Quarterly Newsletter

Substance Use Disorder Services
Winter 2015
Volume 6, Issue 1
Quarterly Newsletter
Substance Use Disorder Services
515 S. Cedar Ave., Bldg. 320
Fresno, CA 93702
Phone: 559-600-6087
Fax: 559-600-6089
Inside This Issue
Department Name Change ............... 1
Changes
Around the Capitol ..........................
You may have noticed that there have been a few changes here at the Drug: Cloud 9 ................................
Department of Behavioral Health – Substance Abuse Services. We are
now called the Department of Behavioral Health – Contracted Drug Tests and Synthetic Marijuana ..
Services Division; Substance Use Disorder Services are a Honey Oil Explosion ........................
component of this division.
Drug: Molly ....................................
With this change come new people, new roles, training and team building (see page 9 Marijuana Use in Colorado ...............
for details). What has not changed is our dedication to our clients and providers. In
fact, the goal with these changes is to improve our services to clients and offer more Drug: Krokodil ................................
assistance to providers.
Drug: Purple Drank .........................
1
3
3
4
4
5
5
6
If you have any questions regarding these changes, including who to contact for specific Provider Spotlight ........................... 8
information, please call Lisa Ruiz at (559) 600-6062.
Meet your SUD Services Staff ........... 9
Around the Capitol
With the new year comes new bill introductions by the
California State Legislature. The bill introduction
deadline is February 27, 2015.
Below are substance use disorder-related bills
currently making their way through the legislative
process. We will continue to keep you updated on bills
of interest as the Legislative Session progresses. If
you’d like more detailed information or are interested
in tracking these bills yourself, go to:
http://www.leginfo.ca.gov/bilinfo.html
Helpful Information
Alcoholics Anonymous
Meetings:
(559) 221-6907
Narcotics Anonymous
24-Hour Addiction Helpline:
(800) 559-9503
Gamblers Anonymous:
(888) 424-3577
AB 26 (Jones-Sawyer) - Medical Cannabis
Existing law, commonly referred to as the Medical Marijuana Program Act, requires the
establishment of a program for the issuance of identification cards to qualified patients
so that they may lawfully use marijuana for medical purposes, and requires the
establishment of guidelines for the lawful cultivation of marijuana grown for medical use.
The Medical Practice Act provides for the regulation and licensing of physicians and
surgeons by the Medical Board of California and requires the board to prioritize
investigations and prosecutions of physicians and surgeons representing the greatest
threat of harm. Existing law identifies the cases that are to be given priority, which
include cases of repeated acts of excessively prescribing, furnishing, or administering
controlled substances without a good faith prior examination of the patient.
For more information, call
Substance Use Disorder
Services:
(559) 600-6087
Or visit the Fresno County
Website at:
http://www.co.fresno.ca.us/suds
This bill would enact the Medical Cannabis Regulation and Control Act and would create
the Division of Medical Cannabis Regulation and Enforcement within the Department of
Alcoholic Beverage Control, to be administered by a person appointed by the Director of
Alcoholic Beverage Control.
Continued on Page 2
Page 1
Substance Use Disorder Services
Around the Capitol (Continued...)
Youth Drug Facts
 More teens die from
misuse of prescription
drugs than heroin/
cocaine combined.
 60% of seniors don't
The bill would also grant the department the power to register persons for the cultivation,
manufacture, testing, transportation, storage, distribution, and sale of medical cannabis within the
state provided that the authority of a city or county to adopt ordinances inconsistent with the
requirements of the act that ban, regulate, or tax medical cannabis activities, and to enforce those
ordinances, would not be affected by the act. Status: Assembly, Pending Referral
AB 34 (Bonita) - Medical Cannabis State Regulations.
This bill would establish a comprehensive and uniform state regulatory structure to govern the
cultivation, processing, testing, and distribution of medical cannabis. Status: Assembly, Pending
Referral
AB 216 (Garcia) - Product sales to minors: vapor products.
Current law prohibits the sale of electronic cigarettes to people under 18 years of age. Existing law
defines “electronic cigarette” as a device that can provide an inhalable dose of nicotine by
delivering a vaporized solution. This bill would prohibit the sale of any device intended to deliver a
non-nicotine product in a vapor state, to be directly inhaled by the user, to a person under 18
years of age. Status: Assembly, Pending Referral
SB 61 (Hill) - Driving under the influence: ignition interlock device.
