pickup on special exception to virtually everyone, and encouraging everyone to go to Lake Charles, where they can be treated at the clinic there.

It looks like we’ll be heading for Lake Charles today or this evening. Liz is still talking with Nick Reuter and Bob Lubran, trying trying trying to get us Suboxone. Nick can’t ship it till he has the address of a treatment program that is working with us. Evidently he couldn’t get a commitment from BRTC that they were working with us, when he called them trying to arrange the shipment. Or something! Please be aware, we’re getting information from about 50 sources simultaneously, and the only way we know what’s true and what isn’t is to wait and see what happens.

So, once again, we’re waiting to see what happens. It’s not my favorite thing to do.

11:33 AM
Liz is talking to Bob Lubran. Dan and I talked to Holly, who’s talked to Bob Lubran. We’ve all talked to Nick Reuter. We’re all talking and talking… amazing, considering how poor cell phone reception is down here. I’m going to try to get an internet hookup in the clinic and get this posted

and in closing, our obligatory daily shot of Lizzie's rear end:

no room at the Inn

2005-09-18T14:00:00.000-07:00

We're still staying with Terri, who's a saint -- and a saint with a washer and dryer!!! hooray.

Holiday Inn central booking says they have no rooms in Louisiana prior to November 30. Hampton Inn says they're not taking reservations for two months. Expedia.com and hotels.com say nothing in the area either.

So... we're still camping, but at least we're camping with a roof and running water HOORAY

It's sunday, so nothing's happening... nothing new to report, so I'll just give you some pictures

Here's Terri's Bed, Breakfast, and Salon:

Holly, you asked about pics of the inside of the van... here's some from the trip, and some old ones I had:

Terri, John, and Dan in the front section:

Lizzie at the filing cabinet, just behind the drivers seat:

Inside the nurse's station, view of the electronic / alarm system:

Rear (counseling) section, nurse's station door closed and locked

Same, with nurse's station door open:

Pictures from first day in Baton Rouge

2005-09-17T18:51:00.000-07:00

From the parking lot at Baton Rouge Treatment Center:

Baton Rouge harm reduction packet:

The Red Cross shelter at the River Center:

John and Terri across from the River Center.
The foot is Liz's, she's preparing to kick some ass:

Would you take clean needles from these people??

CNN

Pics, I think!

2005-09-17T18:35:00.000-07:00

Going to try to post some pictures here

Packing up the van:

LizzieB at the CRA office:

John, armed with Wet Ones:

Following the van into Baton Rouge:

no problems in Baton Rouge, nope!

2005-09-17T18:26:00.000-07:00

Saturday, 17 September 2005, 8:47 AM

BTW, I’ve got my laptop with me, so I can type in this log whenever I want, but access to the internet has been limited. There had been talk that they were going to try to make WiFi available all over Br, but we’re not finding it. Last night’s post I made witting as a squatter in the lobby of the Marriott during a downpour. So… I’ll get things posted as soon as I can, and I’ll get pics up as soon as I have a high-speed connection where I can spend 1-2 hours of quality time with my photobucket account.

Dan and John slept in the van, parked outside Terri Mitchell’s apartment, plugged in so they could have the air on – good thing, it’s 90 degrees already, gonna be hot and steamy. Liz and I camped in Terri’s house… we’re all up and showered now except Dan.

The television is amazing. Every program is about Katrina. There’s a sidebar with pics of missing children, and a running bar at the bottom with phone numbers for relief, etc. Ah… Laura Bush toured a center for missing children in Virginia, good to know. Liz is going crazy seeing the pictures of abandoned pets, she wants to bring about 20 home. Hmmm, we’ll eventually have an empty truck.

Ambience in Baton Rouge: well, we didn’t find a hotel room. Hotels.com showed not a single hotel room in Baton Rouge. 1-800-HOLIDAY said there is no Holiday Inn room available for a 500 mile radius North, South, East, or West of Baton Rouge. We called the Isle of Capri (1-800-THE ISLE) but they had no rooms in Louisiana or Mississippi for the next week – guess we got really lucky the night before huh?? We tried at The Myrtles, a haunted plantation B&B in St. Francisville, but they’re booked up too. Damn. Liz was very disappointed about that.

