The New Normal: Meth, Treatment, and Addiction

Multiple Agencies And A Singular Problem

Meth is a problem in Lake County. Meth is a problem on the Flathead Indian Reservation. The drug has a reputation among everyday citizens, law enforcement officials, and professionals who deal with the aftermath—both directly and indirectly—as an ongoing problem. National campaigns against the drug are launched. Task forces are created and dispatched. The consequences are known; it's highly addictive. An overall awareness has been reached that a meth user's physicality can change; their mental health can deteriorate. Help isn't necessarily on the way, though.

“All of us are short-handed,” Don Bell, Lake County Sheriff said, speaking of the time and effort spent combating the consequences of the drug in Lake County. His job is to watch over the 1.3 million acres – both on the Flathead Reservation and the County. Before being elected Sheriff and taking office Jan. 1, 2015, Bell was a tribal police officer for over 20 years. He knows the meth problem well and has many years of experience working as a member of the Salish Kootenai Tribe.

“The problem is multilayered,” Bell said. For example, if two people, both parents, are arrested (which is not uncommon), that means Child Protective Services needs to be involved, which draws on tax dollars. “I think the maternal aspect is there – they still love their kids,” Bell said. “But the drive for drugs is so strong; it sometimes overshadows their kids.” Bell wants to see more treatment options so the County doesn’t have to depend so much of the draw of tax dollars. [NOTE: Lake House, a mental health facility in Polson opened in December 2015.] If they are going to be a draw on tax dollars, Bell believes it would be more helpful to help them get treated, to get jobs and return to some sense of normalcy. “They become part of the fix,” Bell said.

The problem of policing meth use and subsequent prevention and treatment requires support from the state and federal levels. Money that is hard to come by, even with progress being made. For instance, when Bell worked as a Tribal officer, much effort was spent cracking down on the manufacturing of meth and shutting down labs. As of this year, it is rare for them to hear about meth labs in Lake County, according to Bell. However, now the drug comes from out of state mostly, and Bell believes most can be traced back to Spokane, Washington to the west, among other areas in every direction. “Most [of the drugs] are brought in,” Bell said. “We need to make it not so accessible.”

With limited treatment options in Lake County, drug users and addicts are often recycled through the system. “There’s a high chance with no treatment,” Bell said, “they are going to go back to doing what they were doing before. It starts that same cycle.”

The jails are full, there’s no way around that. “We run at max most of the time,” Bell said. As a result, people arrested for possession of methamphetamines are sometimes returned right back to the streets because of overcrowding. This is not because law enforcement can’t prosecute them, but it also deals with the simple logistics of testing the drug to get a confirmation it is indeed meth to be used as evidence. In the past, getting the drug tested took an average of a year’s time. Demand is high at the crime lab, straining the resources of the state.

“There’s a choke point,” County Prosecutor Steve Eschenbacher said. “How many technicians they have and how many samples can be analyzed. It’s all done in Missoula.” Eschenbacher is a former public defender, which gives him a unique insight into the problem in Lake County. Last year his office filed 204 felony cases. Most were drug-related. This year, he estimates 450 cases being filed. “We’re catching more people. We’re getting rid of the backlog,” Eschenbacher said. It’s important to note that this influx of new case filings does not properly reflect a rise in meth usage, but that the shorter turnaround at the crime lab allows his office to prosecute more offenders and rid the court of older cases. Even with a backlog of cases slowly dwindling, there is still the logistics of what to do with a convicted meth addict.

Not only are the jails full, but when meth samples are sent to the crime lab to be tested and used as evidence, the process can take as long as 2 to 3 months to get a confirmation. This turnaround helps, but there is still a gap. During that time, the persons arrested return home because they cannot be charged. Possession of meth is not the only crime that city and Tribal officials deal with on a regular basis. “Because they are addicted,” Eschenbacher said, “They are going out and creating all these other crimes. Usually burglaries.”

It is not uncommon for law enforcement to arrest that same person two or three more times before the first results come back from the crime lab in Missoula. Thus, the cycle continues into a pattern of criminal activity with very little consequences to the user. Meth users know this and exploit the system. They know how the system works. “Word gets around fast, it’s not hard to figure out,” Eschenbacher said.

The subject of treatment is where it gets complicated. Whereas law enforcement can use evidence for conviction, law enforcement cannot predict what treatment is needed. Everybody has a different need. Furthermore, this is one explanation as to why money is so hard to come by; the Tribes and the government need to be able to predict how the money will be used. Treatment is just as unpredictable as the addict is unpredictable. It will require a lot of leeway. Leeway the State is not prepared to give at this moment.

“The trouble is, there are so many different levels of treatment,” Eschenbacher said. “I would like to have a treatment center. I would like to have a residential treatment center, because in that way we can keep the people closer to their family and friends.” The flipside of that, he said, is that being with the same people will often contribute to the same problems of being addicted in the first place. As a former public defender, Eschenbacher knows the problem and what can happen to common everyday people when they become addicted to methamphetamines.

“I remember in [another] county, where a woman had been using meth and demanded her boyfriend come into the bedroom. He was playing a video game and didn’t come into the bedroom quick enough, so she took a pistol and shot out the window, trying to get his attention. That’s how bad her judgment was.”

Treatment is a viable option for meth users, and can reinstate a person back into society. Just last week Eschenbacher ran into an old client from his public defender days. This person was off of meth and doing well. “He had gone through treatment, and is now training to be an addiction counselor,” he said.

“There is hope.”

A Treatment Disorder

Meth is cheap; treatment is expensive. On the Flathead Indian Reservation and in Lake County, seeking help for addiction is not a viable option due to overcrowding or lack of resources. The system perpetuates the problem, according to two addiction professionals in Polson.

Jay Brewer and Carol Azure both know about addiction. They work at Western Montana Addiction Services in Polson. Brewer is a licensed addiction counselor and Azure is a prevention specialist. They alternate between being frustrated by a system that has no place for addicts and being motivated by what they see on a daily basis. They are fighting to give addicts a chance at a normal life.

[NOTE: Azure no longer works with WMA.] Brewer has seen it all. As a former addict in recovery for over 11 years, he sees the problem of meth as an everyday reminder that the criminal justice system is overwhelmed in the spectrum of law enforcement and addiction counseling.

“Our jail is a warehouse for addicts and alcoholics right now,” Brewer said. Brewer is a counselor in a level-one program in Polson. He is equipped to deal with out patient care; there are no in patient beds in Lake County or on the reservation. People come to Brewer one of two ways: either they are arrested and “forced voluntarily” to come see him by the court, or they come to seek help. “This is as low as it gets,” Brewer said, referring to the level of treatment Lake County currently offers.

When someone comes through the Western Montana Addiction Services doors, he or she is given an evaluation to determine the level of substance use disorder. “There are three types: mild, moderate, and severe according to the DSM-V standards,” Brewer said. In his experience, very few are classified as mild or moderate. “Most on the reservation are severe.”

“We’re killing ourselves,” Azure said. She’s full-blooded American Indian and believes the Tribal authorities cannot easily control meth. “We’re killing ourselves with alcohol and meth,” Azure said. She herself has seen the effects of drug addiction in her own family. In her experience as a prevention specialist, she sees the problem as one that keeps perpetuating itself and will continue to get worse unless something is done. “It’s a causality loop.” Azure said. “You just keep going around and around and around.”

Brewer and Azure agree meth is easy to get on the reservation and in Lake County. “Meth is wherever you go,” Brewer said. “Most of them use it to escape – an emotional reason.” Brewer is a half-Indian and half-Hispanic, and sees both cultures that are “close-knit in family.” On the Reservation, he said, people who grow up must ask themselves: what are the goals? What am I going to do for a job? The debate becomes an internal struggle between staying and leaving.

“Usually the matriarch doesn’t want the kids to move off the reservation,” Brewer said. “Even though if they move off of it, they have a better chance of being successful in life.” Brewer said young people who grow up here are enticed with housing, education, employment, and healthcare. “They dangle carrots to keep you here,” Brewer said. These offerings are persuasive and effective – seen as a solution to the debate of staying versus leaving – but ultimately produces stagnation, no matter how well intentioned. “They get stuck,” Brewer said of people who receive such benefits after time has passed.

Azure continued off of Brewer’s estimation – young people, old people – all get bored with limited opportunities or “nothing to do.” She said it’s easy to see why people use drugs. “They’re going to get it, find it,” Azure says of meth and alcohol. “Meth does not discriminate.”

Brewer and Azure are faced with many dead ends concerning treatment. The resources are limited to help with the problem of meth on the reservation and in Lake County. For example, if someone gets arrested and let go – a common occurrence here – they come Western Addiction Services to see Brewer, as ordered by the court. Brewer will then do an evaluation. If he or she meets the criteria of having a substance disorder, Brewer starts the “mountain of paperwork and red tape” to get them admitted to a bed facility, the Montana Chemical Dependency Center (MCDC). Once the paperwork has been filed, there is a 6 to 8 week waiting list. However, Brewer says, once that time period has elapsed and the person hasn’t used drugs for that time period, they are no longer eligible for treatment. “Isn’t that crazy?” Brewer asked. “It’s crazy.”

