ADDICTS BATTLE BACK

The Brain Damage It Causes Makes Meth Hard to Kick. but Success Rates Are
Rising, and Long Term Recovery Prospects Are Looking Better.

Inside the razor-wire fences and brick walls of the Mitchellville women's
prison, 40 inmates sit in a circle, clapping, stomping and singing their
way into a new day.

". . . A group of women living right," one of them chants.

"A GROUP OF WOMEN LIVING RIGHT," the rest respond.

"That's the way we live our lives."

"THAT'S THE WAY WE LIVE OUR LIVES."

The prisoners are enrolled in an intensive treatment program for
addictions. More than half of them were hooked on meth, which led to the
crimes that brought them to prison.

The room is full of examples of how difficult the struggle can be. Doctors
say meth is even tougher to kick than most other drugs, because it causes
such profound damage to the brain. Treatment methods are improving, and new
research increases hope that the brains of nearly all addicts can heal over
time. But the biggest initial hurdle is that many people trying to recover
can't think straight enough to succeed without intense help.

Few of the women here know the scientific details, but they can describe
the results. Many went through treatment for a few weeks on the outside,
only to return to the pipe or needle. They say being clean left them
miserable beyond description. The drug was the only thing that made them
feel even close to normal.

Here, they spend at least nine months in the program, constantly surrounded
by other women in treatment.

They live together in a big, open area. They eat together, work together,
take counseling together. They praise each other for becoming more
confident and vocal. They criticize each other for slipping back into the
anger and self-pity that helped bring them here. They share wishes for
strength, which they will need when they return to Iowa neighborhoods
riddled with meth.

"It's really sad that you have to come to prison to get into this kind of
program," says Rikki Thornton of Des Moines, a 31-year-old serving time for
drug trafficking.

Thornton has completed the program and now mentors other participants. She
acknowledges that few of them would have volunteered for the intensely
controlled treatment, even if it had been offered to them before they were
arrested.

That fact fits with the reality of the addiction. Counselors say meth users
rarely come in for treatment unless they're forced to do so.

Alcoholics and people hooked on many other kinds of drugs are more likely
to seek help when they see their habits threatening their marriages, jobs
or children, says John Mathias, who helps run Des Moines' Bridges of Iowa
center. Meth quickly strips away such concerns.

"All you want to do is crank up and sleep, crank up and sleep, crank up and
sleep," he says. "Nothing else matters."

Iowa's jails and prisons hold plenty of people who have gone back to meth
after undergoing treatment on the outside. The successes are plentiful,
too, but they're nearly invisible.

A northern Iowa woman explains why. The 38-year-old mother of four knows
that many residents of her hometown are trying to beat the habit, as she
did. She would like to step into the spotlight as an example of a person
who is making it. She wishes that meth addiction could lose some of its
devastating stigma, the way related problems have.

"I know how people are when someone goes into treatment for alcoholism.
Everyone thinks they're the greatest for doing it," she says. "But for
meth, I don't know. . . ."

Michael Edens is an exception. He will tell you exactly how meth grabbed
him, and how he's managing to stay away from it.

Edens will only hint at his past during the addiction-information sessions
he holds in an Ames conference room. If you're the ponytailed teenage boy,
the college-age guy in the Budweiser T-shirt, the young woman with the
squawking toddler son, you've probably come to his class because your
probation officer told you to. You don't want to hear why the muscular
young man in front of you became an addictions counselor.

So this is what he'll tell you: Don't think addicts could quit taking drugs
if they simply had more willpower.

Scientists know that abuse of alcohol or other drugs damages people's
brains, he says, leaving them with an overpowering urge to get more.

He poses a challenge to anyone who believes addicts can simply make
themselves stop: Take an entire box of Ex-Lax, he says, then tell yourself
that you simply won't let the powerful laxative affect you.

"I'm here to tell you," Edens says, "once that chemical change happens in
your body, you're going to need to go to the bathroom. I don't care how
much willpower you've got."

Edens shows a video, "The Hijacked Brain," explaining the science of
addiction. The class members learn how drugs cause brain cells to release
huge amounts of dopamine, a chemical that causes pleasurable feelings. They
learn how the brain adapts to the drug use by decreasing dopamine
production. That leaves addicts feeling dreadful when they're sober.

After a while, they need the drugs just to feel halfway normal. The cycle
continues, causing insatiable cravings for the drugs, even though they no
longer deliver the euphoria that first pulled in the users.

If you ask him outside the class, Edens will talk about how he first tried
meth as a 13-year-old in California. He didn't really want to, he says, but
he had a crush on the girl who offered it to him, and he didn't want to
disappoint her.

He describes how the drug gave him energy, helped him finish his homework
and allowed him to open up to other people. By 15, he'd become nothing but
trouble, and his family sent him to a strict school for boys. As soon as he
got out, he went back to tweaking. The habit wound up costing him a
marriage and custody of his son. It also led to a stint in prison. "I said,
"Wild horses couldn't drag me back to meth," " he says.

