Again and again and again.

That's the pattern in chemical health abuse, where alcoholics and drug users often show up repeatedly in treatment programs at great cost to taxpayers.

Now, Washington County is investigating how to better help drinkers cork their bottles and drug users to just say no. The county will undertake a Legislature-designated pilot program -- the only one in the metro -- to attack every aspect of chemical abuse.

"It would be quite intense services, working on your sobriety and every aspect of your life," said Kathy Mickelson, who supervises the county's chemical health unit. "We just kind of walk them through the recovery process."

Many people who fall into chemical abuse are struggling with problems in their lives, such as bankruptcy, unemployment or mental illness. They tend to show up repeatedly in county programs -- sometimes they are sent by court order or by police or are referred by hospitals and probation officers. People can come on their own, too, if they meet poverty-level eligibility restrictions.

They drink too much, use cocaine, heroin and other narcotics, and abuse prescription drugs, Mickelson said.

Help doesn't come cheap: Washington County spent $1.4 million on mandated chemical health assistance last year. The county won't get extra money to run the pilot program but hopes the long-term payoff will come via lower cost to taxpayers and an eased social toll.

Washington County and 10 counties outside the metro will conduct the pilot program for two years. Treatment will be voluntary. Only people who have had two or more recent treatments would be eligible.

Social workers assess problems and recommend clients for voluntary treatment, which can cost as much as $300 a day for inpatient care and $26.82 to $66.06 per hour for outpatient care. Under the current arrangement, social workers don't probe the underlying causes of chemical abuse.

But the pilot program, which begins in July, puts a client with a "navigator" -- the new term for "case manager" -- who will help the client with jobs, independent living skills, family relations and other challenges to sobriety.

In the end, Washington County hopes to show how to save money and better serve people in need, said Dan Papin, county community services director.

To do that, the county will track health care costs. If the program works, clients will make fewer visits to hospital emergency rooms. They'll spend less time in jails, hospitals and treatment, will stay sober more often and show progress in housing, employment and income.

"The savings will be that they don't go back into a residential treatment facility again and again and again," Papin said.

Kevin Giles • 612-673-4432