Restaurants are all open here. We had lunch at the Backyard Burger and there was a sign that said “Because of Katrina we can accept no credit cards”. At Sonny’s BBQ however, where we had dinner (and damn the pulled pork was fine) the sign on the door said “All our credit card machines are now WORKING”.

We got quite a bit of rain last night, and the frontage roads were flooded. Terri was telling us they were without electricity here for a week… the main thoroughfares were like a ghost town. On the main streets they’ve taken down about half of the traffic lights, as the traffic is so terrible.

Baton Rouge, according to Terri, was fairly lawful and quiet through the emergency. They had almost no police force at first, as the police were all at the River Center taking care of the evacuees – the National Guard just arrived on Thursday, and last Tuesday was the first official day off that the BR police force had since the hurricane.

Bush says “Our goal is to get evacuees out of shelters by October…. Get them apartments…. Get them jobs… yada yada yada.”

Oh jesus! Huge Metra train accident in Chicago! Hmmm… 47th and Wentworth… we can’t think of anyone we know who’d be on that train….

LizziB is talking to addictions treatmentr programs in the area, trying to find ones who know what’s happening. Joanne Brown from Choices of Louisiana in LaPlace told Liz that all the drug addicts were “cleared out” of NOLA (bzuh?) and put… all over.

We figure our goal for the weekend is fact-finding: try to do some Community Action Group meetings, get some feedback from actual participants about what they need.

80 inmates were released from jail – not evacuated, just at the end of their time – their homes had been in NOLA, so they were placed in River Center at the Red Cross shelter… after they were placed at the shelter, somebody remembered to check, and found that the charges were rape, pedophilia, and other very sociable offenses. So now what??

We’ve found out a little more about ‘pain management’ in LA, and why Dr. Dunham last night got very nervous when I mentioned the man we’d seen in the BRTC parking lot. Michael had been prescribed methadone, klonopin, lortabs, and soma… this isn’t the usual ‘triple cocktail’ of lortabs, methadone, and Xanax, but still sounds great huh? Michael’s invoice from his doctor shows that he came by every two weeks, paid $300, and got prescriptions for the next two weeks. Evidently these ‘pain control centers’ pop up along the highway, slap up a sign that says “pain management”, and stay there until it’s time to move on down the highway. Now that we think of it, we’ve seen several along the road….

Our estimate of the situation at the moment is: the entire state of LA doesn’t understand SEP, HR… State of LA’s HR program is MMT… which is ok, but insufficient.

LA doesn’t even have a state registry for MMT patients – which has been one of the problems with getting displaced people dosed.

We’re definitely getting the idea that we’re not terribly welcome. We think we should do a kind of hit-and-run for the moment; we’re quite visible, and that may not be a good thing. We’re going to visit shelters, but most importantly we’re going to try to make stuff available to Terri, Zina, etc…. leave the equipment with the people who can make it count. And we’re going to gather information, and let people who need the information know what’s happening here on the ground. Because we can’t change things here in LA.

Xina says that last night at the River Center, FEMA was passing out cards worth $2300 for each family. Everyone got a card – going to the ATM, getting money, and heading off to the Spot and the Casino. Going to be quite the weekend down by the River Center. By Monday or Tuesday, when they’re all broke and sick again, it’ll be a mess.

7:18 PM

This has been the most frustrating day. We talked with a woman named Samantha Hope Atkins, who has an organization called Hope Systems… she was in contact with a Dr. Mooney who had a medically equipped Winnebago and wanted to do medical detox… the Red Cross absolutely forbade him to do it anywhere near the shelters, so he was setting up elsewhere… but he said he does abstinence-based recovery, so he didn’t think he could work with us. OK, whatever.

Sam said that, even before Katrina, Baton Rouge had a grand total of 10 inpatient beds for addictions treatment. Ten. 95% of addictions treatment in BR is federally funded, and there are 1800 people on the waiting list for treatment. Or rather there were, before Katrina.

