An exploration into methamphetamine addiction among rural Montana women

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An exploration into methamphetamine addiction among rural Montana women views from the community and former addicts
Carrell, Erin D. ( author )
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Methamphetamine abuse -- Montana ( lcsh )
Rural women -- Montana ( lcsh )
Ex-drug addicts -- Montana ( lcsh )
Ex-drug addicts ( fast )
Methamphetamine abuse ( fast )
Rural women ( fast )
Montana ( fast )
bibliography ( marcgt )
theses ( marcgt )
non-fiction ( marcgt )


Includes bibliographical references (leaves 150-164).
Statement of Responsibility:
by Erin D. Carrell.

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University of Colorado Denver Collections
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Auraria Library
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LD1193.L43 2006m C37 ( lcc )


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Erin D. Carrell
B.S., Beloit College, 2003
A thesis submitted to the
University of Colorado at Denver/Health Sciences Center in partial fulfillment of the requirements for the degree of Master of Arts Medical Anthropology

The thesis for the Master of Arts degree by Erin D. Carrell has been approved by

Stephen Koester
John Brett
Susan Dreisbach

Carrell, Erin D. (M.A. Anthropology)
An Exploration into Methamphetamine Addiction Among Rural Montana Women: Views from the Community and Former Addicts
Thesis directed by Professor Stephen Koester
Methamphetamine use has reached epidemic proportions throughout the United States. Rural areas, often perceived as drug-free, are struggling to deal with the social, environmental, and economic burden imposed upon them by the growing methamphetamine using community. Due to this perception, rural areas represent an under-studied population.
Methamphetamine appeals to the cultural ideals held by the American public because it bestows energy, weight loss, enhanced sensation, and sociability upon the user. Unlike other drugs, males and females abuse methamphetamine in similar proportions. However, gender norms and roles impact individual drug use, making the reasons, dynamics, and repercussions of drug use different for males and females. Nonetheless, few studies regarding female methamphetamine use have been conducted.
This study sought to understand female methamphetamine use within the Greater Flathead Valley in Montana to fill an academic void and contribute to improving the community. Research findings indicate that methamphetamine use, like other substance use, is ingrained within the culture. Female community members, facing the stress of financial hardship, community restructuring, and gender role expectations, may choose to consume methamphetamine to help them cope. Methamphetamine is perceived as the devil because it harms the user, community, and the environment. Female methamphetamine users, possessed by demons, struggle to cope with the good/bad duality of methamphetamine use. Former users cite God as their way out of addiction.
This abstract accurately represents the content of the candidates thesis. I recommend its publication.
Stephen Koester

I dedicate this thesis to the women of the Flathead Valley who inspired my work.

I would like to thank my family, my community, and Dr. Steve Koester for inspiring and supporting this work. Furthermore, I would like to thank my thesis committee and my mother for all the hard work they have put into this endeavor. They have helped me gain further insight into this problem and helped make me a better scholar by providing important information and critique. Lastly, I would like to acknowledge my life partner, Eddie Carrell, for encouraging me to follow my dreams and being such a stable part of my life.

1. INTRODUCTION...............................................1
Personal Sketch..........................................1
Flathead Valley Demographic Profile......................3
Study Rationale..........................................5
Specific Aim.............................................9
Thesis Organization.................................... 10
2. DRUG THEORY...............................................12
Psychological Model.....................................12
Social Pathology and Deviance Model.....................13
Brain Disease Model.....................................14
Subcultural Model.......................................15
Trend Theory Model......................................16
Critical Medical Anthropology...........................17
The Use of Theory in this Study.........................21

Origin and History.....................................23
Chemical Makeup and Illicit Production ................26
Physical and Psychological Effects of Methamphetamine
Social Trends in Use and Connotations of Use...........33
THIS STUDY................................................39
Defining Structural Violence...........................39
Female Methamphetamine Users...........................41
Rural Methamphetamine Users............................43
METHAMPHETAMINE USE.......................................47
Montana Epidemiologic Profile..........................51
6. METHODS...................................................52
Setting.............................................. 52
Study Design...........................................53
Objective 1: Define the Demographics and Family History of Women

who Use(d) Methamphetamine..................................66
Part A: Age and Demographics.............................67
Part B: The Women of this Study..........................68
Question 1: How do Women Become Involved with
Part A: Community Response...............................75
Nationwide Drug Trends.................................88
Part B: Former User Response.............................89
Part C: Comparison of Responses..........................94
Question 2 & Objective 2: Motivations & Patterns of
Methamphetamine Use.........................................95
Part A: Community Response.............................. 96
Part B: Former User Response.............................98
Self Worth..............................:.............99
Community of Users....................................104
The Difficulty of Quitting............................110
PartC: Comparison of Responses..........................113

Question 3 & Objective 3: Effect Methamphetamine has on Users
and the Community........................................113
Part A: Community Response............................114
Part B: Former User Response..........................120
PartC: Comparison of Responses...........r...........129
8. DISCUSSION.................................................131
Sources of Structural Violence...........................132
1. Political Mindset..................................132
2. Economy............................................134
3. Gender Norms.......................................136
9. CONCLUSION.................................................136
Study Limitations........................................139
Study Implications.....................................141
Future Research..........................................145

7.1 Background of female methamphetamine users involved in this study 69

Personal Sketch
As a teenager I decided to rebel and seek company with those who seemed to enjoy a life of parties and excitement. I found acceptance among the deviant. We often spent our weekends drinking in the woods and holding bonfires with large groups of teens who liked to experiment with drugs and sex. Though I held close to one or two friends, our larger friend group was always changing due to various infidelities and dramas common to that type of existence.
It was an interesting and temporaiy life for me. However, many of my friends still live as they did years ago, drinking heavily, doing drugs, and engaging in promiscuity. Many of my friends have children now, but they do not know who fathered their child. They exist on minimal wage and social services and they dream of going to college. They have been through the system and some are still in jail.
When we were teenagers, methamphetamine or speed as it was called then, was just something fun that my friends seemed to enjoy. It went well with drinking because it could help a person stay up all night and it made sex all the more exciting. My friends are suffering the consequences of having used methamphetamine now. I never realized it was such a big deal until I read the newspaper and learned of the Dick Dasen trial and my friends involvement with his case.
Dick Dasen was a 62 year old businessman. He was involved with Peak Development Corporation and he owned Budget Finance. As a

property developer, he won many awards and was responsible for building some of the most important businesses in the Flathead Valley. Outside of business, he was a prominent and well-liked community member. Dasen helped fund the Valleys Big Mountain Ski Resort in Whitefish and he was a church elder. He contributed to various charitable groups and he was a volunteer at Christian Financial Counseling where he offered financial salvation to many, mostly young mothers (Herring 2005).
Most notably, Dasen was responsible for building and supporting his own prostitution ring. It is estimated that he invested between $1 and $5 million dollars in the women he was sexually involved with. Some women were paid up to $100,000 for their services and he paid $2,000 for women to recruit new women who were young, thin, decent looking and short on cash. Many of the so-called Dasen girls used or were addicted to methamphetamine. For this reason, many people credit Dasen with funding the purported methamphetamine epidemic in the Valley (Herring 2005).
Methamphetamine has impacted the lives of my friends, my family, my community and me. While reading one of the articles my mom sent me, I learned that a childhood friend of mine was a Dasen girl. I had spent a lot of time with this friend of mine. We partied in high school. She and a few of my other friends did this drug called speed. I didnt think much of it at the time. In fact, I thought they were just having a good time and that they would grow out of it. My friend, the Dasen girl, has a few babies and she has been to prison at least once.

Flathead Valley Demographic Profile
The Dasen case might not have been such a big deal anywhere else. It was alarming because it happened in small town America where everyone knows most everyone else and everyone (95%) is white (US Census 2003). Though the Flathead Valley is sparsely populated and residents are comparatively poor to other Americans, the people are proud working class individuals with a Christian influence (US Census 2003). Prior to the mid to late 1990s the common conception was that nobody did hard drugs in the Flathead Valley.
The Flathead Valley encompasses 5,000 square miles in which Glacier Park, Flathead Lake, and the Bob Marshall Wilderness reside along with various national, state, and private forests, farms and orchards. Within that area, 75,000 people make their home (Flathead on the Move 2004). Together, the population density is just 14.6 people per square mile (US Census 2003). However, the population of the Flathead Valley is growing. It has grown 13% over the last decade, making it the fastest growing county in Montana (Kalispell Montana Chamber of Commerce 2006). Eighty percent of the growth in the last decade is due to in-migration, signifying a major population restructuring (Flathead on the Move 2004).
As the Flathead Valley grows more popular, housing developments are being built and housing prices are rising. Flathead Valley residents are moving to town and living in the new housing developments. Neighborhoods are changing and new schools are being built. Commercial property continues to grow at a steady rate. The total value of the commercial buildings erected in 2005 was $104.5 million, an increase from 2004s $63.8 million (Stang 2006). Formerly there were two high schools in the entire Flathead Valley, one was a traditional high school and the

other was for troubled students. Students would travel up to 30 miles to school. Now there is a new high school being built which will be closer to some of the new housing developments and the newly built strip malls. Flathead Valley natives with working class jobs are extra burdened with these changes.
Job opportunities are changing as well, impacting the cultural and socio-economic environment of the Flathead Valley. People in the Flathead Valley have traditionally made their living by harvesting natural resources. Agriculture, wood products manufacturing, and other basic industries have always driven the Montana economy and residents remain proud of this fact (The Daily Inter Lake 2005). However, the industry is undergoing serious restructuring and about 50% of jobs can now be found in the service industry and retail. As these jobs grow, jobs concentrated around natural resources are fading away and policy makers are heeding environmentalist concerns. Lumber mills for instance, are quickly disappearing. This is a national trend that began in the 1990s. Between 1989 and 2004 over 400 wood products plants closed in the Western United States and over 48,000 individuals have lost their jobs due to the closures. Montana has lost 27 mills since 1989 and multitudes of jobs. The United States is currently harvesting wood outside of the United States to meet its growing lumber needs. The Montana economy suffers with the loss of its lumber mills. When wood products plants close, employees lose their source of income and counties lose federal handing used to improve local land and build roads (Backus 2006).
Though the per capita income in Montana is rising and the quality of life is improving, it is not improving uniformly across different demographic groups (Flathead on the Move 2004). The average income in Montana was $34,375 in 2003. There were 44 states whose average

income was higher and only two where it was lowef (Montana tied with three other states for income level). Fourteen percent of Montana residents live in poverty compared to the national average of 12.1% (US Census 2003). Montana women rank 50th out of 51 areas in the United States for median annual earnings. However, Montana females rank 36th nationally in the ratio comparing men to womens earnings (Caiazza and Shaw 2004). Poverty rates are exceedingly high for single mothers, of which there are 2,202 in the state (8.7 % of households) (Caiazaa and Shaw 2004; US Census 2003).
A woman with two children requires a living wage of $18.46 an hour if she is working a foil time job. Eighty one percent of the jobs in Montana pay less than that and there are an average of 14 job seekers for a position that pays that wage (Osorio et al. 2005). Women are not likely to have the higher paying jobs. Out of 51 US areas, Montana women rank 41st for business ownership and 42nd for having managerial and professional occupations (Caiazza and Shaw 2004).
These data make clear the fact that many Montana residents struggle against poverty. Montanan women are disproportionately vulnerable to becoming impoverished compared to men. Adding to their worries, women traditionally serve as the primary care giver for their children when they are no longer with their partner. Koester et al. (2004) suggest that methamphetamine is an important coping mechanism used to deal with the stress imposed oh daily life by economic and social reality.
Study Rationale
Though once considered a legal and medicinal substance, methamphetamine is now deemed a highly addictive and dangerous drug.

After it became illicit, methamphetamine production and consumption went underground in cities around America.
The 2000 National Household Survey estimates that almost nine million Americans or four percent of the population has tried methamphetamine. From 1999-2000 methamphetamine use has increased by 30% and it is now reaching epidemic proportions (Cretzmeyer et al. 2003). Currently, methamphetamine is the dominant illicit drug in many western and Midwestern states (Wermuth 2000).
It is clear that the problem of methamphetamine is only going to deepen due to the American Drug Policys inability to recognize the growing problem of methamphetamine and the economic disenfranchisement that is spreading across communities placing heavier demands on working, class individuals (Rawson et al. 2002; Wermuth 2000).
The American state and its intellectuals once believed that problems like drug abuse were confined to the city. However, their preconceptions have been recently shattered by the realization that methamphetamine consumption has spread into rural communities across America and reached epidemic proportions throughout the nation. The American state and its intellectuals are particularly bothered by the women who have chosen to consume methamphetamine. Unlike many other illicit substances, methamphetamine appears to enjoy almost equal popularity among both sexes.
The effects methamphetamine initially bestows upon users are considered socially acceptable and even admirable in American society (Morgan and Beck 1997). Such effects include: suppressed appetite, increased energy, wakefulness, opportunity for social interaction, relief from depressive thoughts, and enhanced sexuality and sexual performance

(N3DA 1998). Housewives rave about how methamphetamine allows them to work, care for their children and keep a clean home, while factory, fast food and construction workers depend upon methamphetamine to keep them awake and interested throughout their long days at work (Rawson et al. 2002; Koester et al. 2004).
However appealing methamphetamine may be sustained use of methamphetamine promotes the opposite effectsviolent behavior, anxiety, confusion, insomnia, paranoia, auditory hallucinations, mood disturbances, short term memory loss and delusions (NEDA 1998; Tarter 1992). Exacerbating these symptoms, psychological and behavioral responses associated with methamphetamine use put users at a high risk for acquiring HTV, Hepatitis, STIs, unwanted pregnancies and a plethora of other unpleasant conditions (Gorman 1998). The ultimate effects of methamphetamine use often lead to economic ruin, loss of child custody, and potentially jail or death (Dreisbach February 15, 2005).
The problem of methamphetamine produces a huge burden on the American public and those who are directly impacted by its production and consumption. Methamphetamine is associated with increased crime, infectious disease, and increased spending on public services. Individuals with methamphetamine in their home/family suffer from an increased risk of having a broken home and generational use.
Unfortunately, the burden of methamphetamine is especially heavy for rural towns (Morgan and Beck 1997). In fact, methamphetamine is citied as the most significant drug problem in Montana (ONDP 2004). The 2003 Montana Youth Risk Behavior Survey Report states that 9 % of all kids in high school have tried methamphetamine (Montana State Department of Justice 2005).

In 2000, 620 women were admitted into treatment facilities for methamphetamine addiction in Montana (Kalispell Police Department 2005). However this is likely an underestimate of the prevalence of female methamphetamine users in Montana. In 2002 80 % of Montanan adults requiring substance abuse treatment did not receive treatment either because they did not seek it or it wasnt available (Montana State Department of Justice 2005). This suggests that there is a large population of female methamphetamine users and it also suggests that their treatment needs arent being met.
Current law enforcement, policy, and treatment efforts have been unsuccessful thus far. Clearly we are missing something in our attempts to rectify this problem. I argue that that something is structural violence. Structural violence is a pathology of power that causes individuals to suffer from poverty, social inequality, and human rights abuses (Farmer 2003). I suggest that drugs like methamphetamine offer a temporary alternative to the suffering caused by structural violence (Singer 2001).
Since the methamphetamine epidemic is a relatively new problem, stimulant research has been primarily dedicated to cocaine (Morgan and Beck 1997). Research that has been conducted on methamphetamine has largely focused on city-dwelling populations and the elevated health risks associated with methamphetamine use among men and men who have sex with men in particular. This study is both important and unique in its focus on the growing epidemic of methamphetamine in the rural western United States and the special circumstances in which women figure into this problem.
I investigate the methamphetamine problem using the holistic perspective outlined by the tenants of critical medical anthropology. In using this perspective, I do not mean to isolate critical medical

anthropology from conventional medical anthropology. Instead, I use the term critical because I feel that it brings to light what conventional medical anthropology should aspire to incorporate within its philosophy more regularly. Though critical medical anthropology often falls short of its goals, I feel that it is important to reach for improvement even if it is not fully achieved.
Specific Aim
The aim of this study is to describe methamphetamine use among women in the Flathead Valley. Specifically, this study seeks to understand:
1) how women become involved with methamphetamine; 2) then-motivations for use; and 3) the effect methamphetamine use has on their lives. I hope to use the findings from this study to help inform interventions aimed at preventing methamphetamine use among women as well as programs aimed at helping women who use methamphetamine transition out of it.
1) to define the demographics and family history of young women who use(d) methamphetamine and understand why methamphetamine is appealing to women in that particular demographic
2) to describe the patterns of methamphetamine use among young women who use(d) methamphetamine
3) to characterize the impact methamphetamine has/had on the lives of young women who use(d) methamphetamine and the lives of others around them.

