DO UTAH DRUG COURTS TAME METH MONKEY?

$4.5 Million Treatment Push

For Single Moms, Failure And Relapse Rates Are High; For The State,
Kids Are Safe And It's Cheaper Than Jail

TOOELE - As 28-year-old Tori Curran walks down a narrow hallway in
the county courthouse, portraits of smiling Miss Tooele pageant
princesses gaze down at her.

She steps into Judge Mike Kouris' courtroom, where the young women
inside have led less than picture-perfect lives. Like Curran, many
are single mothers who want to raise happy children but who struggle
with addiction and relationships.

After working 18 months to beat a methamphetamine addiction and stay
clean during her fourth pregnancy, Curran was graduating from a drug
court, which gave her treatment rather than prison.

Only time will tell whether the skills Curran has learned will last a lifetime.

Despite efforts to combat it, Utah's meth problem continues to grow -
especially for women.

For five years, meth has been the top illegal drug of choice for
Utahns entering public treatment. For women it surpasses even
alcohol, the traditional front-runner, making it the only drug in
history to have its female users outnumber males. Nearly half the
women in treatment statewide have children.

Gov. Jon Huntsman Jr. has proposed investing $2 million in Utah's
drug courts and $2.5 million to build two residential clinics in
northern and southern Utah to treat 600 women, giving priority to
those involved with the child welfare system. But Huntsman will have
to convince lawmakers it's a wise investment, no easy task
considering the stigma attached to addiction and a dearth of data on
treatment, including how patients and drug court graduates fare over
the longer term.

Helping Utah's women poses another challenge: transforming a system
that wasn't built for them.

"Substance abuse treatment has been historically geared for white,
middle-aged male alcoholics," said Salt Lake County substance abuse
Director Patrick Fleming. "We're a hell of a lot better at treating
women than 10 years ago, but there's room for improvement."

A review by The Salt Lake Tribune of Salt Lake County data shows men
are more likely to complete therapy than women; a difference of 10
percentage points. A second Tribune analysis of drug-court graduation
numbers found the lowest success rate in family drug courts, which
cater mostly to women with children.

Brent Kelsey, assistant state substance abuse and mental health
director, disputes any gender gap in treatment success. He insists
treatment works: "It has to. What choice do we have?"

How To Treat A Woman

Utah's publicly funded clinics provide about 79 percent of the
state's addiction treatment - a tab for taxpayers of $37 million in
2006. These clinics are required to tell the federal government how
many of their patients drop out of treatment and other details.

Results from all these clinics combined show how elusive success can
be. Thousands of Utah addicts - and more women than men - drop out of
treatment every year.

* Of the 9,699 Utahns discharged from public clinics in 2006, barely
half completed treatment. Statewide, women are only slightly less
likely to finish treatment than men.

* Of those who do finish treatment, not all have kicked drugs. At the
time of discharge, 71 percent reported being abstinent. That compares
to 54 percent nationally.

State officials say it's impossible to judge which clinics are the
most successful because clinics report outcomes incorrectly - or not at all.

National research shows that for severe addicts - the type who
populate Utah's drug courts and public clinics - relapse is in the
range of 50 percent to 90 percent. But each dose of therapy improves
a patient's chances of staying sober, said Fleming, the Salt Lake
County substance abuse director. And it's cheaper than building
prisons, he added.

To better help women succeed, treatment must be tailored to them,
asserts Tooele social worker Terry Bates. She works in Tooele
County's drug court and is doing research for her doctorate at the
University of Utah.

"Anyone who thinks drug court is about keeping clean is kidding
themselves. It's about changing an identity," Bates said.

Women use drugs for different reasons than men - often prompted by
relationships, either social or romantic. To reroute a woman's life,
Bates believes, a woman must come to view herself as a working single
mother or as a student, as examples, instead of as an addict.

"I really believe if they can get a handle on [relationships], they
can choose differently," she said. "If they feel empowered, I'm
hoping they will think twice about going back to drugs and letting it
all fall apart."

Building Women Up

This is Caroline Willey's 18th month of sobriety. A photograph of her
youngest son will soon hang on a Tooele County courtroom wall,
joining some 20 other pictures of children born drug-free.

Bates looked on with pride as Willey and Curran graduated from
Tooele's small drug court in December. She's investigating how well
drug courts work for women.

"I'm really asking the question: Does drug court, as a rehabilitative
effort, do what we think we are doing?" Bates said. "Or does it put
people through a program, but their lives don't get much better?"

The House of Hope in Salt Lake City, which treats women with children
referred by courts across the state, uses strategies similar to those
suggested by Bates, said administrator Ken Brown.

Instead of the more confrontational approach commonly used for men
and teens, therapy aims to build up women's self-esteem. Teaching
them to eat right and exercise helps remove toxins from their bodies
and brains. Classes on parenting, having fun without taking drugs and
choosing healthier relationships give them tools to avoid lapses, said Brown.