This bill would provide that an individual whose license has been suspended for driving a motor
vehicle when he or she has a certain blood-alcohol concentration and who is eligible for a
restricted driver’s license may be eligible for a restricted driver’s license without serving any
period of the suspension if the person meets all other eligibility requirements and the person
installs an ignition interlock device. Status: Senate Public Safety Committee
SB 133 (Galgiani) - Controlled Substances
This bill would expand the definition of a synthetic stimulant compound and a synthetic
cannabinoid for purposes of existing law. The bill would provide that a first offense of using or
possessing those substances is punishable as an infraction, a 2nd offense is punishable as an
infraction or a misdemeanor, and a 3rd or subsequent offense is punishable as a misdemeanor.
Status: Senate Rules Committee
SB 140 (Leno) - Electronic cigarettes
This bill would change the Stop Tobacco
A cc e s s to K i ds En for c e m e n t A c t’ s
definition of tobacco products to include
electronic devices, such as electronic
cigarettes, that deliver nicotine and
make furnishing such a tobacco product
to a minor a misdemeanor. Status:
Senate Rules Committee
see regular marijuana
use as harmful, but THC
(the active ingredient in
the drug that causes
addiction) is nearly 5
times stronger than it
was 20 years ago.
 1/3 of teenagers who
live in states with
medical marijuana laws
get their pot from other
people's prescriptions.
 By the 8th grade, 28%
of adolescents have
consumed alcohol, 15%
have smoked cigarettes,
and 16.5% have used
marijuana.
 Teens who consistently
learn about the risks of
drugs from their parents
are up to 50% less likely
to use drugs than those
who don't.
www.dosomething.org
Page 2
Substance Use Disorder Services
Emerging Drug Trend: “Cloud 9”
By: Vanessa Delgado, Fresno County DBH SUD Services
It’s new. It’s dangerous. And it’s LEGAL. Among the latest drug trends is Cloud 9, a synthetic drug that has been reported to
cause hallucinations, aggressive behavior, racing heartbeat, drowsiness, and vomiting, according to the National Institute on Drug
Abuse. It is becoming popular in cities across the country, and sent almost two dozen youth to the hospital last year.
Research of Cloud 9 is still in its early stages. However, what investigators have learned so far is that this new drug (also sold as
“Relax” or “Crown”) is made up of the chemical compounds AB-FUBINACA and AB-PINACA. AB-FUBINACA was originally developed
in 2009 as a painkiller medication by a pharmaceutical company, though it was never pursued for human use. Years later in 2012,
both AB-FUBINACA and AB-PINACA were found in synthetic cannabis blends in Japan. Now, it has emerged in the United States.
Synthetic cannabinoids, commonly referred to as “synthetic marijuana” or “synthetic pot”, are chemically designed to mimic
marijuana’s active ingredient, THC. The National Institute on Drug Abuse states that makers of these types of designer drugs are
constantly creating new products to evade legal bans on older compounds. Despite their similarity on the molecular level, these
drugs are much more dangerous than marijuana, and have resulted in very serious health consequences including overdoses and
aggressive or suicidal behavior in users.
According to an investigation by NBC News, Cloud 9 is sold in convenience stores and smoke shops as a clear liquid in eyedropper
bottles. Shown below, the labeling includes only the product name. No other information is given, such as what’s in it, who made
it, or where it’s from. Cloud 9 is commonly used with vaporizing devices such as “e-cigarettes” and “hookah pens”. Drops of the
liquid are added and turned into vapor, which is then smoked. The drug has no aroma other than a faint, fruity smell, and users
say when it is used in an e-cigarette, there is no smell at all.
As awareness grows of the harmful effects of Cloud 9, law enforcement and counties are starting to take action. Numerous
hospitalizations in Michigan prompted the Macomb County Health Department to issue an emergency warning and ban the sale of
these drugs.
Sources: National Institute on Drug Abuse, NBC News, Wikipedia
Current Drug Tests Often Fail to Detect Synthetic Marijuana
By: Lisa Ruiz, Fresno County DBH SUD Services
Drug tests required for people on parole or probation often fail to detect the use of synthetic
marijuana, a substance that is increasing in popularity, according to a pilot study recently released by
the White House Office of National Drug Control Policy (ONDCP).
The researchers tested a sample of 1,000 young men who are on parole and probation. They found
that 39% of them tested positive for synthetic cannabinoids, but passed a traditional drug screen.
