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Methamphetamine Basics

Definition of Methamphetamine
A powerful, addictive stimulant that affects the central nervous system, methamphetamine is a derivative of amphetamine. Amphetamines were originally intended for use in nasal decongestants and bronchial inhalers and otherwise have limited medical applications, including the treatment of narcolepsy (a chronic neurological disorder caused by the brain's inability to regulate sleep-wake cycles normally), weight control and attention deficit disorder (inability to maintain attention, impulsive behaviors and/or motor restlessness). Methamphetamine is a Schedule II drug under the Controlled Substance Act of 1970, currently accepted for medical use in treatment in the U.S. Regrettably, methamphetamine is misused by some individuals, creating severe problems for themselves, their families, their workplaces and their communities.

Ways Methamphetamine is Taken and what it looks Like
Methamphetamine can be smoked, snorted, orally ingested and injected. It comes in many forms and can be identified by color, ranging from white to yellow to darker colors such as red and brown. Its form is either powder that looks like granulated crystals, tablets (yabba) or rock, also known as "ice.” Ice can be smoked, producing a faster, stronger high.

Effects of Methamphetamine
As a central nervous system stimulant, meth increases energy and alertness and decreases appetite. It causes high levels of dopamine (a naturally occurring chemical that affects the brain processes that control movement, emotional response and the capacity to feel pleasure and pain) to be released into the section of the brain that controls the feeling of pleasure, creating an intense rush. These effects can last up to 12 hours and are almost instant when smoked or injected. If snorted, the effects can take up to five minutes, and if ingested, can take up to 20 minutes to occur. There are several possible side effects to taking methamphetamine, such as convulsions, dangerously high body temperature, stroke, cardiac arrhythmia (an irregular heartbeat), stomach cramps and shaking.

Consequences of Chronic Use
Chronic use of any illicit drug can result in a higher tolerance for the drug, causing users to take higher doses more frequently and/or changing the method of ingestion and can lead to addiction. Long-term use of methamphetamine can lead to psychotic behavior, including intense paranoia, visual and auditory hallucinations, and out-of-control rages that result in violent episodes. These types of hallucinations contribute to forming body sores, known as "crank sores,” a delusion that bugs are crawling under the skin. Chronic use of meth also leads to tooth decay known as "meth mouth,” a result of the chemicals used in making meth decreasing a person’s ability to make acid-fighting saliva as well as increasing one’s thirst. Because meth causes blood vessel constriction, there is also reduced blood flow to gums. As methamphetamine is a stimulant, other signs of chronic use include anxiety and insomnia. Additional potential consequences of use are cardiovascular problems such as inflammation of the heart’s lining and damaged blood vessels from needle injections; prenatal complications including premature delivery, abnormal reflexes and extreme irritability in the infant, and congenital deformities; and an increased risk of contracting HIV/AIDS and hepatitis B and C by those who inject the drug and share needles. As with any addiction, social and occupational connections also begin to deteriorate with increased drug use.

Abuse and Addiction
Methamphetamine is a highly addictive substance, especially psychologically. After smoking or intravenous injection of the substance, the meth user experiences an intense sensation called a "rush” or "flash.” While this rush is described as extremely pleasurable, it only lasts a few minutes but is followed by a high that can last six to eight hours. The high is followed by a devastating low, often so uncomfortable that the meth user begins to chase the initial rush which will never again be attained, entering the cycle of abuse and eventually addiction.

The initial rush of methamphetamine will never be attained again due to the nature of how the substance affects the brain. Methamphetamine releases high levels of the neurotransmitter dopamine, which stimulates brain cells, enhancing mood and body movement. However, it also has a neurotoxic effect, damaging brain cells that contain dopamine as well as serotonin, another neurotransmitter. According to NIDA, research going back more than 20 years shows that high doses of methamphetamine damage neuron cell endings. Dopamine- and serotonin-containing neurons do not die after methamphetamine use, but their nerve endings ("terminals") are cut back, and regrowth appears to be limited. After the initial release — and accompanying wave of pleasure — the dopamine is depleted and the neurons require time to recover before normal dopamine traffic can resume. Continuous methamphetamine use does not give time for the brain to recover.