We’re hanging out now in the parking lot of a Mobil station. There’s a bunch of trucks parked here, and littered on the ground are used condoms, cookers, and cottons… evidence from Our Peeps.

We’re pretty frustrated. Here’s the plan at this point: do whatever we can to gather information as to the need!!!! What’s driving us really REALLY crazy is everyone saying “everything’s under control here, no problems, everybody’s happy”, when we have information from folks on the streets that everyone is NOT taken care of… but we need to freakin’ prove it. Once we see with our own eyes, once we can document the needs, then we can start first thing Monday morning raising hell with folks who can maybe deliver.

Mobile Care for Drug Users Affected by Katrina

2005-09-16T17:31:00.000-07:00

Friday 17 september 2:35 PM

Got to Baton Rouge Treatment Center (BRTC) at 1:15, found it locked up. Got Carl on his cell phone; he’s taking some of the nurses that were here to do the emergency work to the airport, they’re leaving. He seems to think the emergency is over, everything back to normal.

We’ve been here in the parking lot for about an hour… a car pulled up with a guy named Michaels. He lives in Slidell, is on maintenance for pain (methadone 240mg/d, prescribed every 2 weeks) but his doctor’s office was destroyed. He hasn’t had methadone in 3 days now and doesn’t know where to go. About all we could tell him is what Carl told us: the clinic will open again at 7am tomorrow. Makes me crazy, absolutely crazy. I wish to hell I had a pocketful of bupe. Poor guy was in full-blown withdrawal. He’s not even a MMT patient, he’s a pain patient… showed me his preswcriptions. He’s been to every hospital in BR, nobody will treat him, told him to go to the methadone clinic… and the methadone clinic is closed. This guy was sick as hell, had no food and no water. We gave him a bunch of food and Gatorade….

Zina and Terri have met us here in the parking lot. They don’t agree with Carl, they seem to think there may be some problem. Evidently a lot of people whose NO clinics were destroyed are still coming up to BR. The BR city government isn’t sure they’ve ever had a problem with injection drug use, and they’re pretty sure they don’t want to have one now, but nobody knows quite what to do about it.

And hey, not to be whiny or anything, but it doesn’t seem overly hospitable of Carl not to come by 15 minutes after closing time to greet us, but oh well.

Liz is talking to Nick right now… and putting Zina on the phone to tell him about the situation. If nothing else, we can make lots of noise and not let people continue to fucking ignore the situation. Zina and Terri are pretty excited that we’re able to get in touch with some people who may be able to do something. These two run a harm reduction program here in the city – ANIZ – so they know what time it is… they know what’s going on… but nobody listens to them. Familiar story.

BR has traditionally been a cocaine town, not a heroin town. Crack is smoked, but there are a lot of injectors using powder cocaine, mostly because the mandatory minimum sentences for powder are much lower than those for crack, so the dealers have focused on powder. However, when Katrina hit, the dealers saw a business opportunity and brought in a lot of heroin. They’re holding on to it right now, because in the next week or so the evacuees, currently camping in the River Center, are going to be placed in trailer parks around the city. Then, the dealers can move into the trailer parks with the heroin. Yankee Ingenuity.

4:35 PM

We’re headed now for the River Center, where evidently evacueeshave been temporarily housed, going to try to talk to the Red Cross people there.

Just before we left BRTC’s parking lot another NOLA MMT patient showed up looking for treatment (now why hasn’t BRTC expanded their hours??? Huh????). Her name is Widget, and she had worked as a dancer in the Quarter… she already has a new job here in BR. She hasn’t been dosed since Friday before Katrina, but has been getting by on this and that… said her lawyer let her have some morphine. We gave her Gatorade and told her to come back to the clinic in the AM. She’s staying at a KOA Kampground, and says she doesn’t know of anyone else in the Kampground who’s looking for MMT, but “I wonder what the hell happened to all the junkies!” she said.