These findings suggest not only that people in the criminal justice system are unlikely to be flagged
for the use of synthetic marijuana, but that the same is true of people who undergo routine testing,
such as hospital workers, military personnel and others who are tested in their workplaces.
Expanding testing could help to identify people who take synthetic cannabinoids, but altering testing kits to detect synthetic
marijuana may run into roadblocks since federal, state, and local agencies are facing budget cuts. The special testing for the study
costs an average of $63 per specimen.
Continued on Page 4
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Substance Use Disorder Services
Current Drug Tests Often Fail to Detect Synthetic Marijuana (Continued...)
Rafael Lemaitre, Associate Director for Public Affairs at the ONDCP said, “We hope these findings will help state and local officials
have a greater awareness regarding the prevalence of synthetic drugs in their communities as they seek to stop the revolving door
of our criminal justice system by guiding more offenders into treatment. The agency also hopes that the study will spur state and
local officials to stay ahead of emerging trends related to synthetic drugs”.
Fresno County Honey Oil Explosion
By: Lisa Ruiz, Fresno County DBH SUD Services
A honey oil explosion landed three people in the hospital with serious burns, according to Channel
30 Action News in Fresno. Their injuries are extensive, and in prior cases, victims from
explosions like this have been in the hospital for almost a year. When investigators arrived, they
learned that there were a number of people inside the home saturating marijuana stems with
butane to produce honey oil.
Honey oil is a purer form of cannabis. When made into concentrated form, it largely minimizes
the intake of smoke and carcinogenics. Honey oil has a higher THC content than normal
marijuana, and is much more potent.
The products you need to make honey oil are easy to obtain.
Michael Ortiz with the Fresno Meth Task Force explains, "Because
everybody has a bag of weed or shake or trim and they think they're a chemist and think this is a
better way to get a high and they don't know what they're doing." Ortiz says all butane needs is
an ignition source, and the outcome can be explosive. People caught attempting honey oil
extraction will face felony charges.
Pop Music and a Drug Called Molly
By: Lisa Ruiz, Fresno County DBH SUD Services
During a concert at the Boston House of Blues, three people reportedly overdosed on a strong form of
ecstasy called Molly. The three victims were rushed to a nearby hospital. Authorities told the Boston
Globe that the three incidents were unrelated.
One of the victims was a nineteen-year-old woman named Brittany Flannigan. She died soon after
being admitted to the hospital. Flannigan's sister told the Daily Mail “this was the first concert
Brittany had ever been to, and sadly it was also her last.”
Molly is slang for methylenedioxymethamphetamine (MDMA) and is the active chemical in ecstasy.
What makes Molly stronger than normal ecstasy is that it is in a powder form and higher purity. The
powder is sold in a capsule instead of a pill, like ecstasy.
Molly is featured in several of todays songs. A song called “Molly” by Cedric Gervais has more than four million views on YouTube.
In the song, a woman’s voice begs to “please help me find Molly”. In addition, Madonna asked fans at a Miami concert in 2012,
“How many people in this crowd have seen Molly?”
In June 2013, singer Miley Cyrus released a song called "We Can't Stop". The song has the
drug reference “dancing with Molly”. Miley’s producer first claimed the lyric was "dancing
with Miley". According to the Daily Mail, Miley has set the record straight and was quoted, "It
depends who's doing what. If you're aged ten the lyric is Miley, if you know what I'm talking
about then you know. I just wanted it to be played on the radio and they've already had to
edit it so much. I don't think people have a hard time understanding that I've grown up.
You can Google me and you know what I'm up to, you know what that lyric is saying."
Even with the recent overdoses, some club-goers don’t view Molly as a dangerous drug.
Unfortunately, it seems like the music industry doesn’t either - and doesn’t care that the drug
is hurting the same people they market to.
Page 4
Substance Use Disorder Services
Increase in Teens Referred for Marijuana Use in Colorado
By: Lisa Ruiz, Fresno County DBH SUD Services
Addiction treatment centers in Colorado are bracing for an increase in teens referred for marijuana
use, ABC News reports. The state began legal sales of recreational marijuana for adults in January
2014. While only people twenty-one and older are allowed to purchase marijuana, some experts are
concerned the law will allow the drug to more easily fall into the hands of teens.
Dr. Christian Thurstone, who heads the teen rehabilitation center Substance Abuse Treatment
Education & Prevention Program, said ninety-five percent of patient referrals to the program are for
marijuana use. In preparation for the new law, Dr. Thurstone has doubled his staff.
