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The Meth Crisis: From San Diego to America’s Heartland


San Diego was once known as the "meth capitol of America." The author of the new book METHLAND joins us as we examine the progress of methamphetamine abuse across the USA.

MAUREEN CAVANAUGH (Host): I'm Maureen Cavanaugh, and you're listening to These Days on KPBS. Of all the substances that people abuse to get high, of all the illegal things people can become addicted to, methamphetamine remains in a class by itself. It's relatively easy to make, it produces an energetic, euphoric high and the ravage it can wreak on a human body has no equal. In fact, the devastation this drug can cause goes far beyond the individual addict. Methamphetamine has invaded many small towns in the heartland of America. Those areas already suffering from the collapse of manufacturing industries and dealing with unemployment and recession have been ripe for a boom in the meth trade. And, of course, San Diego has its own history with methamphetamine. In the 1990's, we had the infamous distinction as 'meth capitol of America.' And even today, the majority of people in drug treatment programs in San Diego are there to beat a meth addiction.

The story of how Meth got a foothold in America is documented in the new book called "METHLAND: The Death and Life of An American Small Town." It's my pleasure to welcome METHLAND'S author Nick Reding to These Days.. Good morning, Nick.

NICK REDING (Author): Hey, how are you?

CAVANAUGH: Just fine. Thanks for being with us.

REDING: Yeah, it's my pleasure. Thanks for having me.

CAVANAUGH: Well, I'd like to invite our audience to join the conversation. Is meth a problem we've conquered in San Diego? Or has it just changed locations and populations? You can give us a call with your questions and comments. The number is 1-888-895-5727, that's 1-888-895-KPBS. Nick, in your book "Methland," you say that in many ways methamphetamine is the most American drug. Can you tell us what you mean by that?

REDING: Yeah, you know, meth has a long history that people don't generally know about, dating back more than a hundred years but for much of that history it's been a drug that has been associated with the working class, whether it was given in large amounts to American soldiers during World War II, it was a factory worker drug in the '50s, '60s, '70s, and '80s. And I think the reason is simply that you don't have to eat or sleep and so working another shift is easier, so in a nation that I think has a particular mania for the idea of hard work and what it can get you, if that is a particularly American concept then that makes meth a particularly American drug.

CAVANAUGH: Now didn't methamphetamine used to be prescribed by doctors?

REDING: Yeah, and, in fact, pharmaceutically produced methamphetamine is a legal drug today. It's marketed as a number of things, Desoxyn is one of them, just produced by a company in Westchester, New York, for what it matters. And that's if you suffer from morbid obesity or narcolepsy, you would be given meth. And – But throughout the '60s and '70s, it was given to people, I mean by the millions and millions and millions of pills for – as a weight loss aid, as a depression drug. At one point, meth was supposed to cure alcoholism, so it's had a wide range of uses.

CAVANAUGH: Now how did it shift from the pharmacy to the meth lab?

REDING: In – It started out as sort of a miracle drug. And the problem, and this would've been back in the '30s, '40s, and '50s, and it was considered this miracle drug that would cure thirty-some-odd different problems. At the same time that it was being heralded as this miracle, there were studies being done suggesting that it had really bad side effects. So what happened is in the '60s, the government moved to make it prescription only. Well, there were millions and millions of prescriptions written and eventually, by the '80s, it was – the recipe for it kind of fell into the hands of people who were making it on the black market and that was the point at which meth as we know it, meaning not pharmaceutically produced meth but sort of clandestinely produced meth, that's when that part of the market developed and, of – and it took off because it was a lot cheaper than getting it by prescription.

CAVANAUGH: Now, Nick, in your book "Methland," you document the way methamphetamine has created havoc in the small town of Oelwein, Iowa. And I'm wondering, why did you pick that town, and what did you find there?