Thesis Organization
I have undertaken this thesis work in order to highlight the methamphetamine problem rural Americans are facing today. In chapter two I discuss current drug theories employed within academia today. Such theories include: the psychological model, the social pathology/social deviance model, the brain disease model, the subcultural model, and the trend theory model. I conclude the chapter with an exploration into critical medical anthropology, and I explain how I use it to guide my analysis.
In chapter three I discuss the natural history of methamphetamine from its inception to current times. I illustrate why methamphetamine is biologically and culturally appealing to Western people. I further delve into the rural methamphetamine problem, showing how methamphetamine is both used and treated slightly differently in rural America. I argue how women suffer from an imbalance in power, which puts them at risk for reduced economic capability and greater stress thus provoking substance abuse.
In chapter four I define structural violence and outline how it affects the populations of interest to this study. Specifically, I look at how structural violence impacts females and their involvement with drug use. I also discuss rural substance abuse in relation to structural violence.
In chapter five I evaluate how methamphetamine use promotes poor physical health and endangers non-users due to practical and social factors involved with methamphetamine consumption. I illustrate the dangers of methamphetamine use by discussing public health in Montana.
In chapter six I present the methods I employed in conducting my research. I provide general information regarding the key informants and

participants involved in this study. Furthermore, I discuss the challenges that marked this research.
In chapter seven I provide study findings and analysis. I discuss how and why community members and former users alike attach demonic symbolism to methamphetamine. I then outline the answers to the study questions and objectives.
In the chapter eight I use the concept of social suffering to provide insight into the methamphetamine problem among women in rural Montana. I discuss how methamphetamine and other substances are used as a coping mechanism in a community that is undergoing rapid community reconstruction. I elaborate upon this idea using my findings.
In chapter nine I present the recent changes Montana has initiated in order to combat the methamphetamine problem. I discuss my opinion on such changes, evaluate study limitations, and provide my suggestions for further research.

There are myriad theories explaining drug use patterns and dynamics of use. Though in their most resolute form, the different theories compete with one another. I believe however, that each theory brings to light an important point and should therefore be noted. I will outline the major theories and then provide an integrated perspective that I will later use to gain better insight into the growing problem of methamphetamine abuse among young women inhabiting rural areas. The five theories I will examine include: the psychological model, the social pathology/social deviance model, the brain disease model, the subcultural model, and the trend theory model.
Psychological Model
Psychological models contend that illicit substance use occurs as a result of psychological problems (Singer 2006). For example, the so-called personality theory notes that there is a strong tendency for substance abusers to exhibit anxiety, depression, and low self esteem as adolescents. Such individuals are said to be unable to establish emotional intimacy with others and they are likely to feel isolated (Hirshman 1992).
The personality theory identifies two personality sub-types including: the distressed subtype and the sociopathic subtype. Persons displaying each of the different subtypes use substances for their own specific reasons. Persons who embody the distressed subtype are said to use drugs and alcohol to self medicate their feelings of depression, anxiety, and dysphoria. On the other hand, persons who embody the sociopathic

subtype experience an uncontrollable need to engage in certain activities.
As such, they are hypothesized to use drugs and alcohol on their impulsive quest to experience immediate gratification (Hirshman 1992).
Singer (2006) identifies two major shortcomings of the psychological models approach. First, he contends that psychological models overemphasize individual mental health. Second, they deemphasize social context and learned behavior that influence personal choice and do not stem solely from psychological underpinnings.
Social Pathology and Deviance Model
According to the social pathology and deviance models, self esteem depends upon the cultural context or group norms (Moore et al. 1996). Individuals will make the decision whether or not to use based upon the perceived rewards they will gain by using (Rasmussen and Benson 1998). Individuals weigh the benefits of their behavior based upon the type and value they place on the different social relationships they maintain (Quensel et al. 2002). Those who conform to the group norms will have higher self esteem such that the drug users self esteem will be higher in communities where drug use is considered normal (Moore et al. 1996). Because of this, individuals with certain predisposing factors within their biological or psychological makeup and/or social circle (family, school, peer group, and community) will be more likely to use drugs (Rasmussen and Benson 1998).
Singer (2006) criticizes the social pathology and social deviance models for neglecting to verge outside of the immediate group of analysis into the context of society at large. Specifically, these models do not

address issues like social inequality or structural violence which provide structure to the individual social groups within which deviants live.
Brain Disease Model
The brain disease model recognizes that individuals make the choice to use drugs when they first start using, but undergo altered brain functioning through continued use resulting in uncontrollable compulsive drug craving, seeking, and social difficulties (Leshner 2001). Thus, it is not the pleasure that keeps people using, but rather the neurological changes that occur in the brain that causes addiction. Specifically, scientists believe that addiction results from changes that occur in the dopamine system and the reward circuits in the brain (Volkow and Fowler 2000). The rewiring that occurs in the brain results in new memory connections. These memory circuits are responsible for changes in cognitive and emotional functioning that characterize the addict who suffers from the uncontrollable desire to use despite ill consequences. Unfortunately, altered brain functioning may continue long after the individual stops using the drug (Leshner 2001).
Within this model, addiction is considered a chronic recurring illness and addicts are construed as victims (Leshner 2001; Hirshman 1992). Relapse is likely to occur when individuals are exposed to the environment in which they once used. This is called cue-induced craving. Addiction must be treated formally as a disease and medication may be necessary (Leshner 2001).
Those who ascribe to the brain disease model do not deny the behavioral and social aspects that help shape addiction. They recognize that some people are more prone to becoming addicted than others as a result of different environmental, biological and genetic factors (Leshner

2001). Though they remain conscious of these elements, they do not investigate how they interact to produce compulsive behavior (Singer 2006).
Subcultural Model
The subcultural model offers an alternative status hierarchy in which those who cannot achieve improved social status through conventional means are given an illegitimate way in which to improve their social standing. According to this theory, people inhabiting the lower class can climb the status hierarchy by affiliating with the criminal subculture where status is based on theft, violence, or drug use (Matseuda et al. 1992).
Social scientists have noted that high prestige crimes hold many things in common with high prestige jobs. For instance, they involve specialized skills, long term commitment, ambition, reliability, high monetary returns, and connections to powerful people. Similarly, individuals who participate in high prestige crimes, like those who participate in high prestige jobs, often possess specialized technical skills, they are motivated by money, they see themselves as businessmen, they take pride in their workmanship and they seek higher status through their work. Together, both legitimate and illegitimate employment offer power, money, and prestige in their own way (Matseuda et al. 1992).
The subcultural model posits that individual behavior will be determined according to the opportunities available to that person and their exposure to conventional and criminal subcultures. Those who are cut off from conventional means to achieving improved status will turn to illegitimate means. Though individuals inhabiting the lower class recognize and accept the conventional status hierarchy, they realize that it is

irrelevant to their situation due to structural barriers and seek other means to achieve higher status. The higher their status within their particular subculture, the more they are likely to view illicit acts as just, valuable, and legitimate (Matseuda et al. 1992).
Using this perspective, drug use is considered a product of socialization in an alternative social structure where conventional norms are viewed as unattainable or unreasonable. The knowledge, goals, and values found within the alternative social structure promote drug use among those who inhabit that social structure (Singer 2006).
According to Singer (2006), the subcultural model tends to overemphasize the distinctions between drug users and non-drug users. Drug users, or those inhabiting the alternative social structure, interact and are intimately tied to non-drug users who inhabit the conventional social structure. Denying this important truth neglects the fluid nature of the subculture and their group characteristics (group boundary, identity, structure, and processes that define the group characteristics).
Trend Theory Model
The trend theory model understands that there are several factors involved in shaping the drug use trends over time (Singer 2006). Relevant factors include: the system of production and distribution of the drug outside of the population and the distribution to the inside of the population of suppliers; the system of production and distribution of the drug inside the population; and the factors that might make the population into willing customers (Friedman 2003). Recognizing these factors, the trend theory model contends that incidence is directly related to context. The factors

relating to drug use trends are constantly changing and can be understood over time as they develop (Agar 2003).
The trend theory model attempts to explain local events in terms of the changes that occur among distant social locations and how those changes interact to produce changes at the local level (Agar 2003). The trend theory model uses this information to predict increases and decreases in the incidence of drug use during specified time periods (Singer 2006).
Singer (2006) recognizes the importance and promise of this model, yet he also notes the incipient nature of the model and the esoteric methods used in employing the model. Specifically, he questions how to employ the method, how much emphasis to place on the different factors, and how to predict the next phase in drug use trends.
Critical Medical Anthropology
The previously mentioned drug models have their assets, yet each neglects important facets of drug use and drug use trends. A thorough analysis of drug use dynamics requires investigation into: structural, interpersonal, social, cultural and biological factors (Singer 2006).
Critical medical anthropology is a relatively new segment of anthropology that was developed in the 1980s in an attempt to understand social and cultural issues in a more holistic manner than conventional medical anthropology (Heurtin-Roberts 1995; Singer 2006). Though medical anthropology claims to be holistic, it often tends to follow traditional academic divisions, cutting up larger issues into bite size segments and distorting the human experience (Kapferer 1988). Developed by the Frankfurt school, and influenced by neo-Marxist thought, the genealogical writing of Foucault, postructuralism and postmodernism,

critical medical anthropology seeks to explore social inequality and power imbalances in society (Kincheloe and McLaren 1994; Singer 2006).
Critical medical anthropology is predicated on the philosophies put forth by Gramsci, Marx, the Frankfurt school of critical theory, phenomenology, and political economy (Csordas 1988). Gramsci in particular challenged traditional anthropology which focuses on culture as its object of study.
Traditional anthropology defines culture as a system which is comprised of an internal logic that binds the system together as a whole. In this sense, culture is characterized by a perpetual conflict between tradition, which signifies authenticity, and modernity.
Gramsci, on the other hand, saw culture as a subjective way in which to view and act upon the world. In his view, culture is a product of power which is rooted in history and class as defined by Marx. He felt that culture is fluid and full of internal contradictions, hierarchies and inequalities such that no individual within a particular culture will have the same exact world view (Crehan 2002). The dominant world view, called hegemony, is created by the powerful ruling class and exercised through the state (Frankenberg 1988). Hegemony is deeply ingrained within societys commonsense, taken for granted, and not reflected upon (Kapferer 1988). Hegemony firmly establishes itself within societys life perspective when society accepts oppression as the norm. Individuals choose to misrecognize relations of power for the sake of power or freedom it affords them (Kincheloe and McLaren 1994). However, hegemony is only ephemeral in the scope of history because culture is wrought with conflict (Crehan 2002). Members of the non-ruling class can engage in a struggle to either maintain or challenge the dominant hegemony.

Gramsci asserts that anthropologists, as traditionally defined intellectuals, should develop new ideologies using both their minds and hearts that resolve the material and cultural contradictions within peoples lives (Richters 1988). Using this philosophy, critical medical anthropologists criticize conventional medical anthropology for being overly neutral and a handmaiden for biomedicine because it does not challenge the capitalist structure which promotes power imbalances and inequities in health (Heurtin-Roberts 1995). Conventional medical anthropology, they claim, perpetuates social inequality by ignoring the power structures that sustains it (Johnson 1995).
In contrast, critical medical anthropologists recognize the historical and ever-changing nature of culture using Gramscis concept of hegemony and they attempt to account for this using its holistic perspective (Kapferer 1988). Using a holistic perspective, they explore the economic and class structures that exist in their quest to understand the power imbalance (Heurtin-Roberts 1995). They are particularly concerned with social life, social relations, social knowledge, and culturally constituted systems of meaning (Singer 1995). Moreover, critical medical anthropologists understand health issues in light of the larger political and economic forces that pattern human relationships, shape social behavior, and condition collective experiences including forces of institutional, national and global scale (Singer 1986, 128). They recognize health as a political issue that is molded by issues of power which are played out in class, racial, and sex imbalances (Johnson 1995).
Critical theorists view their work as the first step toward political action aimed at breaking down the injustice in society (Kincheloe and McLaren 1994). Their goals are intentionally political, aimed at criticizing institutions of power and putting an end to structural violence (Csordas

1988; Singer 1995). Their holistic perspective enables them with the tools to demystify the power imbalances that exist within society and promote social suffering (Kincheloe and McLaren 1994).
Unmasking power imbalances is what they call system challenging praxis. Critical medical anthropologists promote system challenging praxis in hopes of realizing a new more progressive hegemony (Heurtin-Roberts 1995; Richters 1988). Critical medical anthropologists recognize that an attack must be launched from all levels of society in order to achieve system challenging praxis and successfully destroy the dominant hegemony (Frankenberg 1988). System challenging praxis can be accomplished by way of unmasking the origins of social inequity, heightening social action and making permanent changes in the alignment of power (Csordas 1988). This involves making practical, attainable goals aimed at improving humankind (Johnson 1995).
Critical medical anthropologists attempt to put together an understanding of health based upon the interaction of macrolevel and microlevel forces (Singer 1986; Singer 1995). Explicitly, they examine political economy at the macrolevel, the political and class structure at the national level, the health care system and the community at the institutional level, the folk beliefs and actions at the population level, and the individual illness experience, behavior, meaning, human physiology, and environmental factors at the microlevel (Singer 1995).
Drug use is a major social problem that persists despite criminal justice and social control efforts. Drug users constitute a highly stigmatized group of individuals that are blamed for the ills of society. Because of this many intellectuals stop short of thoroughly examining the political and economic aspects of drug use and drug use culture. Critical medical anthropology offers a more holistic perspective on the drug universe by way of

confronting power, hegemony, and the political economy of the drug universe (Singer 2001).
Though I endorse the philosophies that comprise critical medical anthropology, I must mention its faults. Many authors criticize critical medical anthropology for separating itself from conventional medical anthropology. Conventional medical anthropology also attempts to use a holistic approach, however it does not focus on economic and class conflicts as much as critical medical anthropology. Conventional medical anthropology should embrace such an approach and it would in its ideal sense. Many medical anthropologists simply arent inclined to examine the world that way, though they hold it within their theoretical and intellectual arsenal to do so. In this sense, conventional and critical medical anthropology arent so different (Heurtin-Roberts 1995). Secondly, though critical medical anthropology endorses a holistic perspective, its philosophies are not often put into action (Csordas 1988; Johnson 1995). Instead of being used to inform a study design, they are often used as an after thought (Csordas 1988). Critical medical anthropologists must be aware of these criticisms and make an effort to avoid the potential downfalls of their practice in their quest to improve health.
The Use of Theory in this Study
I employ critical medical anthropology to enlighten this study. In particular, I pay attention to issues of time, class, gender, race, political economy, folk beliefs, individual experience, human physiology, and environmental factors. The focus of this study is situated on the womens perspective and as such I pay particular attention to understanding how

gender influences an individuals experience with methamphetamine in the Greater Flathead Valley.

Methamphetamines chemical makeup and the effects it bestows are important aspects of the methamphetamine problem. It is a unique drug that initially endows users with culturally preferable traits. Moreover, its history is another important aspect of the current methamphetamine epidemic that has taken hold of Flathead Valley residents. It describes how and why methamphetamine came to the Flathead Valley and it helps explain why residents would choose to consume it.
Origin and History
Amphetamines have a long history. They were first synthesized in 1887 in Germany (Murray 1996; Sommers and Baskin 2004). Their qualities became so renowned that in 1920s amphetamines were used as a panacea, treating almost everything from depression to decongestion. By 1930, dl amphetamine was marketed as an over the counter nasal inhaler called Benzedrine (Derlet and Heischober 1990; Murray 196). In 1935, it was used for narcolepsy (Murray 1996). Later, in 1937, scientists realized that amphetamines can enhance intellectual performance through improved wakefulness (Derlet and Heischober 1990). Within the scope of 50 years, amphetamines came into existence and became known world wide as a wonder drug.