He told ABC News that marijuana can be harmful for some teens, particularly those suffering from
mental illness. He said that after Colorado legalized medical marijuana in 2009, teens began to use much higher potency
products. “Our kids are presenting more severe addictions; it takes them longer to get a clean urine drug screen,” he said. Higher
-potency marijuana can increase the risk of psychotic episodes in some teens, Thurstone added.
“Anecdotally, yes, we’re seeing kids in treatment here who have paranoia and seeing things and hearing things that aren’t there,”
he said. “Adolescent exposure to marijuana [raises] risk of permanent psychosis in adulthood.”
Ben Court, an addictions expert at the University of Colorado Hospital Center for Dependency, Addiction and Rehabilitation, has
also seen an increase in patients addicted to marijuana since the state approved medical marijuana. He says the younger people
are when they start consistently using marijuana, the more likely they are to become addicted. “Most people are going to smoke
weed and it’s not going to be an issue. By eighteen to twenty-four, your odds are less than one in ten that you’re going to be
addicted,” he said. “If you start under eighteen, it’s one in six.”
Krokodil—The Flesh-Eating Drug
By: Lisa Ruiz, Fresno County DBH SUD Services
A powerful heroin-like drug that rots flesh and bone is at epidemic levels in Russia. On the street, it is known as krokodil, (Russian
for crocodile). The homemade opiate is made from codeine-based pills (that can be purchased over-the-counter in Russia) and is
mixed with iodine, gasoline, paint thinner, or alcohol. When this concoction is injected, it destroys a user's tissue, turning the skin
scaly and green like a crocodile. Festering sores, abscesses, blood poisoning, and gangrene are common. The toxic mix also
dissolves jawbones and teeth, much like methamphetamine.
Up to one million people in Russia are estimated to use krokodil, according to New York's Office of Alcoholism and Substance Abuse
Services. Krokodil became popular in Russia because heroin can be difficult to obtain and is expensive. Krokodil costs three times
less with a high similar to heroin though much shorter, usually ninety minutes.
According to Time Magazine, the average life expectancy among krokodil addicts in Russia is two to three years, but one
recovering Russian krokodil addict told Time in 2011 that she injected the drug almost daily for six years. There is no medical
explanation for why she survived her addiction, but she is left with a speech
impediment and impaired motor skills from brain damage. Her brother was among a
dozen or so addicts she shot up with that are all now dead from the drug.
Medical toxicologist Dr. Lewis Nelson at Bellevue Hospital Center in New York doubts
krokodil will be a problem in the United States due to the availability of other cheap,
powerful drugs such as black tar heroin and OxyContin.
A report from the website myaddiction.com indicates that krokodil will be more
difficult for home labs to make, since codeine is regulated and therefore more difficult
to obtain in the United States. It is still a matter for concern; drugs trends often
start in one part of the world and then spread.
There are reports of abuse in the US. Two sisters named Amber and Angie Neitzel
from a small town in Illinois called Joliet claim that they’ve been using Krokodil for
about a year. The sisters are among three others that have been hospitalized
recently due to the devastating affects of the drug.
Continued on Page 6
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Substance Use Disorder Services
Krokodil—The Flesh-Eating Drug (Continued...)
Their doctor, a leading drugs expert named Dr. Abhin Singla, stated that the effects of Krokodil were the worst that he had ever
seen, and that he could tell that the two girls were taking the drug immediately as their scars were completely different to other
heroin addicts that he had been treating in his addiction center. Their sores go all the way to the bone. The sores on Amber’s
elbow were so bad that the doctors thought they would have to cut part of the bone off, but luckily they managed to avoid that.
According to Amber, she knows about seven other people who have been badly effected by Krokodil in her small Illinois town. One
is her boyfriend who she claims actually had maggots in the sores on his legs.
