1. Crystal Methamphetamine: Questions Answered
Luther A. Virgil, Jr., MD
Jay Fournier MS, MSW

2. Crystal Methamphetamine: What is amphetamine?
A synthetic drug that stimulates the heart and respiration, constricts blood vessels and induces sleeplessness.
First synthesized in Germany 1887.
Originally marketed as Benzedrine in the 1920s and was used for suppressing appetite or preventing narcolepsy.
Were available over the counter and quickly became a favorite street drug known as "pep pills" or "Bennies."
Used by U.S. air force during WW II to keep pilots awake on long missions.
End of World War II 2% of Japanese adults were dependent on amphetamines.

3. Crystal Methamphetamine: What is amphetamine? Cont.
Reportedly used in "brainwashing" by governments in the 1950s.
Late 50’s people were injecting content of Benzedrine inhalers.
Performance-enhancing drug by athletes. Severely restricted beginning in the 1950s.
Periods of Meth Epidemic 1950’s, late 60’s and a 3rd epidemic
started in mid 90’s
Now available by low-dose prescription generally used to treat ADD, narcolepsy and to control weight.

4. Crystal Methamphetamine: Questions Answered
What is methamphetamine?
A chemical variation
Became a common street drug known as "speed" in the 1960s which was usually taken in pill form
It is a white or off-white, odorless, bitter-tasting crystalline powder that easily dissolves in water
Has a much stronger stimulant effect on the central nervous system
It is more addictive than the original drug

5. Crystal Methamphetamine: Questions Answered
What are the affects of methamphetamine?
Provides the user with sustained energy, a general sense of well-being, increasing alertness and wakefulness, and it masks the body’s need for food, water, or rest.
Can be snorted or smoked as is or dissolved in water and drunk or injected.
Effects can last from 6 to 12 hours or more
Now available by low-dose prescription form as Dexedrine or Desoxynl and is generally used to treat ADD, narcolepsy and to control weight.

6. Crystal Methamphetamine: Questions Answered
Methamphetamine Street Terms:
Bikers Coffee MethliesQuickChalk
Poor Man's Cocaine Chicken Feed
Shabu Crank
Speed Stove Top
Trash Go-Fast
Yellow Bam Crystal
Glass Batu or Ice (Clear-Wash)
Tina
Office of National Drug Control Policy, Drug Policy Information Clearinghouse

7. Crystal Methamphetamine: What is crank?
A smelly, yellow form of "meth" that is usually snorted.
The cheapest form of the drug.

8. Crystal Methamphetamine: What is lith?
Short for the lithium taken from batteries in the manufacturing process.
Comes in a paste form that is usually smoked.
More expensive than crank but cheaper than the crystal form.

9. Crystal Methamphetamine

10. Crystal Methamphetamine: History
There is not just one street form of the drug.
Likely created in Asia in the late 1980s and then surfaced in California in the 1990s.
Comes in clear, chunky crystals, which are then inhaled or smoked.
In Hawaii are primarily 2 types Clear which is white & highly refined and Wash which is brown and washed using acetone and alcohol to improve its appearance.

11. Crystal Methamphetamine

12. Crystal Methamphetamine: Tools used to smoke crystal meth

13. Crystal Methamphetamine: What is Crystal Meth?
Crystal meth has become the most widespread and popular form of the drug
The user immediately experiences an intense "rush" (also called a "flash") that causes intense pleasure lasting a few minutes. The high could be 3 to 6+ hours. Users can become quickly addicted and dependent.
Swallowing mins, Smoking 7-10 Sec, Shooting sec, Booty bump 3-5 mins, Hot Railing 7-10 sec.
In many areas, crystal meth is cheaper, at $10 for a "point" or about one-tenth of a gram
An ecstasy hit, or tablet, can cost twice as much, about $20

14. Crystal Methamphetamine: How is Crystal Meth produced?
Can be easy to produce in small, clandestine labs, sometimes in a kitchen or bathroom
Produced by mixing a cocktail of about 15 substances, mostly pseudoephedrine (a cold remedy), red phosphorous and iodine, but also including ammonia, paint thinner, ether, Drano and the lithium from batteries. [instructions can easily be found via the internet] But the manufacturing process can be dangerous and cause fires
Law Enforcement officials say an investment of about $150 can yield up to $10,000 worth of the drug.

