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Deconstructing Myths of Meth Heather Edney Behavioral Health Consultant

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1 Deconstructing Myths of Meth Heather Edney Behavioral Health Consultant

2 ALICE MILLER Breaking Down the Wall of Silence What is addiction, really? It is a sign, a signal, a symptom of distress. It is a language that tells us about a plight that must be understood.

3 Proposed Ground Rules Bring open minds and hearts to this workshop Refrain from bringing judgments to what others say This is an interactive workshop; bring up issues as you have them We will all value diversity of perspective

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5 Stimulants Class of drug that has historically been used to treat asthma and other respiratory problems, obesity, neurological disorders, and a variety of other ailments. Prescribed for the treatment narcolepsy, ADHD, and depression that has not responded to other treatments. Stimulants increase alertness, attention, and energy, as well as elevate blood pressure, increase heart rate and respiration, constrict blood vessels, increase blood glucose, and open up the pathways of the respiratory system.

6 Crystal Meth/Speed Benefits: Increased alertness and energy Feelings of intense pleasure, well-being and euphoria Feelings of competence and superiority Self-confidence Sociability Heightened sexual arousal Intense focus Risks: Insomnia, restlessness Paranoid psychosis Hallucinations Violent & aggressive behavior Weight loss, reduced appetite Increased heart rate Increased blood pressure Fatal overdose is possible, but not common

7 Ritalin (Methylphenidate) and Adderall (Amphetamine) Ritalin and Adderall are central nervous system (CNS) stimulants. Researches speculate that Ritalin and Adderall amplify the release of dopamine thereby improving attention and focus in individuals who have dopamine signals that are weak such as people with ADHD. Ritalin 10 mg Adderall 10 mg

8 Ritalin/Adderall Benefits: Wakefulness Increased focus/attentiveness Euphoria Appetite suppression Risks: Increased blood pressure, heart rate Crashing: extreme fatigue, insomnia, irritability, and depression Psychosis Heart attack, seizure, stroke

9 Experimentation Acute Addiction Abstinence ACUTE Physical and Psychological Effects CHRONIC Physical and Psychological Effects

10 What is a “stimulant” overdose? Some users call it “overamping” when the effects of a stimulant like cocaine (powder), crack or speed become distressing or dangerous. Can be a problem with the body, or it can be psychological, or both. Sometimes overamping is considered part of the high for some users, not always negative.

11 Can it be fatal or harmful? Yes but more likely for cocaine to cause a fatality because of heart attack risk. Serious medical complications include seizure, stroke, and overheating (hyperthermia). Drug-induced psychosis can result in dangerous situations, or feeling suicidal.

12 Speed Psychosis Psychosis symptoms can include paranoia, delusions, hallucinations and obsessions. Psychosis can lead to someone becoming a danger to themselves or others. Some enter the psych ER voluntarily or involuntarily

13 Time (min) % of Basal DA Output NAc shell Empty Box Feeding Source: Di Chiara et al. FOOD Natural Rewards Elevate Dopamine Levels Natural Rewards Elevate Dopamine Levels

14 Source: Shoblock and Sullivan; Di Chiara and Imperato Effects of Drugs on Dopamine Release Time After Cocaine % of Basal Release DA DOPAC HVA Accumbens COCAINE hr Time After Ethanol % of Basal Release Accumbens 0 Dose (g/kg ip) ETHANOL hr Time After Nicotine % of Basal Release Accumbens Caudate NICOTINE Time After Methamphetamine % Basal Release METHAMPHETAMINE 0123hr Accumbens

15 Partial Recovery of Brain Dopamine Transporters in Meth Abuser After Protracted Abstinence Normal Control METH Abuser (1 month detox) METH Abuser (24 months detox) 0 3 ml/gm Source: Volkow, ND et al., Journal of Neuroscience 21, , 2001.

