DRUG COURT TRIES NEW, UNTESTED TREATMENT

Pierce County Drug Court is trying an experimental treatment for
methamphetamine and cocaine addiction called Prometa, and so far,
officials like what they see.

This spring, eight people addicted to cocaine and 32 addicted to meth
underwent Prometa treatment, which consists of a several weeks of
common prescription drugs plus dietary supplements and counseling,
through the county's drug court program.

After 60 days of treatment, almost all the addicts had no or only one
relapse and no additional drug arrests, according to Terree
Schmidt-Whelan of the Pierce County Alliance, a private drug
treatment agency that provided the Prometa on behalf of the court.

The normal success rate in the county's drug court program, which
offers treatment instead of incarceration for appropriate defendants,
is about 50 percent, Schmidt-Whelan said.

"We wanted to give this a try and see if it worked," said Jack Hill,
director of the county's Department of Assigned Counsel. "We have
been very gratified with our experience so far."

No one is calling Prometa a miracle cure, only a possible help with
recovery if early findings like those in Pierce County pan out in
larger studies.

It is too early to tell, for example, if Prometa will keep people off
drugs for good and if it will succeed with the broader group of
methamphetamine and cocaine addicts, as opposed to the more motivated
drug court defendants, who are looking to avoid jail time by
completing treatment.

"I think it's a long-shot, a million to one," said Dr. John
Mendelson, who treats addicts and conducts federally funded studies
into addiction treatments at the California Pacific Medical Center in
San Francisco.

The problem, he said, is that the drugs used in Prometa have been on
the market for a long time and have not proved effective in drug treatment.

Another addiction scientist, Dr. Herbert Kleber, a psychiatry
professor and director of the substance abuse department at New
York's Columbia University, said more than 50 anti-addiction drugs
showed promise in early projects like Pierce County's. "None of them
have been shown to work in double-blind, placebo-controlled trials," he said.

Because of that lack of strong evidence, state insurance companies
and state-funded health programs do not cover Prometa.

Los Angeles based Hythiam Inc., which owns the rights to the
treatment regimen and licenses its use to clinics, is promoting Prometa.

Hythiam's chief executive, Terren Peizer, who owns 35 percent of the
company's stock, said his company is developing clinical data that
should persuade scientists and insurance company to start covering
his treatment and thereby make his company profitable.

"I believe this will be a standard of the industry. I have no doubt
about that - it helps people," Peizer said.

Fairfax Hospital, a for-profit drug treatment center in Kirkland, is
the only clinic in Washington that has a license so far. Cocaine and
meth Prometa treatment there is $15,000. For alcoholism, it's $12,000
to $13,000.

The hospitals says around 60 percent of its Prometa patients are
clean at six months.

Pierce County officials heard about Hythiam at a conference.
Desperate for something to help notoriously difficult-to-treat meth
and cocaine users, they decided to give it a try.

Hythiam waived its licensing fee for the county, but the county still
spent more than $40,000 on Prometa treatments, according to Schmidt-Whelan.

One patient, Paul Douglas, 49, a security guard in Tacoma, said he
was startled at how Prometa reduced his craving for cocaine, a demon
he has been fighting since 1987.

"I was about to give up hope," he said Wednesday at a Seattle news
conference describing the county's experience with the drug. "Now,
hope's been restored," he said.

The drugs used in Prometa treatment are nothing new, and if you
bought them at a pharmacy, they would not be expensive. The main
components are flumazenil, which is commonly used to reverse the
effects of tranquilizers after colonoscopies and other medical
procedures; the antihistamine hydroxyzine, which helps recovering
addicts sleep; and gabapentin, traditionally used for nerve pain and
to prevent seizures. Other drugs, like generic Prozac, might be used, too.

Protein drinks and vitamins, along with traditional counseling, are
also part of the Prometa program.

The theory at Hythiam is that the drugs work on brain receptors to
produce long-standing changes in drug craving and use.

What bothers Mendelson, of the California Pacific Medical Center, and
others is that the treatment is being promoted aggressively - one
billboard campaign features the late comic Chris Farley, who had
chronic addiction problems - while evidence is still being gathered.

"It's unethical," Mendelson said. "I don't mind them testing this
unlikely combination, but the fact that they are charging people
today for this up to $15,000 is outrageous."

Peizer is well known in the financial world for his work with medical
start-ups, as well as for being the protege of junk-bond trader
Michael Milken before Milken was convicted of securities fraud in
1990. Peizer testified for the state against Milken and said he was
never accused of any wrongdoing.