4. Methamphetamine: What Professionals Need to Know
Jackie McReynolds
Washington State University
Vancouver

5. 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

6. 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

7. 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

8. 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

9. 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)

10. The Faces of Meth

11. 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

12. Shake and Bake Meth

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

14. Meth Mouth

15. Meth Bugs

16. 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

17. The Brain Chemistry Effect

18. Nerve Cell Damage

19. PET Scan of Meth User

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

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

22. How Does Meth Hurt Children?

23. 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

24. Developmental Vulnerabilities
Immature organ systems, faster metabolic rates, weaker immune systems
Eat more food, drink more fluids, and breathe more air per pound of body weight
Typical behaviors expose them to more hazards
Increased potential for cerebral damage (strokes, brain lesions)

25. Digestive Difficulties
Permanent brain damage causes difficulty in glucose metabolism (12-17 mo. to repair some)
Stomach lining is weakened by high levels of acidity, leading to gastritis
H pylori bacterial infection ensues
Symptoms may include an aversion to food, acid reflux-like symptoms, abdominal cramps, ulcer-like symptoms

26. Treatment for H pylori No safe protocol documented for children
For adults a three-pronged approach:
Amoxicillin or other antibiotic
Bismuth (i.e., Pepto: some risk of Reye syndrome)
Metronidazole (i.e., Pepcid)
Hypersensitive to taste and smell: go for bland
Lactose intolerance: move to soy-based products

27. 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)

28. Pre-Natal Meth Exposure
Easily crosses the placenta; metabolized differently by fetal brain; brain is more sensitive
Constricts blood flow, restricting oxygen and slowing growth
Linked to a greater incidence of multiple births, prematurity, and low birth-weight
Pregnant women and new mothers are less likely to seek help than other addicted women
Mothers who are clean during the 3rd trimester reduce fetal involvement significantly

29. Special Needs Attachment intervention
Medication (chronic and short-term)
Hydration and tube feeding
Cardiac monitoring
Foster care placement
Therapeutic child care

30. Minimizing Stress for Infants
Provide a quiet, calm environment with minimal noise & bright lights
Ensure warmth and comfort by bundling the child in blankets
Encourage habituation by providing sucking opportunity with a pacifier
Initiate gentle rocking or soothing motions to help achieve neurobehavioral organization
Limit exposure to cigarette smoke

31. Working With Young Children up to Two Years of Age
6-18 months of age is referred to as a “honeymoon” period of development for drug- exposed children
All external measures may well indicate the child is symptom-free
Toward the end of this period (18-24 months), speech and language difficulties may appear
Appropriate interventions need to occur as difficulties emerge

32. Interventions: Infants and Toddlers
Design quiet environments with limited sensory stimulation
Implementation of an emotionally centered, attachment focused program (Circle of Security; Promoting First Relationships)
Consistency in schedule, adult contacts, physical stimulation
Use of sign language
Referral for sensory integration therapy; sensory screening

33. Children 3 Years and Older
Attention deficit may become more pronounced as more demands are placed on the child in group settings
May have difficulty controlling emotions and social exchanges
Problems adjusting to a changing environment
Spatial learning and memory (object recognition) are deficient
Tendencies toward aggressive behavior, hypervigilance, and parentification
Type II diabetes and high blood pressure are common
Unstable family units exacerbate problems

34. Preschool (young school-aged) Psychosocial Problems
Low self-esteem
Core boundary issues
Regressive behaviors
Fear and anxiety
Food and object hoarding
Grief and loss behaviors
Influence of family disruption
Initiative (guilt): Preschool
Industry (inferiority): School age

35. Why environmental organization?

36. Dangers of Home Visits

37. 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

38. 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

40. Treatment & Recommendations

41. 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

42. Does Treatment Work?

43. The Matrix Model of Treatment
Combines the following aspects:
- individual counseling (non-judgmental and non-confrontational)
- cognitive behavioral therapy
- motivational interviewing
- family education program
- regular u.a. (once per week)
- aspects of the traditional 12-step program
Rawson, R. (1996)

44. Resources Am. Assn. of Retired Persons, aarp.org/grandparents/
Drug Endangered Children (DEC), nationaldec.org
Children of Alcoholic Families
Natl. Inst. On Drug Abuse: nida.nih.gov
Zero to Three, Zerotothree.org
ACE Study (child impact), ChildTrauma.org
Circle of Security, Circleofsecurity.org
Through the Eyes of a Child, University of Wisconsin fact sheets
DSHS: www1.dshs.gov/kinshipcare/raisingchildren.shtml
Vol. 12(2) 2007 of Child Maltreatment,
Brown Center for the Study of Children at Risk,

45. Other Useful Web Resources
Govt. Meth Resources: Methresources.gov
Montana Meth Project: Montanameth.org
Alcoholics Anonymous :alcoholics-anonymous.org
Al-Anon/Alateen al-anon.alateen.org
Narcotics Anonymous: na.org

46. Other Non-fiction Reading
Addict in the Family by Beverly Conyers
Painted Rocks by Kimberly Ann Freel
The Year of Magical Thinking by Joan Didion
The Way We Are, an essay by Thomas Lynch (included in Bodies in Motion and at Rest)
Under the Influence by Katherine Ketcham & James R. Milan
What About the Kids: Raising Your Children Before, During and After Divorce by Judith Wallerstein and Sandra Blakeslee
Beautiful Boy: A Father’s Journey Through His Son’s Meth Addiction by David and Nic Sheff
Tweaked: A Crystal Meth Memoir, by Patrick Moore

47. Presenter Contact Info
Jackie McReynolds, M.S.
Senior Instructor/Academic Coordinator
Dept. of Human Development
Washington State University
Vancouver, WA
FAX: