DRUG COURT FOCUSES ON TRAUMA

County First in Nation to Treat Post-Traumatic Stress

Tom Poage and his brother were arguing as they drove down the dark Kansas
freeway in a tractor-trailer when his brother threatened to jump out.

"We were going about 65 miles per hour, when he screams out, 'Maybe I
should just get out right here.' And I say, 'Go ahead.' He unlocked the
door and bailed out, and I ran over him with the trailer," Poage said.

It seemed like miles before Poage could stop the truck. Soon afterward, his
brother died in his arms. For the next 10 years, Poage escaped the guilt
and self-blame for what happened by relying on alcohol and illegal drugs.

Poage's addiction spiraled out of control. It wasn't until a second chance
in Thurston County's Drug Court that he learned he was suffering from
post-traumatic stress disorder.

The diagnosis came when he was admitted into a Drug Court pilot program
established to treat addicts suffering from the disorder. Along with the
diagnosis came answers to coping with his emotions.

Poage, 43, a Tumwater native and former motocross racer, put his life back
together and has been sober for almost three years.

He now owns an auto-detailing business in Tumwater and today he will fly to
Las Vegas to marry his fiancee, Carolyn, whom he befriended before entering
Drug Court.

"I'm a contributing and responsible member of the community now," he said
last month from his auto-detail shop on Henderson Boulevard, near Olympia
Regional Airport.

The Program

This year, Drug Court officials secured a $275,000 grant from the U.S.
Department of Justice to establish a two-year trauma treatment program. The
grant application was based on the success of Poage and others who
completed the pilot project a few years ago, Drug Court program
administrator Ellen Goodman said.

"This has never been done anywhere else in the country," Goodman said.

PTSD is commonly associated with combat veterans who have "flashbacks" of
their war experiences. But it also can affect victims of serious accidents,
natural disasters or physical or sexual abuse and is a common disorder
among those with substance abuse.

Studies have shown that 54 percent of people diagnosed with PTSD report
having problems with substance abuse.

Drug Court, which started in Thurston County in May 1998, is a chance for
less-serious drug offenders to avoid jail time by undergoing treatment.
Admittance into the program requires forgoing the right to a trial on the
criminal charges. The charges are dismissed if participants stay sober. But
violating the rules means an automatic sentence to jail or prison.

The goal is to reduce recidivism by treating the underlying addiction.
Seventy-one people currently are enrolled in Drug Court and each will be
screened for PTSD when the new program starts, Goodman said.

Goodman said she became interested in starting the program after seeing
that many Drug Court participants stumbled into addiction because they were
self-medicating. For some, PTSD is rooted in abuse they endured as
children, she said.

"A need surfaced that was the impetus for coming up with this idea."

A Horrible Night

Poage's symptoms of PTSD stemmed from that cold night outside the small
town of Hayes, Kansas.

In December 1989, Poage and his brother, Steve, stopped there on their way
home from a long haul. The two had entered trucking school together and
were driving trucks across the country.

They stopped to pick up some Christmas presents for their families and
decided to have a few drinks at a local bar. They wound up drinking until
closing time, Poage said.

Then, they got into an argument about whether to stay overnight or leave.
Poage wanted to stay. His brother wanted to leave. Finally, Poage caved in
and he hopped behind the wheel for the trip home, he said.

Not far out of town on Interstate 70, the argument flared up. Steve
suddenly sprung open the door and jumped out.

Poage relived the tragedy over and over in his head, he said. "My addiction
to drugs and alcohol started right there."

Only two years before, Poage had lost his father, the former owner of
Poage's Automotive and Towing in Tumwater, to cancer. His mother passed
away not long after his brother's death, he said.

"Every time I thought about my family, every time I thought about my
brother, I couldn't take it," he said. "I'd medicate. That's the only way I
knew how to deal with those problems."

The alcohol problem slipped into a methamphetamine addiction. Soon, Poage
said, he was blowing all his money on drugs. Friends were partying at his
house all night, even though his young daughter was living there, he said.

Poage could no longer hold down a job and he walked away from the family
business. He soon lost his home and his reputation. His daughter moved in
with his ex-wife. Then, overwhelming feelings of shame set in for
tarnishing his family's reputation and putting his daughter at risk, he said.

In 2000, a warrant went out for his arrest because he didn't show for a
traffic court hearing. Tumwater police arrested him and found
methamphetamine in his possession, Poage said.

He failed his first attempt at Drug Court. He was facing a two-year prison
term when Judge Richard Strophy gave him a second chance. This time, Drug
Court officials asked him if he wanted to participate in the trauma
treatment program.

"I was willing to do anything at that point," he said.

Underlying Issues

Poage's relapse wasn't unique. Since 1998, 9 percent of Drug Court
graduates have committed new felonies, and 13 percent have committed new
misdemeanors.

Many times it's because the underlying psychological issues haven't been
addressed, Goodman said.

"We end up in a vicious cycle if we don't ever deal with those underlying
issues."

Drug Court, which involves intensive chemical dependency treatment, random
drug testing and weekly court sessions, lasts 12 to 18 months.

Every Drug Court participant will undergo the first two phases of the
trauma treatment. But only those who meet the clinical criteria for PTSD
will be placed into the third phase, which involves 20 sessions of therapy.

About $40,000 will be used to pay for a specialist to evaluate the program,
Goodman said. Results will be reported to the federal government.

Five people completed the pilot program. Of them, two relapsed, Goodman said.

Drug Court is contracting with Lifeforce Services, a San Diego treatment
provider, to administer the new program.

Poage said therapy taught him techniques for coping with his emotions and
dealing with his addiction. He cleaned up and made enough money to pull his
home out of foreclosure. His daughter, now a senior at Tumwater High
School, has moved back in with him.

"When I think about my brother today, I don't have to go through the last
20 minutes of his life over and over again," he said.

Controversial Therapy Used

Drug Court's new trauma treatment program is centered on a relatively new
and still controversial form of therapy known as eye-movement
desensitization and reprocessing, or EMDR.

EMDR is based on the premise that traumatic memories become "frozen" in the
minds of people with post-traumatic stress disorder.

"The premise is that the brain knows where to go to help this material get
moving and get processed into a more adaptive state," said Susan Brown, a
licensed clinical social worker and co-founder of Lifeforce Services, which
will administer the program.

As part of the therapy, the patient is asked to discuss all beliefs,
emotions and images from the traumatic memories. Then, the therapist uses a
finger or a moving light to get the patient's eyes to move rapidly back and
forth, like they would during rapid-eye movement, or REM, sleep. Another
technique is to alternate a buzzing sensation in each of the patient's
hands. It's known as bilateral stimulation and helps the brain process
information, she said.

"The aspect of it that makes it unique from traditional therapy is the fact
that it is a whole organism experience. The operative principle is that it
gets the entire brain-body activation going on. It gets things moving in
ways that talk therapy does not."