There are three patterns of methamphetamine abuse – low intensity, binging and high intensity. The patterns differ from one another in the form of meth taken and the amount of meth used.

The low-intensity pattern does not involve a psychological addiction, and the preferred form of use is usually swallowing or snorting, which does not produce the rush that smoking or injecting gives. Low-intensity abusers want the extra stimulation the methamphetamine provides so they can stay awake long enough to finish a task or a job, or they want the appetite suppressant effect to lose weight. These people frequently hold jobs, raise families and otherwise function normally. They may include people such as truck drivers trying to reach their destination and workers trying to stay awake until the end of their normal shift or an overtime shift. Because low intensity users are often employed, workplace prevention/intervention efforts targeting this group can be critical to keep a user from becoming addicted. Low intensity abusers are only one step away from becoming binge abusers, and it may take only one exposure to smoking or injecting for them to make the transition.

As mentioned, the methamphetamine rush can continue for five to 30 minutes and is so intensely pleasurable that the user attempts to maintain it through binging and tweaking. The binge is a continuation of the high. Binge abusers smoke or inject methamphetamine and experience euphoric rushes that are psychologically addictive. Within binging there are seven stages in the cycle of abuse: rush, high, binge, tweaking, crash, normal and withdrawal. The abuser maintains the high by smoking or injecting more methamphetamine. Each time the abuser smokes or injects more of the drug, a smaller euphoric rush than the initial rush is experienced until finally there is no rush and no high. During the binge, the abuser becomes hyperactive both mentally and physically. The binge can last three to 15 days.

The high-intensity abusers are the addicts, and their existence focuses on preventing the crash. With high-intensity abuse, each successive rush becomes less euphoric, and it takes more methamphetamine to achieve it. Each high is not quite as high as the one before. During each subsequent binge, the abuser needs more methamphetamine, more often, to get a high that is not as good as the high he wants or remembers. Of most concern is tweaking, the time just prior to crashing, when the user is trying desperately and without success to hang on to the high. During this stage, the user is often overwhelmed with feelings of anxiety and emptiness, and people can be extremely irritable and paranoid – which can erupt in violent behaviors.

Meth Use is Widespread
Nearly 12 million Americans have tried methamphetamine as of 2004, according to the 2004 National Survey on Drug Use and Health (NSDUH). The2005 National Survey on Drug Use & Health found that while the number of past meth users has remained steady since 2002, the number of methamphetamine users who were dependent on or abused some illicit drug did rise significantly during this period, from 164,000 in 2002 to 257,000.

Methamphetamine was once associated with white rural males in their 20s or 30s. Today, there is no longer a "typical meth user,” but statistics show that use is up among women and college students and that the typical age of initiation for meth users is between 20 and 24. All sorts of people use methamphetamine for a variety of reasons, in a variety of places. Some use methamphetamine to help lose weight or alleviate stress.

Geographically, meth appears to be spreading from the west coast, southwest and mid-west to the southeast and northeast. High rates of use are associated with rural areas. The 2004 NSDUH found that rates of meth use in rural communities increased from 2003 to 2004 in those aged 18 to 25. Kentucky and Wyoming are currently among states that have been particularly hard hit. The Carsey Institute at the University of New Hampshire’s Reports on Rural America found that those living in rural areas who are unemployed are seven times more likely than their counterparts in urban areas to abuse stimulants, including methamphetamines.

While meth is perceived as a rural drug, it is increasingly present in urban environments as well. On an international level, the World Health Organization finds that methamphetamine is more abused worldwide than cocaine and heroin combined. The U.S. has significantly cracked down on the manufacturing of methamphetamine, and the majority of small, home based meth labs has decreased. To compensate for fewer labs to supply the substance, drug trafficking from Mexico has increased to provide domestic users with the substance. The imported methamphetamine is often purer than that made domestically and has caused a rise in meth addiction and treatment admissions.

Further, use of methamphetamine by Native Americans has increased to what federal and tribal leaders label a crisis, reaching almost epidemic proportions. Of significance to this population is the fact that most Native American reservations are isolated and offer particularly limited treatment options.