BREAKING THE BONDS OF METH

Treatment:

Minnesota Treatment Centers Struggle to Keep Up With the Increase In
Meth Users and the Severity of Their Addiction.

Just before Luanne Soyring's son, Jonathan, killed himself in their
family home with a high-powered rifle last July, she looked in his
eyes as she pleaded with him.

"He wasn't even there," she said.

The 24-year-old Detroit Lakes, Minn., man was on methamphetamine, a
powerful drug he had been using for about a year.

Last month, Luanne brought her story to the state Capitol in search of
better chemical dependency treatment options for the growing number of
Minnesotans who find themselves hopelessly ensnared in meth addiction.

But some public officials say it's unlikely in the current
cost-conscious economic environment that the state will devote
resources to meth treatment options, especially since there are no
consistently effective treatment programs.

Others say Minnesota could tackle the problem if the state or private
employers provided financial support for long-term treatment programs.

Minnesota Attorney General Mike Hatch said studies have shown that
meth has the lowest addiction-recovery rate of any drug. His office
routinely prosecutes rural Minnesota meth cases. Only 4 percent of
addicts successfully quit meth, he said.

"That's huge, huge," Hatch said. "Methamphetamine is a particularly
cruel drug. It is easy to get hooked and, when you do, it is
extraordinarily hard to get off of it."

In 1996, 1.8 percent, or 711 people, in state-supported substance
abuse treatment programs were there primarily for meth, the Minnesota
Department of Human Services reported. By 2002, that number had grown
to 7.8 percent, or 3,530 people, enough to fill a small town. Meth
treatment patients surpassed those entering programs for crack, 7.1
percent, or 3,225 people, for the first time in 2002.

Why So Tough?

Meth use is very hard to control, said professor Mark Kleiman, who
studies drug law enforcement and distribution at the University of
California-Los Angeles Department of Public Policy. Casual weekend
users are either going to stop altogether or get hooked, he said. He
estimates meth's rate of addiction to be between 15 percent and 30
percent of people who try it.

Sharon Oates, director of the Duluth Detoxification Center, said
because meth alters the user's chemical makeup, that makes it one of
the toughest -- if not the toughest -- drugs to kick. The user's sense
of pleasure gets out of whack, and the euphoria is so great that other
feelings tend to pale in comparison. It becomes everything to the
user, Oates said.

The physical effect of coming down from the drug isn't as great as an
alcoholic's, Oates said. The cravings are strong, but there is a much
greater psychological effect, Oates said.

Addicts also often feel confused for weeks after quitting, said Mike
McIntyre, residential treatment program director of the Duluth Bethel
Society's Port Rehabilitation Center for chemical dependency.

Up to 90 days might pass before the addict realizes that he or she is
in withdrawal and depression kicks in, according to the National
Institute on Drug Abuse.

That's why many drug counselors say if the state really wants to get
serious about meth, it needs to devote more money to long-term
residential treatment.

Effective treatment options may be hampered by the fact that,
nationally, 81 percent of meth users who seek treatment don't have
health insurance, a 2003 University of Minnesota study indicates. That
places a greater financial burden on community-based centers and often
results in shorter residential treatment stays.

Right Treatment, Wrong Attitude

"Unfortunately, right now Minnesota has a dearth of treatment centers
that specialize in meth addiction," said Deborah Durkin, an
environmental health specialist with the Minnesota Department of Health.

She said there are only about five small centers in the state aimed at
meth. Duluth does not have a treatment program geared specifically for
meth.

Establishing more is an "absolutely critical and unfulfilled need,"
Durkin said.

According to the National Institute on Drug Abuse, there are some
effective treatments for meth addiction. The best form of treatment
involves therapy in which addicts are taught stress coping skills and
taught to have healthier expectations, behavior and thinking. Recovery
support groups also seem to work.

There are no pharmacological replacement treatments for dependence on
meth.

A January National Institute of Health report suggests that treating
meth users with antidepressants may improve their chances at success.

Younger Crowd

"Over the past five years, there's been a steady increase of
methamphetamine (users) coming into our program," said Bonnie Johnson,
who works in Bethel's halfway house. Duluth Bethel Society is a
private nonprofit that operates five community programs -- two for
chemical dependency and three for people who are criminal offenders.
"Now, what I see is maybe just two or three who aren't addicted to
methamphetamine."

McIntyre said that, just three years ago, only 5 percent of Duluth
Bethel's clients were younger than 26. Now it's 30 percent -- mostly
due to meth, he said.

