Previous: 
: 
10 Things Your Primary Care Doctor Does That Should Make You Run for the Hills
Sign In >>
Dr Orrange received her BA in Biology at the University of California San Diego and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health She received her MD from the USC Keck School of…
FAST FACTS
Methamphetamine: The Great American Tragedy
I am at the midpoint of my month as the hospitalist at Los Angeles County-USC Medical Center. I have worked as a physician through the Aids epidemic, worked to fight multi-drug resistant Tuberculosis, alcoholic liver disease, and increasing rates of stomach and lung cancer in our young folks. This month, however, my heart is breaking over how Meth is taking over. Methamphetamine use is becoming one of our biggest American tragedies. This blog has been in my mind for a year I've finally sat down to write it out. Here is my tough love blog.
Most of us on Dailystrength know someone who has struggled with Meth and I hope you know our hospitals and emergency rooms are packed with Meth users.
Some background: In the United States medical use of amphetamines began in 1932, when amphetamines (marketed as Benzedrine) was used as a treatment for asthma, narcolepsy, ADHD, appetite suppression and schizophrenia among other things.
Why it caught on? The widespread use of Meth stems largely from its potential to produce euphoria, reduce fatigue, enhance performance, suppress appetite, and induce weight loss among other things. Unlike cocaine and heroin, which are plant derived, Methamphetamine is easily prepared from simple chemical precursors. The more recently available "ice" is created from ephedrine and pseudoephedrine by reduction to its beta-hydroxyl group to form methamphetamine hydrochloride. Domestic and Mexican "superlabs" can produce 10 pounds plus of high purity Meth within a 24 hour period.
How many folks are using? Instead of bombarding you with numbers, I've selected the statistics most striking to me. In 2004, 12 million Americans reported having used Methamphetamine at least once. Emergency rooms, jails and treatment centers are packed with Meth users. In 2003, the percentage of male arrestees testing positive for Meth was 40% in Honolulu, 33% in San Diego and 28% in Los Angeles. The number of new users of Meth increased 250% between 1996 and 2002. In Hawaii 80 to 90% of child abuse cases involve Meth use in one or both parents.
Who uses Methamphetamine? Unlike other drugs, Methamphetamine appeals equally to both genders. Although traditionally used by white, working class males 18 to 34 years of age on the West Coast and College students the demographics are now much broader. Native Americans and Hispanics are using Meth in growing numbers however relatively few African Americans are regular users of Methamphetamines.
What are the "risk factors" for Meth abuse and dependence? Early onset of stimulant use, multiple-substance abuse, daily cigarette smoking between 13 and 17 years of age, depression, ADHD, the manic phase of bipolar disorder, obesity and a desire to enhance sexual pleasure and known risk factors for Methamphetamine abuse and dependence.
What is a stimulant and how does Meth work? Stimulants are powerful modulators of Dopamine activity. Stimulants are grouped into two distinct classes based on mechanism of action. 1) The first group consists of the "uptake blockers" and includes cocaine and Ritalin. 2) The second group is the "releasers" which include the amphetamine analogs like methamphetamine, dextroamphetamine, and MDMA or Ecstasy.
Is Meth more addictive than other stimulants? Yes. Compared to other stimulants, the progression to meth addiction is accelerated. Meth use is characterized by frequent ingestion (8-10 times a day) and users who initially snorted or smoked meth often find they need to administer the drug intravenously to achieve the desired effects. There are differences in neurotoxicity between Meth and other stimulants. Methamphetamine use damages neurons that inhibit dopamine and serotonin pathways while cocaine is not toxic to these neurons. Because of this, the lack of mental energy, dysphoria and depression experienced during withdrawal is more severe and protracted in Meth than with other stimulants. What is STARTLING is that many of the effects of Meth withdrawal (impairment in thinking and performance for example) are present up to three years AFTER quitting.
Treatment, does anything work? In addition to the standard 90 day inpatient rehab facilities that have proven effective, psychosocial therapy (cognitive behavioral therapy) as an outpatient can help. Additionally, there are some pharmacological therapies that show promise. The SSRI antidepressants (Zoloft and Paxil) were studied for Meth withdrawal but were NOT found to be beneficial. Three medications, however, are effective: Mirtazapine (Remeron), Buproprion and Ritalin with several additional therapies currently being studied.
What are we seeing in the hospital? Just this month I have seen patients with dilated cardiomyopathy (heart failure) from Meth with one awaiting heart transplant as his only option for life. We see patients on Meth with active psychosis and the effects of violence are seen every day in our ER and jail ward. Chronic Meth users complain to me of dizziness, nausea, fatigue, hair loss and sores where they have scratched the skin down to the bone. Let's not forget about "Meth mouth", and I have seen every variation of dead and decayed teeth, and even jaw osteonecrosis ("dead jawbone")in a 20 year old woman who looked nothing like her drivers license picture from 2 years prior.
If Meth has wreaked havoc on you or someone you know, please share your story. Spread the word.
Dr O.
