A successful attack on the meth problem requires a three-pronged approach. The frontline of the attack on meth is enforcement. Law enforcement officials vigorously seek out clandestine labs, identify cookers and dealers and devote considerable resources toward the meth problem. State and federal prosecutors have taken a firm stance and have successfully put many meth manufacturers and distributors in prison for long periods. Arrests and prosecutions are visible and hopefully deter meth users from further involvement and cause other involved participants to rethink their involvement. Although the arrest and prosecution of meth violators has been successful, a comprehensive strategy must involve prevention and treatment, the second and third prongs of the approach. If new cooks and users replace those sent to prison the meth problem will not only persist but also grow in magnitude. Some convicted cooks claim to have shared their "skills" with 60-100 meth users.
Prevention simply means dissuading initial involvement. The ageless cliché in criminal justice is “ an ounce of prevention is better than a pound of cure.” Literally, it means it takes fewer resources to stop people from initially using the drug than it does to suppress well-established patterns of abuse. The current project, MEDFELS, is structured toward prevention. Our premise is that grade school children should be familiar with the dangers associated with meth and families, schools, community organizations and criminal justice officials need to continuously reaffirm those dangers. One- time prevention measures or prevention strategies introduced after behavior patterns have been established have a reduced potential for success. The Demand Reduction Division of the Midwest High Intensity Drug Trafficking Area (HIDTA) is dedicated to prevention through education. The prevention program presented here is one of many developed by and for HIDTA in recent years. There are programs available through the Internet and CD Rom as well as through traditional class lesson plans and handouts. HIDTA has successfully developed age relevant programs to meet the varying needs of its constituency, ranging from elementary school students to parents, teachers and interested community members. If you are interested in acquiring more information about these programs you can contact Midwest HIDTA at (816) 746-4911 or http://www.whitehouse.gov/ondcp/high-intensity-drug-trafficking-areas-program
Meth prevention should attack the perceived positives of use. We encourage you to refer back to the section on meth-related costs. Some meth participants rationalize that their use or involvement doesn’t really hurt anyone but themselves. Others are motivated by the financial gain. Is the decision to cook meth rational when one considers the health risks and the extensive prison sentences associated with manufacturing meth? Meth prevention programs provide non-participants with the necessary information to make rational decisions.
A second part of the prevention strategy emphasizes reinforcing positive behaviors. This strategy feeds off attacking the so-called positives. If using or cooking meth results in negatives than what are the positives to be gained from refraining? The answers, although relatively straightforward, need to be constantly reinforced. There are a myriad of benefits associated with abstinence; better health, personal relationships, employment potential, and other quality of life issues. The public and particularly the younger public needs to be personally motivated toward abstinence.
A comprehensive meth prevention strategy should also alert citizens on where to turn. Are your children or your students aware of local, state or regional hotline numbers? Once they learn how to identify the symptoms of meth use or manufacturing they must understand who to relate that information to and that reporting suspected use or manufacture is appropriate.
A thorough program should involve schools, churches, families and other aspects of the community. Dare others to get involved. Inform friends, family members and classmates about the risks of methamphetamine use. Positive peer influence is one of the strongest prevention measures. Young people frequently participate in behaviors because their friends or family display the behavior. Make the peer influence positive rather than negative. The vast majority of citizens don’t condone meth use. Don’t let this become a “silent majority.” Constantly and consistently let others know that the disadvantages of meth use far exceed any perceived advantages.
Meth prevention programs also need to emphasize the role of “Gateway Drugs.” Current research on meth users indicates a history of substance abuse involving tobacco, alcohol and/or marijuana. Thus, one of the keys to meth prevention is to prevent the initial involvement with these three gateway drugs. Obviously all who use alcohol or marijuana do not become meth users. However, our research indicates that more than 80% of the offenders convicted of meth-related offenses report prior abuse of alcohol, marijuana or other drugs. While use of gateway drugs does not necessarily ensure progression to meth, avoiding these drugs probably ensures meth abstinence.
Unlike heroin or alcohol addiction, protocols for meth addiction are still in developmental stages. Dr. Richard Rawson and his associates have enjoyed some success in developing treatment programs for methamphetamine addiction. Meth addiction is a relatively new phenomena and our knowledge of the science of meth addiction and successful treatment strategies has not grown proportionately with the increased use of the drug. Progress has been made but the development, implementation, and evaluation of specialized meth treatment programs takes time. Some of the more successful approaches include; community reinforcement, contingency management intervention, relapse prevention, and network therapy. Presently there is not yet an affective pharmacological treatment for meth disorders.
The custodial status of the meth user may impact the treatment strategy. Users who are confined in jail or prison will obviously have little opportunity to obtain the drug. The lack of temptation does not necessarily diminish the craving despite the length of confinement. Meth addicts who are released on bail or probation or who seek voluntary treatment face the added pressures of interacting with other meth users and cooks and the availability of the drug. The appetite for the meth will be present irrespective of the confinement status. The ability to whet that appetite is easier if the users remains in the community and puts added pressure on treatment staff.
The successful withdrawal from methamphetamine use is predicated on a strong support network. Family members, friends, and co-workers need to support the withdrawal efforts and should be trained to read relapse indicators. The support team should work with counselors and must be vigilant and committed despite any relapses that might occur.
Like most other drugs, successful treatment for meth largely depends upon the commitment of the users. Commitment to methamphetamine withdrawal likely means some substantial lifestyle changes. Alcohol addiction counselors frequently refer to “new playgrounds and new playmates.” Regardless if it is a condition of bail, probation or parole, the meth user can’t associate with other users if he or she is serious about withdrawal. The physical and psychological craving of the drug coupled with the temptations from friends and peers is simply too powerful for most users to resist. Most counselors require the user to avoid all drug use and to disassociate themselves from drug users as much as possible.
Even after an initial period of withdrawal, the meth user may encounter behaviors or situations that “ trigger” the desire for the drug. One of the meth users we interviewed indicated recognizable progress until he smelled ether when having his car serviced. Another convicted meth user indicated simply driving past a club where she had purchased some high purity meth stimulated her craving for the drug. Quality treatment programs help users identify these “psychological triggers” and how to effectively resist the compulsion to revert back to meth use.
Counselors and addicts both agree that aftercare is extremely important. Many convicted meth users will be mandated to undergo periodic drug testing as a condition of probation and parole. Positive tests for meth may result in mandated treatment, imposition of the original sentence and/or a modification of probation or parole conditions. Properly conducted aftercare extends beyond chemical testing for continued drug use. It incorporates participation in support networks, home visits, attention to relapse indicators and continued commitment from the meth user. Quality aftercare requires time and resources. Unfortunately, many treatment centers are understaffed and are unable to deliver the necessary aftercare for successful meth treatment.