Meth's nature tends to make it more conducive to young people. It's
widely understood that meth is extremely dangerous, but kids think
they're invincible, Johnson said.

Duluth Bethel drug counselor Irene Jarvi works in the extended-care
program, which focuses on people who have been in treatment three or
more times. In the past two years, she said about half the clients are
young meth users. "A few years ago, it might have been all people 50,
60 years old who are chronic alcohol users," she said.

More With Less

"When I started in this, I did primary outpatient treatment and
funding was no problem," said veteran Bethel drug counselor Nancy Aus.
"Now it would be like pulling teeth. We actually do treatment
determined by how much time the insurance would give each client."

Many relapses are due to shorter treatment programs, McIntyre said.
The Bethel residential program is 90 days.

"Ideally, I'd like to see someone in a program over six months,"
Johnson said. "They're just starting to function at two weeks."

Today, a typical meth user will only spend 10 to 14 days in a
treatment facility, then they are put in outpatient counseling, which
is considered less effective. After less than a month's treatment, the
system dumps most addicts back on the street and tells them to find a
job, housing and sober network of friends, the counselors said.

"It's not enough time," Johnson said.

Like most addicts, meth users struggle with broken lives, criminal
records and severe depression.

Johnson said court-ordered civil commitments to treatment programs are
becoming more common. The process is triggered when someone expresses
a serious threat to themselves or someone else. Most of Bethel's
clients are so poor that the state handles their treatment costs.

Over the past decade, Department of Human Services budget cuts have
left fewer options for mental health and chemical dependency treatment
in the region, Bethel drug counselors said. Rising insurance and
medical costs -- as well as weaker employee health plans -- have also
taken a toll.

Still, Minnesota spent more than $83 million in 2002 on treatment for
low-income people, and counties devoted another $51 million on
chemical health services, according to the state Department of
Health's 2003 report to the Legislature.

But the report said the state was only able to provide chemical
dependency treatment to about 22 percent of Minnesotans who needed it
that year.

A federal study conducted five years ago concluded that Minnesota
spent $1.39 billion in one year related to substance abuse, but only 4
cents of every dollar went to prevention and treatment. The rest went
to costs such as criminal justice, public safety, health care and
family assistance.

Free for Felons

St. Louis County Drug Court probation officer Cheryl Harder said
people in the court system already can have whatever treatment fits
their needs.

"The funding is there. The support is there, if people want it," she
said. "Access is not a problem."

But most people do not want help, at least the first or second time
they are caught by police, Harder said. For treatment to really work,
an addict must want to change, she said.

"Putting someone in treatment is not a magic wand," Harder said. "As
one of my colleagues said, 'You only have to change one thing, and
it's everything.' "

One of Harder's clients -- Terry "Brian" Parsons -- kicked the habit
and has been clean 15 months. He spent several months in inpatient and
residential treatment and continues with support groups.

His sister, Dalene Kittelson, watched as he failed other treatment
programs. They just weren't long enough to make a difference, she said.

"You can't just go into treatment for two weeks and get out, and
you're OK," she said. "They need more programs like what Brian went
through this time."

No Political Solution?

A bill before the Legislature this session would develop and implement
a state chemical treatment program for nonviolent drug offenders
instead of prison. But no current proposals set up meth-specific
treatment programs.

"This is baby steps," said Special Agent Paul Stevens of the Minnesota
Bureau of Criminal Apprehension, who has lobbied this session for
another set of measures aimed at meth.

There isn't a successful treatment option for meth, said Stevens, who
would support spending $50 million or $100 million for treatment -- if
there was a proven way for addicts to recover.

Rep. Mary Murphy, DFL-Hermantown, said Minnesota needs good,
successful treatment programs to combat meth. She sits on the House
Judiciary Policy and Finance Committee, which oversees the state's
prisons, courts and public safety institutions.

"We need a lot of dialogue on what our priorities are and what our
values are," Murphy said. "The governor said we can't have any new
programs. But with meth, it's growing so fast, we have to find some
solutions today -- not next year or three years down the road."

Luanne Soyring said even if meth treatment was widely available, her
son -- who had battled marijuana and alcohol problems -- may never
have benefited.

A week before his death, Jonathan had been awake at all hours and
paranoid. She and her late husband had begged him to tell them what
was wrong. But when repeatedly asked how could they help him, he
denied everything, she said.

At best, Luanne Soyring would like to see readily available long-term,
meth-specific programs statewide. At the very least, she wants to see
those programs for people in prison or jail.

"I just think the treatment factor needs to be in some bill down the
road," she said. "It's just so important."