REDING: I picked Oelwein, you know, I always say for the simple reason that the people there would have me, and what I mean by that is, you know, this kind of journalism has to begin and end with characters and with people who are willing to be written about. And I found people in that town who were willing to be written about. It's not because Oelwein had the worst meth problem in the world, it's – it is not because there's more meth there than anywhere else. When I was doing this, I – I tru – I believe this is still true. If you throw a dart at a map of the United States, wherever it lands, it will be very easy to find the meth in that place, whether it's a small town or a mid-sized city or even a big city. You know, what I found in Oelwein, though, and this is another reason why I sort of picked that town is what I think is typical of rural America, which is a 30-year steep decline in industry and economy and a sort of vacuum into which meth moved. Oelwein just is exemplary of that.

CAVANAUGH: And there are tragic figures in your book and one of those tragedies is a man named Roland Jarvis. He was terribly burned in a meth lab fire. You say he started using meth, though, to do double shifts at work.

REDING: Roland was a meat packing worker and at one point there were 7,000 people that lived in Oelwein and 2,000 of them worked at the meat packing plant. So the principle source of revenue in that town was meat packing. And people made good money. They made at least a lower middle class living. And they had good benefits, they had health insurance, they had all these different things. Well, as happened everywhere in the meat packing industry, a bigger company bought it, disbanded the union, bye-bye went the benefits, wages dropped by two-thirds. And so Roland is a guy who had started using meth to work double shifts when things were good. When things went back, Roland looked around and said, well, I can either keep buying meth from somebody in order to work two shifts and make much less than I was yesterday or I can start making the meth myself, and that is a very common progression in the life of these places where people who are using it, in order to make a little more money become the makers.

CAVANAUGH: I'm speaking with Nick Reding. He's the author of the book called "Methland: The Death and Life of an American Small Town." And we're taking your calls and comments at 1-888-895-5727. One of the most remarkable people in the book is a woman named Lori Arnold. She…

REDING: Umm-hmm.

CAVANAUGH: She happens to be a sister of comedian Tom Arnold but for a short time she actually developed her own meth empire. Tell us about that.

REDING: Yeah, and – and Lori was one of these sort of – She was educated to the tenth grade but she just was sort of born with a brilliant business mind. I mean, it sort of took, I guess, an unfortunate form but Lori was largely responsible for bringing – for connecting not just her town in Iowa but the midwest in general with what, at the time, and this would've been in the late '80s, was this burgeoning meth economy in San Diego and Los Angeles. Meth was not making its way to the midwest in large amounts back then until Lori came on the scene.

CAVANAUGH: And what did she do?

REDING: She – she sort of – she started out getting a little bit from her brother-in-law and then she decided that it wasn't enough and so she sent her husband out to San Diego to – I'm sorry, to Los Angeles to connect directly with these nascent Mexican drug trafficking organizations who were just taking over the meth trade. And she just – she went right to the source and started bringing huge loads back to the midwest and then, unsatisfied with that, she actually started her own super lab on a horse farm in Iowa and for 20 years, it was the only super lab in production out – ever found outside of the state of California.

CAVANAUGH: And just to document how the allure and the – and how little else is going on in terms of opportunity in that area, when Lori Arnold got out of prison—because she was busted—she went back into business.

REDING: She did. And, you know, the thing that Lori was sort of able to do is, number one, she was able to take advantage of very lax laws governing the importation of meth's principle precursor. Number two, she was able to take advantage of a period in which, in her town, just like in Oelwein, people were either out of work or making only a third of what they'd been making, literally, the day before. Her town was another meat packing town. And – and people wanted to be doing a lot more meth so that they could work harder and try and stay afloat. But, you know, you have to understand, too, that when there's a big hit on the economy of your town like that, lots of things that we take as a foregone conclusion, like the high school staying in business or police officers retaining their jobs, when there's no tax revenue, those things are no longer foregone conclusions and so these places sort of become these kind of wild west sort of things where there's no money, there's very little hope, and there's not things like the number of cops that you need on the street to deal with stuff. So somebody like Lori puts all this together and she makes, you know, I mean, at one point, in a month, she was making ten times the median yearly income of an average person in that town.

CAVANAUGH: I'm speaking with Nick Reding and we're talking about his book, "Methland." We're taking your calls at 1-888-895-5727. And Paul is calling us from Vista. Good morning, Paul, and welcome to These Days.

