Prometa - Pierce County's Swan Song?

Things have gotten hotter than a glass pipe on a Friday night here in Pierce County, who some have referred to as the meth capitol of the nation. Yes, we have had more than our share of woes due to the hideous epidemic, and that is why it seemed a good place to launch the pilot program known as Prometa. As stated in a previous entry, the program consists of the ingestion of three drugs that have been FDA approved, but not together and not for said purposes. The first dose is administered intraveiniously, followed by supplements twice orally. The effect is said to be a reduction of cravings for methamphetamine, cocaine, and alcohol. This is to enable the patient to focus on counseling, which is required in the program, as well as to adhere to court orders, and to perform everyday tasks. Many graduates have claimed to have had phenomenal results and have credited Prometa with saving their lives. But the program is still in its infancy and the double-blind placebo tests, which compare subjects taking the drug cocktail with those who are only told that they are receiving such, have not yet been released.

Last April, the Pierce County Council voted to allocate $400,000 to the Pierce County Alliance to assist in Prometa aid to those unable to afford the costs. Those working with the program at the Alliance, as well as in other parts of the country who have been participating, have reported dramatic improvements in their clients. So much so, that the Alliance executive director Terree Schmidt-Whelan, in her excitement of Pometa's promise, bought stock in the Hythiam Corporation, the company that produces Prometa. So did Pierce County Executive, John Ladenburg. News of Mr. Ladenberg's purchase made it to some of the Council members, who cried foul due to Ladenberg's vote to approve public funding of the program. Ladenberg, as well as Schmidt-Whelan bought their shares after funding was approved and have since sold them at a loss.

Council members Shawn Bunney and Dick Muri commissioned the work of Performance Auditor Matt Temmel to conduct what was told to the Pierce County Alliance would be a pre-audit to determine if an actual audit into Prometa, and its effectiveness, was money well spent. Then, at the Oct.24 meeting, although not listed on the original agenda, but later amended, Bunney called upon Temmel to give his report. Other Council members and the staff of the Pierce County Alliance were informed on the previous day by e-mail that the Prometa funding would be reviewed. In what would prove to be an emotional exchange of debate between impassioned Alliance members, along with a drug court judge who inquired as to why this was being brought up before the original date of April 2008, and before the study results were concluded, and Bunney and Temmel. Claiming to be a concerned "steward of the taxpayers money", Bunney concluded that he would revoke the remaining funds of $150,000 from the Prometa program, even though Temmel admitted that, while he saw little evidence that the program worked, he had not taken into account the numbers as a whole, including patients who had financed their own treatment and those outside of Pierce County. He had instead focused on the patients receiving county funding, as Bunney had asked. The result has been that other areas of the country are facing having funding cut as well. But, on an interesting note, just up the road in Federal Way, Wa. (King County), on the advice of a former employee who is in recovery due to Prometa, City Council member Jack Dovey has authorized the use of $20,000 to begin a trial program in their city. This, even after the cuts in Pierce County.

The Prometa story had caught the attention of the fine folks from the television show, 60 Minutes, who paid Tacoma a visit. As a long-time fan of the show and having an interest in the story, being as we had been keeping an eye on it at Equal Time, I couldn't resist tuning in. Scott Pelley personally spoke to recovering addicts singing the effects of Prometa. He also spoke to the seemingly disingenuous CEO of Hythiam, Terren Peizer, who also rallied the cry for Prometa as he wiped the crocodile tears from his eyes. He did not, however, speak to Terree Scmidt-Whelan, John Ladenburg, Matt Temmel, Shawn Bunney, Dick Muri, or any other Pierce County Council or Alliance member.

Not too surprisingly to anyone who had been keeping an ear to the political ground locally, after the now infamous council meeting, and only after the 60 Minutes episode went into production, Shawn Bunney announced his candidacy to run against Council member Calvin Goings for the Pierce County Executive seat to be vacated next year by John Ladenburg. Unlike the Tacoma City Council, the Pierce County Council is a partisan race. Goings, like Ladenburg, is a Democrat. So is Pierce County Auditor, Pat McCarthy, who recently announced that she will vie for Ladenburg's position. Bunney, however, is the only Republican who has thrown his hat in the ring to fill the vacancy that will be left behind by the man whose ethics have been called into question over the Hythiam stock purchase and the frivolous spending of the taxpayers' money. Concerned representation or power grab?

