By Jesse Marx
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Whittkopp has observed some notable differences between young meth users and other addicts. "You'll see kids in treatment who are primarily marijuana or alcohol abusers. They'll get it out of their systems and you can start to see changes in their whole demeanor. They're becoming normal, functioning human beings again. With meth users, however, even after significant periods away from the drug, you'll still see that frightening flat look. Something is still missing, and I'm afraid there's nothing in traditional therapy that's going to bring that back. There's nothing out there that's going to bring that pleasure back, and they're going to have to find their own compelling reasons for living without the drug."
To Carol Falkowski, such claims are reminiscent of what people were saying about cocaine in the mid-1980s. Falkowski doesn't believe the evidence supports such bleak conclusions about the prospects for meth users. "There has been a large body of research done on the outcomes of addiction treatment programs. What it finds is that there is not a big difference in outcome based on drug type. I'm not saying that there aren't some differences. But I've done addiction-related research for a long time, and I have never been able to document significant differences in outcome."
Hoping to get a handle on those numbers in the mid-'90s, researchers on a project called the California Drug and Alcohol Treatment Assessment looked at outcomes from a representative sample of some 150,000 people who had gone through treatment programs. The findings: outcomes for major stimulant abusers--meth and cocaine users, mainly--were comparable to the outcomes for alcohol users. And, interestingly, the study found that the treatment efficacy seemed to be the same across gender, age, and ethnic lines.
Rick Rawson, a leading meth researcher at UCLA, also dismisses claims that meth addiction is all but untreatable. In Rawson's view, however, there do appear to be differences in relapse rates. While cautioning that the point still needs more study, Rawson is inclined to believe meth relapse rates are somewhat higher than alcohol, lower than heroin, and roughly equivalent to cocaine. As is the case with cocaine, he notes, there are no medications currently approved to treat meth addiction. That means that successful programs must rely exclusively on a combination of behavioral and cognitive therapy. "In general, 50 percent of meth users who enter a proper program should be drug-free at the end of one year," Rawson says.
Unlike alcohol, heroin, and nicotine, meth has no physical symptoms of withdrawal. That's not to say that kicking a meth habit is easy, or that many addicts succeed on the first try. But, Rawson says, most relapses tend to occur in the first six months, when the user's brain is still producing abnormally low levels of dopamine. As the dopamine production increases--and most research indicates that it does--so do the chances of successful recovery.
It is hard to imagine a drug with a worse reputation than meth. Other drugs (beginning with alcohol, but including cocaine and heroin) take more lives in Minnesota. Through the first nine months of 2002, Hennepin County medical examiners linked methamphetamine to a total of eight deaths--one fewer than caused by the prescription painkiller OxyContin.
And yet meth remains uniquely reviled. In part, this is because meth has stamped its imprint on rural, white America, which is not supposed to have "city" drug problems. And, of course, there are the properties of the drug itself, or at least the perceived properties. Meth, the conventional wisdom goes, makes people into violent monsters, causes them to chop the heads off their own children, or, at the very least, makes them into assholes. In a 1965 interview, Allen Ginsberg (who wrote his classic poem "Kaddish" on a three-day speed bender) took pains to make distinctions between meth users and users of other drugs, saying: "All the nice gentle dope fiends are getting screwed up by the real horror monster Frankenstein speed freaks."
There is still some reason to temper broad claims--and they've come from some unlikely quarters. In 1999, the National Institute of Justice, which is the research arm of the U.S. Department of Justice, released a study that looked at the drug history of and criminal charges filed against 7,355 adults arrested in five western cities, including such meth hotbeds as San Diego and Portland. Contrary to the conventional wisdom, the study found that just 16 percent of arrestees who had used meth were charged with a violent offense. Among non-meth-using arrestees, that figure was 28 percent. The explanation of the study's authors: "The popular press has sensationalized cases in which violent acts occurred when the suspect was under the influence of meth."
Then again, Hitler received daily injections of methamphetamine from 1942 onward. Maybe Ginsberg was right after all.