FIGHTING A NEW ADDICTION

Meth Recovery Requires A More Non-Traditional Strategy

Drug abuse is an age-old problem, but the spread of methamphetamine use in
Watauga County has forced treatment specialists to rethink traditional
recovery models.

To address these new challenges, a team of counselors from the New River
Behavioral Health Center opened a ground-breaking program in July designed
to help families recover from the devastating effects of meth addiction in
their homes.

Lance Dome, one of two marriage and family counselors currently working
with the pilot program, said traditional methods often separated the abuser
from family members during treatment.

Such methods experienced a very low success rate, especially with reuniting
families whose children had been removed from the home by Department of
Social Services (DSS) intervention.

"I'm not sure any families had been successfully reunited using the
traditional methods," Dome said.

In Watauga and Ashe counties, where meth addiction has grown to epidemic
proportions over the past four years, Dome said DSS was desperate to
establish a program to more effectively repair the damage being done --
especially to children.

"There were so many issues with families falling apart," Dome said. "No
family that we know of was able to successfully deal with methamphetamine
addiction and stay together. And DSS was really concerned there on that issue.

"And we work very very closely with DSS," he added. "We also work with law
enforcement and other agencies. But it really extends from social services'
need for some type of program that can save these families. One family
after another was just falling apart"

The meth family treatment program is now assisting about 20 families with
its innovative approach.

"I think we're one of the only programs in the country treating
methamphetamine addiction as a family issue," said Joan Zimmerman, another
marriage and family counselor with the group.

She said one of the failings of traditional treatment came from releasing
addicts back into the same environment that helped produce the addiction in
the first place.

To avoid this familiar pitfall, the new program sets out to not only help
the addict recover, but make their home environment a healthier place as well.

"One of the things that keeps happening is that once the individual gets
treated, they go back to their family, which is the same (environment) they
came from. And they go right back where they started. So, there were
relapse issues."

A Team Approach

The New River group has taken the old model, which often would have used a
single counselor to address addiction issues, and expanded it to a team
approach.

In addition to the two marriage and family counselors -- with a third
serving Ashe and Avery counties as well -- they've also employed the
services of Kathy Ronemus, an individual substance abuse counselor as well
as child psychologist Ashley Angliss.

"We try to gather a support group around the individual which includes the
family, and the agencies they're working with," Zimmerman said. "That's one
of the things we do that's very different, having a support team. Which
means meeting very early on and figuring out how people support each other,
what they need and what they need to watch out for."

"We're proactive" Dome added. "We try to surround the people with support
- -- get a real network set up around them -- so it's hard for them to just
go back out and use. It happens. Don't get me wrong. But we're really a lot
more intense than the traditional methods of treatment."

Because it is a new approach, the program has been designed with a keen eye
toward measuring outcomes, Dome said. They work closely with the
Appalachian State University to collect data, though it could be years
before any reliable assessment can be made.

Zimmerman suggests their methods are all the more carefully implemented
because scientifically supportable evidence is so important to assessing
the program's effectiveness.

And success, Dome said, is fairly easy to define. "If they stay off the
drug, then it's been successful."

Careful and frequent drug screening is central to measuring a patient's
progress, and also helps motivate clients to stay clean.

Promising Results

Since July, Ronemus pointed out, the results have been promising.

"Even though we're a new program," she said, "and we've not done the follow
up and the research, we are seeing within our program some real successes.
That could change tomorrow. But for today, we have people who are doing
really well."

Angliss said the children do surprisingly well as their parents recover and
progress toward stability.

"The kids are very resilient," she said. "A lot of times they bounce back
once the parents are more focused and devoted to restoring a relationship
with the child."

"I don't want to talk about any specific cases," Dome added, "but we do
have parents who are doing much better. They're already working on getting
their kids back and having unsupervised visits. So there is definitely a
lot of hope."

Hope has been hard to come by in treating meth addiction. Research has
revealed addiction to the drug as particularly difficult to conquer.

And unlike similar stimulants, such as cocaine, meth affects the brain
physiology in ways that may not be reversible.

Cocaine acts to stimulate the flow of dopamine (the chemical that helps
create the drug "high") from neurons to receptors in the brain. As the drug
wears off, the dopamine is recycled back to the neurons where it becomes
available for later use.

Research has shown that over time meth damages neurons and eventually
inhibits the release of dopamine.

In one study, researchers led by Dr. Nora D. Volkow Brookhaven National
Laboratory in Upton, N.Y., used PET scans (positron emission tomography) to
check dopamine transporter levels in the brain. The study concluded that
the level of these chemical messengers, which are related to movement
control as well as pleasure, was 24 percent lower in meth users than among
a control group.

Volkow and colleagues also used PET scans to measure glucose metabolism, a
marker for brain damage and neurodegenerative disease. They found that meth
users exhibited an elevated level of glucose metabolism, especially in
parts of the brain that control sensation and spatial perception

The symptoms show up in recovery patients as depression and a greatly
reduced ability to experience even the simplest of pleasures.

Dome said this might help explain the high relapse rate, usually after
about six months, in even the most promising clients.

The answer, he said, may lie in longer treatment programs. "After 12, 14,
18 months the brain does seem to show some signs of healing," he said.

Their program is designed to last at least a year, and possibly as many as
two when necessary to complete recovery.

More Costs For Better Results

Longer treatment programs and increased staff mean the New River pilot
program costs more than traditional approaches.

But Dome stresses that the old methods were not working. And the money is
well spent if it helps to heal broken families and reduce the financial
burden on law enforcement, fire, and social services agencies, which are
currently being pushed to their limits by the fallout from meth production
and abuse.

"It doesn't only affect the users -- no drug really does -- but we have a
lot of labs. It's being cooked right here. Labs are blowing up and hurting
people, and killing people and splitting up families and all this damage is
being caused by meth production, specifically. And we don't really have
that with any other drug. You just don't have the same kind of danger, or
environmental impact and cost to law enforcement and all these other
agencies involved. And nearly every one knows of a meth lab bust, whether
they've driven by it, or know someone who was involved.

There are also human elements that cannot be measured in dollar amounts,
Ronemus said.

"Addicts are not unlike other people who have other diseases," Ronemus
said. "They're human beings. And if just one stops using, that affects
their families, and their extended families, and their community."