Methamphetamine has a similar history. Methamphetamine, an analogue to the amphetamines being produced at the time, was later discovered by a Japanese scientist in 1919. Methamphetamine is more potent and easier to make than other amphetamines. Pharmaceutical companies marketed it as Dexedrine and Methedrine in the 1940s and 1950s and it was used to alleviate nasal congestion, asthma, and facilitate weight loss. It became popular when the public learned of its energy boosting effects (Olive 2004; Sommers and Baskin 2004).
The popularity of amphetamines came to the world as a detriment to the health of individuals and spawned world wide epidemics of amphetamine abuse. Amphetamines were first abused during the depression and prohibition in the United States (Sommers and Baskin 2004). Later, during World War II, Japanese, German, and United States military provided soldiers with amphetamines in order to increase their endurance and performance. This provoked widespread amphetamine abuse (Anglin et al. 2000; Hannan 2005). The worlds first methamphetamine epidemic occurred in Japan in 1945 and it lasted until 1957 when the Japanese government created more stringent laws controlling its use (Anglin et al. 2000). Sweden experienced a similar epidemic at that time (Derlet and Heischober 1990). Despite Japans problem with methamphetamine, American soldiers were given the drug during both the Korean and Vietnam wars (Murray 1996).
The United States did not relate the problems amphetamines produced for the military and other nations to the problems it might produce for the American public until quite some time later. In fact, amphetamines were legally available without a prescription in the United States until 1951 and inhalers containing amphetamines were available until 1959. Despite making amphetamines available by prescription only,

amphetamines were widely abused throughout the 1960s. In fact, a quarter of American adolescents had tried methamphetamine at least once in the 1960s (Tarter 1992). A liquid form of methamphetamine meant for injection became available during the 1960s. Doctors prescribed this form of methamphetamine for individuals who were addicted to heroin or alcohol. Ex-servicemen and doctors made injection a popular route of admission in the 1960s (Jenkins 1999).
The nationwide epidemic of methamphetamine abuse provoked the government to invoke even stricter regulation of methamphetamine availability. Methamphetamine was removed from the open market in 1965. At that time, doctors wrote fewer prescriptions for methamphetamine and they paid more attention to the distribution of methamphetamine. This is largely due to President Kennedys speech wherein he identified so called thrill pills or amphetamines as a potential menace, eroding the distinction between a drug and a narcotic (Jenkins 1999). Nonetheless there was enough methamphetamine in 1966 that each person in the United States could have 35 doses of 5 mg tablets a year (Tarter 1992). The controlled substance act of the 1970s further reduced methamphetamine availability by identifying it as a schedule II and II drug (depending upon whether it was liquid or not) and stringently regulating the manufacturing of methamphetamine (Derlet and Heischober 1990; Olive 2004). Still, methamphetamine, along with other designer drugs produced outside the pharmaceutical industry, remained legal until 1986 so long as they were not exactly the same as the prescription they were modeled after. The comprehensive methamphetamine act of 1996 later provided rigid controls for the ingredients used in manufacturing it, stiffer penalties for manufacturing, distributing, and possessing it (Olive 2004). After nearly one hundred years of existence, methamphetamine became better known

for its recreational uses than its therapeutic use causing it to become more tightly regulated.
Today, the laws and regulations surrounding methamphetamine are stricter and more severe than ever before. All forms of methamphetamine are currently classified as a schedule II stimulant, meaning that it has a high potential for abuse (Sommers and Baskin 2004). It is available as the drug Desoxyn and it is prescribed for narcolepsy and Attention Deficit Disorder (Cretzmeyer et al. 2003; Olive 2004). Because it is a schedule II stimulant, it is only available by prescription which cannot be refilled without visiting a physician first (Sommers and Baskin 2004).
Chemical Makeup and Illicit Production
' Different types of methamphetamine have been created throughout the years. Each type of methamphetamine varies in purity and potency. Today there are three types of methamphetamine, 1 methamphetamine, dl methamphetamine, and d methamphetamine (NDIC 1996). Types of methamphetamine differ based upon the process used to synthesize them and their purity. L methamphetamine is made commercially and it is found in an over-the-counter product in the Untied States. L methamphetamine is not very addictive (NDIC 2004). Dl methamphetamine was initially produced by outlaw motorcycle gangs in the San Francisco bay area during the 1960s (Anglin et al. 2000; NDIC 1996). This type of methamphetamine was the first liquid form of methamphetamine and it provoked the first epidemic of intravenous use of amphetamines in California (Anglin et al. 2000; Murray 1996). D methamphetamine, known by its street name ice, first became popular in Hawaii and later became the predominant form of methamphetamine in the 1980s

(Cretzmeyer et al. 2003; NDIC 1996). D methamphetamine is the most potent type of methamphetamine and it produces the fewest side-effects (NDIC 1996).
Methamphetamine production is both cheap and easy. Making methamphetamine involves using inexpensive over the counter ingredients and a recipe which can be found on the internet or in literature distributed on the street (Sommers and Baskin 2004). Methamphetamine can be made anywhere from large labs, homes, apartments, motels, and even the back of a car (Hannan 2005; Olive 2004). The two most popular types of methamphetamine in the United States involve either iodine and red phosphorus or anhydrous ammonia (known as the Nazi method because it originated during WWII in Germany). The Nazi method is common in agricultural areas that tend to have anhydrous ammonia (Hannan 2005).
The methamphetamine consumed by individuals in the United States is produced domestically and imported from other countries as well. Chemists prefer to synthesize methamphetamine in secluded areas, especially when they are using the Nazi method of production (Hannan 2005). Methamphetamine is typically manufactured in small amounts and then distributed by independent and local networks throughout the United States (Klee 1997). However, most of the methamphetamine found in the United States has been imported from Mexico via the established polydrug trafficking trade (NDIC 1996).
Local mom and pop methamphetamine production is generally haphazard and dangerous because the chemicals involved are volatile and toxic and most mom and pop chemists, who manufacture methamphetamine are untrained (Derlet and Heischober 1990; Hannan 2005). The toxic ingredients used in methamphetamine production include: benzene, Freon, chloroform, aerosol fluids used to start cars, acetone, lead, mercury, and

anhydrous ammonia (Cretzmeyer et al. 2003). Illicitly produced methamphetamine can be contaminated with some of these chemicals and lead to lead poisoning and exposure to carcinogenic material (Derlet and Heischober 1990). In clandestine labs, these chemicals are sometimes present in an uncontrolled manner. Adding to the potential dangers, labs sometimes have needles lying around, slip and trip hazards, confined entry space, and explosive booby traps to keep out unwanted guests and destroy evidence (Hannan 2005). Chemists may also possess guns they use to defend both themselves and their source of income (Olive 2004).
Local methamphetamine production threatens the health of community members and the environment. A small lab that produces several ounces of methamphetamine a week generates four gallons of liquid hazardous waste (Hannan 2005). Just imagine how much waste is generated by a super lab that is able to produce 10 or more pounds of methamphetamine in 24 hours! (Maxwell 2005). Such waste is often thrown out the window, poured down the toilet or sink, buried or burned. These practices threaten the environment and public health, as groundwater and soil can become contaminated. Unfortunately, there is no national exposure limit set for methamphetamine and testing the environment for the drug is generally not required. Because decontamination is expensive, homeowners are typically given the responsibility of removing the toxic chemicals associated with methamphetamine production. Post decontamination, samples are collected to confirm successful decontamination. Improper decontamination threatens future unsuspecting tenants and buyers of such properties (Hannan 2005). Hannan (1995) suggests that the law enforcement, public health and environmental regulatory community, and tracking system are somewhat to very inadequate.

Individuals who are closely involved with methamphetamine production are at risk for suffering from health problems. Exposure to the chemicals used in methamphetamine production has not been thoroughly investigated. Yet, it is known that short term exposure to the vapors and fumes involved in methamphetamine production may cause irritation to the eyes, mucous membranes and the upper respiratory tract. With time, individuals may come to experience acute intoxication which involves dizziness, headache, dry mouth, anorexia, insomnia, tremors, rash, chest pain, labored breathing, fainting, blurred vision, impotence, convulsions and possibly a coma. The chronic effects of prolonged exposure to vapors or fumes during methamphetamine production and ingestion include: severe skin conditions, insomnia, irritability, poor concentration, hyperactivity, personality change, weight loss, ulcers of the lips and tongue, anxiety, fear, hallucinations, and/or the development of a psychotic schizophrenic-like condition (Hannan 2005).
Clandestine labs have increased in the United States despite the risks associated with methamphetamine production. Since 1997, methamphetamine has dominated the clandestine lab scene (Cretzmeyer et al. 2003). Recently, ninety percent (8,020 labs) of the labs that have been seized by law enforcement were involved with methamphetamine production. Rawson et al. (2002) suggest that clandestine mom and pop (small) methamphetamine labs will continue to increase as new markets are created.
Twenty five percent of the labs seized by the government (2,078 labs) involved children (Hannan 2005). Children exposed to such environments are surrounded by toxic chemicals, fumes, and poor sanitation. Many such children have poor hygiene and nutrition and they suffer from a high incidence of developmental delays (Maxwell 2005).

Physical and Psychological Effects of Methamphetamine Consumption
Methamphetamine can be ingested in a variety of ways. It comes in powder, pill, and liquid form. It can be absorbed through the gut, airway, nasopharynx, muscle tissue, placenta and vagina (Albertson et al. 1999). This allows for it to be eaten, drunk, smoked, or injected, etc (Tarter 1992). Smoking and injecting methamphetamine produce a similar high which can be felt immediately (Anglin et al. 2000; Derlet and Heischober 1990). My research suggests that smoking and injecting are the most popular routes of administration in the Greater Flathead Valley. It takes five minutes to experience the effects of methamphetamine if it is snorted and up to 20 minutes if it is orally ingested (Anglin et al. 2000). Researchers suggest that many users consume methamphetamine along with alcohol and/or marijuana (Anglin et al. 2000; Tarter 1992).
Methamphetamine produces similar effects to those produced by cocaine. However, it is up to 25% cheaper than cocaine and its effects last longer, up to 10 or 20 hours (Albertson et al. 1999; Murray 1996; Rawson et al 2002; Sommers and Baskin 2004). Researchers suggest that methamphetamine has become popular because it is readily available, relatively pure, cheap, and it produces a high that lasts a long time (Sommers and Baskin 2004).
Methamphetamine consumption produces many desirable and undesirable effects on the human body and emotional state of being primarily through the central nervous system (Sommers and Baskin 2004). Although methamphetamine and cocaine produce similar effects, they each trigger different mechanisms in the central nervous system (Derlet and Heischober 1990). Immediately after consuming methamphetamine, the

user may experience a rush and an overwhelming sense of pleasure that many users equate to that experienced during orgasm (Murray 1996). The user will later experience anything from: increased body metabolism, euphoria, alertness, intensified emotions, improved self esteem, loss of inhibitions, and/or increased energy and sexual appetite (Cretzmeyer et al. 2000; Derlet and Heischober 1990; Maxwell 2005; NDIC 1996; Sommers and Baskin 2004; Tarter 1992). However, with prolonged high dosage, the user could experience nervousness, irritability, and paranoia. Too high a dosage may even produce seizure, stroke, heart failure and prolonged psychosis. The NDIC (1996) indicates that D methamphetamine (crystal methamphetamine) toxicity comes on without warning and often results in sudden and unexpected death. Once the initial high wears off, the user will likely experience a sense of fatigue, depression, paranoia, insomnia, and/or aggression (Maxwell 2005; Sommers and Baskin 2004). Researchers have found that users will consume more methamphetamine to avoid or resolve such feelings (Sommers and Baskin 2004). A study conducted among violent offenders found a relationship between combining sedatives and/or alcohol with methamphetamine and the drastic effect it had on intellectual awareness which lead to an increased risk for violence (Ellinwood 1971).
Tolerance is said to develop quickly with methamphetamine use (NDIC 1996; Tarter 1992). Sommers and Baskin (2004) suggest that over the period of one year, a user may begin consuming 5 mg and end up consuming 1000 mg. Regular users will suffer from lack of sleep and weight loss. Long term heavy use results in malnutrition, skin disorders, ulcers, and diseases caused by vitamin deficiencies (Sommers and Baskin 2004). It can also cause cerebral hemorrhage, infections from contaminants, renal damage, stroke, heart attack, and circulatory collapse (Tarter 1992). Chronic users can develop psychotic behavior involving

intense paranoia, visual and auditory hallucinations, uncontrollable rage and violent behavior (Sommers and Baskin 2004; Yacoubian and Peters 2004).
Tarter (1992) suggests that methamphetamine is both physically and psychologically addictive. However, most experts agree that methamphetamine is at least psychologically addictive. This means that a user will experience severe depression and suicidal dependencies should s/he try to stop using the drug. Methamphetamine withdrawal symptoms can take 30-90 days to appear. Such symptoms include: depression, the loss of the ability to experience pleasure, lethargy, paranoia, aggression, and drug cravings (NDIC 1996; Sommers and Baskin 2004). Negative consequences such as these make it difficult for users to stop consuming methamphetamine especially when treatment is for only 30 days.
Though research findings are mixed, some researchers indicate that methamphetamine use causes cell death in the cortex, striatum, and hippocampus in the brain. Some research goes a step further by suggesting that methamphetamine use can cause long term decreased cognitive functioning including: reduced memory capacity, poor psychomotor speed, and limited learning ability (Cretzmeyer et al. 2000; Maxwell 2005; Zickler 2001). Other studies have found more positive news suggesting it is possible that brain functioning may improve after 9 months of sobriety (Maxwell 2005). So far there is no consensus as toThow methamphetamine use permanently affects the brain.
Along with physical deterioration, methamphetamine use puts individuals and their communities at risk for a variety of social problems. Users are at risk for having psychotic episodes, executing and experiencing violence, and having severe legal sanctions due to their actions while high. Likewise, the community is at risk for increased rates of violence, crime,

and illegal activities (Cretzmeyer et al. 2000). Methamphetamine consumption also puts users and their partners at risk for acquiring blood born pathogens and sexually transmitted diseases. In short, methamphetamine carries with it social, economic, public health, and environmental problems for both the user and the community in which s/he lives (Hannan 2005).
A study conducted among individuals in treatment for methamphetamine abuse in Hawaii, Northern and Southern California, and Montana found that there is a high rate of physical and psychological problems among methamphetamine users. The study also found that few methamphetamine users receive care for problems such as these (Reiber et al. 2000).
Social Trends in Use and Connotations of Use
Methamphetamine has gone from being known as a therapeutic drug to being known as a recreational drug. Its reputation has been deeply impacted by the reputation of those who have chosen to use it and the perceived epidemics that have taken place throughout the years. There have been three separate epidemics of methamphetamine consumption. One occurred in urban areas among men who have sex with men, another occurred in rural areas among white working class men and women, and yet another occurred among urban and rural college and high school students.
In 1936, amphetamines became popular among those who used the drug to enhance wakefulness and/or performance (Murray 1996). Such individuals included college students, athletes, truck drivers and business men and their secretaries (Murray 1996; Olive 2004). After WWII,

amphetamine use became much more prevalent among the general American population (Anglin et al. 2000). Perhaps it rose in popularity because of its utilitarian value or maybe it became more popular because of its affiliation with American beat culture, making it cool to use amphetamines (Klee 1997).
In just a matter of years, methamphetamine went from being a cool and useful drug to being a dangerous and disgusting drug. African Americans and Bohemians began making the first illicit methamphetamine powder (dl methamphetamine or bathtub crank) once licit forms became less available in the 1960s (Klee 1997). Ex-servicemen were responsible for spreading methamphetamine labs throughout the San Francisco bay area in the 1960s (Jenkins 1999). Recognizing the profitability of methamphetamine, biker groups in San Francisco later harnessed the opportunity to manufacture the drug. They are said to have flooded San Francisco with the drug. Because biker groups tend to attract marginalized and deviant individuals, methamphetamine became less attractive to the middle class, bohemians and African Americans who once used it. For the first time, methamphetamine became associated with speed freaks that were seen as lesser individuals in society (Klee 1997). Jenkins (1999) notes that even the most enthusiastic users identified methamphetamine as a medical and cultural problem in the 1960s because it is associated with aggression, violence, the amoral speed freak, organized crime and drug trafficking. In 1969, methamphetamine became associated with Charles Manson and the violence he committed. Because of the increase in murders and assault, methamphetamine was blamed for the collapse of the peace and love ethos in San Francisco during the late 1960s. Life magazine called Methedrine the drug that scares hippies. Accordingly, methamphetamine prescriptions dropped during the 1970s (Jenkins 1999).