Many of us here in our beloved town, ironically dubbed the "most wired city" (in recognition of our own Click! Cable TV company), will be interested in seeing what the placebo studies result in, and whether or not we will continue to tie up our jails and judicial system or continue to look for alternatives that may offer hope.


To follow the News Tribune's coverage of Prometa in Pierce County, see:

http://tinyurl.com/22m7ko

The Prometa Effect

To combat the alarming increase of methamphetamine addiction in our nation, a pilot program called Prometa has been launched in several states, including Washington. While it may also be used to treat alcohol and cocaine abuse, its primary use has been directed at bringing relief to meth users. Prometa is not recommended for the treatment of opiate dependence. The program consists of a cocktail mixture of FDA approved drugs, manufactured by the California based Hythiam Corporation, and nutritional supplements administered both orally and intravenously for three consecutive days. Three weeks later, treatment is administered again, this time for two consecutive days. Afterward, the patient will be given prescription medication as well as nutritional supplements for one month. Behavioral therapy is also a vital part of the program.

Hythiam claims that Prometa works by repairing damage done by drugs or alcohol to neurotransmitters contained within the gamma-aminobutyric acid (GABA) receptors in the brain. This is the area that controls inhibitions and also creates a feeling of calmness. The desired effect is to reduce the cravings, as well as withdrawal symptoms and anxiety. By eliminating these obstacles, the patient is more able to focus on dealing with other life aspects, such as controlling stress and emotions, holding down a job, and taking care of children. These are the areas aided by behavior therapy, including counseling and guidance.

According to Hythium and clinics including Pierce County Alliance that are currently utilizing Prometa in their practices, the success rate has been stunning. It has been reported that after six months in the program, 95% of the participants were still producing negative urine screenings, 80% have maintained court compliance, and 75% are gainfully employed. As this is a relatively new study, the statistics may alter somewhat with the passing of time.

The Prometa program is not cheap. A one-month outpatient treatment program can cost $12,000 to $15,000 in a private practice clinic. However, some states, such as Washington, have financially subsidized the program, therefore making it more accessible. In fact, the Pierce County Council (WA state) recently allotted $400,000 in the budget for Prometa assistance. Council members cited the growing epidemic of meth use, with Pierce County as being among the highest in the nation, as a problem too big to not seek alternative solutions. According to the Washington State Department of Ecology, the cost of cleaning up one meth lab can run upwards of $150,000. The numbers of drug labs have skyrocketed; having reached over 100 seized each year since 2001. In 2004, an estimated $50 million dollars was spent in Washington state alone to deal with the clean-up of meth labs, enforcement, treatment, prison costs, health and dental costs, and foster care. The numbers can not be determined regarding costs involving property damage, insurance costs, burglaries, robberies, hospital costs, and other injuries sustained by victims of crime that the meth epidemic has created.

Then there are the environmental effects and health dangers caused by meth. Seven pounds of toxic waste are produced for every pound produced of meth. The production, or cooking, of meth involves using a number of dangerous solvents that can be absorbed simply by breathing or contacting the skin. The effects can include shortness of breath, chest pain, dizziness, lack of coordination, nausea, and even death. Exposure to these chemicals can cause damage to the skin, respiratory tract, mucous membranes, and central nervous system. Toxins can remain in the carpeting and walls of a building even after the production of meth has ceased.

While it could be argued that the most effective way of combating the problem is to remove pseudoephedrine, which is a common ingredient found in decongestants and the single most important element in the making of meth, from everyday over the counter cold medicines. When ephedra, a naturally growing herb that was the model for the synthetic pseudoephedrine, was shown to increase heart rates and subsequently lead to heart attacks, it was pulled off health food store shelves nationwide. But this action would come at the possible expense of huge
profit losses to the giant pharmaceutical companies. Given the track record of the current members that sit on the board of the Food and Drug Administration, the enforcement of such action seems unlikely anytime soon.

In the meantime, Hythiam's claims that all of the aforementioned symptoms can be relieved, if not eliminated, by curing the addict's desire for the drug, thus changing the behavior of the user, remains to be seen. Ongoing studies and evaluations will determine Prometa's true value, monetary or otherwise.

For more information on the Prometa program, please see:

http://www.prometainfo.com/pi/prometa-treatment/after-care.jsp

http://seattletimes.nwsource.com/html/localnews/2003114981_drugtreatment09m.html

To hear interviews and discussions about Prometa on Equal Time Radio, check the links below:

http://equaltimeradio.org/media/20060728.wma

http://equaltimeradio.org/media/20061124.wma