Despite these gruesome reports and several more examples spanning the country in states including Utah and Arizona, the Drug
Enforcement Administration initially played down concerns, saying they are 'not seeing cases' of abuse of the substance, but
quickly released another statement saying, “The DEA is very concerned about the recent news that several patients who were
treated at Presence St. Joseph Medical Center in Joliet had symptoms consistent with the use of the drug Krokodil. We want to be
pro-active and get out ahead of the curve on this, but until we can get our hands on the drugs and people who are trafficking in it,
we won’t know the extent of what we’re dealing with.” Emerging Youth Drug Trend: “Purple Drank”
By: Vanessa Delgado, Fresno County DBH SUD Services
and Marisol Zamora, California Health Collaborative
From illicit drugs to prescription medication abuse, drugs are constantly evolving. Among the latest drug trends in the youth
population is “Purple Drank” (also known as Syrup, Sizzurp, Lean, Barre, Purple Jelly, Texas Tea, and Tsikuni). It is a concoction
of prescription cough syrup (codeine/promethazine), soda, and hard fruit candies such as Jolly Ranchers or Skittles (for color and
flavor). Purple Drank gets its name from the purple-colored dyes in cough syrup, and is usually seen being consumed in
Styrofoam cups.
What are the Effects?
Usual side effects of this drug include relaxation, euphoria, motor-skill impairment, lethargy, and drowsiness. However, because
the syrup is habitually consumed in much higher doses than medically recommended, effects become more hazardous.
Consumption in high amounts can cause fatal overdose because it depresses the central nervous system, which can slow or stop
the heart and lungs. In fact, deaths from prescription opioid medications now outnumber overdose deaths from all other drugs
combined (including cocaine and heroin).
Where Did This Trend Come From?
Purple Drank may be new to the youth population. However, it actually originated several decades ago. Developed in Houston in
the 1960s, the drink was consumed by blues musicians who would mix Robitussin (over-the-counter cough syrup) and beer.
During the 80s and 90s, the syrup ingredient was switched from over-the-counter to prescription-strength (codeine/
promethazine). It has now reemerged and grown in popularity among the hip hop community, and rappers frequently refer to
Purple Drank in their song lyrics and music videos.
Continued on Page 7
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Substance Use Disorder Services
Emerging Youth Drug Trend: “Purple Drank” (Continued...)
Drake, “Trust Issues”
“Two white cups and I got that drink. It could be purple, it could be pink, depending on how you mix that […]…‘cause I’m on one”
Jay-Z, “Big Pimpin”
"Smokin out, throwin up, keepin lean up in my cup”
Three 6 Mafia, “Sippin on Some Syrup”
“Sipping and dipping and tripping, man I'm bout all out Sippin' on some sizzurp, sip, sippin' on some, sip”
Young Buck featuring D-Tay, “Sippin' Purp”
"Bumpin' choppin' flippin' diamonds on my neck'n'wrist. Sippin on some purple purple [...]"
Lil Flip, “Sippin on Codine”
"I'm sippin sprite tonight because I love the lean A three in a 20 oz, watch a [...] dream "[...]drink till i'm dizzy"
Lil Wayne, “Me and My Drank”
"Up in the studio me and my drank. Please let me be and let me do my thang. Thinkin about a certain..certain somebody that
perfect somebody sexy purple body."
A$AP Rocky, “Purple Swag”
"Purple drank, I still sip, purple weed blunt still lit Real [...], real [...], purple swag, that trill [...] Them candy cars, I'm coming
down, that paint drip, I still tip”
Lock It Up Project—Tackling the Abuse of Purple Drank in Fresno County
Lock It Up Project is a community-based substance abuse prevention project funded by the Fresno County Department of
Behavioral Health – Contracts Division – Substance Use Disorder Services. The goal of the Lock it Up Project is to increase
awareness of the risks and consequences associated with the illicit use of prescription painkillers by teens and young adults ages
12-20 in Fresno County.
In response to the recent surge of abuse of purple drank, the Lock It Up Project has been active in educating the community about
the dangers and consequence of this concoction. Through parent presentations, parents are made aware of the issue by learning
about the history of purple drank, the glamorization by music artists, the impact social media has had on access, and signs to look
out for if they think their children are abusing it. Teenagers and young adults are provided with information about consequences
both to the individual’s health, as well as legal consequences as a result of illegal possession of prescription cough syrup.
Youth participating in the Lock It Up Project Youth Coalition at Firebaugh High School will soon be working on a media campaign
aimed at raising awareness on the dangers of abusing purple drank/lean.
Sources: National Institute on Drug Abuse, L.A. Times, Wikipedia Page 7
Substance Use Disorder Services
Provider Spotlight
Generational Changes, Inc.
Generational Changes Inc. is a treatment program that provides therapeutic counseling
and dependency treatment services for youth and young adults. Generational Changes
Inc. specializes in working with individuals suffering from dual diagnosis including
mental health conditions and chemical dependency issues.