His father, who lived in Iowa, invited him to move here to make a new
start. Edens recalls being stunned at how many Iowans knew how to make meth
using anhydrous ammonia, an easily stolen farm chemical. For two years, he
resisted the temptation to partake. Then he drank a liter of Black Velvet
whiskey at a party one night, and suddenly it didn't seem like such a bad
idea to try some of the meth people were passing around.

Eight weeks later, totally hooked again, he was arrested at a farmers
co-op, trying to steal anhydrous ammonia. He was too messed up to figure
out how to flee. He spent five months in jail, then went to a halfway house
and started going to treatment sessions.

"I was so ready to do something different," he says. "I swore I was not
going to use meth again."

That was three years ago, and he's kept his promise. He's trained as a
counselor and is helping others get clean.

He says people can succeed, but they must pay a steep price. By the time
they quit, many have nothing positive left in their lives. They're broke,
unemployed and friendless. The reality compounds the chemical depression
caused by the drug's aftermath.

"I learned to expect life to be crappy for the next few months."

Researchers believe that if they could reduce the number of months
recovering meth addicts feel crappy, they could greatly increase the
chances of success.

Des Moines is one of five sites nationally for a study on whether
medications could help the brain heal faster and ease the cravings and
depression that drive people back to drug use.

Dr. Richard Rawson, a California psychologist overseeing the study, is
optimistic. Doctors had feared that meth caused permanent devastation
inside brain cells, he says. But recent studies on monkeys show that many
of the cells repair themselves eventually.

Relatively little research has been done on possible medications, because
drug manufacturers don't foresee potential profits from helping meth addicts.

"There is not going to be a Xanax or a Prozac or a Viagra for drug abuse,"
Rawson says. But he predicts at least some benefit from the medications his
program is testing - including some already used by people trying to quit
smoking cigarettes.

A small percentage of meth users suffer permanent psychosis, similar to
schizophrenia patients. Years after they stop using the drug, they still
hear voices in their heads, and they're paralyzed by feelings of paranoia.

"It's clear that they've done something to their brains that's not going to
get better. Those are the most heart-wrenching cases," says Rawson, who
works at the University of California-Los Angeles.

Most addicts can recover, however. One key is that they stay away from all
addictive drugs - including alcohol. Even for patients who never had
serious drinking problems, the odds of relapsing into meth use quintuple if
they resume any alcohol use, Rawson says. "That's one of the few things we
can tell you for sure."

Another key is to find a treatment program specializing in meth addicts.
Older programs designed mainly for alcoholics aren't nearly as effective,
he says. Most programs keep patients overnight for the first few days, then
help them rebuild their lives in the community. To be effective, treatment
must be done several times a week for many months, he says. "You need to be
taught how not to use methamphetamine today. Then you need to be taught how
not to use it tomorrow."

Dr. Dennis Weis, who runs one of Des Moines' largest treatment programs,
says people trying to kick meth have to overcome daunting hurdles.

"Rehabilitation" often is an irrelevant concept. The word implies that
patients used to have decent lives, which they hope to resume.

Many patients at the Powell Chemical Dependency Center grew up around
meth-using parents or even grandparents. They've never known anything else.
They've never succeeded at school, worked steady jobs or maintained healthy
friendships.

Weis oversees the Des Moines portion of Rawson's medication study. He is
optimistic about the prospects of new medications, and he sees benefits
from using current anti-depressant drugs with some patients. Those
medicines are no cure-all, he says, and they shouldn't be taken until a
person is totally off meth. "Taking anti-depressants while you're on meth
is like building a sand castle with a teaspoon while the waves keep
crashing in."

Counselors also must deal with an unusual twist to the addiction: Many
patients have become obsessed with making and selling the drug. It fits
well with the compulsive behavior meth induces, and it's often one of the
only things they've ever succeeded in. The production also gives them a
sense of power over other addicts.

The temptations will be pervasive throughout their lives. Every time they
walk through a store and see batteries, cold medicine or drain cleaner,
they'll be reminded of how easy it was to make money, impress others and
get high.

Even with those complications, Weis and his colleagues stress that success
is increasingly possible. Early in the meth epidemic, success rates
commonly were reported at 15 percent. Nowadays, carefully tailored programs
are seeing 40 percent of their patients stay sober for at least a year,
Weis says. Those numbers should continue to climb, and many people who fail
at first go on to find success after a second or third try.

Society doesn't give up on people who struggle to recover from cancer,
heart attacks or diabetes, counselors say, and it shouldn't give up on
people who relapse into addiction.

The road to sobriety will always be hard, but never impassable, Weis says.
"You don't just walk into treatment and suddenly you're drug-free for life."