by Jennifer Hahn
Six years after President Bush announced a faith-based initiative to treat addiction, Jennifer Hahn investigates its effect on drug- and alcohol-ravaged New Orleans
Like many people living in New Orleans today, James Banks knows what it means to lose everything. But Banks' ruin came not at the hands of a Category 3 hurricane, but from an equally destructive force: crack cocaine.
A criminal defense attorney with his own practice, Banks managed to hide his drug use for twenty years. But in 1999, his addiction took over, and he started behaving erratically and missing court dates. He was disbarred and quickly hit rock bottom. Through word of mouth, he heard about a treatment program run by Living Witness Church of God In Christ. There, with the help of Pentecostal Christian teachings as well as traditional clinical methods, Banks got sober and regained his life. Now off drugs for seven years, he's in training to become a licensed addictions counselor.
Though Banks believes the clinical approach to addiction treatment is important, he, like many who have faced the wreckage of addiction, feels that “without a higher power, you can't recover.” This, in fact, is the central tenet of Alcoholics Anonymous, the most widely utilized addiction treatment program in the world, and many treatment centers and programs throughout the country also stress the fundamental importance of a higher power.
So for some, President Bush's 2003 announcement of Access to Recovery, a new federal addiction treatment initiative that would include faith-based providers, was welcomed as an important new tool in the fight against drug and alcohol abuse. For others, though, it was a dangerous and potentially unconstitutional intermingling of church and state that would do more harm than good to addicts.
Though a favorite program of the Bush Administration, the future of ATR remains uncertain as President Barack Obama reorganizes what he has renamed the Office of Faith-Based and Neighborhood Partnerships. While Obama promised to expand upon Bush's faith-based efforts in July, it is still unclear how his administration will differ in its support and oversight of religious organizations that provide social services. This could have far-reaching effects on federal funding for faith-based treatment programs. But the issue of addiction promises to remain relevant for the new administration, as some researchers predict a potential mass increase in addiction as a result of the economic crisis.
ATR's ability to deal with sudden increases in addiction was tested early on, as the first round of funding for the program came through in 2005, just prior to Hurricanes Katrina and Rita. Recent studies have shown that the traumas inflicted by these hurricanes caused an increase in alcohol dependency and illicit drug use among survivors in New Orleans, putting many ATR recipients on the front lines of the post-hurricane drug and alcohol recovery effort.
ATR works through a voucher system allowing it to circumnavigate the most obvious church/state constitutional violations. The government grants individuals seeking treatment a voucher which they can then use at a treatment program of their choosing, whether faith-based or secular.
More than three years later, are the faith-based options provided by ATR helping to curb the increase in addiction unleashed by the storm? Would the potential elimination of ATR by a new administration be felt as a loss to the addiction treatment community there? Or, are critics of ATR right to protest an intermingling of church and state that they say only siphons federal money away from scientifically vetted secular programs?
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Hundreds of recovering addicts ride the elevator each month to the sixth floor of one of the tallest buildings on Tulane Avenue where Pastor Pythian Noah oversees their treatment. Pastor Noah sits at his desk in front of a window overlooking the New Orleans Superdome. He continuously monitors a television at the back of the room which shows the front lobby because “if anything jumps off that's where it happens”. Many of the clients he treats at Grace Outreach Center are ex-offenders on probation or parole.
According to Pastor Noah, Grace Outreach is unusual in its use of both spiritual and clinical treatment methods. The center, which carries a hospital licensure, employs sociologists, psychiatrists, and addiction counselors, just as a secular program would, but the most important therapist here is Jesus.
“A lot of people are struggling with some simple things like who am I…what's my purpose in life, what would God have me to do?” Pastor Noah says. “And we take that anxiousness away from them because we give them consistent and concise answers. What's my purpose in life? Your purpose in life is Jesus. Where am I going? You're going to Jesus. Who am I going to be? That's inside of him, who he is. You find your identity from who Christ is.”