Even though methamphetamine carried so many negative connotations with it, it remained popular because of its ability to destroy inhibitions and enhance sensation for which it was called high-octane rocket fuel (Jenkins 1999). In the 1970s, college students, young professionals, minorities, and women joined the blue collar population who used amphetamines (Anglin et al. 2000).
Chemists improved methamphetamine production in the 1980s, making a purer methamphetamine. The purer methamphetamine amplified the high associated with consumption and thus promoted higher amounts of recreational methamphetamine use. Researchers suggest that the purer methamphetamine first arrived in the United States in the 1980s when the Hawaiians began smoking crystal methamphetamine (d methamphetamine) from Asia (Anglin et al. 2000).
Crystal methamphetamine, the purest form of methamphetamine, enabled those who feared or disliked needles to try methamphetamine and reap the same benefits as those who injected it (NDIC 1996).
Technological advances in methamphetamine production enabled chemists to mix ephedrine and red phosphorous to make crystal methamphetamine. This was a great advantage since ephedrine and red phosphorous can be purchased locally unlike P2P which has to be imported. This greatly enhanced methamphetamine quality, production and availability (Jenkins 1999). Organized crime caught on to the profitability of crystal methamphetamine and began making it in super labs in San Diego during the 1980s (Klee 1997). California became the methamphetamine production capital of America due to the efforts put forth by organized crime (NDIC 1996).
At that time, methamphetamine attracted young, working class white individuals who lived within the economically declining suburban

communities of America. Methamphetamine was known as poor mans cocaine (Klee 1997). This may be because it produces similar effects for a cheaper price and working class users favored snorting methamphetamine over smoking and injecting it which were highly stigmatized activities (Jenkins 1999).
Methamphetamine first became associated with the western United States. Production was centered in California, Oregon and Texas, which accounted for 76% of the clandestine labs seized by law enforcement in the 1980s (Murray 1996). Methamphetamine production later spread eastward throughout the United States during the late 1980s and 1990s. Accordingly, methamphetamine use increased substantially in the Midwest during the 1990s (Anglin et al. 2000; Furr et al 2000; Sommers and Baskin 2004). In fact, amphetamine use in general outranked cocaine use from 1975-1995 (Jenkins 1999). During this time, both methamphetamine use and deaths attributable to methamphetamine use grew considerably (Olive 2004). However, the government largely ignored the methamphetamine problem during this time and instead put the spotlight on Americas crack problem (Klee 1997).
Methamphetamine use has become a major problem in the United States. The National Survey on Drug Abuse and Health from 2004 estimates that 12 million people in the United States have tried methamphetamine at least once in their lives (OAS-SAMHS A 2005). Amphetamines are the second most popular illicit substance with American teens and the fourth most popular substance out of both licit and illicit substances (Tarter 1992). In 2002, the annual prevalence of methamphetamine use for those aged 15-64 was 1.4% (Maxwell 2005). Some suggest that methamphetamine use has reached epidemic proportions (Derlet and Heischober 1990; Furr et al. 2000; Tarter 1992; Yacoubian and

Peters 2004). Sommers and Baskin (2004) indicate that methamphetamine users are economically, educationally, and demographically different than crack users. Using critical medical anthropology as my reasoning base, I contend that this is important because such factors influence an individuals choice to use, their using careers, their treatment success and life after recovery.
The demographic of methamphetamine users is changing. The NDIC (National Drug Intelligence Center) indicates that dl methamphetamine was previously associated with young white men who were both unemployed and single. Along with other researchers, it now indicates that d methamphetamine, crystal methamphetamine, is popular among a wider age range, different ethnicities, young professionals, and married, widowed, or divorced individuals of both sexes (Murray 1996; NDIC 1996; Sommers and Baskin 2004). Though there is a wide array of different users from different backgrounds, multiple studies have found that the majority of methamphetamine users today are lower middle income white individuals between the ages of 20-35 who have their high school diploma or equivalent (Murray 1996; Yacoubian and Peters 2004). Reiber et al. (2000) and Maxwell (2005) indicate that many methamphetamine users come from abusive backgrounds and/or are involved with violence currently. Although methamphetamine use is higher in cities, rural use is growing beyond expectation (Simons et al. 2005).
The demographics of methamphetamine users are unique compared to the demographics of those who use other drugs. According to the 2004 drug survey, the highest usage of methamphetamine occurs among white and Hispanic individuals. Males and individuals of both sexes between the ages of 18 and 25 also represent the group with the highest usage (OAS-SAMHSA 2005). Unlike many other illicit substances, males and females

tend to abuse methamphetamine in similar proportions (Cretzmeyer et al. 2003). In fact, the rate of past usage for males is .7 whereas it is .5 for women (OAS-SAMHSA 2005).
Despite the adverse effects methamphetamine use can produce, researchers suggest that many individuals who consume methamphetamine have young children (Cretzmeyer et al. 2003). One would wonder why a person would choose to put his/her child at risk for sake of his/her drug use. However, researchers indicate that users are attracted to methamphetamine because they perceive that it enhances both their physical and mental abilities (NDIC 1996). They further contend that women are attracted to methamphetamine because it helps them lose weight (Rawson et al. 2002; Tarter 1992).

Research concerning female methamphetamine users and rural methamphetamine users is limited. This chapter focuses on the available research concerning those populations. I emphasize how structural violence shapes methamphetamine consumption for those populations and I attempt to explore vestiges of structural violence that affect the rural women of Montana.
Defining Structural Violence
Critical medical anthropologists are particularly concerned with structural violence and how it perpetuates social problems such as the current methamphetamine epidemic. Structural violence is a form of oppression that is executed subtly. The oppressors are generally not identifiable individuals or groups, but rather many different omnipresent features of the power structure. Similarly, structural violence is enacted at several different points in the power structure. Specifically, structural violence is enacted through the state, its social institutions, and through the collective psyche. It is even woven into the social norms and cultural fabric of society. It acts to disempower the powerless or less powerful in society. Accordingly, impoverished or marginalized groups are most at risk for suffering from structural violence (Farmer 2003; James et al. 2003).
Though structural violence is experienced at the individual level, it targets

groups of people who experience a common form of lived oppression (Singer 2001).
Structural violence causes social suffering. The victims of structural violence suffer from a reduced sense of agency in making life choices due to the constraints imposed upon them by racism, sexism, political violence and/or poverty (Farmer 1997). Social suffering becomes embodied by a symbolic network that involves the body, self, and society (Kleinman 1988).
Structural violence and social suffering cause emotional harm, prompting sufferers to seek out relief. Singer (2001) posits that drug use offers the relief sufferers desire. He notes that inner city youth and young adults, being barred from achieving the American dream of having a good job, material goods, or social recognition through conventional means seek out drugs to fulfill their dreams on a more realistic level. Operating in this sense, structural violence promotes drug use within oppressed groups.
While structural violence can promote drug use within oppressed groups, drug use can act to deepen the effects of structural violence.
Philippe Bourgois (2003) who studied the political economy of the crack trade among Puerto Rican immigrants in East Harlem notes (p. 9) although street culture emerges out of a personal search for dignity and a rejection of racism and subjugation, it ultimately becomes an active agent in personal degradation and community ruin.
Individuals living in oppressed groups share experiences and social bonds with one another that support drug use technology and culture (Singer 2001). As such, it is important that we attempt to understand the power structure so that we can stop the methamphetamine epidemic.

Female Methamphetamine Users
As I noted above, structural violence acts as a blanket of oppression that is experienced in all aspects of life. It is involved in shaping cultural values and making people feel insufficient. Researchers posit that individuals choose to consume methamphetamine because they believe that it will help them cope with societys expectation of them. However, methamphetamine abuse often further entrenches users within a state of powerlessness.
Women have been using amphetamines for as long as men have. However, researchers suggest that some of their reasons for using are different from those of men. Most social scientists believe that women differ from men in that they are attracted to the weight loss benefits associated with methamphetamine consumption (NDIC 1996; Rawson et al. 2002; Tarter 1992). However, weight loss is just one of the several effects of methamphetamine consumption that are valued by American men and women (Klee 1997; Rawson et al. 2002). Klee (1997) suggests that methamphetamine also helps to promote intense activity, efficiency, persistence, drive, the desire to excel, and the ability to move with greater speedall of these traits are highly valued in todays Western society. The deleterious effects of methamphetamine often take a long time to set in. Because of this, it is likely that methamphetamine will remain popular (Rawson et al. 2002).
Women who have methamphetamine addictions become pregnant and some choose to continue using methamphetamine. Nationwide, illicit drug use during pregnancy is 5.5 % (Cretzmeyer et al. 2003). One study that was conducted in California found that the majority of women who became pregnant while using methamphetamine did not intend to become

pregnant. Another study found that methamphetamine is the third most common illicit drug found on toxicology screens among women giving birth in California (Albertson et al. 1999; Singer 2006). Many such women live in poverty and they are likely to have come from troubled and violent homes. They may have experienced sexual abuse and began using drugs early in their lives after having been introduced to them by their male partners (Singer 2006).
Prenatal exposure to methamphetamine can cause birth defects. Specifically, it can result in cleft palate, decreased growth, retinal defects, rib malformations, limb malformations, abnormal reflexes, variation in IQ, thought disorders and behavioral problems in infants (Cretzmeyer et al. 2003; Maxwell 2005; Olive 2004). Methamphetamine use during pregnancy can cause premature and complicated deliveries (Olive 2004). Moreover, it can also cause infant and maternal death due to intracerebral hemorrhage, cardiovascular collapse, seizure, and amniotic fluid embolism (Albertson et al. 1999). Despite their consistent methamphetamine use and seemingly blatant disregard for these consequences, one study among pregnant women found that methamphetamine remains the mothers number one concern while she is pregnant (Singer 2006).
Children belonging to mothers who use methamphetamine are at risk for experiencing developmental delays, increased family stress and becoming exposed to and/or involved with methamphetamine use and production (Cretzmeyer et al. 2003). Often times such children were exposed to the drug in utero and they live in a poor conditions marked with poverty, neglect, chaos/danger, childhood sexual abuse, and exposure to several different and/or abusive male figures in their lives (Maxwell 2005; Rawson et al. 2002).

Women are more likely than men to believe they are in control of their substance abuse, especially when they have a history of unsuccessful treatment experiences and/or parental or spousal abuse. Therefore, they are generally slower to recognize the need to enter into treatment (Klee 1997).
Pregnant women and women who have children have special treatment needs. They must contend with issues at work, home care, childcare, and family responsibilities. Treatment may serve to increase their lifes burdens by increasing fatigue (Rawson et al. 2002).
Rural Methamphetamine Users
Structural violence operates on many levels to promote substance abuse (Singer 2001). Specifically, it acts at the economic level, political level, social level and cultural level to limit the economic and social opportunities available to rural residents, making substance abuse seem like a feasible alternative to suffering.
A secondary analysis of the Monitoring the Future dataset conducted by Cronk and Sarvela (1997) found that rural prevention efforts aimed at illicit substance use are less common and less effective than those in the urban context. They conclude that rural youth are at the same risk for illicit substance use as urban youth (Cronk and Sarvela 1997).
Although the risk for substance abuse is similar for rural and urban youth, the prevalence of alcohol and tobacco use is higher among rural youth than urban youth (CASA 2000; Cronk and Sarvela 1997). Likewise, drug use among rural adolescents and prisoners is also higher than it is among urban adolescents and prisoners (CASA 2000; Warner and Leukefeld 2001).

Accordingly* Montana has the third highest percentage of alcohol dependence and the ninth highest percentage of illicit drug dependence or abuse in the nation for those of all ages. Moreover, it has the highest percentage of alcohol dependence and the second highest percentage of illicit drug abuse or dependence for individuals aged 12-17 (SAMHSA 2002-3).
Montana youth attribute the statistics to boredom and isolation. The following quote illuminates my point.
The students say they know friends and acquaintances even teens with 4.0 grade point averageswho turn to drinking or other destructive behaviors simply out of boredom (Easterling 2005).
The main types of substances consumed seem to vary according to the rural or urban context in which they are used. One study conducted among urban and rural incarcerated individuals found that rural youth are at a greater risk for using alcohol and sedatives, but protected from marijuana, cocaine, hallucinogen, and heroin use (Leukefeld et al. 2002). Alternatively, another study which involved discerning the 1997 Survey of Inmates in State and Federal Correctional Facilities found that rural drug users are more likely to report marijuana, amphetamines, and sedatives as their primary drug (Warner and Leukefeld 2001). In fact, one study found that rural 8th graders are 50% more likely to use marijuana and 104% more likely to use amphetamines than urban 8th graders (CASA 2000).
Drug law violations increased in many small communities throughout the United States from 1990-1998 (CASA 2000). Methamphetamine in particular has impacted small communities in farm and ranch areas (Freese et al. 2000). In Montana, for instance,

methamphetamine is blamed for the high numbers of females entering the prison and jail system (AP 2006c).
Rural areas are disproportionately poorer than the rest of the nation. One third of Americas poor live in rural areas but rural areas only account for 28% of the population. Residents inhabiting rural areas suffer from limited employment opportunities and isolation which contribute to poverty and poor mental health. Rural areas also tend to have a small tax base which limits funding for social services and adequate staffing and training for police (CASA 2000; Leukefeld et al. 2002).
Treatment is insufficient in rural America (Anderson and Gittler 2005; Freese et al. 2000). Substance abuse treatment in rural areas generally lacks political and monetary support. As such, there are fewer facilities and they utilize fewer trained staff than do urban facilities. Treatment facility staff suffer from being under-resourced. Individuals requiring treatment face transportation difficulties caused by lack of public transport and long distances to travel (Anderson and Gittler 2005; CASA 2000; Robertson and Donnermeyer 1997; Warner and Leukefeld 2001). Moreover, they must contend with higher service costs. Many rural residents lack private health insurance, so they must pay for treatment themselves (Anderson and Gittler 2005; Leukefeld et al. 2002). As such, many chemically addicted individuals who require treatment dont receive it. For example, over 60,000 Montanans have a substance use disorder and only 6.2% of individuals needing treatment received treatment in a state certified facility (McAuliffe et al. 2001).
Further worsening the problem, rural residents appear to possess cultural attributes that reduce the likelihood of seeking treatment (Anderson and Gittler 2005; Leukefeld et al. 2002). Rural residents tend to be conservative and they also tend to value self reliance and individualism

(Leukefeld et al. 2002; Warner and Leukefeld 2001). Entering treatment poses the risk of losing ones anonymity and becoming labeled as a drug user, thus enhancing their suspicion of treatment facilities (Freese et al. 2000; Leukefeld et al. 2002; Warner and Leukefeld 2001).

Stmctural violence causes individuals to suffer from oppressive conditions that can make methamphetamine seem appealing. Methamphetamine consumption however, can produce a greater sense of social suffering. In this chapter I discuss how methamphetamine consumption is related to disease and illness.
Methamphetamine consumption enhances sexual arousal and it promotes uninhibited action (Maxwell 2005). As such, methamphetamine consumption tends to facilitate social and sexual interaction (Klee 1992b). While high, individuals are likely to engage in sex more frequently, for longer periods of time and in an atypical, disinhibited fashion. They are also likely to have more partners and use condoms less frequently those who dont use amphetamines (Kail and Nilsonne 1995; Klee 1992a;
Molitor et al. 1998; Molitor et al. 1999). This enhanced sense of sociability has serious implications for public health (Klee 1992a). For example, one study found that gay males who use methamphetamine are more likely to engage in high risk sexual behavior while under the influence (Rawson et al. 2002). Another study found that heterosexual users had an average of 9.4 partners over the course of two months and engaged in unprotected vaginal, anal and oral sex almost 80 times during that period. Of those individuals, 29 % had suffered from an STD in the last two months, 17 % had Hepatitis C and 11 percent had Hepatitis B (Semple et al. 2004). Accordingly, methamphetamine users are at an increased risk for contracting STDs and blood borne pathogens like HIV/AIDS and Hepatitis

C (Cretzmeyer et al. 2000; Maxwell 2005; Sommers and Baskin 2004; Wu et al. 2004).
Studies have found that there has been an increase in the prevalence of amphetamine injection (Wu et al. 2004). In some parts of the United States injection is cited as the most common route of methamphetamine administration (Perez et al. 1999). Those who favor injection tend to be older males, though females seem to be significantly involved as well (Anderson and Flynn 1997; Darke et al. 1995; Maglione et al. 1998). A study conducted in Australia found that injection seems to be favored because injection equipment is widely available and the media promote the superiority the injection experience brings (Klee 1992b). The injection experience is said to induce a rush that is quasi-orgasmic. Adding to the pleasures of the injection experience, injection seems to waste less of the drug and so injection is cheaper (Klee 1992a).
Contrary to opiate injectors, amphetamine injectors tend to be younger, they exhibit greater sociability, have more sexual interaction, and they believe that they have control over their drug use (Anderson and Flynn 1997; Darke et al. 1995; Klee 1992a; Klee 1992b; Wu et al. 2004). They also show reluctance to meet with drug services, they tend to distribute injecting equipment freely when it is in short supply and/or inject less frequently (Klee 1992a). However, amphetamine injectors show a disregard for hygiene and they tend to share injecting equipment as a show of solidarity and trust (Anderson and Flynn 1997; Darke et al. 1995; Klee 1992a; Wu et al. 2004). According to a study of 301 amphetamine users, females seem to be especially likely to share needles compared to males (Darke et al. 1995). As a result, methamphetamine injectors are more likely than opiate injectors to acquire HIV (Molitor et al. 1999).