PAUL (Caller, Vista): Thank you. I just have a question about nowadays. Do people these days, for their ability to continue in their jobs, use painkillers instead of methamphetamine and get prescriptions from different doctors for things like Vicodin and Norco or OxyContin, things like that? Is that what's being – is that what's happening now?

REDING: You know, the painkillers usage that I saw that was, you know, the heaviest market for that was amongt meth users who would use painkillers as a way to kind of lessen the – take the edge off of their tweak and, you know, in the same way that, I think, people used to use Quaaludes and cocaine, sort of, you know, uppers and downers at the same time or, frankly, for the same reason that people that I ran across, they would do a lot of meth and they would drink very, very heavily as they were doing it. I think just kind of – So that was, you know, that was where I saw it because, you know, a guy like Roland Jarvis was famous for at one point doing meth constantly for 28 days. He didn't sleep for more than 10 or 15 minutes at a time for 28 days. But at the same time, to kind of calm himself a little bit, he was doing a lot of OxyContin so – And when he was done tweaking and he couldn't fall asleep, he used the Oxy to sort of knock himself out.

CAVANAUGH: You know, Nick, we have to take a short break. And when we return, we'll continue to talk about the book "Methland," and we'll also hear how San Diego is dealing with its own meth problem. You're listening to These Days on KPBS.

CAVANAUGH: I'm Maureen Cavanaugh. You're listening to These Days on KPBS. My guest is Nick Reding. He's author of the book "Methland: The Death and Life of an American Small Town." I'd also like to welcome Susan Bower. She's Alcohol and Drug Services Deputy Director with the County of San Diego's Health & Human Services Agency. And welcome, Susan.

SUSAN BOWER (Deputy Director, Health & Human Services, County of San Diego): Thank you.

CAVANAUGH: And I'd also like to remind you that we are taking listener calls at 1-888-895-5727, that's 1-888-895-KPBS. Well, Susan, you know, as I mentioned at the beginning of the program, San Diego has been battling the meth problem for quite some time. I wonder if you could give us some history about methamphetamine use in this county?

BOWER: Certainly. Back in the mid-nineties, some researchers and folks in treatment and law enforcement and the health field started seeing some upticks and some scary things that they were seeing in the emergency rooms. Treatment programs were having lots of people come in with meth problems. So Supervisor Dianne Jacob took the leadership and established the Methamphetamine Strike Force in March of 1996, and brought together a group of about 40 individuals from a variety of disciplines really with a focus on integrating public safety with health services to create a comprehensive approach to address it. That group designed 17 different recommendations originally, encompassing a variety of strategies and, really, those strategies focused on four legs of a stool. One is about prevention, one is about treatment, one is about intervention, and one's about interdiction. So that everything we did was collaborative and approached it from a multi-system level.

CAVANAUGH: As I remember, just reporting news back in the 1990s here in San Diego, what – there used to be an awful lot of news stories about meth labs, largely in the east county, and there were lots of stories about San Diego being if not 'the' at least 'one of the' meth capitals of America. How has that profile changed here in San Diego?

BOWER: Well, since 1996, when the Meth Strike Force was established until now, we have definitely seen the demographics change over time. It's moved throughout the county. We see it in various parts of the county and various different cultural groups but we're really seeing it emerge as a drug of choice among women particularly.

CAVANAUGH: And why would that be?

BOWER: There's a lot of things about methamphetamine that may make it attractive to women, things about weight loss, things about increased energy, more so – feeling more social, and a lot of times it may be used initially to lose weight, a simple thing, or get everything done, and then they're sucked into the grip of the addiction and they just don't see what's really happening to them and their kids.

CAVANAUGH: And, also, isn't there an at risk population, gay and bisexual men as well?

BOWER: Yes, yes, very much so.

CAVANAUGH: What about the number of meth labs in San Diego County? Has that decreased?

BOWER: We've seen a significant decrease in the meth labs. One of the things that in the Meth Strike Force is we established a report card that tracks ten key indicators across a variety of areas and one of those areas has to do with meth labs. And so when we started with the report card and we started the Meth Strike Force back in the '90s, we had almost 70 meth labs in one year. And last year we were down to six – five, five or six.

