Treatment specialists estimate relapse rate of 60% to 95% on first attempts to stop use of drug; strong support essential to recovery

Randy Martin with the Pride Institute said that recovering addicts need to know that they have a network of support to turn to, and that they do not have to “go it alone” in their efforts to kick the crystal meth habit

This is the second part of a two-part series that began in the May 12 issue of Dallas Voice.

Sebastian sits restlessly at a sidewalk cafe in Uptown. The restaurant manager in his mid-20s chain smokes and downs a large cup of coffee, his jumpiness diminishing as he talks about life during the six years he used crystal.

"It'll be two years this June," said Sebastian (not his real name), referring to the last time he used. His tone conveys a degree of self-amazement at the accomplishment as he adds, "It's been hard, but it's been worth it."

He said he never touched drugs before being introduced to them at 19 by his second boyfriend.

"I can't blame him," Sebastian said. "It just happened to be there, and it looked like fun. Of course at first, it was wonderful."

He started off using cocaine, but eventually made his way to ice, a very pure and highly potent form of meth.

"I found heaven with ice," he said, describing the euphoric high he lived on for years.

At first he only used on the weekends when partying. But later, when a three-year relationship ended, Sebastian turned increasingly to ice so that he didn't have to feel any emotion.

"At the height, it was a Tuesday through Sunday thing," he said. "I was off on Monday, and I would do ice the entire week to sustain that energy. Then Sunday night came around and I would crash and sleep all day Monday, until it was time to go to back to work on Tuesday. It took over everything. I didn't want to sleep or eat, I just didn't want the party to end."
As his addiction became stronger, Sebastian needed more and more crystal to maintain his high. In the beginning, a quarter gram lasted him a week. In the end, when he was using five days a week and sharing with a boyfriend, the same amount lasted for just one night. He was spending about $200 a week on the drug.

With so much of his money going toward the drug, Sebastian was evicted from five apartments

over a two-year span and was barely able to hang on to his job.
Sebastian is amazed now that he is not HIV positive.

Dr. Dhiren Patel

"During those six years, I never had protected sex," he confessed. "When I got sober I went and had my first HIV test and I couldn't believe it came back negative. Logic suggested I should have it because of all the shit I had done."
Like many addicts, Sebastian said he used drugs to fill a void. Raised in a devoutly religious household, when he came out he lost all of his relationships with friends and family.

"When I started using, I found this network of people who I thought genuinely cared about me. When you're on it, you feel like nothing can hurt you. You don't give a shit about what people think of you. You don't care that you don't have your family because your friends are now your family this drug is now your family."

Road to recovery
It's that psychological chokehold that the anti-drug forces are battling against with meth. And though new treatments hold promise the war is far from over.

"This problem is real and it's affecting people all over the country," said Randy Martin, director of the Dallas/Ft. Worth chapter of the Pride Institute, a GLBT chemical addiction recovery organization.

Martin said over the last five years there has been a significant increase both nationally and locally in the number of users in outpatient and inpatient meth treatment programs. While alcohol remains the No. 1 substance for which gays and lesbians seek treatment, followed by crack/cocaine, meth has advanced to the third most commonly treated addiction, he said.
The road to recovery isn't easy. It's littered for many addicts with broken self-promises and too much regret.

Despite considerable debate within the medical community over the numbers, it's generally agreed that between 60 percent and 95 percent of meth users who first attempt to quit the drug end up relapsing. According to a report prepared by Row Sciences Inc. in 2000, those who do not drink alcohol or smoke marijuana have a 60 percent chance of staying off meth after one year of sobriety. For those who do drink or smoke pot, the odds of staying sober drops to 10 percent.

Martin knows the odds are tough for users to face, but he adds that treatment works, if they accept help.

"People need to know that there is tons of support for recovery and this is not a "'go it alone' thing," Martin said. "We need to make them free of the shame that surrounds this. It's very important that they understand that this is a disease that has taken hold of their lives, but there is plenty of support for helping them take their lives back."

Starting over
Getting the right help can be difficult for some users. Unlike heroin and other drugs, meth detox is not considered life-threatening. Therefore, Martin said, many health insurance plans will not cover inpatient treatment unless the user is experiencing psychotic episodes that make them a danger to themselves and others.

