What can Iowa do to combat meth's second wave? Here's what experts say could make a big difference

At least three generations of Stephanie Bolyard’s family have struggled with addiction.

The Sioux City woman said she used methamphetamine “functionally” for about 10 years, from the age of 15 to 25. But a job loss and long-hidden struggle with past sexual abuse put her on a path many Iowans know all too well.

At the height of her meth addiction, Bolyard stole to support her habit, neglected her oldest son, suffered domestic abuse repeatedly and drank bleach to avoid dropping dirty drug-detection tests.

"I cried every single day for about two years," the longtime nurse said. "Because of the helplessness and the hopelessness, I was living an animalistic existence."

Alcohol has always been Iowans’ greatest dependency problem, but meth addiction is gaining ground, data from Iowa’s Department of Public Health show.

One in five patients seeking treatment in Iowa are addicted primarily to meth. Last year, more than 9,000 sought treatment for the drug, the highest number in more than 20 years.

That trend is playing out elsewhere across the country as drug cartels flood the U.S. market with more meth, cocaine and other hard drugs to make up for reduced demand for Mexican marijuana, state and federal drug enforcement officials say.

Is Iowa doing enough to address hard drugs?

Gov. Kim Reynolds is expected to sign a bill soon that was passed unanimously in both legislative houses intended to curb access to prescription painkillers.

But too little is being done to address growing dependency on hard drugs and opioids, some policy experts believe.

Nationally, deaths by drug poisoning have reached new highs every year since 2011, outnumbering those from suicide, homicide, firearms and motor vehicle crashes, according to the DEA’s 2017 National Drug Threat Assessment.

“We can’t arrest or treat the way out of it,” said Gary Tennis, president for the National Alliance of Model State Drug Laws.

“It requires more resources that are well-deployed in all the areas of treatment, prevention, law enforcement and intervention. You can’t leave any piece out or you leave a weak link in the chain.”

The prescription-drug monitoring programs that Iowa and other states have joined are useful tools for deterring doctor-shopping for opioids.

Reader’s Watchdog special report:: 20 years after the meth crisis began, Iowa's addiction is worse than ever

But doctors, police and other officials need more training, education and programs to help those already addicted to opioids and other hard drugs, Tennis said.

Iowa's leading physicians' group, the Iowa Medical Society, has said the new opioid law may lead more health care providers to stop prescribing painkilling pills.

But doctors also have a duty to offer help to those suffering from addiction, and without help, those people will likely turn to other street drugs or die, he said.

“Historically, what happens is that the doctor fires the patient. But that can be a death sentence,” Tennis said. “When people are cut off from opioids, they will start to get drugs on the street. And there, there’s the heroin, fentanyl and meth.”

Addicts using more dangerous drugs

Nationally, one of every four families has someone suffering with a substance-abuse disorder. Substance abuse is linked to about 70 percent of crimes committed, Tennis said.

Since 2017, drug courts for juveniles and adults in Iowa — the programs most credited with getting people into drug treatment — have been frozen because of the state budget shortfall.

But problems associated with addiction and crime are expected to grow because of the abuse of more hard drugs in Iowa. Many of those addicts use multiple types of drugs.

More: 'Everything has gotten worse.' Violent crime is surging in rural Iowa, fueled by the state's meth and mental health crises

Some are now experimenting with deadly mixes of hard drugs such as meth and fentanyl. Others are taking prescription pills or heroin to come down from meth, law enforcement officials say.

“What we’re seeing with opioids is what we saw 15 to 20 years ago with meth. In our treatment rate, we’re at the high end now,” said Dale Woolery of the Governor’s Office on Drug Control Policy.

“If more people start showing up, it’s going to require that discussion about where are we and where do we need to be.”

Offering help instead of handcuffs

Elsewhere around the country, more is being done to divert addicts from jails and prison and toward help.

At least 400 police departments in at least 28 states have begun voluntary programs to allow addicts to turn themselves in to police, hand over their drugs and get admitted to treatment.

Begun in 2015 by a former police chief in Gloucester, Massachusetts, these so-called “angel” programs have shown considerable promise in reducing drug-related crime.

The Massachusetts program allowed addicts to be taken to a hospital and paired with a volunteer “angel,” such as a police officer or social worker, who could get them into treatment within 24 hours.

Addicts are told they won't be arrested or jailed even if they are high or carrying drugs.

More: Iowa meth user recounts path of addiction: 'I lost everything in 3 years'

A study by Boston University and Boston Medical Center during that program’s first year in Gloucester found that In 374 instances, or 95 percent of the time, those offered services entered treatment.

Those numbers, reported in 2016 by the New England Journal of Medicine, exceeded the success of similar hospital-based programs.

Similar programs rely on firefighters in the same way the angel programs rely on police. Others rely on navigators or recovery coaches.

Several Iowa police departments have been experimenting with more diversion, but none has an angel program, Woolery said.

Des Moines police do take people to treatment in lieu of arrests, but the department has no formal program to divert addicts.

In the past year, Iowa City police have been offering heroin and opioid users a chance to go to treatment instead of charging them with drug paraphernalia or possession.

The program was initiated because officers were being called to several overdoses involving the same people, who would eventually die.

“We try to get them the help they need before it turns into a death investigation,” said Zach Diersen, a lieutenant in that department.

