LAURENS, Iowa -- Methamphetamine has claimed every tooth in Dennis Patten's head, which is why his face is caving into his jaw and why just about everything south of his neck is falling apart.
The squat Patten is a 28-year veteran of the Iowa drug wars, 25 of them spent as an addict and the past three as an uncertain, just-say-no convert torn by occasional gnawing cravings for the drugs that have crippled him.
"I can't honestly say that if you dumped some [meth] right here," he said, tapping a couple of fingers on a table in front of him, "that I'd turn it down."
Like Patten, Iowa is struggling with meth.
In the two years since the state enacted a law limiting the availability of pseudoephedrine, a major ingredient in the manufacture of methamphetamine, the number of homemade meth lab seizures across the state has plummeted. At the same time, though, investigators say imports of a more powerful meth called "ice," from the Southwest U.S. and Mexico, are soaring.
"Ice trends in Iowa over the last three years have an eerie resemblance to the explosion of meth labs in our state in preceding years," a recent state report said.
And in Iowa, as well as in the rest of the Midwest, it's not clear that anyone is winning the drug war. In 2006, the Midwest had six of the nation's top 10 states in the number of meth lab incidents, according to the U.S. Drug Enforcement Administration.
It's not even clear that the drug-clean Patten, who weighs 387 pounds, down from 450, can say he's winning. As a result of prolonged drug abuse, he suffers from congestive heart failure, diabetes, emphysema and short-term memory loss. At 44, he's had two strokes. Doctors would like to perform a gastric bypass operation to get 150 more pounds off him, but they aren't sure Patten's heart could handle the stress. The cartilage in both knees is shot and his breathing is labored and difficult, which is why Patten carries a small oxygen cylinder with a clear plastic nose hose that wraps around his head and clips to his nostrils.
"If I run into someone who's used, I get cravings," Patten said. Drug counselors say nine out of 10 meth addicts fall back into meth abuse.
The battle against illegal drugs is often measured in terms of numbers -- grams, ounces and pounds, street sale value, state and federal dollars available for drug investigations, arrests and convictions.
But numbers alone often obscure the struggle for police agencies battling the challenge of illegal drugs and addicts who are trying to recover from years of addiction and the often heavy physical toll on their bodies. Addiction produces its own set of numbers, such as rising health care costs, increased caseloads at drug treatment centers, more children exposed to drugs and higher rates of burglaries and domestic abuse.
By one measure, Patten is a victory because he has stopped taking drugs and has vowed to stay clean. He slowly lumbers to health clinics, offering himself as a human testimonial of what not to do. There is no masking the damage to Patten and other addicts who agreed to talk about their years with meth.
When asked what he tells his 5-year-old son, Jere, about the dangers of drug abuse, the long-haired, scraggly-bearded Patten said, "Well," and then he paused, apparently losing his train of thought. He looked quizzically at his wife, Kathy Crapser, and asked, "What do I tell him?"
He recovered and said he had "a hard time focusing on questions." He remembered where he was and said, "I tell him this is what happens when you take drugs. Do you want to look like me?'"
For the most part, Iowa is a sparsely populated state, ranking 30th nationally, with just under 3 million people. But the combination of open spaces and a good road system has helped make Iowa and other agriculture-oriented states in the Midwest a haven for homemade meth. Just about any farm will have anhydrous ammonia, a key ingredient in fertilizer and also in the production of meth.
Bob Cooper has intimate knowledge of the farmland and back roads of this region of northwest Iowa because he skillfully used them to manufacture and sell meth and, by hiding in cornfields, repeatedly eluding capture by authorities who spent years chasing him. Meth "became a way of life," said Cooper, who can still methodically explain his production method -- the pills and the blender, the drain cleaner and a shot of salt. He pocketed a thousand dollars a week making it.
The law caught up with Cooper in late 2000. He was convicted of manufacturing and selling meth, and spent 42 months in prison. Now 32, Cooper is trying to put his life back together in Laurens, the tiny hometown of Alvin Straight, who drew motion picture acclaim for the 240-mile trip he took on a lawn mower to visit his sick brother in Wisconsin. That was in 1994, shortly before Cooper got into meth.
There has been a big drop in homemade meth lab incidents and that, said Gary Kendell, director of the Governor's Office of Drug Control Policy, has reduced the threat to the environment and to children exposed to labs.
"But we still have a real problem," Kendell said, pointing to a rising number of adults treated for substance abuse -- other than alcohol -- up 36 percent since 2000. Over the same time period, cocaine and crack cocaine seizures have soared.
At the Clay County sheriff's office, in Spencer, Investigator Casey Timmer tries to put the progress into perspective. "I think we win the battles we get into, but I don't know if that's winning the war," Timmer said.
Patten says he's available to anyone who wants advice about drugs, but the phone doesn't ring often. His wife added, "It's usually someone asking if this is a good price for an 8-ball," a common street term for an eighth of an ounce of cocaine.
Tim Jones writes for the Chicago Tribune.