Transcript Deconstructing Myths of Meth

Deconstructing Myths of Meth
Heather Edney
Behavioral Health Consultant
[email protected]
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.
ALICE MILLER
Breaking Down the Wall of Silence
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/Adderall
Benefits:
• 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
Physical and
Psychological
Effects
Acute Addiction
CHRONIC
Physical and
Psychological
Effects
Abstinence
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
Natural Rewards Elevate
Dopamine Levels
200
% of Basal DA Output
NAc shell
150
100
Empty
50
Box Feeding
SEX
200
150
100
15
10
5
0
0
0
60
120
Time (min)
180
ScrScr
BasFemale 1 Present
Sample 1 2 3 4 5 6 7 8
Number
Scr
Scr
Female 2 Present
9 10 11 12 13 14 15 16 17
Mounts
Intromissions
Ejaculations
Source: Di Chiara et al.
Source: Fiorino and Phillips
Copulation Frequency
DA Concentration (% Baseline)
FOOD
Effects of Drugs on Dopamine Release
Accumbens
1000
500
0
0
1
2
400
Accumbens
DA
DOPAC
HVA
300
200
100
Time After Cocaine
% of Basal Release
Time After Methamphetamine
250
NICOTINE
200
Accumbens
Caudate
150
100
COCAINE
0
3hr
250
% of Basal Release
% Basal Release
1500
% of Basal Release
METHAMPHETAMINE
Accumbens
ETHANOL
Dose (g/kg ip)
0.25
0.5
1
2.5
200
150
100
0
0
1
2
3 hr
Time After Nicotine
0
0
1
2
3
Time After Ethanol
Source: Shoblock and Sullivan; Di Chiara and Imperato
4hr
Partial Recovery of Brain Dopamine
Transporters in Meth
Abuser After Protracted Abstinence
3
0
ml/gm
Normal Control
METH Abuser
(1 month detox)
METH Abuser
(24 months detox)
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 Reduction
Some 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
number correct
25
20
control
baseline
3 mos
6 mos
15
10
5
0
Word Recall
Word
Recognition
Picture Recall
test
Picture
Recognition
Effective Approaches
• 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)
Experimentation
< 12 Months
Acute Addiction
Abstinence
24 months
Experimentation
< 12 Months
Acute Addiction
Harm
Reduction
Abstinence
24 months
Experimentation
< 12 Months
Acute Addiction
Harm
Reduction
User
Experiences
an Event
Abstinence
24 months
Experimentation
< 12 Months
24 months
Acute Addiction
Harm
Reduction
User
Experiences
an Event
High
Relapse
Potential
Abstinence
Experimentation
< 12 Months
24 months
Acute Addiction
Harm
Reduction
User
Experiences
an Event
High
Relapse
Potential
Abstinence
Support of
Like Peers
Critical
GABOR MATÉ
In the Realm of the Hungry Ghost
HARM REDUCTION COALITION
www.harmreductioncoalition.com
CRYSTAL METH ANONYMOUS
www.crystalmeth.org
TWEAKER
www.tweaker.org
THE MATRIX MODEL OF TREATMENT
Steve Shoptaw, Ph.D., Rawson, Ph.D.
• "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 stimulantintolerant users
There are anecdotal reports of
psychosis from sleep withdrawal