Pubdate: Tue, 29 Nov 2005 Source: StarPhoenix, The (CN SN) Copyright: 2005 The StarPhoenix Contact: http://www.canada.com/saskatoon/starphoenix/ Details: http://www.mapinc.org/media/400 Author: Darren Bernhardt, staff writer Bookmark: http://www.mapinc.org/find?241 (Methamphetamine - Canada) TREAT METH ADDICTS IN COMMUNITY: EXPERT Philosophy At Odds With Gov't, Social Agency's Approach Crystal meth abusers can only truly be healed in the community, not hidden away in treatment centres, says a leading researcher from UCLA. The traditional approach to dealing with addictions simply doesn't work with meth. Those are the blinders that society needs to remove before any progress can be made, Dr. Richard Rawson told a crowd of about 500 people on Monday at the start of a threeday conference. "It's a huge paradigm shift from the idea that we can fix people in these residential centres and send them back as cured. We have a bad habit of saying, 'We know what the treatment is, now the meth user has to fit into our definition of that.' It just doesn't work that way." Rawson is the associate director of the UCLA integrated substance abuse program and a member of the California university's department of psychiatry for more than 20 years. He was Monday's key speaker at the Community Action Against Crystal Meth (CAACM) conference at The Saskatoon Inn. His philosophy flies in the face of the approach favoured by governments and social agencies. Rawson supports residential treatment for hard-core users who cannot go a day without injecting or smoking meth but the same after-care -- support in the community -- must exist for them as well. Users are slaves to their cravings, which are triggered by their environment, including the people they are with, the places they go, the things they do. In treatment centres they are removed from those things and they appear to improve. "But they can't live in a treatment centre. The hard work really has to be done the day they walk out into the real world," said Rawson. "The conditioning hasn't gone away because they haven't been exposed to the real-world triggers that produced the cravings in the first place. That's generally where we drop the ball with treatment." The conditioning has to occur over time in the real world so the "extinction" of the conditioning has to occur over time in the real world as well, he added. "When they relapse it's because we haven't done a good job in teaching them and we haven't done a good enough job of getting resources into the community, which is where they struggle with this problem -- not in the treatment centre." Crystal meth is a disease that cannot be handed off to treatment experts or the police to deal with on their own. It is a community problem which requires "robust" community solutions such as places where those trying to kick the habit can be around likeminded individuals, said Rawson. They need support and activities where they can avoid their trigger, which can be anything from a certain time of day, to music, to holidays. "They have to have a life and that has to happen in the real world communities," said Rawson. The treatments must also be adapted to the individual's environment. Unlike a penicillin pill, which is used and just as effective in Utah as in Saskatoon, meth treatment must be customized. The other key is to smother communities in education and resource materials to cut back on new users, he said. Crystal meth is the only drug where the number of women users equals that of men. Most drugs have a three-to-one ratio with men being the majority users. One of the reasons for meth's popularity among females is that they are lured by the opportunity to lose weight, said Rawson. Meth addicts often stop eating for long periods and rapidly drop weight. "This is not a diet pill. It will kill you," Rawson warned. Other people try it out because they are led to believe it will help them work longer, it will ease their depression or are lured by peer pressure. People need to know the harsh chemicals -- battery acid, drain cleaners, fertilizers -- that go into the production of meth. If they realize that, they may be scared off, he said. "We need to keep the next generation from getting involved. It's the only way to beat it," he said. Some drugs make brief appearances in communities then fade away but meth "moves in and becomes endemic," said Rawson. It also holds no bias to a certain age group, like some other hard drugs. Crystal meth is being used by professionals, teens and children alike. Rawson spoke of a friend whose fourth-grader has been exposed to it at school. Restricting the bulk sales of some materials, like cough medicines, has helped reduce the home-based labs but only for a brief time. Before long, the large suppliers move in and fill the gap, Rawson said, citing examples throughout the United States. - --- MAP posted-by: Larry Seguin