DRUG DEFENSES ARE LACKING

Demand for treatment rising, but programs are being cut back

Sound the retreat.

The most serious drug abuse assault in years finds the region with
shrinking defenses.

Over the last decade the Inland Northwest has lost treatment programs
for many kinds of drug abusers N young people, the mentally ill and
others. The programs are gone because state and federal officials
won't fund them.

Now, with the onslaught of methamphetamine abuse, publicly funded
treatment can handle only 18 percent of the adults in Washington state
who need help with drugs or alcohol, according to the Department of
Social and Health Services.

Spokane County treats only 12 percent of adults in need of help,
putting it third from the bottom among the state's 39 counties.

Most adult drug abusers spend at least six weeks on a waiting list for
public treatment; young people must wait about a week. Data from
private treatment centers isn't available.

Halting the spread of the meth epidemic isn't simply a matter of
arresting users and dealers. Ending their addiction is key to reducing
demand for the drug.

Taxpayers won't want to hear this, but defeating meth is going to take
more money, well-spent, experts say.

And some answers would help.

No one knows how many people use or make meth, or where these people
are.

No one knows how many children are born to meth-addicted
mothers.

No one knows how many children live in home meth labs.

"We need to find out where the problem is," said Dr. Alex Stalcup, a
nationally renowned meth expert who runs a center in California. "We
need to get treatment in those areas. We need to get drug courts or
someone else to supervise treatment."

TREATING THE DISEASE

Efforts to curb meth and other hard drugs often are met with ignorance
and indifference.

"I think society believes if you catch the guy at work using cocaine,
he will quit," said Nancy Echelbarger, director of Substance Misuse
Services at the Spokane Regional Health District.

"Seventy-five percent of society does not think of chemical dependency
as a disease. They think of it as somebody who doesn't want to get a
job."

Society assumes alcohol and drug abuse are totally different problems.
But most drug abusers start with alcohol, at about age 12.

That's why drug and alcohol education programs, now offered for the
bulk of a student's career in Spokane Public Schools, are vital.

"I think kids are pretty naive about what they put in their bodies,"
said Mary Brown, student services supervisor for Spokane schools. "I
think we have a responsibility to give them a heads-up."

Another key to recognizing the roots of the disease is understanding
that a frighteningly large number of addicts were sexually assaulted
as children.

Ninety-five percent of the women involved in the Parent-Child
Assistance Program for drug-addicted mothers were molested, director
Lindy Haunschild said.

"The treatment programs that address sexual abuse are the most
successful," she said.

These women also tend to have several children of their own, many who
are damaged by meth abuse while they are in the womb and then suffer
their own cycle of sexual abuse as they grow up.

A new effort to break the cycle includes connecting drug-using women
with a private foundation that pays them to start using effective
birth control. It was begun by a woman in California after she adopted
the fourth drug-addicted baby from the same mother.

Paying women to take birth control "is happening because we are not
really seriously dealing with the main problem," said Haunschild,
whose program can handle only 45 Spokane women at a time -- far fewer
than need help.

"It's definitely not the whole solution to the big problem. It's
potentially one less life that's shattered."

IT'S AN INVESTMENT

People who deal with meth addicts, their children and their other
victims call for more money, but say it should be spent carefully.

"There isn't just one answer," Echelbarger said. It takes prevention,
treatment and law enforcement.

It takes a publicly funded effort that can detoxify addicts, deal with
their physical and psychiatric problems, guide them through the courts
and confront the needs of the entire family.

Meth addicts require at least six months of intensive treatment
instead of the average 28 days now available, Echelbarger said. They
need support from people who are clean and sober -- their families, or
programs like Narcotics Anonymous.

Many users need long-term counseling to deal with the stresses that
cause them to start abusing again.

Meth addiction is expensive to treat because addicts are more violent
than those on other drugs. They also take longer to come down.

Taxpayers should view treatment as an investment that pays off in less
crime and child abuse, and fewer emergency room visits, environmental
problems and long-term health problems, Echelbarger said.

Perhaps most important, society has to plunge ahead without waiting
for every specific answer about meth abuse, she believes.

"We have to treat as we learn," Echelbarger said. "Usually it is a
good five years into a drug before we know what works."

RESTORING WHAT'S LOST

A decade ago, the region had more to offer.

Spokane County's Center for Drug Treatment handled 500 to 700 patients
a year during its 20 years. The county cut half of the center's
funding in the early 1990s, and decided to spend the other half of the
money with smaller agencies, said Jim Loudermilk, the center's drug
treatment coordinator.

Unable to run on half of its funding, the center folded.

Today, two of the three "smaller agencies" that were supposed to take
over are gone, said Loudermilk, who now works with HeadStart.

This year North Idaho lost its youth drug treatment program. No
providers bid on the contract.

The only state-funded program in Washington that treats mentally ill
drug abusers also recently closed after a labor dispute. The state has
not replaced the program, which was located in Sedro-Wooley.

The Spokane Regional Health District is contemplating cutting or
reorganizing its drug treatment program, Substance Misuse Services.
The Health District's public nursing staff, highly regarded for
getting help for drug-addicted parents and their children, was trimmed
in December and may be cut again.

People who deal with addicts are not surprised that these resources
continue to shrink at the same furious pace that the abuse of
methamphetamine grows.

It's the same managed care mentality that has ravaged the rest of
health care, they say.

And it's geography.

Meth is mostly a Western drug.

"I don't think anyone cares," Stalcup said. "Traditional drug
epidemics get ignored until they hit Washington, D.C., or New York."