PROMETA EXPERIMENT: MEND IT, DON'T END IT

The addiction treatment known as Prometa has a knack for spawning
nasty disputes and nastier ethical problems. Pierce County -- home of
a major experiment with Prometa -- is seeing plenty of both.

The County Council has voted to suspend funding for the pilot
project. Executive John Ladenburg has threatened to override that
vote with his veto. Rather than wrangling with the council, he should
be working to fix the problems that have undermined the program's credibility.

One of those problems has to do with the initial claims of success
that came from the Pierce County Alliance, the nonprofit agency using
Prometa to treat meth addicts on behalf of the drug court. As The
News Tribune's Sean Robinson reports in today's newspaper, the
Alliance sloppily and perhaps naively overstated the number of
addicts clearly benefited by Prometa.

The nonprofit asserted that 86 percent of Prometa clients -- drug
offenders or addicts denied custody of their children pending
treatment -- were drug-free during a 14-month trial. A recent
assessment by county auditors came up with a different number: 50 percent.

Part of the discrepancy stems from the fact that the Alliance didn't
count drug relapses prior to the last 60 days of the program; the
auditors did. The 60-day standard is questionable: The Pierce County
drug court itself requires 90 days of clean tests before a client is
cleared. So does the King County drug court. The drug courts of
Snohomish and Thurston counties require 180 days.

Even using the Alliance's generous definition of "drug free," there's
another question: How many clients were clean before joining the
pilot project? Looking at the records of 19 of the program's 35
clients, it turned out that 12 of those 19 had been drug-free for 61
to 270 days prior to starting Prometa.

None of this means the Alliance was cooking the books. The agency
has struggled to heal addicts for many years; if its staff is guilty
of anything, it's guilty of believing too much in a long-hoped-for
breakthrough treatment. Its 14-month trial was never meant to be a
rigorous scientific study. It started as a simple inquiry into
whether an expanded Prometa program was worth pursuing.

Still, the results were used to win as much as $900,000 in county and
state funding. And Hythiam -- the pharmaceutical company that
licenses Prometa -- has been featuring the Alliance's "success" in
Pierce County in its marketing promotions.

That commercial entanglement is especially troubling in light of the
fact that the Alliance's executive director, Terree Schmidt-Whelan,
owned some stock in Hythiam -- astonishingly, with the blessing of
her board. That may have been legal, but it created the impression of
a conflict of interest that has undermined the Alliance's credibility
on this issue.

We think the experiment with Prometa is worth continuing, pending the
rigorous scientific studies now being conducted on its effectiveness.
Society has few options for treating methamphetamine addiction; if
this is even a little successful -- and there are some indications
that it might be -- it could save a fortune for treatment programs
and the criminal justice system.

But if the Pierce County experiment is to continue, it has to operate
by different ground rules. The Alliance is receiving public money to
run the program, and it must be accountable to the public. First and
foremost, anyone connected with the Alliance must be forbidden from
owning Hythiam stock or having any other personal interest in the company.

Nor should the Alliance let itself be used by Hythiam as a marketing
gimmick. Those preliminary and very rough early numbers should not be
represented by anyone as scientific findings.

Ladenburg -- who unwisely bought Hythiam stock himself and has since
sold it -- ought to be busy reforming the program's ground rules. If
its credibility can be restored, he'll have no need to threaten vetoes.