5:18 PM
Telephone call with Dr. Dunham of the BR Office of Addictive Disorders. She is sorry we came all this way but her understanding is that the situation is completely under control, and the OAD simply can’t ‘sign off on’ any services that we have to offer. Dr. Hoffman from CSAT is here in BR and he has no information that we have been cleared to provide any services. She asked what we could do, and I specified that travel is onerous for people trying to get MMT, and that our DEA licensed methadone van could deliver MMT services to patients, with secure dosing from the van. She politely declined.

6:47 PM

Finagled my way into the Red Cross disaster shedlter at the River Center convention center – Zina is a Red Cross worker there and we got past the automatic-rifle-toting soldiers with my CRA employee badge. The power of a picture ID with a clip attached….

The Red Cross doctor there said that, #1, the Red Cross doesn’t deal with addictions; #2, the Red Cross doesn’t dispense controlled substances (for that we have to go through all the state agencies), and #3, the situation is totally under control with the existing MMT program. So, OK, whatever.

Got a chance to walk a bit in the shelter – the pics are decidedly unauthorized. Things looked good in general, only the minimum amount of babies shrieking, and it didn’t smell bad. Cots lined up right next to each other though, with no privacy whatsoever.

So… there are 5000 people there in the River Center. 52,000 people have come to BR from NOLA. So those 5,000 seem to be totally copacetic, if you believe the reports. Which still leaves 47,000 unaccounted for.

The Red Cross doc said that I was the third doc in two hours who came in wanting to do work with addicts. It’s unforunate though, cos the Red Cross doesn’t need our help.

Zina says that there is an addiction doc who’s going to set up a detox table just outside the convention center at 8 tonight. Maybe we’ll go check that out – at any rate, Zina will see him. I gave her my card with a note: OST? Harm reduction? Call me… on the back. Chances are, whoever’s doing it, I know them. We’ll see…

We’d like to get checked in somewhere, get internet access, get into dry clothes (it rains a lot here, I got drenched walking around the River Center). The Marriott is full; Dan’s in their lobby with his laptop pirating their WiFi to find us rooms. Terri said she’ll be glad to put us up… we may be using the camping equipment soon. Tho hopefully not, the wind is rising and there’s a bit of lightning. Not great for camping. Well I guess it’s about time we starting roughing it, though the dial-up internet connection last night definitely counted as rough accommodations in my book.

Mobile Care for Drug Users Affected by Katrina

2005-09-16T17:20:00.000-07:00

Friday 17 september 2:35 PM

Got to Baton Rouge Treatment Center (BRTC) at 1:15, found it locked up. Got Carl on his cell phone; he’s taking some of the nurses that were here to do the emergency work to the airport, they’re leaving. He seems to think the emergency is over, everything back to normal.

We’ve been here in the parking lot for about an hour… a car pulled up with a guy named Michaels. He lives in Slidell, is on maintenance for pain (methadone 240mg/d, prescribed every 2 weeks) but his doctor’s office was destroyed. He hasn’t had methadone in 3 days now and doesn’t know where to go. About all we could tell him is what Carl told us: the clinic will open again at 7am tomorrow. Makes me crazy, absolutely crazy. I wish to hell I had a pocketful of bupe. Poor guy was in full-blown withdrawal. He’s not even a MMT patient, he’s a pain patient… showed me his preswcriptions. He’s been to every hospital in BR, nobody will treat him, told him to go to the methadone clinic… and the methadone clinic is closed. This guy was sick as hell, had no food and no water. We gave him a bunch of food and Gatorade….

Zina and Terri have met us here in the parking lot. They don’t agree with Carl, they seem to think there may be some problem. Evidently a lot of people whose NO clinics were destroyed are still coming up to BR. The BR city government isn’t sure they’ve ever had a problem with injection drug use, and they’re pretty sure they don’t want to have one now, but nobody knows quite what to do about it.

And hey, not to be whiny or anything, but it doesn’t seem overly hospitable of Carl not to come by 15 minutes after closing time to greet us, but oh well.