CAVANAUGH: Wow, that's a big decrease.

BOWER: So it's really – it's really gone down.

CAVANAUGH: And I'm wondering, as you mentioned that San Diego with the Meth Strike Force, the task force, you have developed a multi-agency approach to dealing with meth. Can you describe how that works and why that's the best approach?

BOWER: It's an absolutely wonderful approach. So oftentimes you hear people say, we can't work in silence. With methamphetamine, it is such an endemic issue to San Diego that you can't prosecute your way out of it. You can't take down all the labs and expect it to be gone because you've got people that are addicted to it and need it, so you need the health, you need the treatment. We have Child Welfare Services involved regarding the kids that are at risk due to their parents' meth use. We have community providers. We have media involved because we have media advocacy to do things like today, raise community awareness. One real good example of the partnership is Operation Tip the Scale. And that's just one example of many where law enforcement is going out and doing the regular sweeps on warrants but they're actually pairing up with treatment, and those folks that treatment may be an option for them or they're interested in going to treatment, the treatment providers are there with law enforcement encouraging them to go to treatment and show them where they can go to get help.

CAVANAUGH: And, Nick, are you still with us?

REDING: I am, yeah.

CAVANAUGH: Yeah, I – I know that you've been listening to this, Nick Reding, author of "Methland," and I wonder how what you're hearing differs from the kind of resources available in a town like Oelwein, Iowa, that you profiled in the book?

REDING: Yeah, I mean, I think the difference in resources is a significant part of the issue and that was one reason why I kind of chose to seat this book in a smaller town as opposed to a major metropolitan area which it's simply that a big city can absorb the associated cost of something like, you know, meth use much more than a small town can, and there are treatment options and there are lots of different law enforcement and synergistic kind of things that can happen that there's just not the money for in Oelwein.

CAVANAUGH: Well, is there anything going on in order to try to intervene in any way in the meth problem in Oelwein?

REDING: Well, you know, the thing there is that they decided – I mean, at one point in the town of 6,000 people, they were dismantling one meth lab every three days. And that was back in 2003, and since then the number has dropped to zero and what they said was that, number one, we've got to get small lab meth production out of our town, which essentially means push it out into the county because the people who are making their money that way aren't going to just stop doing it. But you – The point was to get them out of town. And part two of the plan was to be able to lure decent jobs into town which, of course, you can't do with their houses that are blowing up at, you know, the middle of a Tuesday afternoon. And so, you know, basically their – the idea was that if we can better our economy, then we will go a long way toward dealing with our meth problem. And they've had a remarkable success doing that, even despite the recession or depression or whatever it's called these days. And so, yeah, they have turned things around remarkably.

CAVANAUGH: We're taking your calls at 1-888-895-5727. Let's take a call from David in San Diego. Good morning, David, and welcome to These Days.

DAVID (Caller, San Diego): Thank you. I was just – wanted to ask if the noted methamphetamine drop in production in San Diego, would that be decreased because of the increase of supply from Mexico bringing the cost of amphetamine down, and the supply easier?

CAVANAUGH: Thank you for that question. And Susan.

BOWER: One of the things that we track is the ease of availability of methamphetamine and you're absolutely right, David. There is more product coming over the border from Mexico. But in our tracking around ease of availability, it looks like it's really ranging more and more, the purity, there's a broader range in the purity. And it's definitely stabilizing in terms of the ease of getting it.

CAVANAUGH: And, Nick, I want you to comment about the idea of methamphetamine and drug trafficking organizations in Mexico.

REDING: Well, you know, the – one of the – you know, if there's this thing in the – if there's this idea that economy has gotten more difficult in a place like Oelwein because of consolidation in several of the businesses there that sort of made that town. The other part of the thing and I – this affects San Diego as much as it does Oelwein, is that in the same period there was this incredible sort of vertical monopoly that was developed in Mexico in drug trafficking. And essentially five organizations emerged as the controlling force for 80% of all illegal narcotics exported into the United States, which is by far the richest illegal narcotics market on earth. And they essentially took the business away from what had been a disparate sort of conglomeration of Columbians and Nigerians and Filipinos and Vietnamese and organized crime. And they took the entire market over. One of the ways they did that was because they were smart enough to get into the meth business. And what's smart about it is that with meth, they controlled the entire value chain. They controlled the production, the distribution, and the retail. That is a businessman's dream. Few licit companies in the world control the entire value chain of anything.

CAVANAUGH: We're taking your calls about meth in San Diego and in America. 1-888-895-5727, that's 1-888-895-KPBS. Susan, even though there's been this switch from a lot of local labs to perhaps centralized production and distribution out of Mexico, there's still a lot of effort in California and across the country to cut off the supplies of the ingredients for meth production. And there is pending legislation in California to electronically track sales of cold medicines that contain pseudoephedrine. What do you know about that legislation?

BOWER: Actually there's two bills pending…


BOWER: …right now, one in the Senate and one in the Assembly. One of the versions, as you said, establishes an electronic system so that when somebody buys a cold medicine with ephedrine or pseudoephedrine it in, so like Sudafed or any of those typical cold medicines, it's logged and there's an electronic system to track it. The other legislation actually requires that somebody have a prescription to obtain anything that has those ingredients in it to try to absolutely limit the availability.

CAVANAUGH: And, Nick, that is – that idea about having a prescription is also coming up in other areas across the country, isn't it?

REDING: Yeah, it is. In fact, there's a little town just down the road from me called Washington, Missouri that sort of enacted that, has made that law within – I mean, I believe Washington has more than 5,000 people but I think the – and Oregon has done that but I think this California thing is going to be very interesting because I think it will – it could influence what happens in the rest of the country. I mean, look, the point is that if you take a computer program and you put a lot of names into it, you do nothing. All you do is, you give understaffed police forces more leads to follow to nowhere because the bad guys are, you know, they've all got 30 drivers licenses, you know, so if, you know, if they're registered within a computer under one name, they've got 29 other names, too, that they're using as they buy or steal Sudafed and Contact and whatever else. The only way to do anything about this is to make pseudoephedrine – make cold medicine a prescription only drug, and even then there's going to be some difficulty. But that is the only way to get a handle on this. Now the problem is that, you know, Mexican drug trafficking organizations, they don't just sell meth, they sell everything else. They're not just in – in the Coca-Cola business, they're in the soda business. So as soon as you make it harder to buy meth, then they're going to be selling more cocaine and heroin but if you want to get a handle on the meth component, you've got to put this behind the counter. You have to.

CAVANAUGH: Susan, I'm wondering, what is the opposition to a legislation that would make it – that would force people to have prescriptions in order to get cold medicine that we can buy over the counter now?

BOWER: I think that's exactly what some of the opposition is concerned about, is access. People can go to the store if they have a runny nose and get cold medicine. Now people would have to get a prescription to get that same type of medicine. And I think that's the concern that we've heard from some parts, is related to access, you know, as well as the whole healthcare situation.

CAVANAUGH: Yeah, exactly. We're – People don't have health insurance to go see a doctor so now they'd have to go and get…


CAVANAUGH: …a prescription.

REDING: …so you'd just get cold medicine that's made with phenylephrine…


REDING: …which is just as effective and – as a cold medicine and you can't make meth out of it. I mean, what's driving this whole debate, and it's not a debate, it's not even a conversation, it's a monologue on the part of big pharmaceuticals. What's driving it is that they don't want to make the switch to making cold medicine from something other than pseudoephedrine even though they've had this thing that has been FDA approved for 20 years. And they can't – you can't make meth out of it. And the only reason they won't start making all their cold medicines from it is not because it's an ineffective cold medicine, it's because they're worried about a short term sales drop while the nine plants in the world that manufacture the precursors for cold medicine make the switch from pseudoephedrine to phenylephrine. It's – I mean, we're talking about a very short term, small sales drop. But you're also talking about one of the most powerful lobbys in the world. It's laziness and it's unethical, is what it is.

CAVANAUGH: Let's take a phone call. Karen is calling from Mission Valley. Good morning, Karen, and welcome to These Days.

