Drug keeps addicts in powerful grip

February 25, 2007 

Treating meth addicts has challenged substance abuse counselors in North Carolina.

For one thing, it's hard to get them into a program, and they often turn up in local emergency rooms in the throes of a psychotic breakdown. They are then committed to state mental hospitals and soon released without dealing with their addiction. Because there is no systematic way to force imprisoned addicts into treatment once they are freed, they often pick up the habit again.

Staff writer Mandy Locke recently discussed the issue with Jim Thornton, director of a pilot program in Watauga and Ashe counties designed to treat meth addicts and their families. The federally funded program works with law enforcement and social services to also attempt to deal with the child welfare and job placement struggles that often accompany meth addiction. Here are edited excerpts of that interview:

Q: Are you still having a problem with meth addiction in the western part of North Carolina?

A: There's still a lot of meth here. We have not seen any drop in the meth families being referred to us. That said, over the last few months we haven't seen an increase yet either. The cooks are the hardest to get into treatment.

Each quarter, we might work with about 200 people, 60 or so of those being adult addicts.

Q: Meth addicts tend to be particularly paranoid. Does that make them difficult to treat?

A: They are delusional, more delusional than paranoid. They are paranoid once they get rounded up . Once they stop using, they can present fairly normally. But they never drop their belief in the delusions. That's the interesting part. Years later, meth addicts still believe they have things in their skin, or they believe their wives were extremely promiscuous with men who pop in and out of floorboards. You try to explain to them that delusion was part of their meth addiction, but they can't let it go.

Another challenge is that some people become runners, and it's hard to keep up with them. They flee. We've run down pregnant women on meth. They start using again, and they don't want consequences of testing positive.

Q: What else is different about meth addicts from other kinds of substance abuse addicts?

A: Well, when they are using, they get into periods of intense focus. They might pick their face in front of a mirror for 18 hours. If they are parents, they have no awareness of their children. Cocaine addicts do that, too, but only when they are high. With meth addicts, it's so long-acting, they might ignore their children for weeks.

Q: What's the silver bullet? What works for them?

A: If you are going to engage this population, you can't be a passive treatment center. You must go out and get them. You can't just give them an appointment time. We go out and throw a net over them. We show up at their house early. We set up a team around them. It gives us leverage. That team gets together and solves problems such as transportation. We rope them in pretty well. Our addicts live remotely. They live in chaos in these trailers with no window, no water. They have small children foraging around. It would be very difficult for them to participate otherwise.

Once you get the wrap around them, they do well, particularly the ones with children. But it's a drug that you get habituated to, and it will sneak up on you the rest of your life. We get them straight for good lengthy periods of time, though.

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