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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 * * * ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn