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." - --- MAP posted-by: Terry Liittschwager