“We are very far behind”: Interview with Mike McLemore

AWRN recently sat down with Mike McLemore, president of Alabama Voice’s of Recovery (as well as wearing many other hats), to talk more about the state of Alabama’s drug treatment programs, recovery, and women’s services.

AWRN: Tell our readers more about Alabama Voices of Recovery.

McLemore: Alabama Voices of Recovery is a statewide parent of a couple of other recovery advocacy groups across the state of Alabama, the largest primarily being in Morgan, Madison, Limestone, Lawrence, Cullman and Randolph counties and organized in a chapter called FORMML.  The other large chapter is found in the Mobile area.  The object of advocacy groups in this advocacy organization is to give voice to people who have no voice, that is to people in long-term recovery, as well as to do our best to help secure state and federal funding for the issue of treatment, to help fund and grow a recovery-oriented system of care that is not only focused on the initiation of treatment, but on maintaining and sustaining recovery for people who have substance abuse issues.

One major thing we work on is dispelling the rumor that recovering people…you know there is a silent majority out there that’s in the tens of hundreds of thousands of people who are in recovery, by whatever pathway they got there, people in long-term recovery who know one ever notices because they become normal, productive people—if you will allow me that—but the only people who ever really get any visibility are people who have multiple attempts, like the Lindsay Lohans. And I mean them no disrespect because the nature of the disease of addiction is relapse, but primarily they are the ones that get media coverage and people in long-term recovery don’t get media [coverage].

AWRN: AWRN’s mission is to reduce the number of women in prison and often we talk about the number of treatment “beds.” That is, we discuss the idea that not everyone convicted of a drug offense is in need of inpatient, 24-hour care; rather, there is evidence of the need to utilize outpatient care too as a means of diverting women away from prison or jail, keeping them in their communities, and providing treatment.

McLemore: I will do my best to give you my take on that. What’s happened in the legal judicial system from my perspective is they’ve somehow gotten the idea that residential treatment is the only thing that works.  There is a misconception in the community, most especially the legal judicial community, and a big misconception at Pardons and Paroles and the Department of Corrections, which is that treatment consists of a residential treatment modality, when basically the whole circle of services would be important. 

It’s not that people don’t need residential treatment, but outpatient [treatment] is more cost effective, and is just as successful. But there’s a whole mentality we have to change in people who know nothing about the business of treatment…we spend lots of dollars on unnecessary kinds of treatments when we need to be spending money on providing services in counties which don’t have any, which there are 22 counties that don’t even have outpatient services in the state of Alabama.

There is a terrible gap between women’s [residential treatment] beds and men’s beds, and my take on that is that there is really no women’s organizations outside of advocacy organizations who stand up and clamor that we need residential beds for women.  Some of the reasons for that is that it’s more costly to treat women than it is men because they have children and other kinds of issues. Historically across our state women are kind of neglected, most especially women with children.  Even though they have priority admission status, a lot of women don’t access treatment.

AWRN: So, capacity is low?

McLemore: Capacity is very low and really if you are looking at the public sector, many—if you will allow me this—citizens don’t even know how to access these services.  Most of the advertisements that you see are for programs that have third-party reimbursements.  They are private.  They are advertised everywhere, but it’s difficult to seek out a publicly-funded treatment program because they are not marketed.  Some of the number one referral sources in the state of Alabama are court referrals, P&P, drug court, so most of the beds are sort of captured by the legal judicial system however that may fall.  Many people are accessing services at the wrong levels of care.  Just because you have been arrested for a drug crime does not make it a drug-dependency diagnosis.

AWRN: Tell us a little more about the 22 counties that do not have services.

McLemore: Basically those counties do not have a door.  That doesn’t mean there are not treatment services somewhere, but their county does not have a door.  And if you start looking at the issue of people with dependency issues, most especially people involved with the legal judicial system, they don’t have driver’s licenses.  So if you are in a rural community with no mass transit, how do you access services of any kind?  You have to be dependent upon a loved one, neighbor, family, or friend.  So you are looking at crossing counties.  But in general, they just don’t have services at all, most especially publicly-funded services where there is a facility that can seek out public dollars and get reimbursed for providing those services.

AWRN: You work across the southeastern coast as a board member and regional representative of Face and Voices of Recovery— how would you say Alabama measures up?

McLemore: We are very far behind, even with the other Southeastern states.  Most of the other states have treatment on demand, detox on demand—we only have 2 residential detox centers in the state of Alabama that are publicly funded.  Both of them are located in Jefferson County.

AWRN: Could you clarify what “on demand” means?

McLemore: Treatment on demand is where you can show up and say you need treatment and there is a door waiting.  The average waiting list to access residential services [in Alabama] is approximately 6 weeks. At any given time in the state of Alabama 500-600 people, both male and female, are waiting to access a residential bed. Before you can get into a residential bed in the state of Alabama, you must have an assessment, a clinical assessment to determine a dependency diagnosis or diagnostic impression, and some of the waits for those are 6-8 weeks. So, you may wait 6 weeks for an assessment and 6 weeks to access residential treatment.

AWRN: Our network is interested in knowing more about how many released prisoners are served by treatment providers across the state at the point of reentry, and how many prisoner or parolee referrals are received by providers directly from agencies of the criminal justice system.

McLemore: It would be hard for me to speak for all providers, but I’ll give you my general impression.  There is probably not a treatment modality in this state that is in the public sector. Again, my personal belief is that the referral base is primarily legal judicial—Department of Corrections, Pardons and Paroles, as well as the court referral program, Community Corrections, and drug court—which are basically, as it appears from my limited understanding and my observation, are the number one referral agents.

Now how you document referrals is a whole different story.  There are statistics and data out there that can be gathered from the Department of Mental Health that will tell you how many referrals come from legal judicial.  There is a new system that everyone will put entry codes into which will give us more information as time goes on.  It is a relatively new reporting system at the Department of Mental Health.

AWRN: Thank you for taking time to talk with us today.


Questions about this interview? Please leave a comment below.


One Response

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