Injection drag use is associated with increased risk of acquiring blood born pathogens. Studies have found that drag injectors are six times more likely to be seropositive for HIV. Methamphetamine injectors seem to be especially at risk for acquiring blood bom pathogens. One study found that the prevalence of HIV among amphetamine injectors was three times higher than it is among those who inject other substances (Molitor et al. 1999).
Injection drag use and heterosexual sex together account for 70 % of the HIV cases in women. Sadly, AIDS is the fourth leading cause of death among American women between age 25 and 44. Other risk factors for contracting HIV are: living arrangements, homeless status, drag use, sex trading, and history of STDs. Women drag users tend to engage in social relationships wherein they share injection equipment and have multiple sexual partners. Those who are economically disadvantaged may engage in sex trading and relationships predicated on economic necessity. Women suffer from an imbalance of power which makes it difficult for them to enforce the use of condoms (McCoy et al. 1999). As such, women drag users are at an increased risk for HIV, STDs, and blood borne pathogens. Moreover, one study conducted among 154 heroin injectors and 45 methamphetamine injectors found that methamphetamine injectors are less likely to change their behavior in response to being diagnosed with AIDS (Zule and Desmond 1999).
A study conducted in Pierce County Washington among injection drag users found that such individuals are at an increased risk for acquiring Hepatitis B and Hepatitis C (HCV). One study found that 70 % of injection drag users became infected with Hepatitis B within five years of starting to inject. Unfortunately, many injection drag users in the study lacked medical insurance or a regular source of medical care. Moreover, many

received care where the Hepatitis B vaccine is not offered. Medical providers didnt ascertain injection drug use history or offer the vaccination to injection drug users (MMWR 2001).
HCV affects 170 million people worldwide, amounting to a pandemic. It is five times more widespread as HIV and like HIV, there is no cure nor is there an effective way to prevent its spread. Increased risk for HCV is associated with: injection drug use, blood transfusion before 1990, poverty, high risk sexual behavior, fewer than 12 years of education, and history of divorce or separation from ones partner (Lauer and Walker 2001).
The non-injecting sexual partners of those who inject methamphetamine are at a greater risk for acquiring HTV than the noninjecting partners of opiate injectors because 1) methamphetamine injectors are more likely than opiate injectors to have sex with non-injectors and 2) male methamphetamine injectors are less likely to use condoms than male opiate injectors (Anderson and Flynn 1997; Molitor et al. 1999). Further exacerbating the situation, one study conducted among out of treatment injection methamphetamine users study found that methamphetamine use was an independent predictor of condom use and unsafe injection practice among female users. It also found that female methamphetamine users had an average of 19 different sexual partners in 6 months (Molitor et al. 1999).
A thorough literature search conducted by Maxwell (2005) found that individuals who suffer from HIV/AIDS and engage in methamphetamine consumption are especially vulnerable to hypertension, hyperthermia, rhabodoyolysis, and stroke.

Montana Epidemiologic Profile
According to data collected in 2003, there are 1.4 cases of AIDS per 100,000 Montana residents. There were 52 reported cases of AIDS and 21 reported cases of HIV among females in Montana between 1985 and 2000. Heterosexual contact accounts for 67 % of the HIV cases among women while injecting drug use accounts for 19 percent of the HIV cases between 1985 and 2003. Excluding the Native American population of females, women aged 30-39 account for the highest percentage (47 %) of those who were diagnosed with HIV/AIDS, with women aged 20-29 accounting for the second highest percentage (23 %) (State of Montana Community Planning Group for HIV Prevention 2004).
Both sexual contact and injection drug use can be connected to methamphetamine use. Methamphetamine is second to marijuana in terms of drugs seized by Montana law enforcement in 2001, accounting for 14 % and 65% respectively. Narcotics make for a small percentage (5 %) of the drugs seized in 2001. No heroin was seized in 2001 (ONDCP 2004). We can deduce from these data that injecting drug users are probably injecting methamphetamine over other drugs. Thus, HIV/AIDS incidence rates among injection drug users are likely to be connected to methamphetamine more than other drugs. We cannot make any clear connections between heterosexual contact and methamphetamine in relation to HIV/AIDS incidence rates except to say that methamphetamine users tend to engage in high risk sex with many partners.

Research took place in the Greater Flathead Valley of Montana, as defined by the Centrytel phonebook. The towns included are Whitefish, Kalispell, and Poison. However, research efforts were largely concentrated upon Kalispell, Montana. Data were gathered from June to August of 2005.
Research was conducted during a time in which a major court trial involving methamphetamine and a prostitution ring was in process and concluded. The trial was heavily publicized and spoken about community wide. It involved a prominent business man, Dick Dasen, and a string of young women, some of whom were well acquainted with the key informants and the participants interviewed. As such, research was deeply influenced by the trial.
It is also important to note that during the course of the study, a new law prohibiting the sale of products containing pseudoephedrine on the shelves was enacted to reduce the availability of methamphetamine precursors. Products containing pseudoephedrine must now be dispensed by pharmacy personnel and personnel must document the purchasers information before handing them out. Moreover, individuals are now limited to a quantity of 9 grams per purchase (Montana Board of Pharmacy 2005).

Study Design
Research was conducted in two major phases. The preliminary phase involved interviewing key informants who were identified according to their knowledge and/or experience with methamphetamine. Those who were included in the study were required to have professional contact with methamphetamine related issues. Initially, key informants were located based upon information posted in the phone book for the Greater Flathead Valley. As research progressed, snowball sampling was utilized.
Therefore key informants were located by way of recommendation from other key informants (Patton 2002).
Key informants included: law enforcement personnel, family service workers, members from the violence free crisis line, treatment facility counselors, the landlord of a local homeless shelter, a Narcotics Anonymous leader, a pharmacist, a Teens n Crisis founder, harm reduction workers, and health care personnel. Importantly, many of the key informants were personally affected by the methamphetamine problem whether through occupational experience, personal involvement with the drug, family involvement with the drug or consequences incurred by methamphetamine users on the key informant his/herself.
Daily phone calls were made to solicit interviews. Records of such phone calls were kept in a daily log to keep track of who had been contacted and who should be contacted. This method ensured a more mindful and efficacious selection of key informants.
In total, 20 key informants were interviewed. All but one key informant was interviewed once, however I did interact with some of the key informants several times before and after interviewing them.

With few exceptions, interviews were conducted in an in-depth semi-structured format promoting comparability between interviews, insuring complete data collection, and reducing my bias (Patton 2002).
This format also permitted key informants to provide avenues for further questioning outside of what was originally planned. The questions posed are as follows:
1. Tell me about methamphetamine in the Flathead Valley.
2. Is this different from the past and if so, how?
3. How would you describe a methamphetamine user? Who are they and are there different types of users?
4. What patterns of methamphetamine use are you seeing?
5. What are the primary problems associated with methamphetamine use?
6. Can you tell me about your experience with methamphetamine users?
7. How does the methamphetamine industry operate in Montana?
8. Are there any other methamphetamine related issues you would like to speak about?
While most key informant interviews were conducted in the in-depth semi-structured format, some were conducted in the more informal open-ended format. Open-ended interviews were used as a tool for key informants who had been prior methamphetamine users to integrate their personal and work experiences into a dialogue. Generally such discussions began with a question asking the key informant to describe methamphetamine and how it affects the Flathead Valley.

Most interviews were conducted in the key informants office, although one was conducted in a coffee shop and a few were held over the phone. Interviews lasted anywhere from 30 minutes to over two hours. All interviews, excluding those conducted over the phone, were digitally recorded, uploaded onto a computer, labeled with a numerical code identifying the person from whom the interview was collected, and burned onto a CD for storage in a locked file cabinet. Such methods helped to assure accuracy in transcription for later recollection and anonymity for those recorded. Despite my best efforts, some recordings were lost due to improper technique.
Key informant interviews elucidated a set of themes central to the way key informants perceived the methamphetamine problem in the greater Flathead Valley. The themes identified in the primary phase of research were used to inform the second phase of research.
The second phase of research began at the end of the first phase after the point of information saturation. During the second phase, former methamphetamine users were identified and interviewed. For the purpose of clarity, they were called participants. Purposive criterion sampling was used to define participants (Patton 2002). Participants included women who had formerly used methamphetamine and had begun doing so between the ages of 18 and 30. However, there were no criteria stating how long the women had to be free of methamphetamine. Women who were currently using methamphetamine or began using beyond the defined age limit were excluded from being participants, although some qualified as key informants. Such women were passively recruited by way of key informants who recommended that they participate in the study. They were given my phone number and asked to call me should they decide to participate.

All women who contacted me were qualified for the study. They were referred by two sources: a former drug taskforce worker and the violence free crisis line. Two of the women were referred by the violence free crisis line. The women from the crisis line were actively involved with a religiously oriented anti-methamphetamine support group and vigorously opposed to the business man involved with the trial mentioned previously. In fact, they lay claim to being responsible for the commencement of that case.
Participant interviews began in late July and ended in early August.
Due to a lack of time and the difficulty of locating and encouraging former methamphetamine users to participate, a total of three participant interviews were conducted.
Participant interviews were initially intended to be conducted in the in-depth semi-structured format; however almost immediately I found that the open-ended format worked the best for the opening interview. The open-ended format allowed participants to speak fluently about their personal experiences with methamphetamine in a natural and comfortable manner. To promote further discussion, I occasionally chimed in with questions relating to important themes identified during the preliminary phase of research or by the participant herself. The participant interview guide is as follows:
1. Could you please describe your past experience with methamphetamine?
2. Could you please tell me what attracted you to methamphetamine and why you started using?
3. How long did you use methamphetamine?
4. Can you describe your life while you were using?

5. Were you a part of a larger methamphetamine using social scene? Can you tell me about it?
6. Why did you quit using methamphetamine? How did you quit?
7. Please explain how your life changed since you stopped using methamphetamine.
8. Please describe what methamphetamine means to you.
9. What suggestions would you have for helping people to quit using methamphetamine?
Participant interviews were performed in the participants preferred interview locale, ranging from a coffee shop to a residence. Primary interviews usually lasted about two hours or more. Participants were paid $10 for each interview they attended. When conducted in person, participant interviews were digitally recorded and stored using a numerical code in the same manner that key informant interviews were handled.
Grounded theory was utilized throughout the study. Accordingly, data were constantly analyzed. Detailed field notes, most including exact wording, were entered into the computer as interviews were completed. Headings were given to distinct sections within the field notes. Field notes were printed and stored in a binder as well as saved onto a disk. Both of these items were stored in a locked file cabinet to protect the data from inappropriate viewers.
Intense efforts to analyze data began in August after the field work had terminated. During that time, individual interviews were coded according to the different themes found within them. After that, common

themes found throughout the 21 key informant interviews conducted were identified. Such themes were used to re-code each of the interviews and simplify data into a comprehensible piece of information.
Four major themes were identified during the second coding of interviews including: anti-methamphetamine activities/laws, history of methamphetamine, impact of methamphetamine on the greater Flathead Valley, and user profile. Re-coding the interviews helped solidify the data; however a further re-coding of the data was required to enhance readability. Anti-methamphetamine acts/laws was broken into: treatment, harm reduction, community efforts, laws/law enforcement acts, and inadequacies in anti-methamphetamine acts/laws. History of methamphetamine was stratified into: patterns of use, methods of acquisition, changes in anti-methamphetamine acts/laws, when and why it was noticed, and growing consequences of use. Finally, user profile was broken down into: demographics, activities, physical consequences of use, and interpersonal relationships. Impact of methamphetamine on the greater Flathead Valley was left intact without additional sub-theme identification.
Participant interviews were analyzed alone and with the interviews from key informants who claimed to have been former users. Likewise, the interviews from the three key informants who identified as former users were analyzed alone and with 1) key informants and 2) participants. The key informants included in the user population met all criteria for participation, but they were interviewed as key informants because they worked within a field where they dealt with methamphetamine users. Combining the six individual interviews together was done in order to maximize the amount of data available for analysis. Particular themes emerged from analysis including: self esteem, treatment, methamphetamine

community, loved ones, class, and the physical effects of methamphetamine.
Meaning was sought while looking into each theme. Particular interviews were transcribed to instill greater meaning and ensure accuracy during analysis. Moreover, relevant literature were sought to triangulate data and minimize bias (Patton 2002). A running log was kept to keep track of confusion and insights during this time. Eventually a coherent theoiy was found and documented.
All work was closely supervised by Dr. Koester who has 15 years of experience with drug users and who has completed similar projects. He guided me through constructing a question guide, developing rapport with informants, and talking with the appropriate agencies. Moreover, he reviewed my field notes and aided me through the process of analysis.

1. Methamphetamine is the devil.
(Meth) is poison and it destroys lives. Harm reduction worker
2. Literally and symbolically methamphetamine is construed of as an evil entity. It captures the vulnerable and wrecks their lives and the lives of those around them. Users become vehicles of evil possessed by methamphetamine demons.
Its like meth brings out a demon in you. Its not you. Meth takes you and hides you and puts this horribly ugly demon monster in its place. I mean its like a demonic dmg. It takes the good in everybody and locks it up somewhere and brings out all the bad things in a person... Even when I was doing diet pills and cross tops or other drugs I wasn1 as crazy as when I was doing meth. It really brought the monster out in me. Stella
It is all about the drug. They usually have kids and we see a lot of child abuse. They dont care about their kids. If they did, they wouldn t be in that state now. Law Enforcement personnel
There are cases where people have become homeless out of
use....meth use is pervasive and growing. I have a big fear
of meth labs as a realtor and people coming in. Homeless shelter personnel
The personal problems are enormous. There are health, financial, and relationship problems. They sacrifice

everything. This leads to the societal cost. Media Personnel
Meth is a stimulant so it is goodfor awhile, then you lose your morals, family, job, etc. Treatment personnel
3. Methamphetamine users destroy the most innocent of communities and strike fear in the hearts of the people who inhabit such communities.
We have concerns about workplace violence..they are
dangerous. Medical worker
Meth causes the most problems-property damage, theft, burglary and crimes against people. Law enforcement
On Thursdays, the criminal courts day when they tty felonies, about 80% of the burglaries and bad checks are related to meth. This has been going on for years. Media
A third of the murders over the past 7 or 8 years have a meth connection. Law enforcement personnel
4. There is virtually nothing that can be done to combat the meth devil. Perhaps we can have faith.
Get them sober for a day and then get them into a 12 step program like AA or NA and give them a higher power. Treatment personnel
5. We can do what is worldly possible and try and keep it out of the community and send away those who do use. We will isolate them from their friends and family, there is no other way.

