METH TREATMENT PROGRAM SEEKS PARTICIPANTS

There is no shortage of methamphetamine users in the area, police say, but
Carolyn Rowe is having a hard time finding 10.

Rowe runs a local federally funded treatment/research program designed to
help addicts and develop more effective treatment options for future meth
users.

Ten is the magic number.

That's the number of volunteer participants Rowe needs to complete a
12-week stimulant abuse, research and treatment program. Start uses a
carefully structured, drug-free routine of behavioral tools to help meth
users beat their addiction.

After nearly six months of searching, the program finally signed 10 users.
But only half that number are showing up for every meeting, leaving Start
far from its goal.

If the participants complete the course, more money will be available from
the National Institute on Drug Abuse, and Start will move on to medical
trials. If they fail, the program will be sidelined.

The second phase of the institute's program probably will start in
mid-spring. So the clock is ticking for Rowe, who says she has perhaps two
more weeks to fill Start's rolls.

But where are the meth users? And more specifically, where are the users
who are dedicated to kicking the habit?

"It's frustrating because I know they're out there," Rowe said.

The program, which operates under the institute's guidelines and has an
estimated $171,000 in federal funds, has a built-in stumbling block.

First, federal guidelines governing clinical trials involving human
subjects require that participants voluntarily sign up, not be ordered to
attend by the criminal justice system.

In addition to the basic rules that participants must be 18 years old and
not taking behavior-modifying medications, they must be current meth users.
Rowe's heard about interest from those fearing relapses, but little
interest from current users.

But even so, Rowe said, the program should be appealing. Applicants get a
free physical. Participants receive help with their addiction and vouchers
that should cover all transportation costs.

The program will provide an exhaustive look, three days a week, at how
people feel as they proceed through their withdrawal.

Missouri is known for its prevalent meth, and meth labs -- whether rolling
or home based -- tend to pop up in Jackson County.

Start, which operates out of space owned by Western Missouri Mental Health,
has gotten the word out to community groups and parole officers. They have
placed advertisements and have dropped their names to drug-abuse help networks.

Officials at the local office of the National Council on Alcoholism and
Drug Dependence are sympathetic, though not surprised, about the problem.

Bob Kelly, associate director of the council, which helps match substance
abusers with drug programs, understands the hurdles Start must overcome.

"That's always been the magic question, hasn't it?" he said. "It takes a
little bit of start-up time. Advertising alone's not really going to do it.
In this industry you need to build a network, build word of mouth."

And there is an array of treatment options and facilities, many better
known, to compete with. The rare, research nature of Start's program --
with its promise of a better world for future addicts -- may not mean much
to current users.

Staffing and funding limitations can quickly stymie efforts to reach the
public, Kelly said.

The volunteer nature of the program doesn't help, said Preston Washington,
the council's clinical director. Washington said he had made a number of
referrals to Start.

"You may be sitting there offering help to someone who doesn't want it
yet," Washington said. "Really you're waiting for them to bottom out."

Jan Campbell, a psychiatrist and part of the effort behind Start, is unsure
whether the research element of the program is off-putting. She said all
facets of the program are confidential.

Campbell also wonders how widespread meth use is in the area. She said
she's heard of heavier use north and south and east of the metropolitan
area, and the program's message may not be spreading far enough.

It's all a far cry from her 1991 efforts, when she worked on crack
treatment programs.

"With crack, we would just put a sign on the door and be inundated the next
week."

Officials with COMBAT, Jackson County's anti-drug task force, had no firm
numbers on meth users, but their observations on production suggest perhaps
a waning problem.

In 1996, COMBAT broke up more than 100 area meth labs. In 2000, it was
closer to a dozen.

Frank Vocci, director of treatment research and development for the
National Institute on Drug Abuse, said the 2-year-old study's guidelines
are strict.

The leg of the program Start is stuck on is as much a test of the
organization as it is a study of the users, Vocci said.

"It's a way to get these sites used to the culture of research," Vocci
said. And a test using behavior therapies rather than drug therapies is the
preferred approach, he said, "because behavior therapies are more subject
to slippage ... meds are counted out and given."

Programs such as Start could then move on to testing drugs such as
Ondansetron, an anti-nausea drug prescribed for chemotherapy patients. The
medication also has helped lessen the physical symptoms of withdrawal for
drug addicts.

The institute's goal dovetails with Rowe's own take on curing the country's
illegal drug ills.

"I think it's the real way to fight the war on drugs," Rowe said. "Drug
abuse isn't just a moral issue, a `just say no' issue. It's a chemical
issue, a disease in the brain."

She's ready to fight, but, as of yet, the war is not coming to her.

Vocci said it's an old problem in the health research field, when
well-intentioned, needed research is tripped up by a sudden dearth of
sufferers. The phenomenon has spawned an equally old joke, he noted:

"If you want to cure a disease, start running clinical trials."