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Eden E. Mondanaro

Eden E. Mondanaro, a commercial art consultant based in Sacramento, Calif, is a founding member of the Spiritual Unity Conference. His upcoming compilation, The Art of Shaping the Mass Mind, will be published by the Northern Empire Press in January 2005.

Correspondence: Requests for reprints should be sent to Eden E. Mondanaro, SureWest Communications, 8150 Industrial Ave, Bldg A, Roseville, CA 95678 (e-mail: mondanaro717{at}aol.com).

	INTRODUCTION

TOP INTRODUCTION Dr Mondanaro’s Career:... Epilogue References

 
IN 1975, THE STATE OF California had few funds set aside to help drug-dependent women and their unborn children. Specialized services to treat perinatal and neonatal drug addiction were not available to most women. Aside from a few very dedicated volunteers, whose medical school colleagues gently but firmly warned them that working with individuals with drug addiction was tantamount to professional suicide, most physicians were not interested in treating what is now considered "chemical dependency." In fact, most doctors did not view addiction as a treatable disease.

Even fewer were knowledgeable about the effects that heroin, alcohol, and other substances were having on newborn babies, whose delicate systems were ill-equipped to deal with the effects of withdrawal. What became painfully clear to Dr Josette Mondanaro and her colleagues was that California, a state with considerable resources, was not dedicating any of those resources to developing effective chemical dependency treatment programs to help these babies and their mothers.

Over the past 3 decades, the problems of chemically dependent mothers and their children have been well documented. The relative costs of incarceration, prosecution, and law enforcement versus treatment are now well-known and may seem self-evident. However, in 1975 only those "in the trenches" saw what needed to be done. Society as a whole was still unwilling to take a close look at chemical dependency as a disease, rather than a moral deficiency. This generally scornful outlook was especially reserved for users of heroin and cocaine, resulting in many missed opportunities for treatment and prevention. The desire to better understand the science behind chemical dependency—that is, the chemical and behavioral roots of addiction—intersected with Dr Mondanaro’s special passion, helping children who were too young to fend for themselves.

Dr Mondanaro with her adopted child.

Prototypes is an organization that has developed some of the country’s most successful treatment programs for women with substance abuse problems and their children. It has a training center in Pomona, Calif, named for Josette Mondanaro. Vivian Brown, PhD, who is the chief executive officer of Prototypes, began working with Dr Mondanaro in the late 1970s, as they both developed new models of treatment for women who were being kept out of traditional substance abuse treatment programs. In a recent interview, Dr Brown said, "We found that women who came into our treatment programs frequently had histories of physical and/or sexual abuse and often were in current battering relationships. We needed to develop programs where women and the children could be in a safe environment and be given enough time to recover.

"Dr Mondanaro was a powerful advocate for these women and children and an effective voice in the medical community for their special needs. She understood and made others aware of 3 critical points: that women should not be separated from their children in order to access treatment; that treatment needed to take these women’s frequent victimization into account; and that their children were also vulnerable, not only because of the addiction but also because of the violence in their environment. As deputy director of California’s Drug Abuse Treatment Department, Dr Mondanaro organized what would become a 20-year blueprint for treating and tackling this problem. The Northern and Southern California Alliances of Women’s Treatment Programs was her brainchild. It gave birth to what are now hundreds of nonprofit treatment programs for women on the West Coast alone. These state and federally funded programs, which also received a healthy dose of generous private donations, are still functioning today."

Dr Mondanaro was an avid grant writer and would personally lobby her wealthier friends and political acquaintances to support her chemical dependency treatment programs for newborn and unborn babies.

Dr David Smith is now a White House panel advisor on science and medicine. As he explained at the 30th anniversary of the California Department of Alcohol and Drug Programs, "What we had then was a few free clinics run by Josette and myself on the Haight-Ashbury in the streets of San Francisco. Dr Mondanaro was a pioneer in the field, and she refused to take no for an answer. Back then, when you said you were going to treat heroin addicts your colleagues either urged you to take up a respectable urology practice or gazed at you sorrowfully. This is now mainstream stuff, and Josette was a big part of making that happen." Thirty years later, there is a large cadre of professionals who successfully treat substance abusers and their families. California recently passed Proposition 36, which authorizes voter-approved funding dedicated to channeling drug-related offenders into treatment facilities as opposed to prison.¹ The cost savings alone are staggering, and since most prison sentences in California are for drug- or alcohol-related offenses, the approach makes sense.²

It has often been said that "it takes as much to send a man to prison as it does to Stanford." Indeed, the facts bear this out: the average yearly cost per inmate in California is $30 929 and the annual tuition at Stanford is $25 917.^3,4 These numbers point out that an investment in treatment for women and their children makes good financial sense.