“I’m used to people lying to me about their drug use,” Brewer said, from his experience as a counselor. But here – here on the Reservation drug users are truthful. “They know probation can’t lock them up. They can’t go to jail.” It’s a Catch-22, Brewer said. Another option would be a private facility, but the costs are extremely high. And they also do not admit people without insurance, a common aspect of someone who is poor living on the reservation. Private care is out of the question for most people seeking help.

“Is the population going to be here in 20 years, if nothing changes? Brewer asks, speaking of the continual problem of meth and what it does to both the reservation and Lake County.

Brewer and Azure both agree a treatment facility is needed in Lake County now. They think as an investment, it will be beneficial for the long term. Brewer thinks a 40-bed facility would be a good start to reducing the problem the legal system faces, not to mention citizens who become drug addicts. If the Tribe is not willing to do anything, then the government should step in. “Treatment is not cheap,” Brewer said, but he also notes: “It does not cost $75 - $100 million dollars to build a facility.” Otherwise who picks up the bills? “The taxpayer,” he said.

Brewer has other ideas too. A drug court would be beneficial here, he said, an entity where legal professionals and law enforcement deal with the needs and demands of dealing with non-violent drug offenders. In addition to this type of attention, Brewer would like to specialize in treatment that would keep the tribes in mind. He calls it “Wilderness Therapy.” He envisions a level of treatment where American Indians work their way up to a point that they’d be able to go on a trip – a trip to finalize their treatment, a type of graduation to illustrate how far they have come since being addicted. “It’s something to look forward to,” he said.

Otherwise, he notes, it will be more of the same destruction of societal and tribal standards. Something he sees all the time.

“It’s disgusting. A little 4-year-old sleeping on piss-soiled mattresses with no sheets and no pillowcases,” he said. “Food in the sink, dishes piled sky high; gnats flying around. And yet there are 500 syringes around the house the kid is running around with. That’s what we deal with on a daily basis here.”

It won’t be easy, but there’s a way out of drug culture. There is hope.

“You have to accept help. Let go of the self-will.” Brewer said. “Otherwise you are putting the rest of us in danger.”

No Way To Profit From Addiction

The addictions among a small population are very expensive problems. The criminal justice system here is displaying signs of exhaustion. Speak to law enforcement and they will tell you: the jail is full. Speak to the prosecuting attorneys and they will tell you: most of the cases are drug-related. Speak to addiction counselors here and they will tell you: treatment is not a viable option. Law enforcement (both Lake County and Tribal), prosecutors, and counselors are a small minority that deal with a energy-consuming problem of prevention, policing, and treatment of people they designate as “addicted” to meth.

Addiction is difficult to diagnose. What makes a person “addicted” to a drug? People commonly use the word with other associations, such as Netflix and chocolate. A common phrase has even entered social activity concerning the former: “binge watching” refers to Netflix users sitting down and watching an entire season of a TV show over the course of a few days. “I’m addicted to this show,” a person might say.

Does that logic mean TV shows produce a loss of free will? That the TV show is so good or addicting that a person cannot control his or her self? Drugs are different, is the common thinking, especially methamphetamines. Consider the Montana Meth Project, the state’s most visible anti-meth campaign focusing on fear tactics as a way to thwart any interest in the drug. They are responsible for the famous phrase, “Meth: Not even once.” Their website lists a study in which research shows creating a sense of fear and disgust toward the drug and its societal effects is a successful and quantifiable way to manage the drug’s reach among teenagers and children. Meth use itself is down considerably in those areas, perhaps due to the Montana Meth Project’s singular efforts.

According to a 2009 Montana Meth Project report presented to the Attorney General’s office, the economic impact meth has on the state is significant. It estimates 50 percent of inmates housed by the department of corrections is a result of methamphetamine convictions – using, making, trafficking, or selling. Although that figure is from 2007 cited in the report, it meshes with the population (perhaps more so) here in Lake County and on the Flathead Indian Reservation. It’s interesting to note that in their studies and calculations regarding economic impact of meth on the state, it omits the seven Indian reservations in Montana, further separating the twin worlds of meth addiction in the county and the reservation. The problem is the same, but the identifiable markers and data are different, so it would seem. The Montana Meth Project often describes meth addiction, it’s subsequent economic costs, and it’s nature as “unique.”