KAREN (Caller, Mission Valley): Good morning. Thanks for taking my call. I just wanted to make a comment and this takes me back into a little history I'd really rather not go back to but I was a crystal meth user from 1982 until about mid-1984, and so were all of my friends. We – It was almost a group addiction. We – And I was addicted to it. And it's so – it's so attractive sometimes to people, and I can understand exactly that women are very attracted to it. We were, my girlfriends and I. It kept our weight down, it kept us awake, we could go to work all day, we could party all night. We didn't need to sleep. We didn't need to eat. It was – it's a terrible, terrible thing. And highly attractive as a drug and as an addiction. And it was – Well, not widely known, I don't think, in the early '80s. It was certainly easily available if you wanted it, if you knew about it and wanted it.

CAVANAUGH: Karen, I'm wondering, what made you stop?

KAREN: Well, I realized that I was addicted to it, like I said, about mid-'84 and didn't want to be. It doesn't make you feel real great in the long run, you know, it definitely takes a toll on your body. And I – To break the addiction, I actually left the state for about six months and went somewhere else where I didn't know people and I didn't – couldn't find 'it' if I wanted to.

CAVANAUGH: Well, you know, we're going to be talking about just the – Thank you for the call, Karen. We're going to be talking about just this, the idea of how people break their addiction to meth and what it does to people's bodies who are addicted to methamphetamine when we continue our discussion just after a short break. We're talking about methamphetamine and about the book "Methland" on These Days here on KPBS.

CAVANAUGH: I'm Maureen Cavanaugh. You're listening to These Days on KPBS. My guests are Nick Reding, author of the book "Methland," and Susan Bower, the deputy director of San Diego County's Alcohol and Drug Services. And I'd like to welcome Joel Stegen. He's a substance abuse counselor at Jewish Family Services who works at an outpatient treatment program for gay and bisexual men who use meth. Joel, welcome.

JOEL STEGEN (Substance Abuse Counselor, Jewish Family Services): Thanks, Maureen.

CAVANAUGH: Now, Joel, I think many of us have heard that – kind of know that methamphetamine is a particularly hard addiction to break. Can you tell us why that is?

STEGEN: Well, all drugs of abuse actually work in the area of the brain that sort of governs reward and motivation and increases dopamine levels in this part of the brain. But methamphetamine does so, so much more than any other substance of abuse. This area of the brain called the limbic system that governs our sort of instinctive survival skills and our survival instincts gets turned on by methamphetamine so we get sort of this artificial message that methamphetamine is important for survival and we end up making kind of irrational decisions to use because this part of our brain sort of gets short circuited.

CAVANAUGH: And so when you stop using, does it – do you get any more of those pleasure sensations?

STEGEN: Well, that's another challenge with meth users is that because this part of the brain also governs pleasure and fulfillment, when you stop using, that part of the brain is damaged and it takes a long time to heal, typically 18 to 24 months. During that time, people are unable to get fulfillment out of normal things and so relapse is very high among these people because it's really the only thing that kind of makes life feel like it's worth living.

CAVANAUGH: Well, Joel, I'm wondering while people are on the drug and they're feeling great, I mean, they're feeling euphoric and they have great energy, they have no need to sleep or really eat that much, what is the drug actually doing to their bodies while this is going on?

STEGEN: Well, certainly your body's not designed to function at that capacity. It depletes all sorts of neurochemicals and also nutritionally, people end up with malnutrition, they end up with cardiovascular problems, they end up with some neurological damage that eventually repairs itself. We see – Methamphetamine actually stimulates the fight or flight response, the same sort of – part of your nervous system that would be responsible to reacting to trauma or danger. But you're not designed to be in that state for long periods of time so it's very taxing, very stressful on the body. It turns up blood pressure, respiration, it's – it's – you know, it's just very hard to sort of stay in that – in that space for any length of time. People end up with skin problems because of increased oil production and dehydration and malnutrition and lack of sleep. They end up with dental problems for similar reasons. A whole host of health problems can happen as a result of meth use.

CAVANAUGH: Nick, I wonder, did the users you spoke with have any real idea how devastating this drug was to them?

