Pubdate: Sun, 11 Nov 2007
Source: News Tribune, The (Tacoma, WA)
Copyright: 2007 Tacoma News Inc.
Contact:  http://www.thenewstribune.com/
Details: http://www.mapinc.org/media/442
Bookmark: http://www.mapinc.org/find?159 (Drug Courts)
Bookmark: http://www.mapinc.org/meth.htm (Methamphetamine)
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)

PROMETA EXPERIMENT: MEND IT, DON'T END IT

The addiction treatment known as Prometa has a knack for spawning 
nasty disputes and nastier ethical problems. Pierce County -- home of 
a major experiment with Prometa -- is seeing plenty of both.

The County Council has voted to suspend funding for the pilot 
project. Executive John Ladenburg has threatened to override that 
vote with his veto. Rather than wrangling with the council, he should 
be working to fix the problems that have undermined the program's credibility.

One of those problems has to do with the initial claims of success 
that came from the Pierce County Alliance, the nonprofit agency using 
Prometa to treat meth addicts on behalf of the drug court. As The 
News Tribune's Sean Robinson reports in today's newspaper, the 
Alliance sloppily and perhaps naively overstated the number of 
addicts clearly benefited by Prometa.

The nonprofit asserted that 86 percent of Prometa clients -- drug 
offenders or addicts denied custody of their children pending 
treatment -- were drug-free during a 14-month trial. A recent 
assessment by county auditors came up with a different number: 50 percent.

Part of the discrepancy stems from the fact that the Alliance didn't 
count drug relapses prior to the last 60 days of the program; the 
auditors did. The 60-day standard is questionable: The Pierce County 
drug court itself requires 90 days of clean tests before a client is 
cleared. So does the King County drug court. The drug courts of 
Snohomish and Thurston counties require 180 days.

Even using the Alliance's generous definition of "drug free," there's 
another question: How many clients were clean before joining the 
pilot project? Looking at the records of 19 of the program's 35 
clients, it turned out that 12 of those 19 had been drug-free for 61 
to 270 days prior to starting Prometa.

None of this means the Alliance was cooking the books.  The agency 
has struggled to heal addicts for many years; if its staff is guilty 
of anything, it's guilty of believing too much in a long-hoped-for 
breakthrough treatment. Its 14-month trial was never meant to be a 
rigorous scientific study. It started as a simple inquiry into 
whether an expanded Prometa program was worth pursuing.

Still, the results were used to win as much as $900,000 in county and 
state funding. And Hythiam -- the pharmaceutical company that 
licenses Prometa -- has been featuring the Alliance's "success" in 
Pierce County in its marketing promotions.

That commercial entanglement is especially troubling in light of the 
fact that the Alliance's executive director, Terree Schmidt-Whelan, 
owned some stock in Hythiam -- astonishingly, with the blessing of 
her board. That may have been legal, but it created the impression of 
a conflict of interest that has undermined the Alliance's credibility 
on this issue.

We think the experiment with Prometa is worth continuing, pending the 
rigorous scientific studies now being conducted on its effectiveness. 
Society has few options for treating methamphetamine addiction; if 
this is even a little successful -- and there are some indications 
that it might be -- it could save a fortune for treatment programs 
and the criminal justice system.

But if the Pierce County experiment is to continue, it has to operate 
by different ground rules. The Alliance is receiving public money to 
run the program, and it must be accountable to the public. First and 
foremost, anyone connected with the Alliance must be forbidden from 
owning Hythiam stock or having any other personal interest in the company.

Nor should the Alliance let itself be used by Hythiam as a marketing 
gimmick. Those preliminary and very rough early numbers should not be 
represented by anyone as scientific findings.

Ladenburg -- who unwisely bought Hythiam stock himself and has since 
sold it -- ought to be busy reforming the program's ground rules. If 
its credibility can be restored, he'll have no need to threaten vetoes. 
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MAP posted-by: Richard Lake