As an example of this “unique” nature of meth, it estimates that in 2008 it cost Montana $11.9 million to care for children removed from their homes and placed in foster care. Although is figure is dated, it illuminates the huge expense to Montana and by extension, here in Lake County and on the Flathead Indian Reservation. The report is the most recent study on the effects of meth in Montana, ultimately estimating (through various studies accumulated by the state) that in 2008 meth use among citizens cost $208.3 million.

In 2011, the National Drug Intelligence Center (within the Department of Justice) published its “Drug Market Analysis” of the Rocky Mountain High Intensity Drug Trafficking Area. It states that although meth production is down in the larger area surrounding Montana, Colorado, Wyoming and Utah, the drug is being imported from Mexico. Production is down in Montana, as well, and now it is imported from outside the state and arriving in a continuous stream in places such as Lake County. Meth has a high availability rate in the states listed. Furthermore, meth is one of the main reasons for admitting drug-related treatments to publicly funding facilities in the Rocky Mountain area.

Locally, there are no treatment facilities in Lake County or the Flathead Reservation. James Lopotka, deputy prosecutor for the county, works mostly with drug-related cases. He sees a growing population and growing problem concerning meth that has become difficult to manage. The county has a specific task force to help with the problem of drugs.

“The treatment options available in Lake County are somewhat limited,” he said. While low-level outpatient help is administered to people who are convicted and some who seek to stop taking meth, the effort simply cannot meet the demand that he and his colleagues experience.

“For a lot of people who are using methamphetamines intravenously and have a substantial addiction problem,” he said. “That simply isn’t enough.”

Intelligent and soft-spoken, with a careful way of presenting information, Lapotka asserts that research and data can offer help to law enforcement to manage offenders convicted of drug crimes.

“The county attorney’s office is committed to exploring science-based alternatives that would reduce drug use and recidivism,” Lapotka said.

Lapotka believes now is the time for he and his colleagues to discuss alternatives to just jail being the primary reaction of the court. He’d like to see a type of “day center,” where former users can enter and leave with relative ease, while stressing a sense of normalcy. “We have the population to support it,” he said. For example, a person charged with a crime could enter a plea bargain for probation. As part of that probation, this person is required to drug test frequently as a way the county can hold that person responsible to the order of the judge.

Distinguishing which defendant needs help and which defendant needs jail, is difficult to figure out, he said. It’s relevant to research that person’s criminal history. Before every drug-related case, his office researches the background of the person charged. It’s called a “Pre-sentencing agreement.” Personal details are sealed under law, but he reveals that these histories are often very important in gaining an understanding of each person. “Every defendant is different,” he said. His office recommends what type of sentence is issued. Although his office and the judge might not always have the same sentence in mind, he and the judge are of the same opinion and aim: fairness and accountability. “The judge is the person who ultimately makes the sentencing decisions.” Montana has flexible sentencing decisions, which helps to consider the variety of offenders, especially drug offenders.

“We’re all underfunded in this maze,” he says, speaking of law enforcement as a collective’s role responding to Lake County’s meth problem. And while in a perfect world, he said, people would get the treatment they need, he recognizes the tall-task that implies. Especially for a drug that is so “unique.” He realizes the out patient beds are being rationed for people that hold the most serious risk. “Because we have so few in patient beds, they are rationing that resource to achieve maximum benefit.”

One option that’s realistic to Lopotka is a drug court. It would require his office to apply for federal grants and present data to the right people, but could possibly get a manageable handle on the drug situation. What’s also unique about meth, it that other crimes are committed: property damage, abuse, violence, etc. Those circumstances move it out the strict philosophical realm of drug addiction and it’s effects. But a drug court might help alleviate the pressure. Lopotka says before even entertaining the possibility, law enforcement would need to agree it’s needed. “First thing we need is a broad consensus among everyone in the criminal justice environment,” he says. A consensus for a drug court is growing, slowly but surely. “We’re building it.”

Despite the jail being full, Lopotka can see a certain benefit to the immediate needs of physical withdrawals, which just might help someone a the right time.

“I like to see jail as a means to do immediate intervention,” he said. He’s seen many people get arrested and spend some time in jail and for them to come to the realization that they’ve been without drugs for the longest time since high school. It may not work for everybody, in fact possibly only a few, but still, he said, it’s useful. “It’s a valuable tool. They get a good kick start to being sober. It’s priceless.”

Portions of this Special Report were published in slightly different forms in April and May of 2015. It has been edited for length. —T.B.