REDING: You know, I think – I think the initial – initially no, and by the time that it was too late, I don't think they were – I think, you know, there was this kind of everyday sort of panic of, you know, how am I going to feel human and normal again because, you know, as Joel has pointed out, I mean, if your kind of survival instincts and these things that you are – sort of make you biologically viable in some ways, if those have now been replaced by the need for meth so that having sex and having a good meal and feeling sated afterwards and getting sleep and waking up in the morning, and if all of those things no longer matter because meth is the only thing that does, well, then, you know, I don't – you don't care what you look like, you just care where you're going to get the meth from.

CAVANAUGH: Let's take a call. We're taking your calls at 1-888-895-5727. Arden is calling from the I-5. And good morning, Arden. Welcome to These Days.

ARDEN (Caller, I-5) Good morning. I would like to hear more on the effects on the children of the users. Being an adoptive mom of a meth baby, you know, we do have some challenges and I just would like the awareness raised of, you know, maybe we can talk somebody out of trying it if they know what might happen to their baby. Not only will they lose their baby to the County but the baby's going to have a lifelong sentence. Now, great, the parent's going to be able to get off and be, you know, a functioning person again but the children have a lifetime sentence. And I really would like that addressed more in hopes that it would shake somebody up into not using it in the first place.

CAVANAUGH: Thank you, Arden. I know, Nick, you talk a lot about this in the book.

REDING: Yeah, and, you know, I think one of the – I mean, certainly there has been research that has begun and there has – there's about a decade's worth of it as to what the actual effects are on children and how long lasting, and I think the jury will remain out on that for awhile because ten years just isn't very long to study something. But I think the larger point is that when these behav – I mean, I think we, you know, we all know it with alcohol or with abusive behavior in any regard, that, you know, when mom and dad do it and that is something that just becomes an everyday part of your life, then it – there's this kind of – there's this generational effect and it becomes that much more deeply seated within the kind of psychological, you know, reality of a family and a commun – and that's the real hard part with meth and children, is that they are more likely to do it, you know.

CAVANAUGH: Right. Right. Now, I – Nick told us earlier about the problems in small town America with money resources and so forth. There's just not a lot of resources available either to intervene with law enforcement or medically. But I'm wondering, Susan, how are California's budget cuts impacting our treatment programs here? Are they?

BOWER: Yes. And there are budget cuts all over California, as we know, and throughout Health & Human Services, specifically with alcohol and drug treatment. There was an initiative known as Proposition 36 that authorized certain offenders to go to treatment and the funding for that has been dramatically reduced thereby making treatment less available for everybody trying to seek treatment because there's more people waiting in line at the door. But that's not to say that treatment is not available. We have a very wide treatment system and very rich treatment system in San Diego in terms of the quality of services, and the treatment programs are doing an amazing job of providing services for people while they're waiting to get into treatment, providing some level of service to folks while they're waiting.

CAVANAUGH: Even while they're waiting.


CAVANAUGH: I see. And being in a treatment program, conducting a rehabilitation program the way you do, Joel, you spoke significantly about the frequency of relapse when it comes to treatment for meth addiction. Tell us a little bit more about that.

STEGEN: Sure. We see a lot of relapse with meth addicts because that motivation and reward circuit in the brain is so strongly conditioned toward meth use. They're very prone to being triggered by either external stimuli that reminds them of their use or by internal emotional states that they used over. Meth does a really good job of alleviating emotional pain, pain of trauma, grief, depression, and so people, when they end up in those situations, will quickly return to meth use because it works so well for that. Some of the treatments that we know work better for meth users than sort of traditional social model treatment are treatment that employ specific cognitive behavioral tools or real practical sort of strategies to restructure one's life to avoid triggers and cope with them when they happen and also to develop internal coping strategies to deal with the kinds of things that meth sort of alleviated for them.

CAVANAUGH: So it sounds to me as if, if you wanted to get off meth yourself, you'd have a pretty hard time without a structured treatment program.