The twelve step program is still the cornerstone of treatment. Most folks benefitfrom inpatient because it takes them away from their environment. When you are in outpatient, you go home where the dealers are etc.... the longer the treatment the better. Treatment personnel
What percentage are we arresting to get their penalties waived and sent back to the street? It isnt scaring them off. Like my daughter, it took her time in jail for alcohol to get things figured out. Pharmacy worker
6. We will tell the people of the valley that it doesnt make them pretty or sexy. Most of all we will pray. We know however, that it will destroy us. There is no real way to keep it away, not without god.
I believe in jail and treatment. Treatment doesnt work often, but it is worthwhile to see if it will work. Law enforcement
There is no silver bullet. It requires an integrated approach. Treatment, intervention, prevention. Do it until we re dead. It is never going away. Law enforcement
God. That is the only way. Treatment without god wont help you quit. Bridget
7. We, the community and the former users, are powerless and we are fearful.
This is what I heard from the men and women who contributed to my study of methamphetamine use among women in the Flathead Valley. Both community members (individuals living and working in the Flathead

Valley who have some level of expertise in the field of methamphetamine) and the women who were current or former users felt that methamphetamine is an evil substance. Some literally called it the devil while other danced around the idea of methamphetamine being demonic.
All agreed that methamphetamine is the worst thing to have ever happened to the Flathead.
As an anthropologist I am obliged to explore the reasons why Flathead Valley residents attach demonic symbolism to methamphetamine.
I argue that methamphetamine is not the devil in and of itself. It is nothing special in that it, like many other bioactive substances, can be consumed for therapeutic or recreational purposes. The effects it produces could be interpreted as positive or negative depending upon the context and the desired result. Cocaine and heroin could just as well be the devil, but they arent.
I contend that calling methamphetamine the devil is a cultural construct used to explain the effects caused by methamphetamine consumption and the community of methamphetamine users. Attaching demonic symbolism to methamphetamine enables the community and former users to: 1) understand why methamphetamine has produced such deleterious effects on the Flathead and its people; and 2) grasp why they feel they cant do anything about it.
Community members base their contention that methamphetamine is the devil on the deleterious environmental, economic, social, public health, and public safety impact methamphetamine has made on the Flathead Valley. Although they refer-to methamphetamine as the devil, they recognize that the cause of the methamphetamine epidemic is multifaceted and based in different levels of society. Specifically, they cite grand scale factors such as location, ease of production, economy, and

nationwide drug trends as reasons why methamphetamine has become such a big problem for the people of the Flathead Valley. They also cite small scale factors such as stress and methamphetamines innate characteristics as reasons for the so called epidemic. The following quote from a law enforcement officer sums up my point.
We called meth the devil when we worked because:
1. You cant get away from it
2. It is easy to ingest
3. It isnt easy to get off
4. You do things you wouldn 7 normally do Law enforcement personnel
Former users, like community members, attach demonic symbolism to methamphetamine. They see in methamphetamine a duality. It is simultaneously evil and angelic, temporarily relieving them of the burdens that inhabit their reality while adding to the burden of their problems.
There was a duality, the other part of my brain. (Grace discussing her experience with methamphetamine)
Imagine how weird it can get. It doesn 7 further your belief in humanity. Be a friendfor that, rip them off, have deviant sex. Your sex drive is high. I got into some weird stuff and became a tweaker, a different person. I was like Dr. Jekyll and Mr. Hyde, I was a bitch. I almost got a super bitch tattoo, thank God I didn 7. It was my alter ego. (Grace discussing her experience with the methamphetamine community)
While the community sees the women as morally week and nearly helpless under the power of methamphetamine, the women believe themselves to be free agents who dumbly succumbed to methamphetamine consumption

because it seemed to make their lives better. Stella, for example, commented on how she liked how it enabled her to stay up for days and take care of her kids, clean house, and earn money. Now she likens her experience with methamphetamine to that of Eve eating the infamous apple and becoming possessed or cursed by the devil. The women seem to overlook the larger issues recognized by the community such as the Flatheads location, nationwide drug trends, etc. that may have contributed to their sense of suffering that provoked their need for relief.
I contend that structural violence causes users like the women involved in my study to suffer and seek relief in methamphetamine. Structural violence operates invisibly to reduce agency and cause suffering. While they do not overtly see how structural violence sustains the methamphetamine epidemic, community members recognize vestiges of the power structure that cause the women to experience reduced agency. At the same time however, they feel unable to relieve the suffering of those who fall prey to structural violence. Instead they seek to remediate the methamphetamine problem by tackling more proximate and tangible contributors to the problem. This is what defines methamphetamine as the devil for the community members.
The women involved in my study do not recognize that they are victims of structural violence. Being blind to these issues further disempowers them and makes their situation seem more dire and methamphetamine more attractive. This is what defines methamphetamine as the devil for the women of this study.
I follow the devil theme throughout this chapter as I answer the questions and objectives outlined at the onset of this study. Recall that I designed three objectives and three study questions for this study. The questions were 1) how do women become involved with

methamphetamine?; 2) what are their motivations for use?; 3) what are the effects methamphetamine has on their lives? The objectives align with the study questions, asking to define the demographics of a user, describe the patterns of methamphetamine use, and characterize the impact methamphetamine consumption has on the lives of users. I address my objectives and questions in the following sections, combining the answers to some objectives and answers together when appropriate.
Objective 1: Define the Demographics and Family History of Women who Use(d) Methamphetamine
The individuals who contributed to my study remain vague about the demographics of the typical methamphetamine user. They do not want to pinpoint any certain ethnic group, age group, socio-economic group or gender as a group more likely to use methamphetamine. Instead, they assert that most anybody could be a methamphetamine user. Indeed, the women of my study conform to this perception as some originate from wealthy families and others originate from impoverished families. Some are young and others are old. When asked to define a methamphetamine user, individuals recall the ways in which methamphetamine consumption impacts the user and the psychological characteristics common to many users. Community members indicate that all users are the same. However, they seem to perceive them as otherwise. I will explain in the following sections.

Part A: Age and demographics
One of the objects of my research was to identify and describe who uses methamphetamine in the Flathead Valley. I questioned community members about this specifically and only alluded to this point with former users. As such, I gained much more information from community members than I did from former users. Accordingly, this section will focus on the response from the community members.
The community possesses a disdain for methamphetamine users, yet they are simultaneously sympathetic towards them. Although all of them are intimately involved with the community of methamphetamine users, many have personal experience with users themselves.
Community members indicate that methamphetamine users vary in age and in background. Former users concur with community members in saying that methamphetamine doesnt discriminate against individuals inhabiting different demographic groups. They do however indicate that female methamphetamine users tend to have poor self esteem.
We 're generally relatively low selfesteem and probably already been using other things to do what we think will boost our selfesteem. When they re using they re very erratic and unstable and they are people who give you your word and they really mean it when they say it but there is no follow through. Believe it or not they are very often intelligent people.
Together, community members and former users alike understand that all types of people use and experience the effects of methamphetamine whether personally or through a long chain of connection to someone who uses. Specifically, they recognize that users can be any age, class, or race.

One key informant who works in the drug treatment field noted that his clients included businessmen and government officials in addition to regular Joes and individuals who came from families with a history of substance abuse. He defined a methamphetamine addict as aperson who is preoccupied by consumption and use.
The community does not define a user according to demographics, but according to what the user does to his/herself and to the community. It recognizes that users suffer. Explicitly, the community understands that users tend to end up poor, sick, and lonelylacking friends, family, and his/her self. They see methamphetamine users as victims of a force greater than themselves and they call that force the devil.
I know people who prostitute or commit suicide or steal from each other, abuse each other, dont work, etc. They cant have a normal life and it tears families apart. Law enforcement personnel
It rots your teeth, causes physical problems, heart failure, social problems, and it wrecks marriages. You ignore your wife and kids. It compromises your moral values. You may have sex with someone you wouldnt normally. Substance abuse treatment personnel
Part B: The Women of this Study
The women of my study differ widely in terms of age and socioeconomic groups (table 7.1). However, my personal involvement with the methamphetamine community leaves me unconvinced that the user population is evenly spread throughout such groups as the community and

the women indicate. That is a question that could be answered by future studies that are more quantitative in nature.
Grace V* Stella V* Bridget V* Danny K.I.** Ann K.I.** Margot K.I.**
Age 40 50 27 50s or early 60s 30s or early 40s 50s or early 60s
Marital Status Never married Currently married, previously divorced 3x Never married, currently engaged Currently married Currently married Divorced
Employment History Artist Waitress, bartender, band booker, mother Lifeguard, restaurant manager, painter, construction worker, mother Outreach worker Secretary andNA leader Grant coordinator
Time used 3.5 yrs., beginning at age 27 20 yrs, started at age 28 9 yrs, started at age 16 8 yrs Began at age 29 Began injecting at age 46.
Childhood conditions Wealthy politically active parents. Raised in the Flathead Valley. Single father home with lots of moving around btwn relatives. Ran away from home as a teenager. Raised in Northwest Parents divorced when she was 11. Kicked out of the home and lived with friends. Raised in the Flathead Valley. Unknown Nuclear home with wealthy parents. Raised in California. Nuclear home in California. Always felt like an outcast.
*Participant, **Key informant

The following case studies exemplify the differences and similarities between the women I interviewed. I will rely on the stories of these two women throughout the following chapters. One woman, Grace is from a stable and loving home, while the other woman, Stella had a more tumultuous upbringing. Nonetheless, both are recovering methamphetamine addicts and both have suffered from severe physical and emotional difficulties as a factor contributing to and as a result of methamphetamine abuse.
Grace is a 40 year old woman from the Flathead Valley. She grew up in an upper-middle class nuclear family. Her parents and their peers are/were involved with politics in the area. While in high school, Grace was a self defined choir dork. She later went to the Art Institute of Colorado to hone in on her art skills. After she graduated, Grace ended up in San Francisco for awhile. Grace says she was always a drinker and she felt that drinking was just part of the norm for her career and peer group. She tried other drugs including coke, but never ended up using any one drug other than alcohol in excess. During that time she hooked up with the wrong crowd. She says she devolved, she fell into the stereotypical methamphetamine addict living like trailer trash. In her words, she was sucked into the darkness.
At 27, Grace found methamphetamine. She says she never used casually. She enjoyed how methamphetamine helped her lose weight and control her ADHD. Having a sturdy build, she claims that she would have done anything to be thin, she needed to be thin. While she was using methamphetamine, she began to be more subversive and she began seeing

things differently. It was okay to be secretive, it was ok to lose her job she felt super human and good even though she couldnt function in normal society.
Grace, pregnant and living in San Francisco, decided to move back home to the Flathead Valley and get her life on track and raise her daughter. Her problems did not end. She began using shortly after that and even invited a friend out from California to help her set up a lab in which she made pharmaceutical grade crystal methamphetamine. Grace claims that producing methamphetamine allowed her the freedom to support her methamphetamine addiction without having to prostitute herself. She is glad that she never had to do that.
Eventually, Grace was arrested and charged for conspiracy. Prior to her arrest, she claims to have had a clean record, not even a parking ticket. She served for one year and then she went to rehab and served probation time. Two weeks before her probation was set to end, she began using again and she had to go to back to prison for a few months.
While in prison for the second time, Grace nearly died from undiagnosed and untreated lupus. She proclaims God gave me lupus for methamphetamine. She claims to be lucky to be alive now since many of her friends have died from depression, violence, etc. Without having been caught by law enforcement, Grace admits that she would be dead since she wouldnt have stopped using. Currently, she suffers from this chronic condition which she attributes to her methamphetamine addiction and production. Although she attempts to be positive about her survival, she will always be an addict in her mind. Although shed rather not remember that she is an addict, she is forced to face her past by working with the drug taskforce and speak in front of the community leaders she grew up around and school children like her daughter. This seems to be

denigrating and painful for her. Moreover, she laments her loss of freedom. She feels she is a second class citizen since she cant vote or leave the statemy opinion doesnt matter. She must call in to her parole officer five days a week and she is subject to random drug tests once a week. She feels that her past puts her career in jeopardy.and causes her family to doubt her. Most troubling for Grace, she lost valuable time with her young daughter and family.
Stella is a 50 year old woman who was born in Portland, Oregon. Stella was adopted at birth. Her mother died when she was four years old aiid her dad later remarried, divorced and remarried again. Since her father had to travel every other week and his life was so unstable, Stella was forced to live with her aunt and her friends during different periods of her life. Stella has been married four times and she has three birth children and two step children.
Stella began using substances when she was 14. She was prescribed valium to help her cope with the emotional stress of having been raped.
She later decided to quit using valium in favor of marijuana which she felt was less harmful. Stella first experienced the effects of speed at 16 when she was prescribed diet pills by her doctor because she was 30 pounds overweight. Later she graduated to using cross tops while working at the carnival. When she was 28 or 29 she left Portland for Las Vegas and began using methamphetamine occasionally. She abused methamphetamine daily within five years. Stella has served as a food waitress, cocktail waitress, bartender and band booker during the course of her life.

Stella liked how methamphetamine improved/cured her asthma and kept her awake, improving her ability to work at the bar in which she was employed. At one point, Stellas daughter was molested by an ex-husband who manipulated the system and caused the state to take her kids away. After she lost her kids to the state, she used methamphetamine to help her stay awake and alert in order to meet the states demands. Stella moved to the Flathead Valley in 1992 because her son (who was involved with gangs at the time) begged her to do so. Otherwise, he was sure she would die.
The Flathead Valley was not such a haven for Stella. She continued using methamphetamine after her move. She says she lived like a vampire at night, like a pariah. Stella claims that she couldnt leave the house unless she was high. She was scarred of people, she felt as if she was a worthless piece of shit. She felt guilty, full of shame and disgusting. She believed that good people didnt do dope, intelligent people dont do methamphetamine. Stella was embarrassed about her addiction and thankful that she didnt have to tell her father about her problem since he passed away long before she began using. Despite her shame, or maybe to subdue her shame, Stella continued to use.
She suffered through abusive relationships in which methamphetamine was the only thing that united her and her partner. Her life was chaotic and crazy. There was no rationality, huge amounts of paranoia, and psychotic emotions that were constantly going up and down. She could fall asleep using methamphetamine and she even burned herself once after having done so. She felt good doing methamphetamine, she could dress sexy (like a prostitute she now believes), and she had a large circle of friends with whom she felt she had a spiritual and philosophical connection.

Stella didnt stop using until her friend was killed in a car accident. Her friend, a mother, was high on methamphetamine when she was killed. Stella quit using the day of her friends funeral. She feels that God came to her and took away her addiction. She found an old pipe with enough methamphetamine in it to get her high, but seeing it made her physically sick. She couldnt do methamphetamine again.
Angry with her friends demise, Stella became part of a group of women who brought Dick Dasen down by supplying information to law enforcement about his prostitution ring (more information below) and his involvement with her friend. In addition, she now preaches to women in the jail and she is part of a-womens spiritual group that is oriented around methamphetamine and meets in the womens crisis center. Stella complains of having meth mouth, but she is proud that her life is back on track. She is involved in a loving marriage and she has a close relationship to all of her children and her grandchildren.
On the surface, Stella and Grace are completely different. Stella came from an unstable home while Grace came from a solid and wealthy family. Stella worked as a camie and waitress while Grace pursued a degree at a private school and traveled. Nonetheless, they are both former methamphetamine addicts. Stella and Grace and all the other women involved in my study are more similar than it may seem. They are united by social suffering. Their social suffering is expressed through their feelings of worthlessness, belief in a higher power, and a deep love for family. Through methamphetamine, they have experienced the warmth and connection of the methamphetamine community as well as its paradoxical

hatred and betrayal. They have also experienced deep loss stemming from their involvement with methamphetamine, the desire to overcome methamphetamine and a difficulty in doing so. Using methamphetamine means living in a world of dualities. Their similarities unite them in a lived experience of duality and bring them all to the conclusion that methamphetamine is evil; it is the devil.
Question 1: How do Women Become Involved with Methamphetamine?
Community members and former users agree that the properties of methamphetamine and the physical reactions consumption brings about are only small factors that contribute to the reason why women begin using methamphetamine. Their explanations for womens initiation into methamphetamine consumption differ in scale. Community members relate methamphetamine initiation to grand scale factors such as: 1) location and rural nature of the Flathead Valley; 2) nationwide drug trends; 3) distribution of money within the community and the communitys individual households. On the other hand, former users relate their initiation into methamphetamine use to a more personal level citing individual circumstances as their incentive to use. I will explore their differing perspectives in the following sections.
Part A: Community Response
Community members recognize that users suffer from undue stress. The stress they recognize is caused by structural violence exercised by the dominant hegemony that dictates how individuals should live and be. Although community members recognize that individuals suffer from

stress, they do not recognize the exact power structures that cause the stress.
The community believes that individuals become involved with methamphetamine to relieve stress in their lives. Such stress arises from the need to work more to earn money, keep a trim figure, clean the house, and lead the perfect life. They further believe that individuals would not use methamphetamine were it not for: 1) the Flathead Valleys location and rural nature; 2) nationwide drug trends; 3) the distribution of money within the community and individual households. These factors carry vestiges of the power structure that promote suffering.
Community members reason that these factors serve to make methamphetamine more available and attractive to a community that suffers from poverty and the stress of urbanization. For them, methamphetamine is the devil because it provides an easy solution for individuals who suffer the most simultaneously destroys the lives of those individuals and the lives of the community in which they live. Methamphetamine is also the devil because it is a force that cannot be combated, how can you change the location of the valley for instance?
In sum, the community members believe that individuals who use suffer from the stress of unknown forces and fall prey to methamphetamine, the devil, in their quest to lead better lives. I will now detail the factors that contribute to the methamphetamine epidemic from the communitys perspective.
Many community members mentioned the Flathead Valleys location when they tried to explain why methamphetamine had become

such a problem for the area. Some mentioned how it was rural and how that promoted lab growth, while others mentioned its close proximity to important boarders and methamphetamine production centers. Some related the Valleys beauty to the growth of the methamphetamine problem. Together community members agree that the location of the Flathead Valley impacts 1) where and how individuals acquire methamphetamine; 2) why individuals choose to consume methamphetamine.
The Flathead Valley is situated in an established drug trafficking route and it is a perfect locale for methamphetamine production. When the methamphetamine epidemic began, most of the methamphetamine in the Flathead Valley was made in the Valley itself. Some people say that increased law enforcement efforts in Washington State forced chemists out of the area into the surrounding areas.
Yakima, Washington was the center of meth distribution and manufacturing in the U.S., but then they got more law enforcement and the transplant people started to come here and teach people how to cook. Substance abuse counselor
I can imagine how the Flathead Valley seemed like a perfect locale for new business opportunities due to its: rural location; close proximity to the Canadian boarder and open market; lack of sufficient law enforcement; and lack of public awareness about the drug. Perhaps this is why the displaced chemists began setting up labs in the Flathead Valley and teaching their friends how to make methamphetamine.
In the northwest there is a lot of open space and wilderness so its easier to have a cabin out in the mountains or to go out on a mountain road and not get discovered. Its a little

