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Dr. Brenda Roche

Dr. Brenda Roche of the Center for Families and Children talks on Aug. 21, 2014, about the challenges — and importance — of treating meth addiction, an affliction that is "devastating" for families. 

Treatment providers are seeing an increase in the number of people who need help for methamphetamine addiction — an affliction that is challenging to treat and devastating for families.

And myths persist about treatment for meth addiction: Many still believe that it causes permanent brain damage and that there is no effective treatment for addicts.

Neither is true, according to Dr. Brenda Roche, a neuropsychologist.

She is the director of clinical and evaluation services at the Center for Families and Children, which works with 30 to 40 families a week who are dealing with meth addiction.

Roche and other treatment providers, like law enforcement officials, are reporting an increase in meth use over the last 12 to 18 months.

“We are seeing a bit of an uptick (in meth use), which is distressing,” said Lenette Kosovich, chief executive of Rimrock, a comprehensive treatment center in Billings for people with addictions and mental health issues.

If the right level and length of treatment is provided, Roche said, outcomes for meth addiction are the same as for addiction to alcohol, cocaine and other controlled substances.

But the recovery process is longer for meth addiction than it is for other substances.

When asked how difficult it is to overcome meth addiction, Roche laughed dryly. “How I would explain it is you have to change everything about your whole life,” she said.

Impact on families

Roche said that meth addiction is “devastating” for families and has a tremendously powerful grip on users.

It causes a spike in dopamine, a neurotransmitter that relays pleasure, in the brain. For perspective, she explained that a good meal might give a 150 percent spike in dopamine, sex might give a 200 percent increase, cocaine might give a 300 percent boost in dopamine — and meth can increase dopamine levels by 1,200 percent.

“There’s nothing else we have, even in combination, that we can get that high with,” she said

Roche described a typical pattern of methamphetamine use by the people she works with like this: One or both parents use the drug for one to three days, sometimes without sleeping or eating.

“(They) can get very psychotic, very paranoid, really aggressive,” she said. “There’s a high level of sexual activity that goes on during that time, as well, that the kids are all exposed to.” Add to that the potential for domestic violence, other criminal activity and child neglect.

After that, there’s a crash period of one to two days.

And meth addiction can prove especially traumatic for female users, Roche said. “They don’t have to have money to get the drug.”

Exchanging sex for methamphetamine is “extremely common” among female users, Roche said. “That’s 98 percent of the moms I work with.”

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“Thinking about a child, witnessing all of those things can be very scary,” she said. “So there’s a lot of trauma for the kids we work with, but I haven’t met one kid yet that doesn’t love their mom or dad.”

And once law enforcement and Child Protective Services get involved, the children of meth users are often placed in foster care.

“That’s a whole other traumatic event for them even though it’s for their safety,” she said. “They’re losing their parent. Our goal and objective is permanent well-being for the child. Part of that goal is, if possible, to reunite parents and children.”

A long road

A first step in treatment is often a stay at a center such Rimrock. Inpatient treatment there, depending on a person’s needs, can cost $13,000 to $15,000 for a 28-day stay, Kosovich said.

Inpatient treatment is important because patients “don’t necessarily need to be medically monitored during detox in the early stages,” Roche said. “They’re not going to die from detoxing from it, but they’re going to feel awful, and so they’re going to seek out drugs.”

And during the first six months of abstaining from meth, recovering addicts’ brain functions actually worsen. In the sixth month, their brain function is comparable to someone who has had a traumatic brain injury, she said.

After inpatient care, recovering addicts need as much as 30 hours of intensive outpatient care for 12 to 18 months, followed by months of after care and relapse prevention.

All kinds of things — running into a friend you used to use meth with, something on TV, driving by an older dealer’s house — can trigger the need to use meth, according to Roche.

Recovering addicts can also have dreams about the drug, dreams so intense they wake unsure if they’ve used or not, for years after being clean.

She said she’s often had clients call up saying something like, “Brenda, can you get me cleared to do a UA (urine analysis) because I don’t know if I used last night.”

‘On the edge’: The

importance of treatment

Despite the challenges, Yellowstone County Attorney Scott Twito said that treatment needs to be a part of dealing with the methamphetamine problem in Billings.

Typically, for users — but not dealers — with limited or no criminal history who are convicted for meth possession, “They’re going to get a probationary sentence where the focus is to try to funnel them to whatever treatment the Department of Corrections has available in the community,” he said.

Those same people may also have a shot at going through one of the county’s drug treatment courts, the first of which Roche helped found in 2001.

“To really give them a shot, that would be my goal,” Twito said. “They’re on the edge of the cliff. They’re on the edge of getting into property crimes and the violent crimes to support their habit.”

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City news reporter for the Billings Gazette