In such cases, he said, treatment centers can argue for inpatient detox.
Some health plans will pay for inpatient meth treatment; several recovering addicts interviewed for this article reported that their treatment was covered.
Much of it depends on how good their plan is usually the decision of the individual's employer. But Martin said for the most part insurance companies are going to look to have the patient's recovery handled on a less costly, intensive outpatient basis.

"They are going to cover the treatment, but they are going to cover it at the level that is needed," he said.

Still, while recovering users do successfully kick the habit through lesser means, experts agree the most effective way to achieve long-term sobriety is through inpatient treatment.

During a detox period that can last up to four days, those in recovery experience a variety of side-effects including anxiety, sweating spells and nausea. Often they are overtaken by extreme exhaustion the result of so much expended energy and lost downtime during their use and sleep for unusually long periods of time.

Further complicating the process is the sometimes severe depression many experience. Since meth creates a significant continuous high, Martin said the return to what is a "normal" state-of-mind often feels like "the pits."
"It's really hard for them to cope with life as it is and overcome the cravings to be on that high. It's a lot of 12-step work, helping them deal with that depression, develop new coping skills to deal with life and not have to medicate to avoid it all."

On the physical front, recovering addicts should acknowledge that their use may have done lasting damage to their bodies, Martin said.
"We encourage people to deal more effectively with their health as part of beginning the process," Martin said. That includes everything from developing a regular exercise regimen and having a full physician check-up to getting tested immediately for HIV and other STDs they may have contracted while under the influence.

Some effects can be more visible. Dentists say what is commonly referred to as "meth mouth" is a growing problem.

The acidic chemicals in meth drastically reduce saliva in the user's mouth, which in turn breaks down tooth enamel. That, combined with a user's lack of hygiene when high and increased cravings for sugary foods and beverages, often leads to rapid tooth decay, one of the drug's more lasting and noticeable consequences.

Oak Lawn dentist Dr. Toby Petro said the number of recovering meth users he's treating has risen over the last six months.

"Very often we're dealing with severe decay, which means a number of extractions," Petro said. "These patients are facing a lifetime without teeth."
He adds it can take as little as six months for the drastic effects of meth mouth to take hold.

Finding support
Beyond the Pride Institute and similar treatment programs, there are other avenues for meth recovery. Meetings for Crystal Meth Anonymous, part of the 12 Step group of programs, began in Dallas 18 months ago. Sources say that, since then, meetings have increased from twice a week to five times a week, with attendance at single gatherings sometimes as high as 50 people.
"I couldn't have done it without the support of the meetings because I had to cut all my existing ties again," said Sebastian, who attended Alcoholics Anonymous meetings that helped him eliminate both alcohol and meth.
He drinks on occasion now, he said, but has not touched drugs: "It took some getting used to. I had to get comfortable with myself again."

Still, some say that despite meth's addictiveness and the danger users put themselves in, the mainstream recovery community has yet to put its full weight behind addressing the drug. That's because plenty of people remain addicted to far deadlier substances, said local physician Dr. Dhiren Patel.
"As long drugs like crack and heroin are issues, drugs that appear to have a less dramatic effect like meth are not going to get the attention needed to fix the problem," Patel said. In the meantime, meth use continues to climb and its grip on addicts' lives intensifies.

Martin said though some claim they can use meth "just for fun," eventually the drug takes its toll: "They may not lose their career or their home over meth, but it's still having an effect on their body in more ways than they might realize."

Back at the Uptown caf?, Sebastian talks about how much his life changed with meth, and how it's changed since. He has a good job and friends, and he's happy with the direction he's moving in now. But he believes he has permanent brain damage from the meth a lasting reminder of a horrible mistake: "I run into things all the time, even if I'm aware of them, it still happens," he said. "My jaw twitches when I'm in deep concentration or doing something that requires focus."

That someone can use meth in a truly recreational way is a fallacy, he said one he wishes he could convince others simply isn't true.
"I know people who say it's just for fun, but if it's every week, that's a problem. It may take time for some, but eventually it will take over," Sebastian warned.

This article appeared in the Dallas Voice print edition, May 19, 2006.