	Dr Mondanaro’s Career: Love Comes First

TOP INTRODUCTION Dr Mondanaro’s Career:... Epilogue References

 
Josette Mondanaro attended Syracuse University in New York, receiving her undergraduate degree in 1967 and her medical degree in 1971. During her residency in New York, she worked a regular job in addition to performing (as many a practicing doctor can attest) the standard 80-hour-plus weekly regimen of the medical school resident. After moving to California, she faithfully served the State Department of Health and Human Services and then opened a small but thriving medical clinic dubbed Wingspread in Santa Cruz, Calif. The clinic had 10 beds and outpatient facilities to serve mostly low-income patients. Dr Mondanaro went into private practice and lectured at the University of California, Santa Cruz. Her obstetrics/gynecology classes were among the most sought-out on campus, and her students were known to appreciate her hallmark sense of humor and booming laugh. Many of her former students are practicing doctors today and remember her classes with fondness. She encouraged her students to challenge preconceived notions about both themselves and their patients. She was especially active in helping her female students navigate through what was at the time a profession dominated by men.

After leaving her teaching post to devote more time to teaching, research, and private practice, Dr Mondanaro lectured and treated patients from her home. She had just finished a series of training courses and "her book" (what she considered her seminal collection of strategies to treat and beat chemical addiction)⁵ when she was diagnosed with a golf ball–sized brain tumor (astrocytoma) at the age of 41. The bundle of nerves that connects the 2 halves of the brain together was in grave jeopardy. After numerous surgeries, standard radiation treatment, many types of chemotherapy—some highly experimental—and a radioactive uranium implant, her ability to function as an effective physician was impaired. The effort to survive took all her strength over the next 16 years, but she never lost her compassion, her keen powers of observation, or her trademark sense of humor.

	Epilogue

TOP INTRODUCTION Dr Mondanaro’s Career:... Epilogue References

 
Dr Josette Mondanaro passed away Christmas Day, 2003, and, true to form, donated her body to science for medical students to learn from. Although the true effect of her work is hard to quantify, tens of thousands of success stories are testimony to how the lives of many mothers, children, and now grandchildren have been quite literally saved over the years. I am always honored and moved by the requests to appear and accept an award or dedication in her name. Total strangers, speaking in the most urgent tones, are constantly reminding me of the depth, courage, and love that this woman possessed. She was to me simply Mom, a single mother who, unbelievably, found the time, strength, and energy to raise me to the best of her abilities.

". . . For Those With No Voice of Their Own, She Will Be Sorely Missed," reads her epitaph. For in the final analysis, hers is a legacy of love, and her spirit will be alive for generations to come.

	Acknowledgments

 
The author acknowledges Kathryn Jett, Dr Vivian Brown, and Dr David Smith for their valuable contributions to Dr Mondanaro’s work and to this article.

Accepted for publication April 2, 2004.

	References

TOP INTRODUCTION Dr Mondanaro’s Career:... Epilogue References

 
1. The Substance Abuse and Crime Prevention Act of 2000. Drug Policy Alliance, California Capital Office, Sacramento. Available at: http://www.prop36.org. Accessed May 1, 2004.

2. French M, Inciardi JA. Treatment costs effective for offenders—drug treatment reduces reincarceration rates. Law and Policy. January 2003. Available at: http://alcoholism.about.com/cs/issues/a/blsap040125.htm?terms=Treatment+Costs+Efffective+for+Offenders. Accessed May 1, 2004.

3. California Dept of Corrections. Facts & figures, 4th quarter 2004. Available at: http://www.cdc.state.ca.us/CommunicationsOffice/facts_figures.asp. Accessed May 1, 2004.

4. Jones BM. The admissions standard: comparing educational expenses proves TAMS is an affordable luxury. Available at: http://www.tams.unt.edu/admn/E-%20Newsletter/feb99newsletter.htm. Accessed May 1, 2004.

5. Mondanaro J. Chemically Dependent Women: Assessment and Treatment. Lexington, Mass: Lexington Books; 1989.

This Article Extract Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Mondanaro, E. E. Search for Related Content PubMed PubMed Citation Articles by Mondanaro, E. E. Related Collections Community Health Mental Health Alcohol Drugs Women's Health