1. Rural Crime & Justice Center A University Center of Excellence Minot, North Dakota

3. Cycle of Abuse 1. Rush The initial intense response the abuser feels when smoking or injecting methamphetamine. Those who snort or swallow the drug do not experience this.

4. Cycle of Abuse S Alex Stalcup The New Leaf Project

5. Cycle of Abuse 2. The High The rush is followed by the high, sometimes called “the shoulder.” The abuser often feels aggressively smarter and becomes argumentative, often interrupting other people and finishing their sentences. The high can last from 4-16 hours.

6. Cycle of Abuse S Alex Stalcup The New Leaf Project

7. Cycle of Abuse Low-Intensity Methamphetamine Abuse A user who is not psychologically addicted, but uses methamphetamine on a casual basis by swallowing or snorting. Uses it in the same way many people use caffeine or nicotine. These people frequently hold jobs, raise families, and otherwise function normally.

8. Cycle of Abuse 3. The Binge Maintains the high by smoking or injecting more. Begins to experience addictive euphoric rushes. Becomes mentally and physically hyperactive. The binge can last 3-15 days. Each time the abuser smokes or injects more, a smaller euphoric rush is experienced until, finally, there is no rush or high.

9. Cycle of Abuse S Alex Stalcup The New Leaf Project

10. Cycle of Abuse High-Intensity Methamphetamine Abuse Psychologically addicted, often called “speed freaks.” Their existence focuses on preventing the crash, and they seek that elusive, perfect rush, like they had when they first started smoking or injecting methamphetamine. Tweaking begins to occur.

11. Cycle of Abuse 4. Tweaking Tweaking occurs at the end of the binge when nothing will take away the feeling of emptiness and dysphoria, including taking more methamphetamine. Tweaking is very uncomfortable, and the abuser often takes a depressant to ease the bad feelings. The most popular depressant is alcohol, with heroin a close second.

12. Cycle of Abuse S Alex Stalcup The New Leaf Project

13. Cycle of Abuse Tweakers Most dangerous state No sleep in 3-15 days

14. Approaching a Tweaker Keep a social distance Do not shine bright lights at him/her Slow your speech Lower the pitch of your voice Slow your movements Keep your hands visible Keep the “tweaker” talking United States DEA

15. Cycle of Abuse 5. Crash The crash means an incredible amount of sleep. The body uses the crash to recover from the strain caused by extended use.

16. Cycle of Abuse S Alex Stalcup The New Leaf Project

17. Cycle of Abuse 6. Withdrawal Withdrawal symptoms vary depending on length and intensity of abuse. Symptoms can include: Sleepiness Fatigue Increased appetite Slowed thinking Boredom Depressed mood Agitation Anxiety Mood instability Craving to use

18. Source: S Alex Stalcup New Leaf Project

19. Binge and Crash 5-30 minutes 6-12 hours or more 3-15 days 1-3 days Source: http://www.ouc.bc.ca/psyc/path/parent-teacher-info.html Indefinite length of time

20. Any Questions?