It's been written about in Newsweek and Time. It's been on the evening news, and there's hardly a newspaper in the country that hasn’t covered stories about it. It’s been the focus of a Frontline documentary and discussions around millions of America’s dinner tables. It’s been talked about everywhere, and no one knows what to do about it.

Methamphetamine, commonly known as “crystal,” “crank,” “glass,” “ice,” “speed,” and “Tina,” is a powerful and addictive synthetic stimulant that causes a high that lasts from 6 to 24 hours. It seems that every illicit substance that comes onto the scene is talked about as “the worst” or “the strongest” or “the most addictive.” By the time we got to “crystal meth,” we had used all the superlatives.

According to the United Nations, meth is the most abused hard drug on earth. The world’s 26 million meth users equaled the combined number for cocaine and heroin abusers in 2004.²⁰ An estimated 1.4 million Americans over the age of 12 used meth in 2004.²¹

Meth is not a drug of the ghettos or the suburbs. It’s not a drug of the big cities or the heartland, or of the upper class, or of the Gen Xers. It’s a drug of everywhere. Andrea Fuller, coordinator of case management services at Tarzana Treatment Center’s Specialty Care Clinic in the San Fernando Valley, puts it this way: “It’s cheap. It’s easy to get. It’s on the street. And it’s highly addictive.” She adds, “And when people are high on crystal, the last thing on their minds is using a condom.”

“I would estimate that 50 percent of our clients have suffered past sexual abuse or severe trauma associated with violence and psychological abuse,” explains Tom Martinez, director of community programs and services, “The power that meth has to transport you away from that pain leaves many people drawn to it.”

When it is exposed to meth, the brain releases about 1,200 units of dopamine, almost four times the amount produced by a high from cocaine. Dopamine is a neurotransmitter that causes euphoria. But with repeated use, meth depletes the brain’s stores of dopamine and destroys the dopamine receptors. The user then becomes unable to experience pleasure without the drug, which exacerbates addiction and often triggers depression during withdrawal.²²

Chronic meth users experience other permanent brain damage, which includes the loss of reasoning, judgment, and motor ability. In 2005, 58 percent of law enforcement officials in 500 counties cited methamphetamine as the biggest drug problem in their jurisdictions. ²³

Dancing With Tina

Scott, who has been a client at Tarzana for almost one year, says: “I grew up south of Los Angeles and went to college for two years at Loyola Marymount. I double-majored in English and Classical Greek. I like the challenge of translating and kind of figuring things out.

“There was a lot of fantasy involved with my growing up. I didn’t want to be in the family dynamic that we had; it was really repressive and verbally abusive. I turned to reading at a really young age, trying to escape, and then to video games, but obsessively though. You know, it was something to get outside of myself. I looked for validation by excelling in school and all that stuff. I found sex and that was like an immediate validation for me. And then the drugs and alcohol helped the sex work even better. Then after that, it was just the drugs and alcohol because I kind of didn’t really want to exist anymore. I was homeless. Stuck in between staying on the streets and on a friend’s couch, using a needle. Shooting up speed every day.

“I’ve attempted to stay sober for . . . God, for the past 6 years I’ve been in and out of 12-Step programs. I asked for help the first couple of times from God— even though I didn’t really have a definition of what God was. And now, I’m willing . . . This is really hard to explain . . . how do I say this . . . There came a point where I was willing to change my ideas and beliefs and admit that what I knew wasn’t working for me.

“My life isn’t great, but it’s a lot better than it was, and it’s getting better slowly. It’s really hard to go through life for 10 years instantly gratified as an addict, and then having to go through life changes slowly like a regular person. I just turned 30. I’m learning now that I never really learned how to take care of myself. I never grew up. I’ve been sober for 10 months and 3 days right now. It’s very clichéd, but you know, I take it one day at a time.”

Stopping the Music

The Tarzana Treatment Centers must look almost too good to be true to someone trying to get off drugs. To say that its continuum of services is comprehensive would be an understatement. Included are HIV primary care, case management, and transitional case management for people in corrections. Also included are inpatient and outpatient drug treatment, residential services and medical care, 12-Step programs, and job training. The organization was founded in 1972 and since that time has helped thousands of people address addiction and build new lives. The Tarzana Treatment Centers are widely known throughout Los Angeles County. Today, 775 of its clients are HIV-positive. “Meth is the drug of choice among about 70 percent of them,” says Martinez.

“To treat this population,” Jose Rodriguez, coordinator of housing and re-entry services, explains, “you have to disconnect with your own expectations. It’s a point better understood when you see the physical devastation in the faces of many patients. It would be great if you could pull out the HIV part and treat that, and then pull out the addiction part and treat that, but you can’t,” explains Martinez.

“One of the reasons we are successful is that we do not end our relationship with clients who relapse,” states Martinez. “We keep engaging them. We tell them to show up whenever they can—but just show up and do it today.” This approach is a perfect illustration of “meeting clients where they are,” a practice that for one man on staff is about returning to where he came from.

A New Song

Chris Perry is the program’s supervisor of HIV/STD mobile testing services. He’s changed from a life of manufacturing, selling, and using crystal to one of reaching out to people who have lost everything.

It wasn’t an easy path: “I was in and out of jail. I remember once thinking that I would give anything to be released—and then when that day came, the first thing I did was look for my old dealer. This is what addiction does to you.”

Perry’s role at Tarzana reflects the value that peers—people who share a common experience—bring to the work of serving people living with HIV/AIDS. The critical role that peers can play in reaching the underserved and building a more relevant care system has been documented in the literature—and is in full view at Tarzana.

“You have to treat mental illness if you’re going to get off drugs,” says Perry, “and you have to address the issues that have caused you so much pain.” He says that, for him, this meant learning to stop caring so much about what others thought of him and finally accepting that life was never going to be any different unless he addressed his addiction.

It is a lesson that Perry and his colleagues at Tarzana are helping Scott learn. “A big tool I use now when I want to be impulsive,” says Scott, “is to not do anything. It sounds insignificant. Sometimes you can be proactive by doing nothing. It’s actually a step up from doing something impulsive, you know.

“Today is a typical day,” he explains with a smile. “I got up. I showered. I brushed my teeth … which I didn’t used to do. I had breakfast and I went to school. I’m taking one class, just to get back into the swing of things at a community college. I am trying to figure out what I want to work towards, with the help of vocational rehabilitation, Tarzana, and vocational counseling and stuff.

“I came for this interview after school. And I’m debating if I should go home and do laundry before going over to Studio City, where I have an AA meeting tonight. And then I’ll go home, watch cable, and go to bed.”