15. Crystal Methamphetamine: Who uses Crystal meth?
Addiction experts say crystal meth first became popular in poor areas of rural North America for a number of reasons. It was a cheap high and, in initial stages of use, it actually gave the energy that allowed the user to keep working. It was also considered "cool" by young people who did not have big-city connections to other street drugs.
In Hawaii some people attribute directly the rise in Crystal Meth use to the major marijuana eradication program in recent history.

16. Crystal Methamphetamine: Who uses Crystal Meth?
According to mental health workers, police and research scientists, the people who use crystal meth include:
Large numbers of rural and small town poor across North America.
Some young people in the rave and dance scene.
Some young people who want to lose weight.
Gay males involved in the dance scene or who frequent bathhouses.

17. Concentration of Crystal Meth in US

18. Crystal Meth in Hawaii ICE/BATU = Crystal Meth Two Forums:
Clear- White in color highly refined. Most prevalent.
Wash- Brown tint less highly refined and washed with
alcohol or acetone. Less expensive.
Decrease of Meth price from a high of $10,000 an once in 97
to $2,500 an once in ‘2000.
1 gram of Ice = +/- 30 doses
1gram in Honolulu = $300
in Hawaii Co. = $250
in Maui = $350
in Kauai Co = $500

19. Crystal Meth in Hawaii
38% of all arrestees in Honolulu tested positive for Ice.
29% in Sacramento and 28% in San Jose –
National Arrestee Drug Abuse Monitoring Program, 2001
Hawaii has nation's highest rate of adults who have tried ice.
Department of Health
Ice replaced alcohol primary substance used by Hawaiian adults in
treatment programs – Department of Health, Drug Abuse Division
Deaths attributed to crystal meth have doubled in two years. 
They have surpassed those related to alcohol –
Honolulu Medical Examiner's Office
Nationally 14% of sentenced traffickers were involved
with methamphetamines in 2001
In Hawaii the rate was 51%. - U.S. Attorney's Office

20. Crystal Methamphetamine: Questions Answered
Source: Drug Abuse Warning Network.
Number of emergency department methamphetamine mentions, 1995–2002
1995 (15,933) 1996 (11,002) 1997(17,154) (11,486)
1999 (10,447)
2000(13,505)
2001(14,923)
2002 (17,696)

21. Crystal Methamphetamine: Treatment
According to the Treatment Episode Data Set
During the year 2000, methamphetamine treatment admissions accounted for 4.1% of total admissions or 66,052 admissions.
In Hawaii of 28,601 eleventh and twelfth graders surveyed 1.8% used meth at least once in last 30 days.
Those admitted for methamphetamine/amphetamine related complications were primarily white (79%) and male (53%).

22. Crystal Methamphetamine: Crystal Meth and Youth
According to the Centers for Disease Control and Prevention's Youth Risk Behavior Surveillance—United States, 2001 study
9.8% of high school students had used methamphetamine within their lifetime.
Overall, white (11.4%) and Hispanic (9.1%) students were more likely than black students (2.1%) to report lifetime methamphetamine use.

23. Crystal Methamphetamine: Questions Answered
According to the U.S. Department of Health and Human Services' Results From the 2002 National Survey on Drug Use and Health: National Findings
more than 12 million people age 12 and older (5.3%) reported that they had used methamphetamine at least once in their lifetime
597,000 persons age 12 and older (0.3%) reported past month use of methamphetamine

24. Crystal Methamphetamine: Short-term Effects
What are the short-term effects of methamphetamine use?
Elevated mood, induced euphoria, increased alertness, reduced fatigue, increased energy, decreased appetite, increased movement and speech, increased alertness and wakefulness, a sense of increased personal power and sexual prowess.
Mirrors body’s natural fight or flight. Slows digestion and increases alertness and concentration.
Unfortunately, there's also a down side. The same process produces increased blood pressure, heart rate and sweating, and can cause anxiety, irritability, insomnia, paranoia, and sometimes even psychosis.
Once the high wears off, mental and physical exhaustion set in often with a deep depression that sometimes includes thoughts of suicide.

