Series: Part 7 Of 8

ADDICTS, COUNSELORS WALK A DIFFICULT ROAD

LONG BEACH - Paul Duncan calls it the rage.

It would hit when he was coming down off crystal meth, starting deep in his
stomach and moving up through his body, overwhelming his senses.

He couldn't sleep. He couldn't talk. There was only one thing that would
curb it: more meth.

"It took every ounce of energy in me," the 51-year-old Long Beach resident
says. "I could just feel it down here when I was getting sober," he said,
pointing to his gut and making a slow, sweeping motion toward his chest. "I
could just feel it going up."

Crystal meth dependence is one of the hardest addictions to treat. The
stimulant is highly addictive physically, mentally and, for many, sexually.

Residential treatment is usually the last stop on the block for addicts,
experts say. Many have already failed at getting clean on their own by the
time they check in. Even then, there is no guarantee they will be successful.

"The hardest part about getting sober was the fact that I felt very alone,"
Duncan says, who has been clean for two years. "All of the people I
associated with I could not associate with anymore. It's a thing they keep
drilling you with. You have to break those ties. And then what do you got?
You got nobody."

Treatment facilities differ in size, character and severity. Some are
homey, some are stark. The Substance Abuse Foundation at Seventh Street and
Obispo Avenue in Long Beach is designed like a small village, bisected by
an alley, with open courtyards and an outdoor gym. Positive Steps of
Downey, with its stark classrooms and multi-bed residential area, could
easily be confused with a college dormitory. The Redgate Memorial Recovery
Center in downtown Long Beach looks like a motel, with long halls and
pastel colored wallpaper; Life's Journey Center in Palm Springs looks like
a posh desert resort.

About 70 percent of patients at the Substance Abuse Foundation and 90
percent at Positive Steps are recovering from crystal meth.

Redgate is the only drug treatment center in Long Beach with detox, a form
of drug treatment in which addicts get clean under medical supervision.
Many Redgate patients are recovering from addiction to heroin or alcohol,
substances that lead to withdrawal symptoms more severe than meth's. But
crystal meth addicts still fill a good portion of the center's 63 beds,
administrator Alyce Belford says.

Daryl Flynn, an HIV-AIDS specialist at Redgate, said he's seen a 40 percent
to 60 percent increase in crystal meth use over the past five years.

For the first seven to 14 days getting clean off crystal meth, the body is
still expelling the drug from the system. Typically, that period is marked
by body aches, temper, hunger, anger, depression and sometimes drug-induced
psychosis.

Once the drug is gone, the hard part starts.

'Your soul is stripped bare'

"Your soul is stripped bare in front of you," says Rick Reyes, substance
abuse counselor at Positive Steps.

Reyes has seen the catch phrase in action: In every group of 10 recovering
addicts, only one will make it. So, he says, he treats each person like
he's the success story.

Addicts are often afraid to stop using crystal meth because of the
resulting crash. Coming down can bring on depression, fatigue and malaise
so profound, it's unbearable for some people.

Separating from the stimulant usually requires parting with all
temptations, or anything that would serve as a trigger: drug-using friends,
old hangouts, even the Internet.

Some things are harder to part with than others.

It's the high-intensity sex that makes the drug uniquely hard to kick,
Reyes says.

At the Los Angeles-based Van Ness Recovery House, where 88 percent of men
in 2004 were HIV-positive, Executive Director Kathy Watt confronts that
problem head on. Developing a healthy sexual life without meth is one of
the core elements of the treatment program, which is targeted toward gay,
lesbian and transgender addicts.

They take a unique approach at Van Ness. There, masturbation with condoms
is required, three times a day.

"We have them masturbate so that they can create new fantasies without
crystal meth," Watt says. "And then we talk about it in group, how the
fantasies are changing. A lot of what it's about is talking about intimacy,
bringing sex back to its roots, and having sex in a new fashion."

A bowl by the door has a variety of different condoms: lubricated,
nonlubricated, extra large and flavored. And unlike most treatment
programs, addicts are encouraged to date and have sex while in the program,
as long as it's not with other patients.

Some talk about the need to mourn meth-fueled sex as a part of that
recovery process, says Steven Shoptaw, UCLA-based psychologist and researcher.

"What the rest of us are getting, it's not the food of the gods," he says.

Many in recovery point to Crystal Meth Anonymous 12-step meetings, modeled
after Alcoholics Anonymous, as their salvation.

In his early 20s, Ron Morrison, now 48, was diagnosed with HIV after
injecting crystal meth with dirty needles. Twenty years later, he found
himself in a hospital bed with a heart infection and a dismal prognosis.

But he survived the infection and, three years ago, went on to start three
of the first 12-step meetings in Long Beach for crystal meth abusers.

The number of CMA meetings have since grown to eight, the largest of which
has about 60 members.

"The meetings we have going on right now are just incredible," says
Morrison, who now has five years of sobriety. "People call each other every
day and check up on each other. ... It's really a close fellowship."

Elizabeth Eastlund, substance abuse and mental health coordinator at CARE,
founded a peer support group designed to be an alternative to AA, Narcotics
Anonymous and Crystal Meth Anonymous. Her group is an outlet for people who
are either still using, not ready to go to group meetings, or turned off by
the religious leaning of the 12-step program, she said.

Affectionately (and admittedly) known as "The Queen of Meth" in the gay
community, Eastlund's style is funky: tricolored hair bleached along the
hairline, earrings that climb up her earlobes like vines, and black
platform shoes. Her strength lies in her compassion, clients say, and in a
street-smart approach that is open-minded and judgment free.

Her group has a harm-reduction philosophy that is founded on acknowledging
that drug use is a part of society while striving to educate people on the
dangers of using.

"It's about getting someone to drink more water in a day, sleep more and
see their doctors more," she says. "It's about helping them to take care of
themselves."

It's also about urging them to adhere to their AIDS medication regimen.

"We'll probably see in the coming years even more of a link (between
crystal meth and HIV)," Eastlund said. "Of newly diagnosed guys in their
40s who lived through (the AIDS epidemic of) the '80s and '90s, it's
shocking how many are coming in and being diagnosed."

Dee Cliburn, a volunteer for Being Alive Long Beach, an HIV action
coalition, and a former IV drug addict herself, makes a series of stops
five times a week to places she knows are frequented by meth users. She
goes to homeless encampments, parks and other known drug hangouts.

"Need some condoms?" she asks as men walk by. Sure, they say, and she
offers them five or six condoms, as well as abscess kits with cleansing
pads, alcohol swabs, gauze, tape and antibiotic cream.

Cliburn urges people on the streets to get testing and helps them find
counseling and housing. She brings food for people who are hungry. She
hands them education pamphlets on alcohol, drugs and HIV.

"I'm just glad I'm not doing any of this garbage here today," she says.