Transcript of Audio Interview with Stephan Arndt (posted Jan. 26, 2006)
We're talking today with Stephan Arndt, professor of psychiatry in the University of Iowa Carver College of Medicine and director of the Consortium for Substance Abuse Research and Evaluation at the UI. Arndt is also a non-voting member of the state's Drug Policy Advisory Council.
Dr. Arndt will discuss methamphetamine problems in Iowa, including a report issued Jan. 17 by the state of Iowa on efforts to control pseudoephedrine, the key ingredient used in making meth. A state law passed in May 2005 put cold and flu medications containing pseudoephedrine behind lock-and-key at pharmacies, with the goal of reducing the manufacture of meth in Iowa. The report shows that meth labs incidents dropped from an average of 119 a month before the law to less than 20 a month after the law.
Q1: Dr. Arndt, what is the overall message of the report?
Arndt: The report points out that the law has successfully made it much harder for people to make meth in Iowa, and there's a huge reduction in the number of meth labs that have been found. It also highlights that the meth problem has not gone way. Use remains the same, and accessibility probably was not damaged all that much.
Q2: What are the dangers that are involved in the manufacture of methamphetamine?
Arndt: Methamphetamine manufacture requires putting a lot of very toxic and flammable chemicals under pressure and heating them to just the right temperatures. There's problems with exposure to the toxicity of the chemicals; they're flammable. It's just generally explosions, fires or having the chemicals on your skin is not a good thing.
Q3: So if less meth is being manufactured in Iowa, where are people getting the drug?
Arndt: They import it. It's coming in on the interstates. I think the drug enforcement agency believes that it is coming from Mexico, but we can never tell for sure. About 80 to 90 percent of the meth in Iowa, even before the law, came from outside.
Q4: What remains to be done in controlling the use of meth?
Arndt: Methamphetamine and other stimulants and other substances are still an issue in Iowa. We need demand reduction, which is to say that fewer people need to want it. This means we need to cut down on the number of people who are addicted to it. Accessibility is always an issue, but as long as people want something bad enough they'll find ways of getting it, and that's what addiction does to people.
Q5: In addition to impacting the people who use methamphetamine, how does meth affect Iowans?
Arndt: I think in the news there's be a lot of focus on children because they were either found in or around meth labs. But I think the number of cases of child abuse has not gone down as a result of the law. And so would imply that most of the abuse is coming from people who are actively using meth, and it's not only the children [who are affected], it's the families, it's the neighbors, it's the people driving their cars, it's the police -- and it's the user themself, who is destroying their lives.
Q6: What are the treatment opportunities for meth?
Arndt: Treatment opportunities are good in Iowa. There's a fairly good success rate with substance abuse treatment. We've seen success rates at sixth months between 60 and 85 percent -- for six months' abstinence after a prolonged period of treatment. There have been a number of instances in jails, prisons, and even the community, which show that kind of success rate for methamphetamine. It actually turns out to be a little better than alcohol or marijuana to come off of.
Q7: Would you say that meth is one of the more difficult substances to "kick?"
Arndt: It probably is but one of the problems with meth is that the downside in your life is so megalithic and great and so quick that people have very, very good incentive for stopping.
Q8: What other substance abuse problems must Iowa tackle, or what are issues in terms of substance abuse that need to be addressed today?
Arndt: I think more access to treatment is high on the priority. It's easy enough to go down to a treatment center and get in. There are waiting lists, but it's still not that difficult to get treatment in Iowa. I think there's stigma involved; there are problems. For a person to willingly say, "I am a methamphetamine addict" is admitting to committing a crime, so there are lots of barriers to treatment other than just accessibility to the treatment plan.
Q9: Is there anything that you wanted to add or points that we haven't discussed?
Arndt: There's a whole issue that methamphetamine certainly is a problem in Iowa, but still the number one drug of choice among people who are having substance abuse dependence is alcohol. As a matter of fact, it's about two-and-a-half times the amount of people going in for substance abuse treatment are going in for alcohol addictions. The other people are marijuana people going in with dependency issues. So methamphetamine is certainly a major part of substance abuse but it's by no means the primary drug of choice.
Q10: Something that just came to me: it seems that the methamphetamine issue or problem has been around, or at least in the news media and on the public's mind, for ten years, let's say. But was meth a problem before that? Has it been here longer than just the past few years in terms of the attention that it's received?
Arndt: Well, we've singled out meth because it's easy to manufacture. The broader class of stimulants, including amphetamines and meth, have been around for 50 years plus as an issue. In the 1950s, truck drivers used to use amphetamines to get across the United States driving their trucks. During World War II, the U.S. government was giving amphetamines to the airplane pilots so they could get to Europe. So the drugs and the issues with the drugs have been around a very, very long time. We tend to single out a particular drug that causing a particular problem, attacking one thing at a time or maybe trying to divert attention from a bigger issue.
Q11: Does the law have any other positive effect? Is it a deterrent, let's say, to use?
Arndt: I guess there's not a very big deterrent to use...the meth labs were usually done by individuals or a group of very close friends that produced a very small amount of methamphetamine. You'd only go to that trouble to build that lab if you really, really wanted it. The downside now is that those people have to get money in order to buy it. So one might wonder where they are going to get that. The other issue that's a downside with the law is that the overall purity of the drug in Iowa has increased because the meth-produced in laboratories was generally lower quality that what you can buy outside of Iowa. So there have been some downsides to the law, although the law was not intended to do anything except the reduce the environmental impact of meth production.