Pubdate: Wed, 18 May 2005 Source: Oak Ridger (TN) Copyright: 2005 The Oak Ridger Contact: http://www.oakridger.com/ Details: http://www.mapinc.org/media/1146 Author: John Ammons Series: Other articles in this series may be found at http://www.mapinc.org/source/Oak+Ridger THE DEADLY METH CYCLE Profoundly psychological EDITOR'S NOTE - "The Faces of Meth" is the final part of a three-part series that focuses on the growing problem of methamphetamines and the devastating effect that its use has on people's physical and mental health. A number of physicians and other healthcare professionals from Methodist Medical Center have contributed to this series of these articles. * "Fire," "ice," "crystal," "crank," "meth" - whatever we call it, methamphetamine is a highly addictive, illegal and deadly drug. It can be produced with relative ease using over-the-counter ingredients, and it gives users a more intense high or feeling of euphoria than they get with cocaine. People smoke, snort, inject or take meth orally. There have been reports of users placing it in food and chewing it, as well. The high may last six to eight hours, and the depression that follows is severe. Methamphetamine is a danger to the people who produce and use it, to those who come in contact with it inadvertently, to the environment, and to the community. The Meth Cycle While under the influence of methamphetamine, users may develop symptoms that are similar to schizophrenia, such as hallucinations and homicidal or suicidal thoughts. They also have a tendency to become violent. This extreme behavior is usually the result of amphetamine-induced psychosis, in which the user loses contact with reality. Users may experience a severe "crash" as the drug's effects subside, and the crash can be more extreme and last longer than crashes following cocaine use. One of the primary problems that plagues meth users is an intense craving for more of the drug when the effect of previous use subsides. This is due, in large part, to the profound depression that quickly accompanies stimulant use. A cycle rapidly develops that includes many rituals that provoke use. These rituals include seeking out or obtaining the drug, setting up a "works" or a device to deliver the drug to the body, using the drug, and experiencing the effects of the drug. All of these steps are gratifying and provide comfort to the addicted person. A feeling of despair sets in when the effects of the drug diminishes. This despair quickly descends into depression that drops below what was the emotional baseline for the user. All of this means that the meth user does not feel "normal" even when not under the influence of the drug. The depression, in turn, provokes a conscious craving, and prolonged use of meth results. With continued use, the body develops a tolerance to the drug that results in a diminished "high." The user experiences less euphoria, which provokes an ongoing desire to use methamphetamine. The addiction cycle, as it relates to stimulant usage, is not characterized by a family history or a biogenetic predisposition, as is seen with alcohol overuse. Methamphetamine addiction is profoundly psychological in nature and is most closely related to cocaine dependence. The withdrawal process associated with meth use does not generally require hospital inpatient admission. An exception would be the presence of psychosis. The long-term physical consequences of using methamphetamine may be seen years after use has ceased. Treatment Users generally resist attempts at intervention and do not typically enter treatment for substance abuse until faced with drug-related legal problems. They may also require treatment for physical health problems caused by meth use. Current treatment for meth addiction includes detoxification, residential care, and outpatient rehabilitation. During withdrawal, users experience depression, extreme irritability, a craving for the drug, nausea, excessive sleepiness or difficulty sleeping, profound surge in appetite once the drug effect wears off and other symptoms. Relapse is common because of the complex psychiatric, physical and social aspects associated with meth use. There are no medications to treat meth addiction, although antidepressants help combat depression. Psychiatric treatment known as cognitive behavioral therapy has proven somewhat effective. Its goal is to change a patient's thinking and behavior. In order for treatment to be effective, users must make major life changes and have an ongoing mechanism of accountability for abstinence. These changes must include avoidance of people who continue to consume and/or manufacturer methamphetamine because easy availability of the drug will inevitably result in a return to use. * About the Author -- John Ammons is a licensed alcohol and drug abuse counselor with the Behavioral Medicine Unit at Methodist Medical Center of Oak Ridge. He has been a nationally certified addictions counselor for more than 15 years. At Methodist, Ammons helps patients struggling with addiction issues and also assists local businesses in establishing policy and procedures to implement drug-free workplace environments, educating them about the signs and symptoms of impairment, and assisting them as they help employees find appropriate care. Prior to joining Methodist Medical Center in 1991, Ammons worked at Peninsula Hospital. He majored in psychology at Pellissippi State Community College and received additional education in addiction treatment through the Tennessee Training and Professional Development Program. He is a member of the National Association of Alcoholism and Drug Abuse Counselors and the Tennessee Association of Rescue Squads. * Using meth? Common signs * Extreme anxiousness * Constant talking; rapid and/or pressured speech * Extreme moodiness * Nervousness * Repetitious behavior, such as pulling at their hair * Sleep problems * Severe depression * Aggressive or violent behavior * Deterioration in dental hygiene with significant damage to the teeth in the form of decay and tooth loss - --- MAP posted-by: Josh