Dec. 31--The problems of substance abuse and alcoholism are not the exclusive territory of the poor, but for people living on the edge of poverty, addiction's catastrophic effects can come faster and with greater force.

Even for those who succeed in treatment, there can be more challenges to get back on their feet.

Over the past six years, the number of clients from Pueblo County admitted to Crossroads Turning Points' detox and treatment centers has been rising steadily.

Crossroads follows a fiscal year, beginning in July and ending in June.

For the year ending in June 2004, the agency admitted 1,960 clients. By the fiscal year ending in June 2009, the agency saw 3,247 people.

"I think when people are on hard times such as these, families react more quickly and are more ready and able to do something about it," said Leroy Lucero, chief executive officer at Crossroads.

Nearly all of Crossroads' clients earn less than the median family income in Pueblo County, and 84 percent of the agency's patients during the past year earned $18,000 or less.

But that's not surprising given Crossroads' mission to provide treatment services to those who wouldn't normally afford it.

Lucero contends there isn't any realistic way to gauge the full extent of substance abuse in a community because more affluent people can find other means of treatment and others may not look for help at all.

"The scales are tipped already when you're within a certain income bracket.

And your continued use then drives you further into debt and affects your

ability to get out of poverty," Lucero said. "People at the poverty level who

begin to have these problems, it makes it even harder and there are limited resources they can access."

According to Crossroads' numbers, alcohol easily tops the list of substance abuse problems in Pueblo.

Over the past six years, alcohol has been the primary drug of choice for between 60 and 71 percent of all clients checked in at Crossroads. Cocaine is a distant second with between 10 and 17 percent of clients claiming it as their drug of choice.

But Lucero suggests the numbers could be misleading.

Alcohol, after all, is the only legal substance on the agency's list.

Lucero said he did a 90-day study taking urine samples from patients admitted into the detox center and found that nearly half of the clients were on oxycodone or cocaine at the time of their admission.

The results were not verified by a lab and suggest that while alcohol may continue to be the primary drug of choice, more people are using it in combination with other substances he said.

"The old winos you used to hear about; they're gone. They don't exist," Lucero said. "It's just very uncommon to get a person who is just drinking."

Lucero said the road people take to addiction varies with the individual. People turn to substance abuse out of despair, experimentation, peer pressure, trauma or other factors.

"The interesting part of it with people in poverty is that it's these folks who are already making it from one check to another and when they blow what money they have on a bottle of alcohol instead of milk for their family, that's when it's really a problem," Lucero said. "People are looking at their wants, rather than their needs."

Their risk factors vary as well.

"Every family needs to be concerned. If there's a family history, certainly there's going to be a risk factor there," Lucero said.

But people with no family history of substance abuse can become addicted as well.

"This is what makes the addiction process unique," he said. "There are no boundaries. It respects none of that."

As the director of a treatment center, Lucero said he's faced with two schools of thought when it comes to treating his clients.

The first and current model is to take in clients, clean them up and send them back out into the community.

This model lacks what Lucero calls "wraparound" services.

Many people who get out of treatment need essential services such as health care, education and even a place to live. Without them, chances increase that all of an addict's work in treatment will be undone.

But providing those wraparound services takes money.

Without additional funds, Lucero estimates he could serve about a quarter of the number of people in treatment at Crossroads today.

Changing the model at Crossroads isn't possible anyway, because the criteria of his funding requires Lucero operate in a specific matter.

So, it falls to the community.

Lucero said it would help if Puebloans could find ways to celebrate things like graduations without alcohol and urges parents to provide examples for their children to live by.

He also hopes that other agencies such as Pueblo Community College continue to try to help people get the training they need to get on their feet.

"I can get anybody sober, but it takes a whole community to keep them sober," he said.