harder in the city because of the odors. Substance abuse counselor
Meth is a rural problem. You can have drug labs in rural areas. Montana has lots of rural areas. You can avoid detection in rural areas. Substance abuse counselor
Labs began tapering off after 2003. Community members attribute this to community and statewide efforts to rid the state of its methamphetamine problem. The community has become more aware and they are enlisting new policies to further increase awareness and stop methamphetamine production. The police force is also becoming sawier to the world of methamphetamine and it seems to have reduced the amount of labs in the area.
Now an interesting thing that is developing is how community and states are responding. You may have already encountered this, but Montana for example just this past legislative session passed some new laws that put basically sudafedrine products behind the counter of pharmacies and stores that sell it. We then have a thing called meth watch which is a statewide effort to identify products that are used and the authorities and agencies like us that do prevention work with merchants to put out actual stickers and labels that this product is a precursor for methamphetamine. So people are more aware and watching and seeing. So if somebody goes to a grocery store and buys 20 boxes of 100 matches in each box.
Whats somebody gonna use all those matches for? Well they use the strike plate which has a certain chemical on it and they get the chemical out of it and use that for part of the making process. Or if somebody is buying a lot of lighter fluid. So merchants are putting things like that in more visible areas so it is harder to shoplift. If somebody is buying a big quantity sometimes they are refusing a sale or just raising the question of why they are needing this

many or that. Sometimes that will scare a person off and they ll go somewhere else that is not as scary. Oklahoma passed a law similar to this a few years ago and they re reporting a dramatic drop in laboratory busts. But you have to be careful with whether it's a causal relationship or a corollary relationship. They might just be doing it other places and so they re having less arrests, but they might not be having less stuff. Substance abuse counselor
....what Ive noticed in the past 2 or 3 years that our
attention in the paper has decreased a little bit. And the number of arrests, especially labs has also decreased quite a bit. I think that there are a umber of theories about why that is. I dont think they re more clever about it. I think
there really is less....The drug team is really diligent
in tracking down leads, I think their connections are really good, there information is good. They havent eased up on their work and their making fewer arrests especially for
labs.......I think its harder to get the precursors or
chemicals to meth than it used to be. I think its been a community effort. I think the farmers are more viligent about their anhydrous ammonia. I think that feed and ranch stores and things like that have changed their policies about Sudafed and its harder to get. And I think thats had an impact. Media personnel
Currently, most of the methamphetamine in the Flathead Valley is brought in from elsewhere, mostly the Tri-Cities area in Washington State, Mexico, and Southern California.
There wasn t much meth here until 1998 and it hit in the form of labs. There were a tremendous number of labs from 1998-2003that was all we did. Now it is changing to trafficking. There is a tremendous amount from Mexico and Southern California and the Tri-Cities. Law enforcement personnel

The DEA (2006) indicates that Mexican poly-drug trafficking organizations transport much of the methamphetamine to Montana. They acquire their methamphetamine from Colorado, the southwest border, the Pacific northwest, and Mexico (DEA 2006). Community members indicate that motorcycle gangs are also involved with drug trafficking in the area. They indicate that the Mexican mafia and motorcycle gangs alike travel to or through Montana from Washington by way of two routes. Some go directly from Washington into Montana on the interstate and others (perhaps with larger quantities) travel the well established drug trafficking route that goes from Washington State into Canada and drops into the Flathead Valley.
The dealers go to Washington, California, and Idaho to get 3-12 ounces of meth and they sell it by the gram or ounce. Law enforcement personnel
Mexicans bring in the ciystal to Montana. There is no crystal being made in Montana. To turn it into crystal you need carbon tetrachloride. Thats what they use in dry cleaning to soften material and it's a controlled substance. So usually you have to get a dry cleaning business or it has to be ordered. Outreach worker
The biggest smuggling route in the country is in Eureka. All the Canadian pot, cocaine, comes down in Canada and rolls over the boarder. They routinely catch shipments of marijuana that come into the boarder there in Kalispell.
You know $5 to 8 million dollar shipments.... You also have an established drug trade that has been working for over 30 years.... We don 7 have the money to combat it. Its usually overlooked. Canada is a free and open boarder. Outreach worker

In-migration and tourism have also impacted the availability and desirability of methamphetamine in the Flathead Valley. The Flathead Valley is nestled between Canada and Idaho. Within its bounds it contains the most beautiful national park in the country, the biggest freshwater lake in the west, the least inhabited wilderness in the nation, two ski resorts and some great golfing/hunting/hiking/fishing. Such luxury attracts a variety of tourists and transplants (tourists who take up residence in the Flathead Valley). In fact, 80 % of the population growth that has occurred in the last decade in the Flathead Valley is due to in-migration of those from other regions and/or states (Flathead on the Move 2004). Montanans arent keen on the new migrants from other states.
Montanans are afraid to death that little towns are going to become like Aspen or Vail, where the billionaires chase out the millionaires, and employees have to live 45 or 50 miles away to drive to work (Wes Spiker, cited in Yu 2005).
However, migrants and tourists are integral to the Flathead Valleys economy. Directly and indirectly construction alone is responsible for almost 20 percent of the Flathead valleys employment. Construction workers earn an average wage of $31,400 compared to the average wage of $26,600 for all other private industries (Spence 2006).
With all the construction around the lake, every contractor in town is driving a new pickup truck, which came from the local car dealer. Everybodys more prosperous (Pat Donovan, former lineman with the Dallas Cowboys and developer of Iron Horse Golf Club in Whitefish, cited in Yu 2006).

Montana state residents make the 47 lowest income in the United States (US Census Bureau 2004). Compared to Flathead Valley residents, the tourists are rich. They can afford what they want even if very few of the Flathead Valleys inhabitants can.
Evelyn Rodewald, 69, and her husband, Gordon, decided to sell their lakefront house in 2002 and buy a home in town after property taxes became a burden and noise from new construction nearby increased (Yu 2006).
According to many of my key informants, tourists and migrants also bring things including illicit substances into the valley, our pure and angelic little world. Perhaps even more devastating to the natives, they bring along their city culture.
We have attracted West Coast inhabitants and they bring their problems here. They have lots ofmeth addicted kids. The growth in the valley comes from those types of areas and they bring their culture. They bring the gang attitude where drugs are ok and the parents are ok with that. Law enforcement personnel
When asked why meth was a problem, a substance abuse counselor responds:
We are close to the boarder, Whitefish is a party town and people come in from all over the world.
Community members blame tourists and migrants for the drug problem. Flathead Valley residents depend upon them, yet they seem to hate them at the same time.

Were the Flathead Valley community in a different place with a different population distrubution, perhaps the methamphetamine devil would not have had such an easy time destroying the community.
However, Flathead Valley residents cant change the location of their community to better situate themselves away from major drug trafficking routes. They cant change the fact that the area in which they live is beautiful and full of outdoor adventure. However, they could try to be less tourist oriented if they really believe that the tourists and the tourists who become residents are the ones to blame for the methamphetamine epidemic in the Flathead. They could also deny future home and business developments. Is the methamphetamine problem worth the economic consequences the Valley would suffer from? The answer is no.
The Flathead Valley is situated in a prime locale for the methamphetamine epidemic to occur because it is situated in a drug trafficking route and it is rural in nature. Adding the Valleys poor economic situation lessens the degree to which residents can prevent and stop the problem from happening. These are structural factors that contribute to the problem, making methamphetamine more available and enticing to the vulnerable populations that I will discuss later. By promoting methamphetamine this way, they are causing structural violence.
Community members blame the methamphetamine problem on economic stress that promotes individuals to seek relief and the lack of financial resources available to stop such individuals from using substances. In other words, they believe that the financial state of the

Flathead Valley and the individuals who inhabit it impacts: 1) why
individuals choose to use; and 2) why they have a difficult time quitting.
Residents of the Flathead Valley struggle to earn a good living wage. The Flathead Valleys economy has traditionally relied on natural resource utilization including logging, tourism, recreation, and agriculture.
However, the Flathead Valley is currently undergoing economic restructuring, shifting its economic interests to the service industry including jobs in health care, business, engineering, management and social services. Due to the massive amount of in-migration, construction, manufacturing, finance, insurance, and real estate are also growing (Flathead on the Move 2004). In other words, the valley is growing rapidly and community residents who have traditionally relied on blue collar work are slowly being headed out by white collar workers. In essence, Montana is in the process of moving from a developing economy to a developed economy.
Currently, the top ten employers in the Flathead Valley include: 1) Kalispell Regional Medical Center; 2) Plum Creek Lumber Co.; 3) Semitool; 4) TeleTech; 5) Winter Sports Inc.; 6) Walmart; 7) Burlington Northern Santa Fe; 8) L.C. Staffing Service; 9) Immanuel Lutheran Home and 10) North Valley Hospital (Kalispell Montana Chamber of Commerce 2006). In terms of the amount of money the different industries contribute to the economy, agriculture, wood products manufacturing and other basic industries drive the Montana economy. Agriculture, nonresident tourism, and aluminum are also major contributors to the economy. Air travel has increased over the years due to increased tourism (Flathead Facts 2005). However, this is all changing as jobs concentrated in the natural resource extraction sector are becoming less plentiful and the economy is becoming more service driven.

In 2004 the living wage for one adult in the Flathead Valley was $8.61 an hour for 40 hours a week and 41% of jobs paid less than that. The scenario was even worse for families. The living wage for an adult and two kids in the Flathead Valley was $17.07 an hour for 40 hours a week and 75% of jobs paid less than that (NW Job Gap Study 2004). The living wage for an adult and two kids in 2005 was $18.46 an hour (Osorio et al. 2005). Accordingly, 14% of Montana residents live in poverty compared to the national average of 12.1%. The poverty rate has increased by .9% since 2001 and only .4% in the U.S. Forty four states boast a higher income than Montana (Caiazza and Shaw 2004; US Census Bureau 2001-3).
Women of the Flathead Valley especially struggle to keep financially afloat. Nearly nine percent or 2,202 of the homes in Montana are female headed (US Census Bureau 2003). Unfortunately, Montana women rank 50th out of 51 regions in the U.S.A. for median annual earnings, and 36th out of 51 for ratio to mens earnings. They rank 42nd out of 51 for having managerial and professional occupations and 21st for having graduated from a four year college. Montana women rank 33rd for having insurance. Not surprisingly, Montana women rank 41st for living above the poverty level. Montana women suffer from one of the highest rates of mortality from suicide and a relatively high rate of mortality due to lung cancer (Caiazza and Shaw 2004).
Community members blame the Flathead Valleys, not to mention Montanas, methamphetamine problem on money. Workers are stressed to their breaking points trying to make ends meet. They are forced to be resourceful and they will seek out any viable solution they can to make life easier.

Montana is in the top 5 per capita for drug and alcohol abuse. Whitefish is a railroad town, with construction workers, laborers, and even affluent people. Columbia Falls and Kalispell have mostly laborers and blue collar workers. Even the affluent use, but blue collar workers and professionals are those who are seen most. Substance abuse counselor
Montana has difficulty supporting anti-methamphetamine endeavors. The state could not afford to designate enough money to maintain social services, law enforcement, and prevention and treatment programs in such a way so as to quell the methamphetamine problem as soon as it was necessary.
The drug taslforce is undermanned. They need more money and more people. The fines, jail time, and sentencing should be made higher, because the money that can be made on meth is such that the sentence is worth it. Substance abuse counselor
The DEA says that it is the most addictive substance. Ninety-six percent won 7 get over using it. We aren 7 equipped for it. They need six months of inpatient. The maximum treatment here is 28 days and people mostly get outpatient. We don 7 treat them when we treat them and we don 7 treat them enough. Law enforcement personnel
Now that there is money for anti-methamphetamine activities, methamphetamine is receiving more attention than ever. However, some feel that the attention and money are being applied to the wrong causes. Montana has an abstinence based approach to drugs. Because of this, it directs most of its fiscal resources to law enforcement and the criminal justice system. Some suggest that the money would best be directed to

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"The students say they know friends and acquaintanceseven teens with 4.0 grade point averages-who turn to drinking or other destructive behaViors simply out of boredom


(Meth) is poison and it destroys lives. "It's like meth brings out a demon in you. It's not you. Meth takes you and hides you and puts this horribly ugly demon monster in its place. I mean it's like a demonic dmg. It takes the good in everybody and locks up somewhere and brings out all the bad things in a person ... Even when I was doing diet pills and cross tops or other drugs I wasn't as crazy as when I was doing meth. It really brought the monster out in me. It is all about the drug. They usually have kids and we see a lot of child abuse. They don't care about their kids. they did, they wouldn't be in that state now. There are cases where people have become homeless out of use ... meth use is pervasive and growing. I have a big fear ofmeth labs as a realtor and people coming in. The personal problems are enormous. There are health, financial, and relationship problems. They sacrifice


eveJything. This leads to the societal cost. Meth is a stimulant so is good for awhile, then you lose your morals, family, job, etc. We have concerns about workplace violence .... they are dangerous Meth causes the most problems-property damage, theft, burglary and crimes against people On Thursdays, the criminal courts day when they tlY felonies, about 80% of the burglaries and bad checks are related to meth. This has been going on for years. A third of the murders over the past or years have a meth connection. Get them sober for a day and. then get them into a step program like AA or NA and give them a higher power


The twelve step program is still the cornerstone of treatment. Most folks benefit from inpatient because it takes them away from their environment. When you are in outpatient, you go home where the dealers are etc .... the longer the treatment the better. What percentage are we arresting to get their penalties waived and sent back to the street? It isn't scaring them off. Like my daughter, it took her time in jail for alcohol to get things figured out. I believe in jail and treatment. Treatment doesn't work often, but is worthwhile to see will work. There is no silver bullet. It requires an integrated approach. Treatment, intervention, prevention. Do it until we're dead It is never going away. God That is the only way. Treatment without god won't help you quit.


"We called meth the devil when we worked because: 1. You can't get away from it 2. It is easy to ingest 3. It isn't easy to get off 4. You do things you wouldn't normally do." There was a duality, the other part of my brain. Imagine how weird it can get. It doesn't further your belief in humanity. Be a friend for that, rip them off, have deviant sex. Your sex drive is high. I got into some weird stuff and became a tweaker, a different person. was like Dr. Jekyll and Mr. Hyde, was a bitch. almost got a super bitch tattoo, thank God didn't. It was my alter ego.


Part A: Age and demographics "We 're generally relatively low self esteem and probably already been using other things to do what we think will boost our self esteem. When they 're using they 're very erratic and unstable and they are people who give you your word and they really mean itwhen they say but there is no follow through. Believe it or not they are very often intelligent people.


"a person who is preoccupied by consumption and use. I know people who prostitute or commit suicide or steal from each other, abuse each other, don't work, etc. They can't have a normal life and tears families apart. It rots your teeth, causes physical problems, heart failure, social problems, and it wrecks marriages. You ignore your wife and kids. It compromises your moral values. You may have sex with someone you wouldn't normally. Part B: The Women of this Study


Grace Stella Bridget Dan"y An" Margot






Part A: Community Response




Yakima, Washington was the center ofmeth distribution and manufacturing in the but then they got more law enforcement and the transplant people started to come here and teach people how to cook. In the northwest there is a lot of open space and wilderness so it's easier to have a cabin out in the mountains or to go out on a mountain road and not get discovered It's a little


harder in the city because of the odors. Meth is a rural problem. You can have drug labs in rural areas. Montana has lots of rural areas. You can avoid detection in ntral areas. "Now an interesting thing that is developing is how community and states are responding. You may have already encountered this, but Montana for example just this past legislative session passed some new laws that put basically sudafedrine products behind the counter of pharmacies and stores that sell it. We then have a thing called "meth watch" which is a statewide effort to identify products that are used and the authorities and agencies like us that do prevention work with merchants to put out actual stickers and labels that this product is a precursor for methamphetamine. So people are more aware and watching and seeing. So somebody goes to a grocery store and buys 20 boxes of 00 matches in each box. What's somebody gonna use all those matches for? Well they use the strike plate which has a certain chemical on it and they get the chemical out of and use that for part of the making process. Or somebody is buying a lot of lighter fluid. So merchants are putting things like that in more visible areas so it is harder to shoplift. somebody is buying a big quantity sometimes they are refusing a sale or just raising the question of why they are needing this


many or that. Sometimes that will scare a person off and they'll go somewhere else that is not as scary. Oklahoma passed a law similar to this afew years ago and they're reporting a dramatic drop in laboratory busts. But you have to be careful with whether it's a causal relationship or a corollary relationship. They might just be doing other places and so they're having less arrests, but they might not be having less stuff" what I've noticed in the past or yea;s that our attention in the paper has decreased a little bit. And the number of arrests, especially labs has also decreased quite a bit. I think that there are a umber of theories about why that is. I don't think they're more clever about I think there really is less ...The drug team is really diligent in tracking down leads, I think their connections are really good, there information is good They haven't eased up on their work and their makingfewer arrests especially for labs ... think it's harder to get the precursors or chemicals to meth than it used to be. I think it's been a community effort. I think the farmers are more viligent about their anhydrous ammonia. I think that feed and ranch stores and things like that have changed their policies about Sudafed and it's harder to get. And I think that's had an impact. There wasn't much meth here until and hit in the form of labs. There were a tremendous number of labs from 1998-2003-that was all we did Now is changing to trafficking. There is a tremendous amount from Mexico and Southern California and the Tri-Cities.