16 Effective Approaches Real harm reduction techniques can work for some at key stages of use – thought maybe not addiction Can be most effective with early users Harm reduction = honesty Works when the messenger is on the user’s team

17 Examples of Harm Reduction Some tips from fellow users: Breathing or meditation exercises Physical contact, like massage Walking, walking, walking—walk it off! Take a warm shower Get some fresh air

18 Some tips from fellow users: Drink water/sports drink, eat some food Try to sleep Switch how you’re doing your speed or coke (From shooting -> smoking) Change your environment or peers Take a benzo (a small, safe dose of Ativan or similar sedative)

19 Longitudinal Memory Performance test number correct

20 First 12 months can be the most difficult Relapse potential very high in the first six months Different from alcohol, opiates and other drugs – there’s an earlier payoff Effective Approaches

21 Crystal meth users in recovery find great value in relating to other users in recovery – not just anyone with an alcohol or addiction problem; Language is distinct Unique experiences *Are You A Tweeker? (CMA) Effective Approaches

22 Experimentation Acute Addiction 24 months < 12 Months Abstinence

23 Experimentation Acute Addiction 24 months < 12 Months Abstinence Harm Reduction

24 Experimentation Acute Addiction 24 months < 12 Months Abstinence Harm Reduction User Experiences an Event

25 Experimentation Acute Addiction 24 months < 12 Months Abstinence Harm Reduction User Experiences an Event High Relapse Potential

26 Experimentation Acute Addiction 24 months < 12 Months Abstinence Harm Reduction Support of Like Peers Critical User Experiences an Event High Relapse Potential

27 CRYSTAL METH ANONYMOUS HARM REDUCTION COALITION GABOR MATÉ In the Realm of the Hungry Ghost THE MATRIX MODEL OF TREATMENT Steve Shoptaw, Ph.D., Rawson, Ph.D. TWEAKER

28 "ARE YOU A TWEAKER?" It doesn't matter what you call it. It doesn't matter how you did it.? It brought us to our knees, because, without exception, that's what it does. Is speed a problem in your life? Are you an addict? Only you can answer those questions. For most of us who have admitted defeat, the answer is very clear. Yes, we had a problem with speed, and no, we couldn't fix the problem by ourselves. We had to admit defeat to win. Speed was our master. We couldn't control our drug use. What started out as weekend or occasional use became daily use, and we soon found ourselves beyond human aid. We truly suffered from a lack of power to fix our problem. Some of used speed as tool to work harder and longer, but we couldn't keep a job. Others picked at their faces and arms for hours and hours or pulled out their hair. Some of us had uncontrollable sexual desire. Others endlessly tinkered with projects, accomplishing nothing, but found ourselves so busy we couldn't get to work on time. We deluded ourselves into thinking that staying up for nights on end was OK, that our tweaking was under control, and that we could quit if we wanted to, or that we couldn't afford to quit, or that our using didn't affect our lives.

29 Maybe we saw a friend go to jail, or lose their apartment, or lose their job, or lose the trust of their family, or die, but our clouded minds wouldn't admit we were next. Most of us saw no way out, believing that we would use until the day we died. Almost universally, if we had an honest moment, we found that our drug use made seemingly insurmountable problems in our lives. The only way out was if we had the courage to admit that speed, our one time friend, was killing us. It doesn't matter how you got here. The courts sent some of us; others came for family or friends, and some of us came to CMA on our own. The question is if you want help and are willing to go to any lengths to change your life.

30 Bath Salts MDPV is a powerful stimulant that effects the central nervous system and cardiovascular system. 1.physical: rapid heartbeat, increase in blood pressure, vasoconstriction, sweating. 2.mental: euphoria, increases in alertness & awareness, increased wakefulness and arousal, anxiety, agitation, perception of a diminished requirement for food and sleep. MDPV is sometimes labeled online as legal cocaine or legal amphetamines. Last about 3 to 4 hours, after effects such as rapid heart beat, hypertension, and mild stimulation lasting from 6 to 8 hours. High doses can cause intense, prolonged panic attacks in stimulant- intolerant users There are anecdotal reports of psychosis from sleep withdrawal


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