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Primary Drug Type Identified by Crossroads Turning Points Clients from Pueblo County

Drug Type

FY03-04 FY04-05 FY05-06 FY06-07 FY07-08--FY08-09

Alcohol:

1313

1299

1504

1377

1767

2308

Cocaine Hydrochloride/Crack:

274

307

407

400

474

348

Marijuana/Hashish:

195

223

238

210

293

198

Methamphetamine:

88

129

199

143

170

162

Heroin:

43

57

60

80

70

81

Other opiate/synthetic opiate:

33

44

46

50

62

115

Other drug:

14

21

16

29

108

35

Total:

1960

2080

2470

2289

2944

3247

Percent Alcohol:

66.99

62.45

60.89

60.16

60.02

71.08

Percent Marijuana:

9.95

10.72

9.64

9.17

9.95

6.10

Percent Cocaine/Crack:

13.98

14.76

16.48

17.47

16.10

10.72

Percent Meth:

4.49

6.20

8.06

6.25

5.77

4.99

Percent Heroin:

2.19

2.74

2.43

3.49

2.38

2.49

Percent other opiate:

1.68

2.12

1.86

2.18

2.11

3.54

*In fiscal year 2007-2008, barbiturates were among the top six primary drugs of choice with 79 cases. In every other year, there were less than five clients using barbiturates as their primary drug.

- Source: Crossroads Turning Points

Secondary Drug Type Identified by Crossroads Turning Points Clients

Drug Type

FY03-04

FY04-05

FY05-06

FY06-07

FY07-08

FY08-09*

None/Unknown:

1288

1321

1504

1405

1891

1121

Marijuana/Hashish:

275

328

402

314

377

435

Alcohol:

179

195

253

250

259

267

Cocaine Hydrochloride/Crack:

117

137

200

175

251

301

Methamphetamine:

41

64

60

80

89

73

Other opiate/synthetic opiate:

15

13

20

21

29

67

Heroin:

13

7

14

22

18

23

Other drug:

32

15

17

22

30

960

Total:

1960

2080

2470

2289

2944

3247

Percent none:

65.71

63.51

60.89

61.38

64.23

34.52

Percent Marijuana:

14.03

15.77

16.28

13.72

12.81

13.40

Percent Alcohol:

9.13

9.38

10.24

10.92

8.80

8.22

Percent Cocaine/Crack:

5.97

6.59

8.10

7.65

8.53

9.27

Percent Meth:

2.09

3.0

2.43

3.49

3.02

2.25

Percent other opiate:

0.77

0.63

0.81

0.92

0.99

2.06

Percent heroin:

0.66

0.34

0.57

0.96

0.61

0.71

*In FY2008-2009, nicotine was listed as a secondary drug of choice and 915 Crossroads' clients identified it. No clients identified nicotine in previous years.

- Source Crossroads Turning Points

Education Level of Crossroads Clients

Education Level

FY03-04

FY04-05

FY05-06

FY06-07

FY07-08

FY08-09

None

8

18

40

23

9

12

1-6 years:

49

24

27

31

32

28

7 to 9 years:

219

255

260

206

294

291

10 to 12 years:

1258

1267

1462

1303

1817

2080

13 to 16 years:

414

496

638

682

771

808

More than 16 years:

12

20

43

44

21

28

Total:

1960

2080

2470

2289

2944

3247

Percent some or all high school:

64.18

60.91

59.19

56.92

61.72

64.06

Percent some college:

21.12

23.85

25.83

29.79

26.19

24.88

Percent four years college or more:

0.61

0.96

1.74

1.92

0.71

0.86

Income Levels for Crossroads Clients from Pueblo County*

Monthly Income

FY03-04

FY04-05

FY05-06

FY06-07

FY07-08

FY08-09

None:

738

732

916

853

1171

1438

$1-$500:

313

345

424

350

459

449

$501-$1,000:

468

524

635

524

615

664

$1,001-$1,500:

158

203

207

170

246

184

$1,501-$2,000:

74

106

82

125

136

96

$2,001-$3,000:

39

71

72

90

74

80

Greater than $3,000:

29

38

36

49

39

42

Refused/Unknown:

141

61

98

128

204

294

Total:

1960

2080

2470

2289

2944

3247

Number under the median family income (more than $3,000 a month):

1790

1981

2336

2112

2701

2911

Percent under median family income:

91.33

95.24

94.57

92.27

91.75

89.65

*Crossroads' mission is to provide treatment services to people who wouldn't normally be able to afford it.

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