Liz is talking to Nick right now… and putting Zina on the phone to tell him about the situation. If nothing else, we can make lots of noise and not let people continue to fucking ignore the situation. Zina and Terri are pretty excited that we’re able to get in touch with some people who may be able to do something. These two run a harm reduction program here in the city – ANIZ – so they know what time it is… they know what’s going on… but nobody listens to them. Familiar story.

BR has traditionally been a cocaine town, not a heroin town. Crack is smoked, but there are a lot of injectors using powder cocaine, mostly because the mandatory minimum sentences for powder are much lower than those for crack, so the dealers have focused on powder. However, when Katrina hit, the dealers saw a business opportunity and brought in a lot of heroin. They’re holding on to it right now, because in the next week or so the evacuees, currently camping in the River Center, are going to be placed in trailer parks around the city. Then, the dealers can move into the trailer parks with the heroin. Yankee Ingenuity.

4:35 PM

We’re headed now for the River Center, where evidently evacueeshave been temporarily housed, going to try to talk to the Red Cross people there.

Just before we left BRTC’s parking lot another NOLA MMT patient showed up looking for treatment (now why hasn’t BRTC expanded their hours??? Huh????). Her name is Widget, and she had worked as a dancer in the Quarter… she already has a new job here in BR. She hasn’t been dosed since Friday before Katrina, but has been getting by on this and that… said her lawyer let her have some morphine. We gave her Gatorade and told her to come back to the clinic in the AM. She’s staying at a KOA Kampground, and says she doesn’t know of anyone else in the Kampground who’s looking for MMT, but “I wonder what the hell happened to all the junkies!” she said.

5:18 PM
Telephone call with Dr. Dunham of the BR Office of Addictive Disorders. She is sorry we came all this way but her understanding is that the situation is completely under control, and the OAD simply can’t ‘sign off on’ any services that we have to offer. Dr. Hoffman from CSAT is here in BR and he has no information that we have been cleared to provide any services. She asked what we could do, and I specified that travel is onerous for people trying to get MMT, and that our DEA licensed methadone van could deliver MMT services to patients, with secure dosing from the van. She politely declined.

6:47 PM

Finagled my way into the Red Cross disaster shedlter at the River Center convention center – Zina is a Red Cross worker there and we got past the automatic-rifle-toting soldiers with my CRA employee badge. The power of a picture ID with a clip attached….

The Red Cross doctor there said that, #1, the Red Cross doesn’t deal with addictions; #2, the Red Cross doesn’t dispense controlled substances (for that we have to go through all the state agencies), and #3, the situation is totally under control with the existing MMT program. So, OK, whatever.

Got a chance to walk a bit in the shelter – the pics are decidedly unauthorized. Things looked good in general, only the minimum amount of babies shrieking, and it didn’t smell bad. Cots lined up right next to each other though, with no privacy whatsoever.

So… there are 5000 people there in the River Center. 52,000 people have come to BR from NOLA. So those 5,000 seem to be totally copacetic, if you believe the reports. Which still leaves 47,000 unaccounted for.

The Red Cross doc said that I was the third doc in two hours who came in wanting to do work with addicts. It’s unforunate though, cos the Red Cross doesn’t need our help.

Zina says that there is an addiction doc who’s going to set up a detox table just outside the convention center at 8 tonight. Maybe we’ll go check that out – at any rate, Zina will see him. I gave her my card with a note: OST? Harm reduction? Call me… on the back. Chances are, whoever’s doing it, I know them. We’ll see…

We’d like to get checked in somewhere, get internet access, get into dry clothes (it rains a lot here, I got drenched walking around the River Center). The Marriott is full; Dan’s in their lobby with his laptop pirating their WiFi to find us rooms. Terri said she’ll be glad to put us up… we may be using the camping equipment soon. Tho hopefully not, the wind is rising and there’s quite a bit of lightning. Not great for camping. Well I guess it’s about time we starting roughing it, though the dial-up internet connection last night definitely counted as rough accommodations in my book.

