Deconstructing Myths of Meth

Heather EdneyBehavioral Health Consultant

heatheredney@gmail.com

ALICE MILLERBreaking Down the Wall of Silence

What is addiction, really?

It is a sign, a signal, a symptom of distress. It is a language that tells us about a plight that must be understood.

Proposed Ground Rules

• Bring open minds and hearts to this workshop• Refrain from bringing judgments to what

others say• This is an interactive workshop; bring up

issues as you have them• We will all value diversity of perspective

Stimulants

• Class of drug that has historically been used to treat asthma and other respiratory problems, obesity, neurological disorders, and a variety of other ailments.

• Prescribed for the treatment narcolepsy, ADHD, and depression that has not responded to other treatments.

• Stimulants increase alertness, attention, and energy, as well as elevate blood pressure, increase heart rate and respiration, constrict blood vessels, increase blood glucose, and open up the pathways of the respiratory system.

Crystal Meth/Speed

Benefits:• Increased alertness and

energy• Feelings of intense pleasure,

well-being and euphoria• Feelings of competence and

superiority• Self-confidence• Sociability• Heightened sexual arousal• Intense focus

Risks: Insomnia, restlessness Paranoid psychosis Hallucinations Violent & aggressive behavior Weight loss, reduced appetite Increased heart rate Increased blood pressure Fatal overdose is possible, but not

common

Ritalin (Methylphenidate) and Adderall (Amphetamine)

• Ritalin and Adderall are central nervous system (CNS) stimulants.

• Researches speculate that Ritalin and Adderall amplify the release of dopamine thereby improving attention and focus in individuals who have dopamine signals that are weak such as people with ADHD.

• Ritalin 10 mg

• Adderall 10 mg

Ritalin/AdderallBenefits:• Wakefulness• Increased focus/attentiveness• Euphoria • Appetite suppression

Risks:• Increased blood pressure, heart rate• Crashing: extreme fatigue, insomnia,

irritability, and depression• Psychosis• Heart attack, seizure, stroke

Experimentation Acute Addiction

Abstinence

ACUTEPhysical and Psychological

Effects

CHRONICPhysical and Psychological

Effects

What is a “stimulant” overdose?

• Some users call it “overamping” when the effects of a stimulant like cocaine (powder), crack or speed become distressing or dangerous.

• Can be a problem with the body, or it can be psychological, or both.

• Sometimes overamping is considered part of the high for some users, not always negative.

Can it be fatal or harmful?• Yes but more likely for cocaine to cause a

fatality because of heart attack risk.

• Serious medical complications include seizure, stroke, and overheating (hyperthermia).

• Drug-induced psychosis can result in dangerous situations, or feeling suicidal.

Speed Psychosis

• Psychosis symptoms can include paranoia, delusions, hallucinations and obsessions.

• Psychosis can lead to someone becoming a danger to themselves or others.

• Some enter the psych ER voluntarily or involuntarily

0

50

100

150

200

0 60 120 180Time (min)

% o

f Bas

al D

A O

utpu

t

NAc shell

EmptyBox Feeding

Source: Di Chiara et al.

FOOD

100

150

200

DA

Con

cent

ratio

n (%

Bas

elin

e)

MountsIntromissionsEjaculations

15

0

5

10

Copulation Frequency

SampleNumber

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

ScrScrBasFemale 1 Present

ScrFemale 2 Present

Scr

Source: Fiorino and Phillips

SEX

Natural Rewards Elevate Dopamine Levels

Source: Shoblock and Sullivan; Di Chiara and Imperato

Effects of Drugs on Dopamine Release

0

100

200

300

400

Time After Cocaine

% o

f Bas

al R

elea

se

DADOPACHVA

Accumbens COCAINE

100

150

200

250

0 1 2 3 4hrTime After Ethanol

% o

f Bas

al R

elea

se0.250.512.5

Accumbens

0

Dose (g/kg ip)

ETHANOL

0

100

150

200

250

0 1 2 3 hrTime After Nicotine

% o

f Bas

al R

elea

se

AccumbensCaudate

NICOTINE

Time After Methamphetamine

% B

asal

Rel

ease

METHAMPHETAMINE

0 1 2 3hr

1500

1000

500

0

Accumbens

Partial Recovery of Brain Dopamine Transporters in Meth

Abuser After Protracted Abstinence

Normal Control METH Abuser(1 month detox)

METH Abuser(24 months detox)

0

3

ml/gm

Source: Volkow, ND et al., Journal of Neuroscience 21, 9414-9418, 2001.

