Oklahoman Online
Treatment advocate has seen addiction
2001-07-15
By Tom Lindley and Penny Owen
Staff Writers

Bill Crowell didn't set out to become the state's most outspoken
advocate for substance abuse treatment. It just happened.

First, there was heartache -- the painful realization that both
of his children were addicted to methamphetamine
and that he couldn't help them.

Crowell eventually dug himself out the best way he knew how,
one textbook at a time.

"I wanted to know what I had done wrong and what it was about
the way that I raised my kids that caused this," he said.
"We were church attendees and said the right prayers.
My kids were raised in little league baseball, took dance
and piano and played the flute, so why my kids? Why me?"

That was 18 years ago. Crowell, who at the time was a physician,
pathologist and medical examiner for Grady County,
went back to school to learn about addiction. Along the way,
he obtained a master's degree in chemical dependency
and became an internationally certified alcohol
and drug counselor.

"My deal is education," Crowell said. "My grandmother on my
mother's side couldn't read or write and marked her name
with an X. My mother said, 'You can do better.'"

Now, Crowell is putting his passion and knowledge to use
in an attempt to convince the public that substance abusers
should be treated, not stigmatized.

"As a pathologist, I know people are dying out there
from drug addiction," he said. "I see the bodies when they do.
I see the bullet wounds and the blood on the wall."

Crowell knows he is dealing with an unsympathetic public
on one hand and addicts who refuse treatment on the other.

"People think people who use drugs are going to hurt other
people, and they want to avoid being hurt," Crowell said.
"The use of chemicals goes way back to before I was born
when people thought they could stop that kind of behavior
and that those who were dependent had less morality,
less ethics and were lower class, whatever that means."

Addicts, meanwhile, fail treatment
two, three, four and even five times, Crowell said. Many can go
from a 30-day outpatient treatment program right back to using
meth or their drug of choice, and the relapse rate among meth
users is among the highest.  Crowell defines chemical
dependency as a pathological relationship with a mood-altering
substance where there is an anticipation of a rewarding experience,
meaning that the addict can get "high" at the mere thought
of using a drug.

"The challenge is how do we get to a point in treatment
where that doesn't happen?" Crowell said. "The contradiction is
that we don't know the genetic aspects of how proteins are made
by individual cells and what genes or multiple genes are involved
in the creation of proteins, which means we don't know about all
the proteins that are made in people with chemical dependency.
Until this basic research is done, we can't amplify our knowledge."

Kathleen West, director of the Drug Endangered Resource Center
and Clearinghouse in Los Angeles, said they have been studying
the long-term effects of meth addicts for years  and
there is still much they don't know.

Meth depletes the brain of dopamine, the chemical that promotes
a sense of well-being. Researchers have reported that as much
as 50 percent of the dopamine-producing cells in the brain can be
damaged after prolonged exposure to relatively low levels
of methamphetamine, according to a National Institute
on Drug Abuse report.

Worse, the damage can be permanent. West said the younger
the user, the more complete the damage.

Although after time the brain may start producing dopamine again,
it never seems to reach pre-addiction levels. How long it takes
for the brain to partially recover depends on the person's
biological makeup, with no way to tell who will recover
at what pace.

Another fear, though unproved, is that the epidemic of meth users
today will create an epidemic of Parkinson's disease victims
tomorrow.

Parkinson's is an incurable disease that is related to dopamine
depletion in the brain, which is the same effect that meth has.
The disease causes uncontrollable tremors, loss of balance,
speech and so forth. It generally strikes older people,
but with so many young users and exposed children,
West said the potential for young Parkinson's victims
is a big concern.

"It's a huge cautionary tale for all of us," West said. "We do not
want to see Parkinson's disease in our 30-year-olds,
nor in our children."

How fast and permanent brain damage is from meth depends
on the individual person. So does the recovery
and it isn't about who has the strongest will to stay clean.

Some former meth addicts have experienced psychotic breaks
several years into their recovery, with full-blown bouts
of paranoia and hallucinations. Why, no one knows.

Crowell believes it will be 20 years before science is able
to identify who is at risk of being a substance abuser,
but he knows society can't wait that long to address the problem.

His solutions include increasing the number of counselors
and doubling the number of beds in chemical dependency centers,
establishing parity in insurance coverage where insurance
companies set the same rates for coverage for substance abuse
as they do for mental health treatment, increase the length
of treatment of people with meth addiction and encourage
long-term residential treatment instead of outpatient treatment.

"To treat the disease with counselors would cost a dollar,
maybe $2, per person in the state on a monthly basis,"
Crowell said. "That's a small amount."

But Crowell suspects that the drug addiction program
will have to devastate even more families before public
opinion changes.

"When it's your family, it's hard to conceptionalize what you
were taught with what the reality is," he said. "I remember that
people wouldn't talk about my kids. They'd talk about theirs
but not mine."

Crowell said he believes most families who deal with addiction
have a philosophy similar to his.

"Those who bear the mark of pain are never really free for they
owe a debt to the ones who still suffer," he said.

SOURCE: The Oklahoman Online
http://db.oklahoman.com/cgi-bin/show_article?ID=719711&pic=none&TP=getarticle

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