Travel Blog Day 2

2005-09-16T07:30:00.000-07:00

9/15/05 7:57 AM CST
Arrived in Memphis a little after one; had to do a bit of exploring before we found a hotel with a vacancy. The Holiday Inn (free high-speed internet) was full, so we’re in the… I don’t know, EconoLodge? Anyway, they have electricity but that’s about the extent of the amenities. There is a Waffle House next door though… John approves.

9/15/05 12:35 PM CST
The Waffle House was everything we hoped for and more. I love grits.

Stopped at Wal-Mart to get some coolant for the van, and a digital voice recorder… Dan will spend half an hour with it and make it sing and dance… I’ve got it to record my voice then download the file. I’m happy. Crossed the Tallahootchie River, and moving down through Mississippi.

At the Wal-Mart I noticed a sign at the cashier that said “FEMA debit cards welcome” – this is just south of Memphis.

Talked to Nick Reuter this morning. He’s working hard on getting everything smoothed out, but evidently Reckitt-Benckiser has some restrictions on the distribution of the Suboxone they’ve donated… exactly what those restrictions are, Nick was not in a position to discuss. OK, whatever. Anyway, he’s doing heroic work trying to bring sense out of chaos.

Read USA News this morning aloud to Liz in the car. 100 tractor trailers packed with supplies (like water and other frivolities) have been sitting in Montgomery Alabama for a week waiting for the order from FEMA to move. Unbelievable. People seem to have gotten a little bored with finger-pointing, and Blanco and Nagin are doing mea culpas. And Bush will speak tonight, assuring everyone that there is no classism or racism involved in the whole debacle. I believe him, because there’s a picture of him talking to Condoleeza Rice, so he can’t be a racist.

9/15/05 11:39 PM CST
At Jackson MS we turned west and drove over to Vicksburg, then headed straight south on Hwy 62 towards Baton Rouge. As soon as we were off the interstate we started seeing the signs for “Evacuation Route”. It’s a little unsettling that all the signs point south. John suggests that’s an effort to consolidate the evacuees. I think it’s because FEMA put up the signs.

We decided to stay in Natchez, then go into Baton Rouge fresh in the morning. We’re not making as good time as we might have hoped – the van is a sweetheart, and Dan corrals her around like a champ, but she’s no Ferrari.

As we drove through Natchez we passed the Convention Center – surrounded by Porta-Johns and people. People lined up on the sidewalks for blocks, sitting in lawn chairs, reclining on blankets, all obviously settled in for the night. Evidently the Red Cross will be arriving tomorrow with money, and that’s what people are here waiting for.

The only hotel with a vacancy is the Isle of Capri Casino Hotel. Checked in about 10:30 and brought peanut butter & jelly, Vienna sausages and tuna salad up to our rooms to dine sumptuously. In the elevator is a sign for evacuees, describing a community center (counseling, free WiFi access, phones, showers) at the Methodist church.

I’m glad we stopped tonight… we’ll have the drive into Baton Rouge proper first thing in the morning, and by light of day so we can see the situation. So… finally! We’ll have some real information here instead of inane ramblings about not much at all……..

Our Travel Log Begins Sept. 14th

2005-09-15T10:33:00.000-07:00

9/14/05 1:54 CST
Just finished lunch at Cracker Barrel (getting into the whole southern thing with chicken fried steak and biscuits). Dan wiped down the entire console of the van – did it at first with a dampened paper towel taken from the restaurant washroom. He was delighted when we dug up a can of Wet Ones. Dan always feels better when he can wipe things down, I’ve noticed that on the outreach van.

Liz has talked to Brenda Lanz, SMA of Louisiana… seems that BR has been inundated, but now that some FEMA money is coming thru, people are taking the money and leaving, mainly to Houston. Houston seems to now be the place where resources are being overwhelmed… so maybe we’ll be going down there, don’t know. We’ll have to see what the situation is when we get there. We have a call in to Mr. Gordon, SMA in Texas. I want a 10-gallon hat, but most of all I want to hand out methadone in George W Bush’s home state.

Liz has a video camera, both Dan and I have digital still cameras… I think I’ll pick up a digital audio recorder on the way as well. I’m trying to think of all the ways we can document this whole experience, and collect as much data as we can. The data will necessarily be qualitative and organic, but all data are data….