Though Pastor Noah believes that the concise answers provided by Jesus play an important role in recovery, he does not think all faith-based programs are created equal. “A lot of the faith-based and a lot of churches and such are not equipped for the malady of drug addiction and mental illness,” he says. “It can be done through faith-based, but it has to be done correctly so they won't do more harm than good.”
In overseeing the Access to Recovery program in Louisiana, the state does make distinctions between programs that provide clinical as well as faith-based treatment and those that just use faith-based methods. According to Charlene Gradney, the state's ATR project director, both in-patient and out-patient treatment programs must be licensed by the state's Department of Health and Hospitals and must include a clinical component. In contrast, recovery support services – which include life skills training, job readiness preparation, and spiritual support groups – can be solely faith-based, but a client can only take advantage of them if he or she is first enrolled in a clinical program.
This rubs some in the faith-based community the wrong way. Keenan Dufauchard runs a Christ-centered recovery support service program affiliated with the Apostolic Outreach Center church. Dufauchard says that prior to ATR, he actually saw more clients because there was no government program requiring them to go to clinical treatment before coming to see him. He says that attending both clinical treatment and faith-based recovery support services is just too much for some people to take on at one time, so they drop the optional faith-based component to comply with the required clinical component.
“While I love the fact that President Bush has put this program into place, I think that it's misleading in that they make it sound as though it pays only faith-based organizations,” he says. “But that's not true. Clinicians are the ones that are getting paid, not necessarily faith-based unless we have clinicians. But as a faith-based organization you won't always have clinicians. That's why so many of us have gone away from ATR and have ceased to use their services…”
One group that stopped working with ATR is Louisiana's branch of Teen Challenge, a nationwide faith-based drug and alcohol treatment program. Their Ruston center benefited from ATR status for a few years, but the state refused to renew their contract due to insufficient dormitory space, among other things. “Unfortunately, like anything that comes from government even though it was earmarked faith-based it still had a lot of bureaucratic red tape and regulations attached to it,” says Greg Dill, the executive director of Teen Challenge in New Orleans.
But Alex Luchenitser of Americans United for Separation of Church and State has a different set of problems with ATR. Though the voucher system purports to give clients a choice between faith-based and secular treatment, Luchenitser still believes ATR is a misguided policy, which may also be on shaky constitutional ground.
“What we know is that this program has been used to funnel substantial sums of federal money to religious organizations that supposedly provide substance abuse treatment,” Luchenitser said. “But some of these organizations that provide treatment under this program don't use methods of treatment scientifically accepted by social scientists, but use purely religious methods.”
Luchenitser believes that the fact that states determine which treatment programs are eligible to receive the vouchers leaves ATR vulnerable to a constitutional challenge. “The less individual choice there is and the more government choice there is, the more likely it is that the court will find public funding of the religious institutions to be unconstitutional.” It doesn't help, he says, that the Louisiana Office of Addictive Disorders has explicitly stated the goal of increasing faith-based participation.
Stanford psychiatry professor and addictions specialist Keith Humphreys served on the White House Advisory Committee for Drug Free Communities from 2005 to 2006 and consulted on the creation of ATR. He says that while he sees where organizations like Americans United for Separation of Church and State are coming from, he believes ATR's ability to provide more treatment options to a diverse population outweighs their concerns.
“The issues are always framed in terms of how would someone not religious feel in a program that was religious and I just think it is also important to think about the fact that the situation is often reversed,” Humphreys says. “What's happened, you've got the chattering class, the sort of commentator class, the professional class, the academic class [who] are generally white educated people who have health insurance and they will never access any of these programs. They're also very secular people. And so they think, 'I would really be upset if that happened to me.' But that's not who we're talking about. We're talking about the most religious segment of the country, who don't have health insurance, who end up in the public sector system. So I'm ultimately worried less so about how somebody who is not part of that world and will never be affected by this program speculates about it and how the people who actually need these services so they don't die of this rotten disorder feel about it.”