Residential treatment lasts four months. Children receive care - and
help from child development experts - at on-site day care.

Having stable housing, keeping her 10-month-old son with her and the
camaraderie of other women are what Tamara cites as key to kicking
her three-year habit. Her last relapse was triggered by the removal
of her son by child welfare workers.

"My whole world came crashing in," she recalled.

Like many women at the House of Hope, Tamara was introduced to meth
by a man in her life, her husband. A staunch Mormon and returned
missionary, she said "the drug world was completely foreign" to her.
Still bristling from being branded an addict, she asked that only her
first name be used.

At first, meth gave her confidence and energy; her low-self-esteem
was tied to a poor body image, but also abuse as a child.

"Since I was 4 years old I struggled to lose weight, working out and
starving myself," Tamara said. "With meth, I went from a size 18 to a
size 7 and lost 100 pounds in nine months. But I lost everything else with it."

Tamara says she has recovered her "dignity and hope." Pregnant with
her second child, the 30-year-old said she hasn't touched meth since July.

Pushing For Change

The closest evidence of success might be found in drug court
programs, which are the most popular and studied treatment models
nationally. Started in 1989 in Florida, drug courts debuted in Utah in 1996.

There are now 32 drug courts in Utah, targeting felony or misdemeanor
offenders, juveniles - and parents in danger of losing their children
due to drugs.

One in two parents in treatment in family courts fails, creating the
worst graduation rate among the state's drug courts. Comparing such
rates is problematic because different courts serve different types
of addicts and no two operate exactly the same.

Still, those who work in family courts say they aren't surprised by
the results. Parents in drug court must do more, faster.

They must meet the demands of drug court while satisfying
requirements from the Division of Child and Family Services. Also,
federal timelines for reuniting families give parents dramatically
shorter deadlines for change.

"It's just not as simple as saying they should be more motivated,"
said Davis County's family drug court coordinator, Kevin Koopmans.
"If you're a single mom with no job skills, no license, and if to get
your kids back, you need transportation and need a $7 an hour job
that works around drug court and meetings and drug tests, I'm not so
sure that in some cases we don't create more problems for people," he said.

Still, Koopmans and others point to financial benefits. A typical
family of three in public treatment costs $28,000 to $35,000 a year.
To keep a mother in jail and her two children in foster care for a
year costs $100,000.

Even when a parent fails, "there are no losers here," he said. "If
the parents want to be addicts, that's fine, but at least the kid is
in a safe place. I think our impact is in the next generation."

'I Did Struggle'

In her family court in West Jordan, 3rd District Juvenile Court Judge
Christine Decker walks the line between being a cheerleader helping a
parent and a guardian charged with protecting children.

Before court, Decker talks about parents' progress with counselors,
child protection officers, prosecutors and others. The group agrees
one woman needs more support: Her husband is in another drug court;
they have a history of domestic violence; and she feels isolated
while trying to cope with the demands of rearing her four children.

"Drug treatment is complicated as it is, but you put on these other
layers," she said. "We [scrutinize these cases] more intensely,
because there is a lot at stake. It isn't sending them back out on
the street; it's giving them their children back."

She wishes treatment were quickly available for all parents.

"I have cases in my regular caseload where we can't get them in. As
the child welfare timelines go on, you don't get your kids back.
Maybe you would fail in treatment, but it seems to me you never even
had a fair chance," she said.

Waiting lists in Salt Lake County average four to five months, and
much of rural Utah lacks in-patient services altogether. Kelsey, the
assistant state substance abuse and mental health director, estimates
annual unmet demand for treatment statewide exceeds 90,000 people.

Today, Curran is grateful for the chance drug court has given her.
She thought she could control meth when she was introduced to it at
age 19. Like many women, she liked the high and initial weight loss.
But the addiction drained away her money, cars, a home; she lost
custody of her three children and ended a marriage before she hit rock bottom.

After her second stint in jail, her parents helped her find a drug
court. Now she has visitation with her three children and custody of
her 1-year-old.

"Nineteen months ago, I was a huge mess," she told a courtroom packed
with supporters. "I let my friends and family down, but most of all,
I let my kids down.

"Today I stand here clean, happy with myself and my life. I did
struggle in drug court, but I would not change it for anything."

Monday: An experiment tries to help longtime criminal addicts
Tuesday: Improving prevention: Halting addiction before it starts

Meth Addiction: Effects And Treatment

* Is it treatable? Methamphetamine addiction is treatable but
challenging, said Glen Hanson of the University of Utah's Center for Addiction.

* Why is it so addictive? Meth enhances dopamine, a neurotransmitter
related to pleasure and thinking. "Do well on a test or win
recognition for something at work [and] you get a little squirt of
dopamine," Hanson said.

* Why is it so dangerous? Prolonged use can damage dopamine
receptors, making it harder to take joy in everyday life. It also
creates free radicals in the brain, damaging critical thought. Users
tend to be impulsive and struggle with early abstinence. "It can take
six to eight months for the brain to sort itself out," he said.