Their mission is to provide treatment, intervention, and prevention programs to
adolescents and adults seeking counseling and recovery. Their services are designed
to guide families toward change, independence, self-efficiency and productivity. Their
goal is to stabilize the lives of families by providing therapeutic counseling, treatment
for alcohol and substance abuse, and mentoring in order to affect future generations.
They offer a holistic approach that includes mental health promotion, early
intervention, treatment and self-awareness. Their agency believes full recovery can be
reached through intensive group therapeutic treatment along with referral services
such as education, employment, housing, and social reorganization.
You can learn more about Generational Changes Inc. by contacting them at
(559) 981-2795.
“Changing Lives One Day at a Time”
Page 8
Substance Use Disorder Services
At Your Service—Meet your SUD Services Staff
Joseph Rangel is the Division Manager for the Department of Behavioral Health – Contracts Division –
Mental Health and Substance Use Disorder Services. He began his career 14 years ago as a Staff Analyst for
the Department of Children and Family Services.
He earned both his Bachelor’s and Master’s degrees in Social Work from California State University, Fresno.
Joseph has been married for over 10 years, and has two children, Addison and Avery. In his spare time,
Joseph enjoys camping, hiking, hunting, going to the gym, and playing golf.
Natasha Hagaman is a Principal Staff Analyst with the Department of Behavioral Health (DBH) - Contracts
Division – Substance Use Disorder Services. Before transferring to DBH, she worked for the County
Administrative Office. Previously, Natasha worked for the City of Carlsbad, and later in Sacramento as a
Legislative Analyst for lobbying associations.
Natasha earned her Bachelor’s degree in Gender Studies and English, and Master’s degree in Public Policy.
Natasha is married and has a four-year-old son. In her spare time, she enjoys going to the gym, reading,
and occasionally teaching at California State University, Fresno.
Kathy Anderson, Senior Staff Analyst, has been with us since winter 2011. She began her County career
as a Staff Analyst for the County Human Services System Administration in 1999.
Kathy has a Bachelor of Arts degree in Liberal Studies from California State University, Fresno. Her prior
profession was being a Partnership Account Representative for OK Produce.
Kathy enjoys being with friends and family. She has been married to her husband Mark for 20 years and
has two children Michael (almost 10) and Katy (9).
Adam Balto, Substance Abuse Specialist II, began his career with Fresno County in 2000. He worked as a
Juvenile Correctional Officer with the Probation Department. In 2008, he moved to the Department of
Behavioral Health as a Substance Abuse Specialist for the Assessment Center. Currently, he works with SUD
Services – Site Review Team.
Adam is working on obtaining his Bachelor’s Degree, and aspires to become a Licensed Marriage and Family
Counselor or Licensed Clinical Social Worker.
In his free time, Adam enjoys cooking meals for his family and friends and singing karaoke.
Continued on Page 10
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Substance Use Disorder Services
At Your Service—Meet your SUD Services Staff (Continued...)
Baldomero Berber, Staff Analyst, started his Fresno County career thirteen years ago as a Job Specialist
for the Department of Employment and Temporary Assistance. He has also worked for Substance Use
Disorder Services before; he was a Staff Analyst for our prior Administration from July 2003 to October
2004. Prior to working for the County of Fresno, he was a cashier for Gottschalks Department Store.
Baldomero went to Firebaugh High School and earned his Bachelor’s degree at California State University,
Fresno. He has been married for fifteen years and has two boys, Sean (9) and Ethan (6).
He spends his free time with family and plays in a basketball league. His hobbies include: golfing,
paintballing, bike riding, fantasy football, racing RC cars in the neighborhood, and fishing from time to time.
He is also a self-proclaimed practical joker and is very competitive.
Please welcome Jose Conchas, Staff Analyst, to our team. Jose began his career with Fresno County as an
Eligibility Worker for the Department of Social Services. Prior to that, he served in the U.S. Navy for
fourteen years, and later, spent several years working in the Non-Profit Sector.
Jose has two Bachelor’s degrees, one in Political Science, and the other in Sociology. He also has a Master’s
degree in Healthcare Administration.
Jose is a father of three adult children, and has a one-year-old grandson. He also has three dogs and one
cat, who were all adopted from the SPCA. In his free time, Jose likes to cook and visit new and exciting
places.
