Contact: Ana Gutierrez Sisneros 505-753-0166 Media Contact: Carolyn Gonzales 505-277-59205915

October 28, 2002 UNM NURSING STUDENT STUDIES HEROIN USE IN RIO ARRIBA COUNTY Ana X. Gutierrez Sisneros (Mora), RN MSN CCM MA, is quite a mouthful. Her plate is full, too. One of eight statewide field care coordinators for the Presbyterian Health Plan Salud! BHO, she also juggles coursework toward dual masters degrees in Advanced Practice Psych/Mental Health Nursing and Latin American Studies at the University of New Mexico. Working in and around Rio Arriba County inspired her to want to help her community, so Gutierrez Sisneros began working in the substance abuse field in 1986. As an Adult Child of an Alcoholic (ACOA), Gutierrez Sisneros' prior research focused on alcoholism. "The high incidence of black tar heroin use and overdose in the county gravely concerns me. Many anecdotal reports stated that these problems were multigenerational, some going back as many as four generations," she said. Her thesis, a pilot study, "Sobreviviendo la 'Segunda Jornada del Muerto': Measuring the Effects of Daily Spiritual Experience on Relapse Rates in Recovering Heroin Addicts in Rio Arriba County," involved a 15-person sampling from treatment centers, jails, and the community at large. The hypothesis is that those with more daily spiritual experience have lower relapse rates. "Of the fifteen participants, about half were from Chimayó," she said. Eleven were male, four were female. Thirteen were Hispanic and two were Anglo. Subjects ranged in age from 24 to 54 years with a mean age of 41. She tried to extend the sampling to nearby pueblos, but was unable to locate Native American heroin addicts within Rio Arriba County. The results indicated that heroin use, in this sample, isn't multigenerational. "A common answer I got was, 'No, my parents or my grandparents didn't use heroin. Just me. I'm the black sheep of the family,'" she said. Gutierrez Sisneros was surprised that few of her sampled individuals had relapses. "The mean was 1.6 relapses since last quitting heroin, with only 26 percent, or 4 out of 15 having relapsed at all," she said. Her other surprise was discovering how most got off heroin. "None of the participants were on methadone. Most of them quit 'cold turkey' while incarcerated, suffering through the 'malías,' or withdrawals," she said. Others quit heroin by using other drugs or alcohol, she said. Gutierrez Sisneros looked at why heroin use was so high in Rio Arriba County. Some participants think the 'mulas,' those who transport the drugs, need to rest or hide along this route. "They travel the same Jornada del Muerto on El Camino Real, used for hundreds of years between Mexico, New Mexico and Colorado," she said. "Rural, remote northern New Mexico lends itself well to method of operation. Some of the drug traffickers remain in the area," Gutierrez Sisneros said. She says the situation is distressing because many of the houses in Chimayó are the homes of drug dealers, and yet, ironically, the land, the town itself, is a very spiritual place to both Hispanos and Native Americans. "A participant told me, 'Where there is good, evil will come to take over,'" she said. "Gutierrez Sisneros points to the county's poor economy as a cause. "We adjoin Los Alamos and Santa Fe counties, two of the richest in the state. Rio Arriba ranks just above Mora as the poorest county. Hopelessness and despair can result. People turn to drugs to fill economic and other voids in their lives," she said. One participant told her that a lot of tecatos, people who use, have a similar experience. They try to fill the void in their spiritual or psychological self with substance. Unfortunately, the substance is a lie they keep going back to, she said. Given the county's land grant history, Gutierrez Sisneros wondered if people turned to drugs because of the loss of land and water. This possibility was formulated into two qualitative questions asked of the participants. "Only one study participant said 'yes,' the loss of land was the direct cause of his addiction," she said. The rest of the participants had other reasons behind their drug use, such as peer pressure, troubles at home, guilt over a relationship gone bad, the need to feel validated, an absent father and many other reasons," she said. A positive side to the story does exist. "The addicts say they feel bad for the youth, and they are all trying now to teach younger people not to use," she said. In response to the crisis, many prevention and treatment programs are funded and operating in the area. Plus, Northern New Mexico Community College offers a substance abuse curriculum towards licensed alcohol drug abuse counselor (LADAC) certification. "But to become a CNS, in psych/mental health, you have to travel to UNM for classes," she said. Gutierrez Sisneros noted success in battling the heroin problem through Narcotics Anonymous (NA), a 12-step program, and other treatment programs. She found that about half, 53 percent, or eight persons, of the sample population had gone to counseling for some reason, with depression being the most common diagnosis. And, although 60 percent of the participants had been abused in their lifetimes, only one female was actually counseled specifically for abuse, post-traumatic stress disorder, or PTSD. "This failure to receive counseling for abuse is significant in planning for treatment interventions for heroin addicts of both genders," she said. "No one method works for every addict. My family has been in New Mexico since 1603 and has had many healers within those generations of familia. It is my goal to treat substance abuse with traditional medicine handed down from our ancestors," she said. Gutierrez Sisneros discussed addiction with local Curandera Patricia Padilla, operator of a mental health clinic in Denver for 32 years before moving to the Tesuque, New Mexico area. "Doña Padilla thinks that the problem of drug addiction is related to the fact that many of the addicts are self-medicating manic-depressives. For example, they treat depression with cocaine, and then they progress to treating their mania with heroin. It becomes a vicious cycle, but there is treatment," said Gutierrez Sisneros, noting it is an area she intends to study. Gutierrez Sisneros was born in Barrio San José and grew up on Albuquerque's west side. She attended West Mesa, Rio Grande, New Futures and Freedom High Schools. "I was given the choice to indicate one school on my diploma and I chose Rio Grande," she said. She earned an associates degree in nursing from the University of Albuquerque in 1983. "We were their last graduating class," she said. She and her family moved to El Norte, Española, thereafter. She went on to earn a bachelor's in nursing from UNM in 1994, while working full-time and raising a family. As a field care coordinator, Gutierrez Sisneros visits behavioral health (BH) facilities, residential treatment centers, group homes and school-based health centers to ensure Medicaid clients' behavioral health needs are met throughout northern New Mexico, where she resides. "We also meet with family providers, mental health professionals, physicians and educators, participating in their clinical staffings, as well as client and family meetings regarding their needs upon discharge from a BH facility," she said. Her UNM education, scheduled for completion in December, will allow her to become an advanced practice nurse, as a behavior health provider. "It is licensure as a CNS, a clinical nurse specialist, as a nurse psychotherapist," she said. Gutierrez Sisneros said that she is getting the dual masters degrees because she sees the need for Indo-Hispanos to take a leadership role in healthcare in the state of New Mexico. She praises the career of nursing as "the best friend I've ever had, being more dependable than any mate." She has been nominated for the March of Dimes' 2002 Nurse of the Year Award and she earned one of only three UNM Raza Excellence Awards for community service from El Centro de la Raza in April 2002. In graduate school, she won the national J.O. Pollack/ NLN scholarship for community service and the UNM College of Nursing's Florence Nightingale Lamp of Knowledge award, both in 2000. She said, "I have been very inspired by psychologist Carl Jung, whose areas of interest were both medicine and spirituality. I think that having the combined credentials in enfermería and americalatina will be helpful as I continue to practice using both Western psychiatric and traditional medicine models in my work in the field of addiction and mental health." # # #

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