Pubdate: Mon, 15 Jan 2007 Source: Columbian, The (WA) Copyright: 2007 The Columbian Publishing Co. Contact: http://www.columbian.com/ Details: http://www.mapinc.org/media/92 Author: Stephanie Rice, Columbian staff writer Bookmark: http://www.mapinc.org/meth.htm (Methamphetamine) THE HIGHEST HIGHS THE LOWEST LOWS Emergency department physician Jack Stump, who first sounded an alarm about methamphetamine in the early 1990s, shows a PET scan reflecting how drugs erode the brain. The red-colored portions are the most damaged. (DAVE OLSON/The Columbian) Years before brain scans proved his theory, Dr. Jack Stump figured the toxic brew known as methamphetamine irreversibly damaged the areas that control behavior and emotion. An emergency room doctor in Medford, Ore., in the early 1990s, Stump saw a steady increase in meth users. Aggressive, twitchy and ranting, these meth users couldn't settle down. They came to the hospital for different reasons: Maybe they burned themselves making a batch of the superstimulant or had provoked a fight with police. Maybe they had picked their skin bloody because they were hallucinating, believing they were covered in bugs. Maybe their teeth had rotted because their mouths had stopped producing cleansing saliva. Every user would eventually tell Stump they needed meth just to try to feel normal. So they'd use it again and again. As one patient later said, "'This once' turned into a thousand times." The costs of methamphetamine addiction are so great that Clark County commissioners recently increased the sales tax to raise an estimated $6 million to combat meth on a number of fronts, including prevention and treatment. Commander Rusty Warren of the Clark-Skamania Drug Task Force said up to 80 percent of identity theft and related crimes are committed by meth addicts. The most prevalent drug in the area is marijuana, he said. "However, the most destructive is meth," Warren said. So just how good does that first shot of meth feel? Consider it in terms of dopamine, a feel-good chemical released when you do pleasurable activities, said Stump, now an emergency room doctor at Southwest Washington Medical Center who lectures nationwide on meth's destructiveness. Savoring a meal, for example, raises a person's dopamine level to 150. An orgasm rates 200 on the dopamine chart. Methamphetamine goes a step further and attaches itself to the dopamine-producing nerve cells, triggering a flood that shoots a person's dopamine level to 1,050. And while the after-bliss of food or sex lasts minutes, that first meth high can last 16 hours. Users go on binges to avoid the comedown and end up staying awake for two weeks. They can do this, often going without food, because meth also causes the adrenal glands to pump out the "fight or flight" chemical that, among other things, suppresses appetite. For days, the user feels energized and euphoric, Stump said. But too much of a good thing can be bad, and sustained levels of dopamine can turn users psychotic. Brain can't handle drug The inevitable crash is equally dramatic, causing numbing depression and the need to sleep as long as 72 hours. When the users wake up, they are singularly focused on getting more meth, even though they'll never get as high as the first time. Instead, Stump said, the unrelenting flow of chemicals exhausts the brain. Unlike drugs from natural sources the brain recognizes, such as cocaine (derived from the coca plant), heroin (opium poppies) and alcohol (fermented fruit or grain), meth causes such a supernatural pleasure simply because our brains were never meant to be able to handle it. So after that first high, everything falls apart. Dopamine production, for example, shuts down. So the normal, small bursts of dopamine -- the ones a sober person feels when his baby falls asleep in his arms or he cuddles with his wife -- don't happen anymore for users. Dr. Stump said researchers have mapped the brains of meth addicts. The decay the drug causes in the areas responsible for cognitive functioning and memory resembles the injured brain of a person with Parkinson's or Alzheimer's. Unlike with those incurable diseases, the meth-damaged brain can partially heal after two years or so of sobriety, Stump said. But imagine a meth brain as a piece of Swiss cheese. While the holes may grow smaller over time with sobriety, in the least-resilient users the damage can be permanent. Physical toll evident A user's appearance suffers, too. Superior Court Judge John Nichols said he can spot meth addicts right away when they enter his courtroom. Often malnourished, the addicts are bone-thin. "They've got dry hair sticking out, and blotches on their skin," Nichols said. The judge said he's often shocked to learn an addict's age. "They look 45, and they are 25," Nichols said. Bernard Veljacic, a Clark County deputy prosecuting attorney, can rattle off stories about the meth addicts he has encountered during his years in the department's drug unit: the real estate agent who tried meth once at a party and ended up losing his home, job and marriage; the shackled defendant who flipped out and had to be restrained by a half-dozen officers. Or the suspects he charged with an additional crime -- worth up to an extra year in prison -- after they tried smuggling meth into the Clark County Jail inside their rectums or vaginas. "They'll give away sex for it, kill for it, and they'll steal from their own mother," Veljacic said. He recalled a father who sobered up in Superior Court's drug court, where defendants stay out of jail if they stay clean. The man had shared how dead he'd felt when he wasn't high. "His first son was born and he couldn't feel anything," Veljacic said. "(Meth) literally steals your joy." "What is life without those joys?" Veljacic said. "Instead it's supplanted by this artificial high, forever fleeting, and it's never as good as the first time." Stephanie Rice covers the courts. She can be reached at 360-759-8004 or Did you know? * Methamphetamine belongs to a class of central nervous system stimulants called amphetamines. It was first made in the 1800s by Japanese and German chemists. * Meth was used by Axis and Allied troops in World War II to stay awake during missions. * Evolving recipes and methods have raised meth's power. While recipes vary, the most common form in Clark County is a blend of red phosphorus and iodine (which make hydriodic acid), water, and pseudoephedrine. - --- MAP posted-by: Derek