Please help us welcome Dwayne Davis, Substance Abuse Specialist, to our team. He comes to us from
Mental Health Systems where he worked with their Fresno FIRST CalWORKs program.
Dwayne earned his Associate’s degree in Drug and Alcohol Counseling, and is a certified Addictions
Treatment Counselor-II.
Dwayne has two sons named Boone and Jacob, along with four grandchildren, Chloe, Cayden, Sammy, and
Sophie. In his free time, he enjoys fishing, going to the movies, spending quality time with his family, and
playing the drums.
Welcome to the team, Dwayne!
Please welcome Vanessa Delgado, Program Technician I. She transferred to us from the Department of
Behavioral Health - Urgent Care Wellness Center.
Before Vanessa worked for the County of Fresno, she worked for a staffing agency and was placed at a
freight distribution company for two months. Prior to that, she worked for a human resources consulting
firm that provided telephone and website support for employment law risk management. She provided
administrative and technical support there for six years.
Vanessa received an Associate’s degree in Liberal Arts at Fresno City College in 2010, and she is currently
attending California State University, Fresno, studying Social Work.
In her free time, she likes to do crafts, currently crochet. Vanessa also likes to relax at home watching TV
shows or movies. She also reads and enjoys spending time with family.
Welcome, Vanessa. We’re happy to have you here!
Continued on Page 11
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Substance Use Disorder Services
At Your Service—Meet your SUD Services Staff (Continued...)
Sharon Erwin started with the Fresno County Department of Behavioral Health June 2012 with Substance
Use Disorder Services. Her previous employment was with the El Dorado County - Health and Human
Services Agency. In El Dorado County, she assisted with the development of the department’s budget,
provided fiscal/financial support to affordable housing, homelessness, and economic development programs,
and also prepared state reports for the Social Services Department. She was employed there for over nine
years.
Sharon graduated from Folsom Lake College in May 2006 with two Associate degrees in Business and
Accounting. In 2007, she returned to school at the University of Phoenix and earned her Bachelor’s degree
in Business Management.
Sharon has a twenty-three-year-old son named DJ. In her spare time, she likes to take bike rides and road
trips to the coast.
Tina Hedstrom, Senior Substance Abuse Specialist, has been working for Fresno County Department of
Behavioral Health for over fourteen years. Her responsibilities include contract monitoring with our Site
Review Team, as well as the provision of Alcohol and Other Drug/Mental Health counseling services for the
Pathways to Recovery program.
Tina earned her Master of Arts degree in Counseling Psychology from National University, specializing in
Marriage and Family Therapy. Tina is a Registered Intern with the California Board of Behavioral Sciences,
and maintains multiple advanced credentials in the treatment of substance use disorders.
During her time off, Tina enjoys spending weekends at the ranch with horses, and riding motorcycles with
her boyfriend, Bill.
Tina’s passion is to assist those struggling with mental health challenges to learn about strategies to manage
their symptoms, and gain the ability to function at their best in everyday life.
Brandon Hill, Staff Analyst, has been with Fresno County for four years. He began his career in the
Department of Social Services, working as an Eligibility Worker. In April 2013, he moved to the Department
of Behavioral Health Administration. Prior to working for Fresno County, he worked for Starbucks Coffee.
Brandon earned his Bachelor’s degree in Political Science from Fresno State, and is currently working on his
Master’s in Public Administration.
Brandon has been married for two and a half years. He enjoys many hobbies, including playing with his cat
and dog, watching crime shows, hiking, Search and Rescue training, camping, and woodworking projects.
Robert Johnson is a Senior Substance Abuse Specialist with SUD Services—Site Review Team. He began
his career in 2004 providing AOD counseling for a detoxification program, and has been working for Fresno
County since 2008.
Robert has an Associate’s degree from West Coast Christian College, and has obtained certificates of
completion and achievement in Alcoholism and Drug Abuse Counseling from Fresno City College. He is also
certified as an Addictions Treatment Counselor-II.
Robert grew up in Auberry and enjoys outdoor activities, such as fishing, camping, and four-wheeling, and
spending time with his family. Robert is happily married, and has five daughters and three grandchildren.
He also has three siblings, one brother and two sisters.
“I enjoy being a part of helping people recover from drugs, alcohol and other problems.”
-Robert Johnson
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At Your Service—Meet your SUD Services Staff (Continued...)
Kelley Juhrend, Secretary IV, began her career with Fresno County twenty-seven years ago, working in the
Health Department Business Office as an Office Assistant II. She received her education from Heald
vocational school.
