Responding to the meth epidemic: More treatment, less hype

By: MARGARET DOOLEY - Commentary | Saturday, August 11, 2007 7:01 PM PDT ∞

Before methamphetamine was a policy issue for me, it was a drug. It was part of the landscape for all of us who grew up in North San Diego County in the 1980s and '90s. Methamphetamine is a substance that people close to me have used and abused, and that many people I know and love have reclaimed their lives from. I am particularly disturbed, then, by the end-of-the-world hype surrounding it ---- and the silence about the fact that methamphetamine addiction is treatable, and that long-term recovery is common.

The truth about methamphetamine in San Diego is that use has reached epidemic levels, and the appropriate response is treatment. As the Little Hoover Commission recognized in its 2003 report on addiction, "Most of the substances abused in California ---- alcohol, cocaine, marijuana, methamphetamine ---- are at the epidemic stage, where the benefit of enforcement is limited and treatment is essential to reducing the negative consequences."

The truth about methamphetamine addiction is that it is absolutely treatable. It will not be the end of us (just as crack cocaine wasn't in the 1980s). A growing body of research reveals that methamphetamine-addicted individuals actually respond better on average to treatment than do people addicted to other substances. Treatment providers, including Casa Raphael in Vista and Serenity House in Escondido, are increasingly experienced and successful at treating methamphetamine addiction.

The hype about methamphetamine is a lamentable distraction from the real problem, addiction ---- and the solution, treatment. Even if methamphetamine were to disappear tomorrow, people would still suffer from addiction because its underlying causes would remain: a variety of genetic and environmental factors, as well as sexual abuse, domestic violence and other trauma. Addiction will be a part of the human condition for at least as long as other chronic ailments, such as diabetes and hypertension.

The hype has also led us to identify not just the drug, but people who are addicted to it, as the enemy. Methamphetamine has been described as the "devil drug" of our generation, and people who use it "tweakers" and "speed freaks." Such demonizing paved the way for increasingly punitive policies in the 1990s. The total number of people in prison for drug possession in California quadrupled between 1988 and 2000, peaking at 20,116.

This alarming trend toward mass incarceration of drug offenders ---- our family members and friends ---- had no measurable impact on methamphetamine (or other drug) use rates in San Diego or elsewhere. So, as our loved ones' drug problems persisted, they were compounded by the trauma and health risks of incarceration. In the ultimate irony, although drug treatment programs are hard to come by behind bars, drugs are not.

San Diegans rejected this destructive policy in 2000, when they helped pass Proposition 36, the state's treatment-instead-of-incarceration law, which provides treatment to more than 35,000 Californians convicted of nonviolent low-level drug offenses (usually simple drug possession) each year. When the law was implemented in 2001, treatment admission rates for methamphetamine jumped dramatically in San Diego ---- a sign that more people who need help are getting it.

Over half of Prop. 36 participants statewide ---- about 20,000 people ---- enter treatment for methamphetamine abuse each year, making Prop. 36 the world's largest methamphetamine treatment program. In just six years, more than 120,000 Californians who suffer addiction to methamphetamine have received treatment under Prop. 36, and about 42,000 have completed their mandated course of treatment.

No, a single dose of treatment may not be enough to help put a person in remission. But methamphetamine users as a group have actually exceeded Prop. 36's statewide average treatment completion rate each year. Methamphetamine-addicted individuals complete at a higher rate than people receiving treatment for addiction to cocaine or heroin.

However, the provision of addiction treatment services is still too limited. In 2002-05, San Diego saw a significant dropoff in treatment admission rates. Although that drop appears to have leveled off in 2006, there are now far fewer people accessing treatment in the county than there were in 2002. The number of people accessing treatment in San Diego for methamphetamine, alone, dropped by nearly one-third in just three years.

Perhaps this gives us some insight into the increase, in the same period, in San Diego arrestees who test positive for methamphetamine. We need to make sure that people have reliable access to treatment as soon as possible, whether they get there through the health care system or the criminal justice system. It is both cheaper and better for public safety to provide treatment to those who need it sooner rather than later.

Margaret Dooley is the interim Southern California regional director for the Drug Policy Alliance, the nation's leading organization advocating for drug policies based on science, compassion and justice. She grew up in Escondido and is "a proud graduate" of Orange Glen High School.