TREATMENT ADVOCATE HAS SEEN ADDICTION
"When they're little children on the playground, people don't say: 'I want
to grow up to be a methamphetamine addict. I want to mess with dangerous
chemicals. I want to hurt people. I want to become demented. I want to
become out of control.' They don't wish that. It just happens." Bill
Crowell, a Grady County pathologist

Bill Crowell didn't set out to become the state's most outspoken advocate
for substance abuse treatment. It just happened.

First, there was heartache -- the painful realization that both of his
children were addicted to methamphetamine and that he couldn't help them.

Crowell eventually dug himself out the best way he knew how, one textbook
at a time.

"I wanted to know what I had done wrong and what it was about the way that
I raised my kids that caused this," he said. "We were church attendees and
said the right prayers. My kids were raised in little league baseball, took
dance and piano and played the flute, so why my kids? Why me?"

That was 18 years ago. Crowell, who at the time was a physician,
pathologist and medical examiner for Grady County, went back to school to
learn about addiction. Along the way, he obtained a master's degree in
chemical dependency and became an internationally certified alcohol and
drug counselor.

"My deal is education," Crowell said. "My grandmother on my mother's side
couldn't read or write and marked her name with an X. My mother said, 'You
can do better.'"

Now, Crowell is putting his passion and knowledge to use in an attempt to
convince the public that substance abusers should be treated, not stigmatized.

"As a pathologist, I know people are dying out there from drug addiction,"
he said. "I see the bodies when they do. I see the bullet wounds and the
blood on the wall."

Crowell knows he is dealing with an unsympathetic public on one hand and
addicts who refuse treatment on the other.

"People think people who use drugs are going to hurt other people, and they
want to avoid being hurt," Crowell said. "The use of chemicals goes way
back to before I was born when people thought they could stop that kind of
behavior and that those who were dependent had less morality, less ethics
and were lower class, whatever that means."

Addicts, meanwhile, fail treatment two, three, four and even five times,
Crowell said. Many can go from a 30-day outpatient treatment program right
back to using meth or their drug of choice, and the relapse rate among meth
users is among the highest.

Crowell defines chemical dependency as a pathological relationship with a
mood-altering substance where there is an anticipation of a rewarding
experience, meaning that the addict can get "high" at the mere thought of
using a drug.

"The challenge is how do we get to a point in treatment where that doesn't
happen?" Crowell said. "The contradiction is that we don't know the genetic
aspects of how proteins are made by individual cells and what genes or
multiple genes are involved in the creation of proteins, which means we
don't know about all the proteins that are made in people with chemical
dependency. Until this basic research is done, we can't amplify our knowledge."

Kathleen West, director of the Drug Endangered Resource Center and
Clearinghouse in Los Angeles, said they have been studying the long-term
effects of meth addicts for years - and there is still much they don't know.

Meth depletes the brain of dopamine the chemical that promotes a sense of
well-being. Researchers have reported that as much as 50 percent of the
dopamine-producing cells in the brain can be damaged after prolonged
exposure to relatively low levels of methamphetamine, according to a
National Institute on Drug Abuse report.

Worse, the damage can be permanent. West said the younger the user, the
more complete the damage.

Although after time the brain may start producing dopamine again, it never
seems to reach pre-addiction levels. How long it takes for the brain to
partially recover depends on the person's biological makeup, with no way to
tell who will recover at what pace.

Another fear, though unproved, is that the epidemic of meth users today
will create an epidemic of Parkinson's disease victims tomorrow.

Parkinson's is an incurable disease that is related to dopamine depletion
in the brain, which is the same effect that meth has. The disease causes
uncontrollable tremors, loss of balance, speech and so forth. It generally
strikes older people, but with so many young users and exposed children,
West said the potential for young Parkinson's victims is a big concern.

"It's a huge cautionary tale for all of us," West said. "We do not want to
see Parkinson's disease in our 30-year-olds, nor in our children."

How fast and permanent brain damage is from meth depends on the individual
person. So does the recovery - and it isn't about who has the strongest
will to stay clean.

Some former meth addicts have experienced psychotic breaks several years
into their recovery, with full-blown bouts of paranoia and hallucinations.
Why, no one knows.

Crowell believes it will be 20 years before science is able to identify who
is at risk of being a substance abuser, but he knows society can't wait
that long to address the problem.

His solutions include increasing the number of counselors and doubling the
number of beds in chemical dependency centers, establishing parity in
insurance coverage where insurance companies set the same rates for
coverage for substance abuse as they do for mental health treatment,
increase the length of treatment of people with meth addiction and
encourage long-term residential treatment instead of outpatient treatment.

"To treat the disease with counselors would cost a dollar, maybe $2, per
person in the state on a monthly basis," Crowell said. "That's a small amount."

But Crowell suspects that the drug addiction program will have to devastate
even more families before public opinion changes.

"When it's your family, it's hard to conceptionalize what you were taught
with what the reality is," he said. "I remember that people wouldn't talk
about my kids. They'd talk about theirs but not mine."

Crowell said he believes most families who deal with addiction have a
philosophy similar to his.

"Those who bear the mark of pain are never really free for they owe a debt
to the ones who still suffer," he said.