STEGEN: Sure. If you were – Yeah, if you were addicted to methamphetamine, you know, quitting on your own is definitely difficult. I mean, you have to change everything, all of the – so many associations get made with meth use that you have to rearrange your environment and – and add a lot of structure. And it's really hard to do that when you're newly clean and really the only thing that kind of feels okay is using meth. So a lot of structure and a lot of guidance is really helpful.

CAVANAUGH: So, Matt – So, Nick, that sort of reinforces your idea that in small towns with few resources that it's very difficult for people to get a handle on this problem or to solve the problem in their own lives. And I'm wondering, you know, in your book "Methland," you said that after years of ignoring the problem, meth was headline news as America's most dangerous drug, a few years ago. And now there seems to be a certain amount of silence again. So, from your research, I want to ask you, are we close to getting a handle on the meth problem in this country?

REDING: I don't think we are in any way really. And just to put a little finer point on what you were just talking about, there's 6126 people in Oelwein, Iowa, and there is exactly one addiction specialist and she's a honey, man. Her name is Ginger O'Connell and she is – I mean, talk about vastly outnumbered. I mean, there's one. That’s it, you know. And I think that, you know, one of the – I mean, you know, the way that I look at it in terms of, you know, how are we doing with meth and all, Oelwein right now, as an example, they're doing very well but what they've succeeded – they haven't lessened the number of addicts. They haven't lessened the number of cooks. They've just kicked them out of town into the county and now they're all taking up residence in different towns. So neighboring towns have become the new Oelweins and so until there is the sort of – you know, there's all – people are always going to come home from work and, you know, drink a few beers and people are always going to do – There's always going to be some people that do meth or do coke or whatever it is, but the question is what proportion of them. And the more poverty there is, the more – There's a direct correlation with the proportion of people that do these things to free themselves of the burden of, you know, the cruddiness of their life. And so, yeah, Oelwein is doing well now but until there's an economic resurgence in – across the board, it doesn't really matter because it just goes from Oelwein to a town ten miles away.

CAVANAUGH: And there seems to be – We only have a short period of time left, Nick, but there also seems to be a cyclical nature in the kind of awareness that there is about methamphetamine abuse in America. It's on the front page one month and then six months later we hear that it's solved. Why do you think that is?

REDING: You know, I think that – that media, kind of like politics, is run by a culture of simplicity, and so it's like, you know, if there's one thing that appears to be the answer or the cause then we'll – when, in fact, there are 19 things, well, it's a lot easier to focus on the one. And, you know, I think that there's – there – you know, the idea that people can make meth in their bathtub and occasionally blow themselves up is this sort of typically American morality play that we get in – you know, interested in every 12 months. Well, the story has very little to do with a guy who makes it in his bathtub. It's about economics and politics and pharmaceutical lobbys and immigration, frankly, and Mexican drug – and all these bigger things. But, you know, that would be a lot for people to focus on and so instead of focusing on that, every six months or a year we say, wow, it's weird, somebody can make it in their bathtub, blow themselves up and then we're done with it for a while.

CAVANAUGH: Right. We have to leave it there. I'm sorry. It was such a very good conversation. I want to thank you so much, Nick Reding, author of "Methland: The Death and Life of an American Small Town." Thanks for speaking with us, Nick.

REDING: Thank you.

CAVANAUGH: And Joel Stegen is substance abuse counselor at Jewish Family Mens Services. And I appreciate your coming in, Joel. Thank you.

STEGEN: Thanks, Maureen.

CAVANAUGH: And Susan, you have a number that you'd like to give us for the Meth Hotline.

BOWER: Yes, we do, for the Meth Strike Force, have a Meth Hotline where anybody can call and if they see suspicious activity, maybe indications of a lab or selling, or they need treatment help for themselves or a family member. The number is 1-877-NO2METH, so it's, again, 1-877-NO2METH.

CAVANAUGH: And that's Susan Bower, Alcohol and Drug Services, Deputy Director for the County of San Diego. And I want to let you know, too, that the County of San Diego is sponsoring Recovery Month this month and they're going to have a "Together We Learn, Together We Heal" recovery situation. That's Friday, September 11th. It's an event at the County Administration Center, and if you want more information for it, you can go online at You've been listening to These Days on KPBS.

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