Meth has not resulted in as many overdoses, but the program could be used similarly for those addicts.

“I think we’re interested in deferring any drug users that we can,” Diersen said. “As people are starting to mix fentanyl and meth, that will start to kill people like heroin does.”

Tennis said police tell him that it helps when such programs also have consequences for those who flee treatment.

But treatment, especially the type of long-term residential care needed to treat meth addiction, is not available on demand, especially in rural areas.

In Des Moines, the waiting list for inpatient treatment at Prelude Behavioral Services, what used to be called MECCA, is a month long.

Iowa has 120 drug treatment programs, and the capacity of that system has not changed much in recent years, state officials say.

“Someone needing methadone may need to drive a fair piece,” Woolery said.

Needed: More detox

Dr. Frank Filippelli has treated legions of people with addictions in state prisons, through UCS Healthcare’s medication-assisted treatment program and Prelude.

He said he’s worked with second-generation users, some who have started as young as age 9.

“A lot of people don’t realize that addiction is really a disease. It’s not something you can just say no to," Filippelli said. "…It’s a physical reaction that you can’t get over.”

Meth and heroin, he said, are both highly addictive. But meth causes damage to the brain and stores in fat cells.

It can take up to 30 days to detox users, Filippelli said.

“But that doesn’t stop the cravings,” he said. “And there are so many triggers for these clients.”

Unless addicts are committed to treatment by families or courts, Filippelli said, they often can’t get access to immediate services. The state, he said, needs a place to safely detox from the drug.

“The biggest city in the state has no place to send people,” he said.

Treatment programs often won’t admit new patients when they’re using, so treatment while someone is incarcerated or afterward is sometimes the only opportunity.

Historically in Iowa, state prisoners only become eligible for treatment at the end of their sentences. But Iowa’s Department of Corrections is experimenting with offering more treatment to opioid users at the beginning of their prison terms, Filippelli said.

In Iowa, meth often is more plentiful than opioids or heroin. But there is no reversal drug approved by the FDA that helps users kick the addiction.

Some are experimenting with Naltrexone, a drug that has been used to block the high and pain relief that comes with alcohol abuse.

“When you take it, it diminishes the reward so it doesn’t give the same rush … which is pretty amazing,” Filippelli said.

Coming up from rock bottom

Earlier this month, Bolyard, 37, watched as her oldest son, Joe, graduated a second time from the same 90-day inpatient recovery program in Sioux City that helped her get clean 6½ years ago.

She said she dropped out of school at 15 and thought she used drugs out of boredom. In treatment, she realized she used primarily to block feelings from when she had been abused.

The crystal meth used today is far more pure than the crank Bolyard used in her 20s. But that crank became a serious problem nonetheless after her ex-husband began dealing.

"At first when you’re on it, you’re more focused, you're more sociable and you get more done," she said. "But later, I would stay up for four days on end. I was isolated, paranoid, miserable. I was desperate.”

Bolyard’s now 15-year-old son was “the victim of two parents on meth” from about the age of 5 until he was 9, she said.

“He had a TV, clothes and food, but … he saw a lot of domestic violence. When he would have to friends over, I would clean up the glass pipes and tinfoil in the basement.”

At her worst, Bolyard said, she was virtually homeless, and not allowed back in her mother’s house because she had stolen from her to buy drugs.

Bolyard went to jail for violating a restraining order, and her mother called Iowa's Department of Human Services, concerned about her grandson.

“I went to jail for one night and set up an (substance abuse) evaluation the next day,” she said.

Bolyard did 30 days of inpatient treatment at Jackson Recovery Center’s Synergy treatment program. After Synergy, she spent 5½ months at the Women’s and Children’s Center, also at Jackson.

She got a divorce, relapsed once, sought more support and treatment, and spent more time in Jackson’s halfway house for addicts early in recovery.

“My son went back to my mom’s to live, and I found out I was pregnant again in the halfway house," she said.

Two months after her baby boy was born in February 2013, his father died of an accidental overdose.

“He had gotten clean in Synergy and he relapsed,” she said. “I found him. He was blue, lying in his bed.”

“Sometimes unfortunate incidents make you get your butt in gear,” she said. “Eventually, I applied for a nursing job and I got it. I became a single mom raising two boys. I went from an apartment renter to a homeowner. Now I sponsor other women to help them get clean and stay clean.”

A nurse now in an adolescent inpatient crisis stabilization unit, Bolyard sees reminders every day of why she’s glad she’s in recovery.

She now feels like she’s present as a mother, with a sense of self-worth and value in the community.

“The big thing is just letting others know there’s hope,” she said.

Signs and symptoms

Crystal meth is a powerful stimulant that may include a number of symptoms:

Increased physical activity

Increased blood pressure and breathing rate

Headache

Uncontrollable jaw clenching

Elevated body temperature

Dilated pupils

Heavy sweating

Loss of appetite

Sleeplessness

Paranoia or irritability

Fleeting euphoria

Unpredictable behavior

Doing repetitive, meaningless tasks

Nausea, vomiting, diarrhea

Tremors

Dry mouth, bad breath

Source: DrugAbuse.com

How to get help

Iowa has several detox and rehab centers. For help, go to www.addicted.org/meth-treatment-iowa.html or call 800-304-2219.

Source: addicted.org