CATEGORIES:
News
CONDITIONS AND COMMUNITIES:
ADHD / ADD
•
Alcoholism
•
Anger Management
•
Anxiety
•
Bipolar Disorder
•
Bipolar Disorder - Teen
•
Chronic Fatigue Syndrome
•
Chronic Pain
•
Cirrhosis
•
Cocaine Addiction & Recovery
•
College Stress
•
Depression
•
Depression - Teen
•
Eating Disorders
•
Families & Friends Of Addicts
•
Hepatitis C
•
Heroin Addiction & Recovery
•
High School Stress
•
HIV
•
HPV
•
Incest Survivors
•
Inhalant Abuse & Recovery
•
Irritable Bowel Syndrome (IBS)
•
Meth Addiction & Recovery
•
Migraine Headaches
•
Obsessive Compulsive Disorder (OCD)
•
Oppositional Defiant Disorder (ODD)
•
Panic Attacks
•
Physical & Emotional Abuse
•
Post-Traumatic Stress Disorder
•
Prescription Drug Abuse
•
Seasonal Affective Disorder
•
Self-Injury
•
Sexually Transmitted Diseases - Female
•
Sexually Transmitted Diseases - Male
•
Smoking Addiction & Recovery
•
Teen Anxiety
•
Teen Sexuality
•
Weight Loss For Teens
Displaying comments 61-42 of 61
Got a Question?
There are diseases and there are self-induced diseases. This is an obviously preventable example of self-induced issues! Like alcoholism -- the last legal drug -- the things that folks will do -- I guess -- to relieve stress in the name of fun is always amazing.
What really attracts folks?
At that point she still had her license and insurance, although she should not have been driving. That is gone now, too.
Jail may be a good thing if she is convicted on burglary charges.
I know I have to remain strong, but it is not easy.
For many, it's not simply the meth (or any amphetamine, and some other psychostims) that's at the root of the addiction- but the mixture of sex and stimulants. The stimulants cause an increase in libido, plus a profound effect on ones usual sexual inhibitions. Then comes the cycle of increasingly risky sexual behavior, which on it's own is a high, combined with the high from the stimulant... and eventually you have a situation where the user is chasing more and more stimulation, seeking out new and novel experiences, because the old ones aren't as stimulating anymore- and none of it is as stimulating as it is when one is sober. In later stages, one is just trying to re-experience the euphoria they experienced earlier in their experimentation of drugs/sex, and it's a goal that's impossible to attain. Married couples can get much worse. If they are working in tandem with each other, the sexual world has far more opportunities for a couple.
You asked how you can be sure. If you aren't opposed to invading privacy (and you shouldnt be if there are children involved, or the risk of danger to others), you can always pluck a hair from a comb, or freshly fallen in a sink...or... get creative. There are mailorder hair drug tests that will give you the answer. It'd be better if you stepped in before the law or the courts do.
(and now its harder to purchase a 24c box of Sudafed during allergy season than it is to purchase near pharmaceutically pure methamphetamine)
This topic reminded me of a news article I recently read about how Doc's are considering prescribing Stimulants to normal people to help boost their brain! I was astounded when I read it. I totally disagree with throwing stimulants at people so they can be better at work, school, etc. It can backfire on them, and let alone the addiction factor.
http://news.yahoo.com/s/ap/2008120...
Stimulants can backfire if given to someone with the wrong brain chemistry. People need MORE SLEEP! Americans are sleep-deprived more than ever now. How is a Doc truly going to judge whether a person is well-rested and needs a stimulant??
We are too focused on 'Want it Now' and this type of activity in our lives will lead us to be stressed out and eventually Heart Disease, etc, etc...
Stimulants do NOT work for all people...it's not a fix-all. They don't even work for some type of ADD'ers.
Thought I'd share! Thanks Dr. O for all your wonderful insights!
I want to say to the grandparent, who's story I just read here, my step son is now 28 and fine...for the most part. I want to tell you it is worth it to not give up; I understand what you are going through, with the roller coaster of emotions and problems. My life, my husband's and my stepson's would have been much easier if (forgive me) the birth mother would have died, or at least stayed out of his life 100%...Instead, she would show up every so often, not for long, and always for selfish reasons, but long enough to mess up my stepson's head.
I am going to ask you, as a grandparent, or caretaker of a such a child, something very difficult:
Please be careful how you talk about the child's parent.....it does hurt them deeply when they hear someone speak ill of their mother or father.....
This was the single-most difficult thing I faced in raising our wonderful child. When he was old enough and the questions came, I tried to explain to him that she has a sickness, and I did my best to not make it sound like she is "bad" or didn't love him. Sometimes, this took the every ounce of strength I could muster, but it is well worth it. I myself, am a recovered drug addict, so I know what it is like to be so helpless to change... It is a disease and we need to change the way we look at drug addiction . It is not something to be dealt with in jails, it needs to be dealt with medical intervention as well as multi layered psychological help....medication, cognitive behavior therapy, many things. Keep in mind that 12 step programs just don't help everyone with an addiction.
I take methadone. There, I said it. I had an opiate addiction, and I am very lucky to have methadone because I can function and work and raise someone's child.....etc. (I am going to ask you to be open minded about what I just said because so many people fear my life saving medication)
I feel more sorry for a meth addict, because I don't know of a treatment for that which is as effective. It must be a miserable and scary thing to be addicted to.
Please , everyone, educate yourself about addiction with facts. Don't just jump on the bandwagon of "The War on Drugs" or "Just Say No". Clearly those approaches don't work. We need to de-stigmatize addiction and treat the victims with support and understanding. Not to say you should become an enabler.
Talk to your children early in life about the dangers of addiction. It truly is The Great American Tragedy.
I was able to stop I believe for one reason only, I'm pregnant.
Even after 5 months I still have cravings, dreams, and simply have to stay FAR FAR AWAY.
my little sister got popped with a meth charge and that didnt even change me. its the worst/best drug ever.
i hate it and i love it.