2. Intimate Partner Violence & Methamphetamine Claudia J. Wilcox, CADC II Policy & Program Development Specialists April 27, 2007

3. Methamphetamine Is a Powerful Central Nervous System Stimulant

4. Meth causes the release of dopamine in the pleasure and reward pathway of the brain at significantly higher levels than virtually all other drugs of abuse.

5. The one and only thing… Marijuana Alcohol Heroin Cocaine Crack Nicotine Caffeine Eric Martin, M.A., CADC III

6. 0 0 50 100 150 200 0 0 60 120 180 Time (min) % of Basal DA Output NAc shell Empty Box Feeding Source: Di Chiara et al. FOOD Natural Rewards Elevate Dopamine Levels

7. 0 0 100 200 300 400 500 600 700 800 900 1000 1100 0 0 1 1 2 2 3 3 4 4 5 hr Time After Amphetamine % of Basal Release DA DOPAC HVA Accumbens AMPHETAMINE 0 0 100 200 300 400 0 0 1 1 2 2 3 3 4 4 5 hr Time After Cocaine % of Basal Release DA DOPAC HVA Accumbens COCAINE 0 0 100 150 200 250 0 0 1 1 2 2 3 3 4 4 5hr Time After Morphine % of Basal Release Accumbens 0.5 1.0 2.5 10 Dose (mg/kg) MORPHINE 0 0 100 150 200 250 0 0 1 1 2 2 3 hr Time After Nicotine % of Basal Release Accumbens Caudate NICOTINE Source: Di Chiara and Imperato Effects of Drugs on Dopamine Levels

8. Methamphetamine Increases autonomic functions, Increases autonomic functions, (heart rate, body temperature, breathing) (heart rate, body temperature, breathing) Causes damage to the brain, Frontal Lobe Causes damage to the brain, Frontal Lobe (memory, judgment, impulse control) (memory, judgment, impulse control) Depletes serotonin which is a mood stabilizer, Depletes serotonin which is a mood stabilizer, (anxiety, depression & aggression) (anxiety, depression & aggression)

9. Function of Frontal Lobe Impulse control Impulse control Judgment Judgment Language Language Working memory Working memory Problem solving Sexual behavior Socialization Motor function

10. Crime increases during the last three years The Meth Epidemic in America, July 2005 The Meth Epidemic in America, July 2005 NACo NACo 87% of counties report an increase of methamphetamine related arrests in the past three years. 87% of counties report an increase of methamphetamine related arrests in the past three years. Oregon, Washington, Utah, California, Nevada and Arizona are some of the states reporting such increases. Oregon, Washington, Utah, California, Nevada and Arizona are some of the states reporting such increases.

11. Seventy Percent of the Responding Officials say… Seventy Percent of the Responding Officials say…

12. Abuse and Violence History of Men and Women in Treatment for Methamphetamine Dependence CSAT Methamphetamine Treatment Program 1999-2001 CSAT Methamphetamine Treatment Program 1999-2001 Largest Randomized Clinical Trail of Meth-dependent persons Largest Randomized Clinical Trail of Meth-dependent persons To help clarify the limited understanding of treatment seeking methamphetamine dependent persons. To help clarify the limited understanding of treatment seeking methamphetamine dependent persons.

13. Reporting of abuse and violence was extensive  80 % of women reported abuse or violence from an intimate partner  40 % of Men reported experiencing violence from friends or others  A high percentage of both reported threatening or coercive experiences with their partners.

14. A history of 57.6 % of women reported sexual abuse and violence A history of 57.6 % of women reported sexual abuse and violence A history of 15.7% of men reported sexual abuse and violence A history of 15.7% of men reported sexual abuse and violence Women were more likely than men to report a history of sexual abuse from each of the categories in the chart on the following slides. Women were more likely than men to report a history of sexual abuse from each of the categories in the chart on the following slides.

15. Reported History of Sexual Abuse or Violence Were you ever forced to have sex? # Women % # Men % # Rprtg“Yes” 321 57.6% 71 15.7% Parent 58 14.2% 58 14.2% 6 11.3% 6 11.3% Sibling 89 21.8% 89 21.8% 10 6.3 % 10 6.3 % Partner 130 31.6% 11 6.9% 11 6.9% Friend 145 35.5% 38 24.0% 38 24.0% Strnger/Other Strnger/Other 78 19.3% 78 19.3% 16 10.1% 16 10.1%

16. Physical Violence Reported by Source of Violence Violence Reported “Ever” # Women % # Men % # Rprtg “Yes” 480 85.4% 316 69.6% Parent 178 35.0% 109 32.4% Sibling 84 16.6% 84 16.6% 60 17.8% 60 17.8% Partner 407 80.0% 89 26.3% 89 26.3% Friend 54 15.9% 54 15.9% 113 37.5% Strngr/Other 56 14.4% 56 14.4% 118 43.4%

17. Women vs Men with History of Abuse Women  70 % Any Abuse  21% Physical Abuse only  8% Sexual only  40% Both Sexual & Physical

18. MEN 29 % Any Abuse 29 % Any Abuse 20 % Physical Abuse only 20 % Physical Abuse only 2.5% Sexual Abuse only 2.5% Sexual Abuse only 7 % Sexual & Physical Abuse 7 % Sexual & Physical Abuse

19. High Prevalence Population Substance Abusers Substance Abusers Persistent Physical problems Persistent Physical problems Persistent Psychological problems Persistent Psychological problems

20. RECOMMENDATIONS Need to provide thorough assessments Need to provide thorough assessments Identify Co-Occurring Disorders Identify Co-Occurring Disorders Implement Integrated Tx Implement Integrated Tx Data Collection Data Collection Treat the Trauma by Use of Evidence Based Practices Treat the Trauma by Use of Evidence Based Practices

21. Evidence Based Practices Dialectical Behavioral Therapy (DBT) Dialectical Behavioral Therapy (DBT) Seeking Safety Seeking Safety Eye Movement Desensitization Reprocess (EMDR) Eye Movement Desensitization Reprocess (EMDR) http://www.oregon.gov/DHS/mentalhea lth/ebp/practices.shtml http://www.oregon.gov/DHS/mentalhea lth/ebp/practices.shtml

22. Thank You Questions or Comments Questions or Comments Claudia J. Wilcox, CADC II Department of Human Services Policy & Program Development Specialist Addictions & Mental Health Division (503)945-5765Claudia.j.wilcox@state.or.us