As a senior programmer with county mental health who has worked with this population for 10 years, I would like to draw more attention to the remarkable statistic mentioned in Jocelyn Wiener's article on the "breakdown" of mental health treatment in California ("Breakdown," Feb. 21). Wiener writes that, in the past five years, "the number of people in California who were deemed incompetent to stand trial after arrest ... increased by 60 percent." And, while Wiener mentions that a subject of the article, Jeffrey Jurgens, was "self-medicating" with meth, the issue of how a number that was pretty historically stable has exploded so much in just five years is really not explored in this article.
The reality is that the huge growth in incompetency is due to methamphetamine abuse. The term "self-medicating" is an entirely misleading euphemism for the self destructive impact of this highly addictive drug. Just as meth ravages a person's external appearance, it ravages the functioning of a person's brain. Extended periods of sleeplessness cause the buildup of toxic metabolites in the brain and meth use strips fat for the myelin nerve coatings required for cognitive functioning. The consequence is a behavioral presentation that appears to be a severe, psychotic mental illness but is actually a progressive cognitive disorder, a kind of dementia, caused by toxic exposure to meth.
And, whether a person who has "self-medicated" with meth does get restored to legal competency or not, the brain damage caused by meth will persist. We not only need expanded treatment availability for this problem now but we will need to have large numbers of skilled nursing beds in the future, where a population of brain damaged former meth users can be provided care when they are no longer physically able to care for themselves.
Even if all meth disappeared today, the damage it has done to those who have abused it will burden our social care systems for decades to come.
Mark Lamers, Eureka