What is Methamphetamine? A very powerful stimulant A highly addictive, synthetic drug A powder or crystallized form Can be taken orally (tablet), injected, or inhaled (smoked), absorbed through skin Methamphetamine stimulates release and blocks re-uptake of neurotransmitters called monoamines (dopamine, norepinephrine and serotonin) in the brain.

Addiction Potential 42% of first time users go on to 2nd use. 84% of 2nd time users go on to develop regular use. OHSU.Org

Physiological Impact Increased metabolic rate, heart rate, and blood pressure (blood flow restricted as vessels contract) Body temperature rises (sweat glands shut down; more prevalent in men than women) Body energy surges, excessive activity may result Loss of appetite as digestive tract slows down Extreme euphoria within 5-20 minutes Enhanced sociability Increased sexual arousal; loss of inhibitions

Phases of Meth Use Rush (5-30 minutes): all about pleasure High (4-16 hours): aggressive & argumentative Binge (3-15 days): hyperactivity Tweaking (most dangerous): hallucinations Crash (1-3 days): mostly asleep Normal (2-14 days): back to a slightly deteriorated normal state Withdrawal (30-90 days): depression, lethargy, cravings, suicidal tendencies

Negative Side Effects: Immediate and Long-term Stroke Cardiac arrhythmia Stomach cramps Convulsions & shaking Significant weight loss Lung disorders similar to asbestos exposure Insomnia Chronic sinus infections; deviated septum Paranoia and hallucinations; high-level anxiety; aggression Brain damage; risk factor for development of Parkinson’s Skin rashes and dental decay; burns Poor personal hygiene (bathing is physically uncomfortable)

The Faces of Meth

Homemade Meth Ingredients Pseudoephedrine Red phosphorous (matches) Drain cleaner Sulfuric acid Paint thinner Iodine Freon Driveway cleaner Lye Acetone (nail polish remover) Methanol (brake fluid) Ammonia Ether Lithium metal (batteries) Pesticide Anhydrous ammonia

Shake and Bake Meth

“Parents who are addicted to drugs have a primary commitment to chemicals, not to their children.” Beckwith, 1989

Meth Mouth The drug causes the salivary glands to dry out, which allows the mouth's acids to eat away at the tooth enamel, causing cavities.

Meth Bugs

How Does Meth Impact Brain Function? Immediately begins to change brain chemistry Damages neurons more severely in ways that other drugs do not Not all areas of the brain affected: centers for reward, memory, and judgment are most heavily impacted Profound changes in dopamine and seratonin systems PET scans resemble Parkinson’s patients Brain chemistry resembles paranoid schizophrenics In children, integration of sensory-based functions is most vulnerable

The Brain Chemistry Effect

Nerve Cell Damage

PET Scan of Meth User

Loss of Memory, Emotion, and Reward Systems in the Meth Brain

Brain Scans: Healthy vs. a 15-year user of Meth

Meth and the Brain Click Here

How Does Meth Hurt Children?

Double Jeopardy for Children Children are at risk due to prenatal exposure and postnatal environmental effects Poverty Chaotic and dangerous lifestyles Symptoms of psychopathology (personality disorders, depressive symptoms) History of sexual abuse Domestic violence

IDEAL Study The Infant Development, Environment and Lifestyle (IDEAL Study: Dr. Barry Lester of Brown University) Clinical outcomes: - smaller head size - evidence of feeding difficulties - sleep disturbances - delays in development domains - ADD - early and multiple interventions produce positive outcomes (healthcare, mental health, social services)

Recognizing a Meth House Unusual odors (ammonia, ether, cat urine, rotten eggs, or old mayonnaise) Covered windows Strange ventilation Elaborate security Dead vegetation Excessive/unusual trash Frequent visitors and/or deliveries Uncharacteristic display of wealth Round-the-clock activity, followed by quiet days

Recognizing Meth Production An unusually large supply of main meth ingredients in the home or trash - blister packs of cold meds (Sudafed or comparable), batteries, camp fuel, and others Presence of equipment or apparatus used to make meth - stained coffee filters, funnels, turkey basters, improvised glassware, tubing

Treatment & Recommendations

What About Treatment? Communities are unprepared for treatment of meth addicts (effective 40-50%) Meth addicts are particularly challenging: *poor engagement rates *high drop-out rates *high relapse rates *protracted depression, paranoia, anxiety Some emerging info on histamine effect (OHSU) First 4-6 months of treatment are most critical to recovery