Pubdate: Sat, 01 May 2004
Source: Olympian, The (WA)
Copyright: 2004, The Olympian
Contact: http://www.theolympian.com/forms/lettrfrm.shtml
Website: http://www.theolympian.com/
Details: http://www.mapinc.org/media/319
Author: Scott Gutierrez
Bookmark: http://www.mapinc.org/find?159 (Drug Courts)
Bookmark: http://www.mapinc.org/meth.htm (Methamphetamine)

DRUG COURT FOCUSES ON TRAUMA

County First in Nation to Treat Post-Traumatic Stress

Tom Poage and his brother were arguing as they drove down the dark Kansas 
freeway in a tractor-trailer when his brother threatened to jump out.

"We were going about 65 miles per hour, when he screams out, 'Maybe I 
should just get out right here.' And I say, 'Go ahead.' He unlocked the 
door and bailed out, and I ran over him with the trailer," Poage said.

It seemed like miles before Poage could stop the truck. Soon afterward, his 
brother died in his arms. For the next 10 years, Poage escaped the guilt 
and self-blame for what happened by relying on alcohol and illegal drugs.

Poage's addiction spiraled out of control. It wasn't until a second chance 
in Thurston County's Drug Court that he learned he was suffering from 
post-traumatic stress disorder.

The diagnosis came when he was admitted into a Drug Court pilot program 
established to treat addicts suffering from the disorder. Along with the 
diagnosis came answers to coping with his emotions.

Poage, 43, a Tumwater native and former motocross racer, put his life back 
together and has been sober for almost three years.

He now owns an auto-detailing business in Tumwater and today he will fly to 
Las Vegas to marry his fiancee, Carolyn, whom he befriended before entering 
Drug Court.

"I'm a contributing and responsible member of the community now," he said 
last month from his auto-detail shop on Henderson Boulevard, near Olympia 
Regional Airport.

The Program

This year, Drug Court officials secured a $275,000 grant from the U.S. 
Department of Justice to establish a two-year trauma treatment program. The 
grant application was based on the success of Poage and others who 
completed the pilot project a few years ago, Drug Court program 
administrator Ellen Goodman said.

"This has never been done anywhere else in the country," Goodman said.

PTSD is commonly associated with combat veterans who have "flashbacks" of 
their war experiences. But it also can affect victims of serious accidents, 
natural disasters or physical or sexual abuse and is a common disorder 
among those with substance abuse.

Studies have shown that 54 percent of people diagnosed with PTSD report 
having problems with substance abuse.

Drug Court, which started in Thurston County in May 1998, is a chance for 
less-serious drug offenders to avoid jail time by undergoing treatment. 
Admittance into the program requires forgoing the right to a trial on the 
criminal charges. The charges are dismissed if participants stay sober. But 
violating the rules means an automatic sentence to jail or prison.

The goal is to reduce recidivism by treating the underlying addiction. 
Seventy-one people currently are enrolled in Drug Court and each will be 
screened for PTSD when the new program starts, Goodman said.

Goodman said she became interested in starting the program after seeing 
that many Drug Court participants stumbled into addiction because they were 
self-medicating. For some, PTSD is rooted in abuse they endured as 
children, she said.

"A need surfaced that was the impetus for coming up with this idea."

A Horrible Night

Poage's symptoms of PTSD stemmed from that cold night outside the small 
town of Hayes, Kansas.

In December 1989, Poage and his brother, Steve, stopped there on their way 
home from a long haul. The two had entered trucking school together and 
were driving trucks across the country.

They stopped to pick up some Christmas presents for their families and 
decided to have a few drinks at a local bar. They wound up drinking until 
closing time, Poage said.

Then, they got into an argument about whether to stay overnight or leave. 
Poage wanted to stay. His brother wanted to leave. Finally, Poage caved in 
and he hopped behind the wheel for the trip home, he said.

Not far out of town on Interstate 70, the argument flared up. Steve 
suddenly sprung open the door and jumped out.

Poage relived the tragedy over and over in his head, he said. "My addiction 
to drugs and alcohol started right there."

Only two years before, Poage had lost his father, the former owner of 
Poage's Automotive and Towing in Tumwater, to cancer. His mother passed 
away not long after his brother's death, he said.

"Every time I thought about my family, every time I thought about my 
brother, I couldn't take it," he said. "I'd medicate. That's the only way I 
knew how to deal with those problems."

The alcohol problem slipped into a methamphetamine addiction. Soon, Poage 
said, he was blowing all his money on drugs. Friends were partying at his 
house all night, even though his young daughter was living there, he said.

Poage could no longer hold down a job and he walked away from the family 
business. He soon lost his home and his reputation. His daughter moved in 
with his ex-wife. Then, overwhelming feelings of shame set in for 
tarnishing his family's reputation and putting his daughter at risk, he said.

In 2000, a warrant went out for his arrest because he didn't show for a 
traffic court hearing. Tumwater police arrested him and found 
methamphetamine in his possession, Poage said.

He failed his first attempt at Drug Court. He was facing a two-year prison 
term when Judge Richard Strophy gave him a second chance. This time, Drug 
Court officials asked him if he wanted to participate in the trauma 
treatment program.

"I was willing to do anything at that point," he said.

Underlying Issues

Poage's relapse wasn't unique. Since 1998, 9 percent of Drug Court 
graduates have committed new felonies, and 13 percent have committed new 
misdemeanors.

Many times it's because the underlying psychological issues haven't been 
addressed, Goodman said.

"We end up in a vicious cycle if we don't ever deal with those underlying 
issues."

Drug Court, which involves intensive chemical dependency treatment, random 
drug testing and weekly court sessions, lasts 12 to 18 months.

Every Drug Court participant will undergo the first two phases of the 
trauma treatment. But only those who meet the clinical criteria for PTSD 
will be placed into the third phase, which involves 20 sessions of therapy.

About $40,000 will be used to pay for a specialist to evaluate the program, 
Goodman said. Results will be reported to the federal government.

Five people completed the pilot program. Of them, two relapsed, Goodman said.

Drug Court is contracting with Lifeforce Services, a San Diego treatment 
provider, to administer the new program.

Poage said therapy taught him techniques for coping with his emotions and 
dealing with his addiction. He cleaned up and made enough money to pull his 
home out of foreclosure. His daughter, now a senior at Tumwater High 
School, has moved back in with him.

"When I think about my brother today, I don't have to go through the last 
20 minutes of his life over and over again," he said.

Controversial Therapy Used

Drug Court's new trauma treatment program is centered on a relatively new 
and still controversial form of therapy known as eye-movement 
desensitization and reprocessing, or EMDR.

EMDR is based on the premise that traumatic memories become "frozen" in the 
minds of people with post-traumatic stress disorder.

"The premise is that the brain knows where to go to help this material get 
moving and get processed into a more adaptive state," said Susan Brown, a 
licensed clinical social worker and co-founder of Lifeforce Services, which 
will administer the program.

As part of the therapy, the patient is asked to discuss all beliefs, 
emotions and images from the traumatic memories. Then, the therapist uses a 
finger or a moving light to get the patient's eyes to move rapidly back and 
forth, like they would during rapid-eye movement, or REM, sleep. Another 
technique is to alternate a buzzing sensation in each of the patient's 
hands. It's known as bilateral stimulation and helps the brain process 
information, she said.

"The aspect of it that makes it unique from traditional therapy is the fact 
that it is a whole organism experience. The operative principle is that it 
gets the entire brain-body activation going on. It gets things moving in 
ways that talk therapy does not."
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MAP posted-by: Terry Liittschwager