Kathie Kane-Willis has talked to people at NIDA who want to study The Impact of Katrina on Drug Addicts. That’s a little broad for a research question, so we’re trying to narrow it down to some specific questions: e.g. when people evacuated, did they go with their families or with their using networks? Also, is there a difference in addicts who went to the Superdome vs. the convention center v s. stayed in the city? In terms of heroin addicts we won’t have that much diff between in- and out-of-treatment, as 95% of heroin addicts in NOLA were out of treatment.

Liz is worried about her fish. Sal is feeding them, but he’s never done so alone before.

Where would we go if we all had to leave Chicago? We’re driving thru the Heartland now…. Lots and lots of room, but it’s not very hospitable in the middle of a soybean field. Pretty scraggly looking soybeans too, what with the drought in Illinois this year.

The cows are standing up now. Liz pointed out that means the weather will be clearing up. The decreased clouds and increased sunshine are probably indicative of the same thing. Honestly – no rain in Chicago for six months, and it has to rain the day we leave to do hurricane relief.

9/14/05 3:46 PM CST
Stop for gas – a full tank for the van costs $80. It also gave John a chance to go into the convenience store and get window cleaner and a roll of paper towels – Dan had gone through the whole can of Wet Ones, and John was tired of handing them to him. The dashboard console of the van is very clean now. Likewise the windshield. Dan is keeping a log in the back of the owner’s manual – you know, where they have, like, 2 blank ruled pages. So we’ll have good information there.

There is nowhere in the continental United States a stretch of road more boring than I-55 between Chicago and Springfield. At least as we approach St Louis it gets a bit more rolling.

9/14/05 9:23 PM CST
Stopped at a Steak & Shake in, of all places, Arnold Missouri. Liz says it was named after the pig in Green Acres. Our waitstaff was a sweet little guy who could have been poster child for the Don’t Marry Your Cousin Campaign. He was a bit confused by us; on the other hand, better men than he have been discombobulated by conversation with Dan Bigg.

He asked if we were on a road trip, where we were from, and where we were going. I told him Baton Rouge. “Awesome!” he sez politely. “Y’all have fun, now.”Maybe they don’t get news in Arnold, Missouri.

9/14/05 11:48 PM CST
Dan had the idea to stop at the casino in Carruthers and do a couple of quick hands of blackjack. Ok, whatever… we pull off at State Highway 84. ‘Carruthers, 5 miles’ the sign says, so we head east. A

few minutes later my phone rings. “Abort! Abort!” cries John. Huh? We turn around, pull over. “It’s a bait and switch,” insists Dan. “We’ve gone five miles by the odometer and there’s no casino in sight. I wouldn’t trust their tables if they can’t count to five.”

OK, whatever. So much for Carruthers, MO. Which, just FYI, is just northeast of Braggadocio, MO … would I make it up?

A Journey Begins...

2005-09-15T07:05:00.000-07:00

A little background to explain the purpose of this Blog. In September, Chicago Recovery Alliance (CRA), a community-based organization dedicated to supporting people living with HIV and drug use, received its final set of licenses to operate a Mobile Opiate Substitution Therapies (MOST) van in Chicago. The van is a fully equipped satellite treatment program of the Bobby Buonauro clinic. When Katrina hit the Gulf Coast, the team members thought that the best contribution they could make to relieve the suffering of people affected by the hurricane and its aftermath was to christen the van where it was most needed right now (the opening of the Chicago MOST program has now been postponed and will launch when they return from the Gulf Coast).

The team plans to join forces with the overwhelmed treatment programs in Baton Rouge and/or Houston areas and provide outreach healthcare, substitution treatment and harm reduction services to drug users in the affected areas, as well as to assist the existing drug treatment systems and services in re-building post-Katrina.

The team will be posting messages, reports and photos from the road at this site. You can communicate with them here, as well.

The Team is comprised of Dan Bigg, Elizabeth Buonauro,John Gutenson and Sarz Maxwell. For more about the team check out the left side bar biographies.