TREAT METH ADDICTS IN COMMUNITY: EXPERT

Philosophy At Odds With Gov't, Social Agency's Approach

Crystal meth abusers can only truly be healed in the community, not
hidden away in treatment centres, says a leading researcher from UCLA.

The traditional approach to dealing with addictions simply doesn't
work with meth. Those are the blinders that society needs to remove
before any progress can be made, Dr. Richard Rawson told a crowd of
about 500 people on Monday at the start of a threeday conference.

"It's a huge paradigm shift from the idea that we can fix people in
these residential centres and send them back as cured. We have a bad
habit of saying, 'We know what the treatment is, now the meth user has
to fit into our definition of that.' It just doesn't work that way."

Rawson is the associate director of the UCLA integrated substance
abuse program and a member of the California university's department
of psychiatry for more than 20 years. He was Monday's key speaker at
the Community Action Against Crystal Meth (CAACM) conference at The
Saskatoon Inn.

His philosophy flies in the face of the approach favoured by
governments and social agencies. Rawson supports residential treatment
for hard-core users who cannot go a day without injecting or smoking
meth but the same after-care -- support in the community -- must exist
for them as well.

Users are slaves to their cravings, which are triggered by their
environment, including the people they are with, the places they go,
the things they do. In treatment centres they are removed from those
things and they appear to improve.

"But they can't live in a treatment centre. The hard work really has
to be done the day they walk out into the real world," said Rawson.
"The conditioning hasn't gone away because they haven't been exposed
to the real-world triggers that produced the cravings in the first
place. That's generally where we drop the ball with treatment."

The conditioning has to occur over time in the real world so the
"extinction" of the conditioning has to occur over time in the real world as
well, he added.

"When they relapse it's because we haven't done a good job in teaching
them and we haven't done a good enough job of getting resources into
the community, which is where they struggle with this problem -- not
in the treatment centre."

Crystal meth is a disease that cannot be handed off to treatment
experts or the police to deal with on their own. It is a community
problem which requires "robust" community solutions such as places
where those trying to kick the habit can be around likeminded
individuals, said Rawson. They need support and activities where they
can avoid their trigger, which can be anything from a certain time of
day, to music, to holidays.

"They have to have a life and that has to happen in the real world
communities," said Rawson.

The treatments must also be adapted to the individual's environment.
Unlike a penicillin pill, which is used and just as effective in Utah
as in Saskatoon, meth treatment must be customized.

The other key is to smother communities in education and resource
materials to cut back on new users, he said. Crystal meth is the only
drug where the number of women users equals that of men. Most drugs
have a three-to-one ratio with men being the majority users.

One of the reasons for meth's popularity among females is that they
are lured by the opportunity to lose weight, said Rawson. Meth addicts
often stop eating for long periods and rapidly drop weight.

"This is not a diet pill. It will kill you," Rawson warned.

Other people try it out because they are led to believe it will help
them work longer, it will ease their depression or are lured by peer
pressure. People need to know the harsh chemicals -- battery acid,
drain cleaners, fertilizers -- that go into the production of meth. If
they realize that, they may be scared off, he said.

"We need to keep the next generation from getting involved. It's the
only way to beat it," he said.

Some drugs make brief appearances in communities then fade away but
meth "moves in and becomes endemic," said Rawson.

It also holds no bias to a certain age group, like some other hard
drugs. Crystal meth is being used by professionals, teens and children
alike. Rawson spoke of a friend whose fourth-grader has been exposed
to it at school.

Restricting the bulk sales of some materials, like cough medicines,
has helped reduce the home-based labs but only for a brief time.
Before long, the large suppliers move in and fill the gap, Rawson
said, citing examples throughout the United States.