25. Crystal Methamphetamine: Signs of Continued Crystal Meth Use
Grinding teeth
Obsessive picking of the face or body
Hallucinations (auditory or visual)
Euphoria
Lack of inhibitions
No sleep for 2-3 days
Dramatic weight loss
Paranoia
Aggressive behavior
Extreme energy
Mask body’s need for food
Common indicators that someone is “tweaking” or using meth include: grinding teeth, obsessive picking of the face or body, hallucinations (auditory or visual), euphoria, extreme energy, and no sleep for 2-3 days, dramatic weight loss, paranoia and aggressive behavior.

26. Crystal Methamphetamine: Crystal meth and Sex
Does crystal meth cause better sex?
There is no direct connection between the use of crystal meth and better sex.
As a stimulant, however, crystal meth stimulates your libido and enhances sexual sensation.
Crystal meth can increase your self confidence and lower your inhibitions.
For many people, sex under the influence of crystal meth rapidly leads to an incredibly strong association between the two which is hard to break. One without the other can become inconceivable.
More/Longer/Rougher sex can expose a person to HIV,Hep B/C.

27. Crystal Methamphetamine: Long Term Effects
What are the long term effects of methamphetamine use?
Methamphetamine causes long lasting changes in brain chemistry.
Changes impact cognitive abilities such as memory, judgment, reasoning, and verbal learning.
Changes do not reverse themselves quickly (it takes many months away from the drug before your brain begins to heal).
Other long term effects include frequent bouts of drug craving, frequent agitating dreams of using crystal or frequent frustration dreams of being unable to use(these take many months to fade away also).

28. Crystal Methamphetamine: Risks
Is it possible to overdose from methamphetamine?
Yes, one can fatally overdose from use of methamphetamine.
Death from a methamphetamine overdose is associated with the rapid onset of kidney failure and collapse of the circulatory system.
A large percentage of patients who die usually have symptoms of coma, shock, inability to pass and secrete urine, and muscle twitching.

29. Crystal Methamphetamine: Addiction Risks
Can an addict recover?
Experts say that crystal meth is one of the most addictive street drugs and one of the hardest to treat. Addiction counselors say the relapse rate of 92 per cent is worse than cocaine.
There are no pharmacological treatments for methamphetamine dependence. Antidepressant medications can be used to combat the depressive symptoms of withdrawal. The most effective treatment for methamphetamine addiction is cognitive behavioral interventions, which modify a patient's thinking, expectancies, and behavior while increasing coping skills to deal with life stressors.
Those who do manage to recover from addiction and retain memory and the ability to function in society are usually subject to some memory gaps and extreme mood swings.

30. Crystal Methamphetamine: Why is there an association between crystal and viruses like HIV and Hepatitis?
The association between meth and HIV transmission is related to: 1) tendency to engage in unprotected and uninhibited sex while under the influence of meth and 2) the risks associated with injection drug use for those who shoot speed.
Hepatitis B can be transmitted through unprotected sex or through sharing of syringes and injection supplies.
Hepatitis C is mostly transmitted through blood to blood contact, usually by sharing syringes or other injection equipment.
Gay men who use meth have a much higher rate of HIV prevalence than gay men who don’t use speed.Number of studies found meth use and HIV 2-4 times higher in gay men or men who have sex with men.
For people living with HIV, even occasional use of crystal can lead to a lapse in taking HIV medications and drop in T-Cells.

31. Crystal Methamphetamine: Resources
Crystal Methamphetamine Fast Facts
CBC News INDEPTH: DRUGS Crystal meth
American Council on Science and Health
US NO DRUGS.com is a comprehensive directory

32. Thanks!!! jay.fournier@abbott.com
THE END!!!!
Thanks!!!