Kelley has been married for twenty-six years, and has two children, William (24) and James, (20). She
enjoys spending time with her family and partaking in different hobbies, depending on the time of year.
Please help us welcome Okie Lewis, Staff Analyst, to our team. Okie comes to us from the Department of
Social Services, where she worked as a CalWORKs intake worker.
Okie was born in South Korea, and came to the United States when she was two years old. She grew up in
Northern Virginia in a suburb of Washington, D.C., and moved to California to attend U.C. Berkeley. Later,
she moved to Fresno, and completed her education at California State University, Fresno where she earned
her Bachelor’s degree in Liberal Studies.
Okie is married, and has a teenage son and small dog. In her spare time, she enjoys traveling and baking.
Welcome to our team, Okie!
Please welcome Christopher Pettebone, Program Technician II, to our team. He has been working for
Fresno County for twelve years, and began his County career as an Office Assistant for the County Clerk/
Elections office. Prior to that, he worked for a grocery store.
Christopher has three children, Garry, Brandon, and Helena. He enjoys barbequing for his family and friends
in his spare time. He is also a huge sports fan, and loves the Oakland Raiders, Los Angeles Lakers, and Los
Angeles Dodgers.
Welcome to the team, Christopher!
Lisa Ruiz, Program Technician, has been with the County of Fresno for seventeen years. Her County career
started as an Office Assistant for the Department of Human Services, Personnel Department. After working
for the department for four years, she was promoted to Program Technician and transferred to the
Department of Behavioral Health. Her prior employment was with Valley Family Health Center in Riverdale,
CA. She was a medical assistant and phlebotomist with the company for four years.
Lisa graduated from San Joaquin Valley College with vocational training in the medical field and also
attended Fresno City College majoring in nursing. She plans to finish her prerequisites someday for the
nursing program.
She has been married to her soul mate, Steve Ruiz, for almost twelve years. They have one son named
Adam (9) who is the center of their lives. Lisa spends most of her free time with her family. They love to go
to the coast, play Jenga, and watch Adam’s favorite show, America’s Funniest Home Videos.
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Substance Use Disorder Services
At Your Service—Meet your SUD Services Staff (Continued...)
Mary Ann Smilie has been with Fresno County - Department of Behavioral Health since 1998. Throughout
her career as an Office Assistant, she has worked in Intensive Mental Health Services, Administration,
Conservatorship, and now Contracts Division - Substance Use Disorder Services.
Mary Ann loves animals, and enjoys spending time with her family, which includes a daughter, son-in-law,
and three grandchildren, one boy and two girls.
Please welcome Chao Xiong, Senior Staff Analyst, to our team. Chao has been with the County of Fresno
for over five years. For three of those years, she has served in the Department of Behavioral Health as a
Staff Analyst performing quality improvement and contract management activities. Chao joined the
Contracts Division as a Senior Staff Analyst in Facility Management. She also brings to her role as a Senior
Analyst over ten years of experience working in residential and affordable multi-family housing real estate.
Chao has a Bachelor’s degree in Social Sciences from UC Irvine.
Chao has been married for seven years, and has three children, Sienna (6), Savannah (4), and Dylan (2). In
her spare time, she enjoys spending time with her family and playing tennis.
Paula Zapata has recently joined our team as a Senior Staff Analyst with the Department of Behavioral
Health (DBH) – Contracts Division – Substance Use Disorder Services. Before this assignment, she worked
overseeing the Department’s Human Resource Division; previously, Paula worked for the Department of
Social Services.
Paula earned her Bachelor degree in Management of Human Resources from Fresno Pacific University and
Master’s degree in Public Administration, and presently serves as Chairperson for the City of Selma’s
Personnel Commission.
Paula is married, has two children, and one grandchild. In her spare time, she enjoys spending time with
her family, volunteering at her church, and gardening.
Welcome to the team, Paula!
Fresno County Substance Use Disorder Services Mission
The Department of Behavioral Health (DBH), Contracts Division – Substance Use Disorder (SUD) Services is
charged with the planning, development, and administration of a countywide substance use disorder prevention
and treatment system. The Contracts Division - SUD Services’ mission is to support appropriate education,
prevention, and treatment services to reduce or eliminate alcohol and other drug (AOD) - related barriers to
ongoing health, well-being, and economic independence of individuals and families.
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