Effective Approaches• Real harm reduction techniques can work for

some at key stages of use – thought maybe not addiction

• Can be most effective with early users

• Harm reduction = honesty

• Works when the messenger is on the user’s team

Examples of Harm ReductionSome tips from fellow users:

• Breathing or meditation exercises• Physical contact, like massage• Walking, walking, walking—walk it off!• Take a warm shower• Get some fresh air

Some tips from fellow users:

• Drink water/sports drink, eat some food• Try to sleep• Switch how you’re doing your speed or

coke (From shooting -> smoking)• Change your environment or peers• Take a benzo (a small, safe dose of Ativan

or similar sedative)

Longitudinal Memory Performance

test

num

ber c

orre

ct

• First 12 months can be the most difficult

• Relapse potential very high in the first six months

• Different from alcohol, opiates and other drugs – there’s an earlier payoff

Effective Approaches

• Crystal meth users in recovery find great value in relating to other users in recovery – not just anyone with an alcohol or addiction problem;

• Language is distinct

• Unique experiences

• *Are You A Tweeker? (CMA)

Effective Approaches

Experimentation

Acute Addiction 24 months< 12 Months

Abstinence

Experimentation

Acute Addiction 24 months< 12 Months

Abstinence

Harm Reduction

Experimentation

Acute Addiction 24 months< 12 Months

Abstinence

Harm Reduction

User Experiences

an Event

Experimentation

Acute Addiction 24 months< 12 Months

Abstinence

Harm Reduction

User Experiences

an Event HighRelapse

Potential

Experimentation

Acute Addiction 24 months< 12 Months

Abstinence

Harm Reduction

Support of Like Peers

Critical

User Experiences

an Event HighRelapse

Potential

CRYSTAL METH ANONYMOUSwww.crystalmeth.org

HARM REDUCTION COALITIONwww.harmreductioncoalition.com

GABOR MATÉIn the Realm of the Hungry Ghost

THE MATRIX MODEL OF TREATMENTSteve Shoptaw, Ph.D., Rawson, Ph.D.

TWEAKERwww.tweaker.org

• "ARE YOU A TWEAKER?"

• It doesn't matter what you call it. It doesn't matter how you did it.? It brought us to our knees, because, without exception, that's what it does.

• Is speed a problem in your life? Are you an addict? Only you can answer those questions. For most of us who have admitted defeat, the answer is very clear. Yes, we had a problem with speed, and no, we couldn't fix the problem by ourselves. We had to admit defeat to win. Speed was our master.

• We couldn't control our drug use. What started out as weekend or occasional use became daily use, and we soon found ourselves beyond human aid. We truly suffered from a lack of power to fix our problem.

• Some of used speed as tool to work harder and longer, but we couldn't keep a job. Others picked at their faces and arms for hours and hours or pulled out their hair. Some of us had uncontrollable sexual desire. Others endlessly tinkered with projects, accomplishing nothing, but found ourselves so busy we couldn't get to work on time.

• We deluded ourselves into thinking that staying up for nights on end was OK, that our tweaking was under control, and that we could quit if we wanted to, or that we couldn't afford to quit, or that our using didn't affect our lives.

Maybe we saw a friend go to jail, or lose their apartment, or lose their job, or lose the trust of their family, or die, but our clouded minds wouldn't admit we were next.

Most of us saw no way out, believing that we would use until the day we died.

Almost universally, if we had an honest moment, we found that our drug use made seemingly insurmountable problems in our lives.

The only way out was if we had the courage to admit that speed, our one time friend, was killing us.

It doesn't matter how you got here. The courts sent some of us; others came for family or friends, and some of us came to CMA on our own. The question is if you want help and are willing to go to any lengths to change your life.

Bath Salts • MDPV is a powerful stimulant that

effects the central nervous system and cardiovascular system.

1. physical: rapid heartbeat, increase in blood pressure, vasoconstriction, sweating.

2. mental: euphoria, increases in alertness & awareness, increased wakefulness and arousal, anxiety, agitation, perception of a diminished requirement for food and sleep.

• MDPV is sometimes labeled online as legal cocaine or legal amphetamines.

• Last about 3 to 4 hours, after effects such as rapid heart beat, hypertension, and mild stimulation lasting from 6 to 8 hours.

• High doses can cause intense, prolonged panic attacks in stimulant-intolerant users

• There are anecdotal reports of psychosis from sleep withdrawal