The dealers go to Washington, California, and Idaho to get 3-12 ounces of meth and they sell by the gram or ounce. "Mexicans bring in the clystal to Montana. There is no crystal being made in Montana. To turn into crystal you need carbon tetrachloride. That's what they use in dry cleaning to soften material and a controlled substance. So usually you have to get a dry cleaning business or has to be ordered "The biggest smuggling route in the countJy is in Eureka. All the Canadian pot, cocaine, comes down in Canada and rolls over the boarder. They routinely catch shipments of marijuana that come into the boarder there in Kalispell. You know to million dollar shipments .... You also have an established drug tiade that has been working for over 30 years .... We don't have the money to combat it. It's usually overlooked Canada is a free and open boarder.


"Montanans are afraid to death that little towns are going to become like Aspen or Vail, where the billionaires chase out the millionaires, and employees have to live or 50 miles to drive to work "With all the construction around the lake, every contractor in town is driving a new pickup truck, which came from the local car dealer. Everybody's more prosperous


"Evelyn Rodewald, and her husband, Gordon, decided to sell their lakejront house in 2002 and buy a home in town after property taxes became a burden and noise from new construction nearby increased We have attracted West Coast inhabitants and they bring their problems here. They have lots oj meth addicted The growth in the valley comes from those types of areas and they bring their culture. They bring the gang attitude where drugs are ok and the parents are ok with that We are close to the board er, Whitefish is a party town and people come in from all over the world.




Montana is in the top per capitafor drug and alcohol abuse. Whitefish is a railroad town, with construction workers, laborers, and even affluent people. Columbia Falls and Kalispell have mostly laborers and blue collar workers. Even the affluent use, but blue collar workers and professionals are those who are seen most. The drug taskforce is undermanned. They need more money and more people. The .lines, jail time, and sentencing should be made higher because the money that can be made on meth is such that the sentence is worth it. The DEA sCO's that it is the most addictive substance. Ninety-six percent won't get over using We aren't equipped for They need six months of inpatient. The maximum treatment here is days and people mostly get outpatient. We don't treat them when we treat them and we don't treat them enough.

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(Montana says) either you quit using or you get out. It doesn't work because they keep ending up in the program. With harm reduction, they hardly ever relapse because they aren't forced to go. It is a waste of resources, time, and money. It makes more sense to give them time, education, and goals when they are ready.

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Nationwide Drug Trends It is a growing problem. It started in Hawaii then went to California, to Arizona, to Montana, to Idaho and to the Midwest. The most drug busts are in the Midwest. Missouri leads the country in the number of drug busts. The East Coast is infested with cocaine.

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Part B: Former User Response

PAGE 104

I was probably always a drinker. I chalked it up to being an artist. It's the law. I had a predisposition. I would have continued without consequences as a functioning alcoholic. I ran across a guy who was my segeway into the drug. Everything changed. All of my behaviors were on the fast track. I devolved and went into a downward spiral. I was in a scene with good friends with everything going for them and I compromised my morals. I'm me now. There was a duality, the other part of my brain. The circumstances were unique to happen to be on drugs. I was an angry drunk and all I had to do was go over the edge and running, that's it.

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"When I started, I was raised in a sex drugs and rock n roll environment. I was when I met meth. I was high. I used alcohol since I was or years old I was on a first date with a guy when I first tried it. He invited me to the bedroom and there was a line on a tray and I did it. It shows the level of disease. It didn matter what was. I was hooked at that point.

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I was an injector at the age of There is something powerful about it, especially for women, especially self injection. I was a scardy cat. I was in an abusive marriage and I was afraid of everything. I shot by myself and it felt empowering, especially because the experience was mixed with meth. I thought I'll never be afraid again. I wasn't afraid until afew years after I stopped

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Part Comparison oj Responses

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Part A: Community Response There aren t really any gender differences.

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50% ofmeth users are women because it causes weight loss and an increase in energy. You can get your housekeeping done and manage everything in life. a)false sense of esteem. Power. They have a lot of different roles. They might be a career person or hold down a job and often times they are a spouse and then they're a parent also. So they end up juggling a lot of things." Methamphetamine can give them a real energy boost and it makes them feel like they can handle anything, which they actually can-early on when they're using. The trouble comes later when the drugs take over their lifestyle. Infact they end up getting less done because they're dealing with the addiction. They have no concern for themselves, their work, their kids, or anything .... .Jt is all about the drug. They usually have kids and we see a lot of child abuse. They don't care about their kids. they did, they wouldn't be in that state now. They are too worried about the drug to feed their addiction.

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Part B: Former User Response.

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Self Worth It is euphoric and it made me glad to be alive and I didn't have much experience with that. "We're generally relatively low self esteem and probably already been using other things to do what we think will boost our self esteem. When they're using they're very erratic and unstable and they are people who give you your word and they really mean it when they say but there is no follow through. Believe it or not they are velY often intelligent people.

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"Definitely the sexual promiscuity and the skin issues and I didn't mention teeth before but we should mention teeth cause there's some serious stuff that go on with the teeth. The teeth decay really bad and I think we tie varying degrees, but I think women in general we tie self worth to appearance. With teeth decaying, and skin issues you know, it's that circular thing where I feel bad about myself so I use to make myself to feel better which makes me look worse so I get high to feel better. "I thought I looked really good The person I saw in the mirror looked really good You know. I could wear little clothes. For once my clothes were loose in my life. I spin around and I wasn't having to buy extra large shirts. I could wear small shirts and they were loose on me. It was sick. I look at my teeth today and I have what they call meth mouth. My teeth are decaying at the gums and I lost several of them. It was really hard on my body and the repercussions are still happening. Like what? "Osteoporosis, softening of the bone. Teeth, I've got teeth that have broken off at the gum line..... I think it stupefied me and I have a hard time remembering things.

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As a woman, I was attracted to probably because of my weight. It had a huge impact on my life. I graduated in when the average model was 12% underweight and now they are underweight. Young women do anything to be thin. I was on the verge of having an eating disorder. I am built sturdier. I wasn't fat, but I thought so. I needed to be thin.

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There is a mindset about moms. They are ashamed They keep in the closet. They are isolated because not many talk about it.

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I am thejace of an addict. I am not a toothless biker. I've gone to town meetings and they think I'm an upset mom. I don't have track marks and bad teeth. I know you people. I grew up here, I had potential for success. It is backwards. I am a second class citizen. I'll never vote again, my opinion doesn't matter. I should be able to petition for voting rights qfter having valuable life experience.

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Community of Users The common denominator was drugs. (The community consists oj) people who don't hang out-canyon critters, bikers, then other people. I had a friend who was blonde, tan, and had a big ring. She drove all the kids around in a big Suv.

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"That's kind of what I was saying. They think they're real loyal and they're not because they will throw you out the door in a second it is all about what do you have to offer me today and if you're out then it is 1 don't have time for you. That's entirely what friendships are about in that community..... 1 had people in my life who 1 thought I'd be with forever and they were like sisters and when I got arrested I haven't heard from them since. When you're doing something illegal you have loyalty. There is always distrust and adding a drug to that makes you paranoid Imagine how weird it can get. It doesn't

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was supposed to go to the house and clean the house while I was working. And she and I got off work and got home at 3 0 'clock in the morning and she shows up at in the morning with a broom and a dust pan dressed in a mini skirt with fishnet stockings on and going I came to clean the house, what are you doing? Because I had already done the dishes at that time, the floors were washed, I vacuumed I was like you weren't here man. I'm supposed to get married in the morning. Where have you been? Well oh my goodness I didn't know it was that late. I didn't know it had been that long. Well when I saw her at the bar she had blue jeans on. You know, she was a person I'd remember waiting for hours sometimes. "Why does it take so long?" "Because time goesfaster than you realize. You can be focused in on one project which you might think would be 20 minutes and you've just spent hours on it. "You don't realize. "Yeah, you don't realize. You have no concept of time at all. It is just the opposite of pot you know. When you smoke pot, time doesn't pass quick enough. When you do meth, time passes too quickly. Meth put me in the middle of stuff. I was open to other people. I sat and listened to other people talk about what's

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important. My drug partners were younger than me and] had the role of big sister/grandmother/etc. ]t was flattering, but bullshit. "Can you tell me about your past experience with meth or crank? Well what do you guys call it? "Dope. Pot is pot and dope is meth. Cause it makes you dopey. thought people felt smarter on meth? "Well, they think they do, bzit they're not. "When you're using it do you call it dope? "We call it whatever comes out of our mouth at the time. 've called it dope for a long time. mean that's what it is. Because it makes you stupefied because you think you're invincible and all poweiful and all in control and your not. When you're coming down you realize how stupid you were. "Things you wrote when you were high makes no sense whatsoever you're like ok and you thought it was so good at the time. You're like wow that was so cool ... "Something that a lot of people do is sit and write and write and write and write when they're high. kept some of those things just to remind me how stupid we were."

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The Difficulty of Quitting The DEA says (methamphetamine) is the most addictive substance known to man.

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Also, slhe

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"I take offense to that (once a drug addict, always a drug addict mentality) because don't consider myself a drug addict in recovery anymore. I'm a new person in Christ. I don't have cravings. don't have withdrawals anymore. The stuff makes me sick to my stomach. I'm normal people. I do believe you aren always in recovely. do believe that Jesus Christ can make you new. don't want to be an addiCt, wasn't my first career choice. I'm searching my way out.

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Part Comparison of Responses

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Part A: Community Response

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"Hepatitis The majority of our meth users that are IV users. Hepatitis is very common. That is sexually transmitted disease right there. They can spread it through sex, but needles too."

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the uniquness is the chemical involved in methamphetamine are very toxic and dangerous so there's a lab going on, often times the environment is contaminated We're also finding that through child and protective services that a lot of the kids are at a health risk. You might have babies and kids crawling on floors that are contaminated with the chemicals. Sometimes the precursors or the leftovers byproducts of the process are laying around and kids can get into them. Some of the chemicals can be absorbed through the skin so they're not "taking" it but they're still being effected and then just breathing some of the air is very dangerous. And then of course there's always the danger and explosions because of the products involved are flammable or explosive. Child and protective services are saying that most of the cases where they place the child out of the home are methamphetamine cases. That is another unique element." "The cost to society in terms of cleaning up a meth lab house is huge. There are no standards for that. There are no state wide health standards for declaring a house habitable qfter it's been used to make meth. So what does that mean? A youngfami/y can buy a house and not know the health ramifications. A lot of those houses are just raised as property that has gone in ruins."

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MCDC has an adult inpatient program that lasts 28-45 days and it has an outpatient program which consists of nine hours a week. This isn't enough.

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slhe "Meth has and is overloading the system because of the serious nature of it. The kids can't stay in the home. This region, region has the highest referral rate in the state. Missoula, Missoula County and Flathead County run neck in neck and we have half the population that they The impact on the system and I think in any state is just enormous.

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".Are whole trial here about Dick Dasen. It was just a glimpse into the methamphetamine community that's not. You know I think that those girls where not necessarily so far out of the mainstream. A lot of them were mothers, they had families here. They weren't just some transients who came in who were just homeless and addicted to this drug a lot of them grew up here. That kind of changed my thinking a little bit too. They were just a part of the community. They got hooked into the drug and just shows how far they degenerated The whole sex for drugs for money thing is so pervasive."

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Part B: Former User Response

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"I guess probably the only thing I keep thinking of is the sadness, how really really sad it is. It's really hard to explain if you've never done meth. At one point you mentioned how you are trying to get a grasp on how people just lose everything. It's really hard to explain how that is because in the midst of all somehow you really believe that what you are doing is right and it's good and everyone else around you is wrong. So when people are saying you're gonna lose your kids. I'm not, those are my kids. And the next thing I know I'm voluntarily moving away from my kids from my state to the next away from them. And I had all kinds of people to blame for it but myself." I gave up things for her and wondered why she hated me. I figured I wouldn't give up using and move to the city. I hoped my daughter would die in a car wreck so would be justified to use. It took me two years to develop a life separate from her. use.

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"Out of siblings there were of us who did meth and we totally lost communication w.ith the rest of the family, but we kept close to each other. We kept real close with each other. And I think that's basically it there's a family member who's using meth, they'll stay close to each other but not it really breaks up the families. you're not using it you can't understand the behavior and you can't be around It's ugly, they're up all night and they sleep all day they lie cheat and steal from you. You know that's my sister and she never lied cheat or steal before and she's doing now. I don't want her around

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God I am blessed to be here-aware, clean, and with the love of my family. The love of my family is the major reason why I'm here. Without family what would happen? They took care of my daughter, they visited, and they let me move in. It doesn't happen with many. That was painted out to me by lawyers, etc. One said I don't know anybody like you who is still here. So many women lost everything including their kids. They're broken and falling apart.

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"God, it's the only way. You can go through treatment or whatever and you don't have God it ain't gonna happen. "I did treatment for two years in Nevada and it didn't happen. Six or seven months out of treatment I was using meth again daily and then I quit again ... .1 went to this place in Kalispell called the healing room and I go pray and I got prayer from my church and I started this bible study and I read this book called the Bondage Breaker. God, that's how I stayed clean. "Only now after being in the bible study for over a year are we really getting into learning about God and learning about Jesus Christ. We all had a belief, but what 'we didn't know is that there are demons and there are things that are beyond our worldly being to understand. "The battlefield is not of this world where we would swordfight or battle with somebody. It's in the mind. It's a spiritual battle in the mind. "Satan is the father of lies and that's all you hear, that's all you act on, that's all you are.

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"I don't consider myself a drug addict in recovery anymore. I'm a new person in Christ. I don't have cravings I don't have withdrawals anymore. The stuff makes me sick to my stomach. I m normal people. I do believe you aren't always in recovery. I do believe that Jesus Christ can make you new. I do believe in change I went to treatment for eight months for being an alcoholic or whatever and you know they tell you your higher power can be whatever you want it to be, but flat out your higher power is God Yau know? I don't see how a person's recovery can work you higher power is a tree or your higher power is an animal. It doesn't work that way. I did learn the basics in treatment. I learned the effects of coming down and withdrawing and how to deal with it and the emotions that come along with it. Yeah, all you really need is beliefin a higher power and it should be God He can get you through anything. Once you believe he's there with you and he forgives you for everything you have self worth and he never gives up on you and you shouldn't give up on yourself. God gave me lupus in exchange for meth.

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I'm a success story. many are only half alive like zombies or they're in prison. I don't see many out there. I'm fortunate to have had such severe consequences and to have my life saved The last time I was in jail I was stressed I couldn't believe jail. I was sick. I got lupus for the first time. Gaurds were awful, they didn't give me aspirin. When I got out and got tests from when I was there they didn't know why my kidneys didn't shut down. I am very blessed It is amazing because all the women are in on meth. Most women there were serving lengthy sentences. When I was in jail the second time, I wasn't in a drug stupor because I was caught immediately. The women were raw, emaciated and they had bad teeth. They took care of me and made sure that I got meals etc. Something happened to me when I was that sick It was evident that something was shown to me. The word grace-epiphany. Then I got out and I started talking. It was velY healingfor me to talk and to put it out there in my hometown is huge. "I've seen a mix of treatment combinations and every one of them both works and fails. I did.6 months in jail and 6 months in outpatient. The court ordered me to go to meetings. I attribute my success to my relationship with Christ. I know people with Christ, and no NA and they went back to using. I believe my success came from Jesus and I reqUire NA and to go to jail meetings. I've seen people with just NA like my husband and he is clean after 16 years of NA. I know people who were clean for or 9 years and they used again and lost it all. Some are court ordered and they succeed, while others don't. The biggest thing I believe in a person needing to be ready. They need to be sick and tired of being sick and tired7!ed up.

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"My parents didn't do anything right or wrong. We weren't raised with a spiritual background The only thing to do is go back to spirituality. It is too random, inconsistent, so spirituality is the only thing that makes sense." slhe Part Comparison of Responses

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Political mindset "it is a cultural issue and a lot of people think it's an infringement of their rights

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"Folks here don't like blackmail from the federal government, Galt said. "They don't like the federal government withholding highway money to force them to pass laws they don't agree with

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2. Economy

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2004). 2000).

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3. Gender Norms

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PAGE 175 t 10/20/06.