Tonja Myles agrees that church/state concerns miss the point when it comes to ATR. She operates a faith-based inpatient treatment program in Baton Rouge, Louisiana called Set Free Indeed and has trained many faith-based organizations on how to provide addiction treatment. In 2003, when Bush announced the ATR program during his State of the Union address, Myles was a special guest in the First Lady's box and Bush gave a shout out to her program.
Myles believes that while everyone should have a choice in where they seek treatment, faith-based programs are better equipped when it comes to addressing addiction. “What a faith-based program can offer is more hope, more long-term treatment,” she says. “I'm just not worried about a person and them being sober, I'm worried about their eternal life.” Frustrated by constant questions over the effectiveness of faith-based treatment, Myles says “The proof is in the changed lives. How many changed lives do they want me to give them?”
But Luchenitser of Americans United for Separation of Church and State says that he's not convinced it's true that everyone always has a choice between faith-based and secular programs. He points to the fact that as of January 2008, 48 out of 52 ATR providers in Missouri were either Christian or Christian-affiliated. He says that the dominance of faith-based programs presents a particular problem for addicts living in rural areas where there may be very few options for treatment, none of them secular.
Of the 45 providers in Louisiana able to accept ATR vouchers through the 2007 federal appropriation to the program, 24 are faith-based. Gradney says her office has worked to make sure that there is always a secular option within 35 miles of any potential client, and notes that ATR pays for transportation.
Many faith-based groups readily admit that their goal is to convert their clients to their particular form of Christianity and away from any other faiths or behaviors, such as homosexuality, that they perceive as anti-Christian. Pastor Noah, for example, says he would happily take in a Muslim client and even “provide the place for him to put his rug down and to face the north and to pray three times a day.” But asked if he would try to convert him, Pastor Noah hesitates. “No…” he says. “Do I lean towards it? Yes. Everything that come out of my mouth? Yes.” He says he takes a similar approach to homosexuals, emphasizing that they must be met with love and acceptance when they come in and through his program they eventually learn that “even though their physical man wants to do these things, that's not who they are,” he says. “They realize, 'You know, I'm not gay. I'm a child of God.'”
While Pastor Noah's remarks would obviously irk more secular Americans, defenders of ATR note that clients know what they're getting into when they sign up for a particular faith-based program. Since there's always a secular option, they argue, concerns over conversion to Christianity (or heterosexuality, for that matter) are really irrelevant.
Luchenitser believes it's not always so clear just how religious a particular program is and this could have major ramifications for certain clients. “What happens if an individual enters one of these religious programs and then when they get there they realize it was more religious than they were notified?” he says. “These issues might be particularly important for someone who is…using this program to satisfy the terms of their parole. In that case, [they] may not be able to leave the provider they're using without getting in trouble with the court [and] having their parole or probation revoked.”
While the state of Louisiana does collect information on success rates for clients of ATR-affiliated programs, as of yet they have not broken these numbers down to compare faith-based vs. secular programs. As of August, 77 percent of ATR clients had been abstinent from drugs or alcohol at discharge and 98 percent had avoided encounters with the criminal justice system for at least 30 days. National data from March 2007 showed that 71 percent of ATR clients were abstinent at discharge and 85 percent were not involved with the criminal justice system. Again, there is no breakdown of the data along religious vs. secular lines at the national level.
Statistic comparing faith-based and secular programs might become essential as the new administration evaluates Bush's faith-based legacy. But for now, faith-based providers like Living Witness eagerly apply for ATR status, hoping that increased funding will help them expand their ministries.
Gilbert Olinde, 42, is working the Living Witness program with determination. Recently released from prison after serving six years, this is Olinde's second time at Living Witness. In 2002, he quit the program three weeks shy of graduation and quickly got himself sent to prison.
“Some people say, well [God] gave me a second chance,” Olinde says. “I have messed up so many times in my life [and] he gave me another chance and I don't want to take that for granted, to go backwards. I want to go forwards.”