METH AND DESTRUCTION, PART IV

As methamphetamine moves from the rural Heartland into American
cities, police, experts and health officials sort through their
toolbox for ways to fight the epidemic.

It's a challenge that can be seen from the darting eyes of recovering
users to the wringing hands of concerned community members.

But allowing use to spread unimpeded is costly to the public pocketbook.

More than 12 million people in the United States have used meth at
least once, estimated a U.S. Department of Health and Human Services
survey. More women now use meth than cocaine.

Despite its spread, methamphetamine remains a rural drug in much of
the country.

Take Maryland, where meth use is most common in the state's western
hills, said Vern Conaway, commander of drug enforcement for Maryland
State Police.

Clubgoers in the Baltimore area use crystal meth and ecstacy, two
forms of methamphetamine. But Conaway said the most common profile of
a meth user in Maryland is a middle-aged employed white male of low
to moderate income who lives in rural parts of the state.

Caught Med-Handed

Retailers faced meth-related costs after pseudoephedrine, a legal
cold medicine ingredient, was targeted for its role in producing
meth. Some retailers were concerned about convenient access to the
products. A wave of state regulations restricted sale, but some
companies did not wait for the laws before they made changes.

In February, Pfizer, the maker of Sudafed, launched Sudafed PE, a
decongestant that uses phenylephrine instead of pseudoephedrine. The
similar drug is not used in meth labs. Erica Johnson, a Pfizer
spokeswoman, said the company responded to the problem of its
products being misused, not the tide of state laws. Pfizer continues
to market both types of Sudafed.

Target stores took pseudoephedrine behind counters at pharmacies,
though it means only locations with pharmacies can sell the medicine,
said Brie Heath, spokeswoman in Minneapolis. By July, the policy was
implemented in all stores.

But at Walgreens, change came after it was required by state law, not
before. And the price tag was more than $2 million.

The Challenge

The search for solutions is not an easy one. Meth is a sticky drug,
not for its (mailto:newsroom@itemonline.com)texture so much as its
chemical and social effects. It sticks to the places and people that
it contacts.

Its toxic residue seeps into the carpets, permeates the walls and
remains in the vessels where it is synthesized. Gases get into
building materials - even concrete, which has to be chipped away and replaced.

And recovering users have suffered permanent damage as brain cells
are left with altered nerve endings that do not regrow, according to
the National Institute on Drug Abuse. The brain also suffers
irreversible blood vessel damage that puts users at higher risk of
strokes, even years after quitting meth.

Connecting Experiences

Efforts to combat meth use have ranged from restricting the drug and
its ingredients to educating the public and expanding treatment.

The greatest gains could be made between public education and
potential users' personal experiences, said David Rosenbloom,
director of Join Together, a project of the Boston University School
of Public Health.

"The biggest dent is going to get made in people figuring out just
how bad this stuff is," Rosenbloom said.

Judges in the western United States, where much of meth's early use
occurred, told Rosenbloom it was an "economic drug," he said. People
who work extensive hours in two jobs often use the drug to stay
awake. Rosenbloom reasoned that a higher minimum wage could be
another weapon against meth use.

Drug Courts

Economic pressures to use meth can be seen in Dalton, Ga., said
Philippa Maister, spokeswoman in the Administrative Office of the
Courts in Atlanta.

Many work long shifts in Dalton, known as the carpet capital of the
world for its manufacturing specialty.

The community's drug court has a higher proportion of meth users than
its counterparts around Georgia, Maister said. But meth has not been
around long enough for the state to have measured the users' success
rates in drug courts.

But the results elsewhere have been much better than what came
before: locking up drug addicts in jail, where many returned soon
after their release.

Uncooperative users can be diverted for criminal sentencing. More
successful participants graduate back into society.

Judges, elected officials and recovering meth users often emphasize
the courts are not a soft on crime, get out of jail free card. And a
year in drug court costs less than one-fourth the price of
incarceration, according to Georgia's Administrative Office of the Courts.

The success rate for meth users in drug courts rivals the overall
success rate, according to Terry White, fiscal analyst for the
Oklahoma Department of Mental Health and Substance Abuse Services.

Meth users enter Oklahoma's drug courts earning lower salaries than
marijuana users - but they graduate earning more than graduating
marijuana user, a 173-percent increase.

Helfrich said incarcerated meth users who do not receive treatment
return to society "still an addict and they're just a better criminal."

Treatment programs for meth users will see the greatest success if
they offer cash rewards for clean urine tests - prizes even as small
as $1, according to a recent study. Results were published in the
October 2005 issue of Archives of General Psychiatry.

Legal Efforts

After its strict pseudoephedrine law took effect - putting Sudafed
and similar cold remedies behind pharmacy counters - Oklahoma saw a
downturn in meth labs seized by authorities. Drug agents along the
state's borders said in a recent survey that meth cooks were taking
home most of their key-ingredient pseudoephedrine from other states,
and most of it was locally bought before the law change.

A cascade of similar laws followed, sweeping through state
legislatures and landing in Washington this year.

Pseudoephedrine retailers are not required to keep logs or check them
to see if a customer has already bought the limit.

Strict pseudoephedrine laws in Oklahoma and Texas have been answered
with waves of imported meth from Mexico. Made by large operations
instead of in small home labs, the new meth is often pure enough to
be called "ice" - 90 percent purity or higher.

In the first eight months of 2005, 60 percent of meth seized in Texas
was ice, said Michelle Deaver, spokeswoman for the Drug Enforcement
Administration's Dallas Field Division. The previous year, 25 percent
was pure enough to be called ice.

Some law enforcement departments are using freed resources after the
decline of homespun meth labs to pursue large drug syndicates.

But the failure of pseudoephedrine laws to reduce use of the drug
points to alternative solutions to address the scourge. In Kansas,
some coalitions between local governments and community groups draw
training and funds from Prevention and Recovery Services, a
Topeka-based nonprofit.

Cristi Cain, coordinator, said a central role of the group is helping
drug-endangered children.

A grandmother called her on a recent Friday morning to seek help for
her grandson, a 3-year-old whose mother cooks meth.

After they are identified, endangered children need to be
decontaminated from chemical exposure and treated for disorders.

PARS also trains retail workers to spot meth cooks by their
pseudoephedrine purchases and trains farmers to lock up their
ammonia, another ingredient.

Solving the meth crisis takes more than one strategy. The program's
solutions are most effective in tandem, she said.

"It really has to be a comprehensive approach," Cain said. "Just
doing one thing probably wouldn't have much effect."