The Truth About Methamphetamines

Darlene M. Walker, MA, LAADC

Emily Ibrahim, BA, RADT-I

LABIOMED/Options for Recovery

Darlene M. Walker, MA, LAADC Emily Ibrahim, BA, RADT-I
 Disclaimer

 Please note that this Power Point presentation is an

educational tool that is general in nature. It is not intended to
be a extensive review of methamphetamines as data and
information on most substances changes frequently. The
presenters are clinicians who work with women with
methamphetamine use disorders. Materials in this presentation
may encompass the use of other resources and will be cited
appropriately at the close of the presentation.
 Learning
Objectives

1. The history of methamphetamines in the U.S

2. The impact of methamphetamines on the individual and
community risk factors
3. Treating methamphetamine addiction
4. Strategies for helping pregnant and parenting women succeed
in stopping and recovering from methamphetamine use.
https://www.mentimeter.com/
 History of Methamphetamine

• Amphetamine created in Germany in 1887

• Used widely during WWII by the Nazi and Japanese armies
• Japanese kamikaze pilots were documented to be high on meth
• Major challenge in postwar Japan
• Biker gangs in California after WWII began to distribute meth

Source – www.history.com
 What is Methamphetamine?

 Produced most commonly using the

ephedrine/pseudoephedrine reduction method

 Meth is commonly manufactured in illegal, hidden

laboratories, mixing various forms of amphetamine
or derivatives with other chemicals to boost its
potency.
What is Methamphetamine? Continued…

 Meth is a highly addictive drug made from a variety

of toxic ingredients.
 Man made substance using common household
chemicals
 Meth is a central nervous system stimulant, similar to
cocaine.
 Meth produces a rush, followed by a state of
agitation..
 Highly Toxic Substances

Drain Cleaner Battery Acid Antifreeze Over-the-counter asthma

medicine containing ephedrine
or pseudoephedrine

Lye
Lantern Fuel Hydrochloric Acid
Match-box striker
(Red phosphorous)
 What Does Methamphetamine
Look Like?
• Typically an odorless powder that dissolves quickly in water
• Another form of meth is clear chunky crystals referred to as
crystal meth or ice smoke-able meth which includes terms like
Hanyak, Hironpon, Hiropon, Hot Ice, Cristy, Batu, Kaksonjae, LA
Glass, LA Ice, Quartz, and Super Ice.
• May be in the form of small brightly colored tablets, referred to as
YABA
 Methamphetamine

Source – Novarecoverycenter.com
 Methamphetamine
Laboratories
AKA Meth Labs

 Contain dangerous chemicals which are potentially explosive.

 Meth cooks are typically individuals with substance use disorder
problems who make a significant amount of money from meth
sales.
 Cooking can cause severe burning , disfigurement and
explosions that are dangerous
 Methamphetamine
Laboratories
AKA Meth Labs
Continued…

 The illegal laboratories create a lot of toxic waste — the

production of one pound of methamphetamine produces five
pounds of waste.
 People exposed to this waste material can become poisoned
and sick.
 Nearby homes or buildings along with health concerns for the
community.
 How Does Methamphetamine Work?

Methamphetamine releases large amounts of

dopamine in the brain, causing feelings of
pleasure and euphoria.

Source: National Institute on Drug Abuse. April 1998, Reprinted January 2002. Research Report Series:
Methamphetamine Abuse and Addiction. www.nida.nih.gov/ResearchReports/methamph/methamph.html
Source: National Institute of Health (NIH)
 Craving for Stimulants is a Central and Very
Powerful Component of Stimulant
Dependence

 Classical conditioning and craving

 The brain and addiction
 Craving is automatic and creates a
powerful push to use
 For many the craving seems overpowering
and uncontrollable
 The craving is triggered by external
(people, places, things, times of day) and
internal (emotional states) stimuli
 Managing exposure to triggers and
responses to triggers is important
Forms of Distribution
How is Methamphetamine
Used?
 Why Methamphetamine

Methamphetamine is three times as powerful as cocaine and is among

the most difficult drugs to permanently quit.
It triggers dependency faster than a majority of other illicit substances.
Methamphetamine forces the brain to release an unnatural amount of
dopamine at a given time, as well as norepinephrine, also known as
adrenaline.
The result is a rush, followed by a high. This chemical combination deeply
affects the brain’s limbic system, which is responsible for emotion and
memory.
 People who use meth will often spiral into something called a
binge, in which they become hyperactive and repeatedly dose
with methamphetamine in hopes of maintaining the initial,
euphoric high.
 This uncontrolled drug use will often decrease its potency,
however, making achieving the high impossible.
 Many users continue to seek lines of meth to attempt to obtain
the same high
 Eventually, a user will stop experiencing a high and “tweaking”
begins. While tweaking, a user feels emptiness and unease.
 Many people testify to feeling a loss of identity during this time.
It is also common for users to experience hallucinations and
extreme itchiness.
 Addicts at this stage are at high risk for self-harm.
 Effects of Drugs on Dopamine Levels

1100 Accumbens AMPHETAMINE COCAINE

1000 Accumbens
400
% of Basal Release

900

% of Basal Release
800 DA
DA
700 DOPAC 300 DOPAC
600 HVA HVA
500
200
400
300
200 100
100
0
0 1 2 3 4 5 hr 0
Time After Amphetamine 0 1 2 3 4 5 hr
Time After Cocaine

250
NICOTINE 250 Accumbens MORPHINE
% of Basal Release

% of Basal Release
Dose (mg/kg)
200 Accumbens
200 0.5
Caudate 1.0
150 2.5
150 10

100
100

0
0 1 2 3 hr 0
0 1 2 3 4 5hr
Time After Nicotine Time After Morphine
 Effects of
Methamphetamine Use
• Increased alertness
• Decreased appetite
• A distorted sense of well-being
• Effects that can last 8 to 24 hours
Behavior Changes Health Changes

Psychotic behavior Stroke

Paranoia
Brain damage
Aggression
Weight loss
Anxiety
Death
Fatigue

Depression

Delusions

Mood swings
Confusion

Insomnia

Hallucinations Source: Congressional Research Sites

 Methamphetamine -
Acute Psychological Effects
Increases Decreases
Confidence
 Boredom
Alertness
 Loneliness
Mood
 Timidity
Sex drive


Energy


Talkativeness

 Methamphetamine -
Acute Psychological Effects

 Increases  Decreases
 Heart rate  Appetite
 Blood pressure  Sleep
 Pupil size  Reaction Time
 Respiration
 Sensory acuity
 Energy
https://www.youtube.com/watch?v=yjCwXqHZ8mE
 Treatment Approaches

 Counselor relationship
 Classes and discussion on other addictions; Physical
Health Classes, Emotional Health Classes, Life Skills
 No judgment ( Weight and Teeth)
 Support and motivation
 Specialized relapse prevention techniques
 Focus on the entire family
 Empathy
 Clinical Challenges With
Stimulant Dependent
Individuals
 Limited understanding of Stimulant Addiction
 Ambivalence about need to stop use
 Cognitive impairment and poor memory
 Short attention span
 Anhedonia
 Powerful Pavlovian trigger-craving response
 Sleep Disorders
 Poor retention in outpatient treatment
 Elevated rates of psychiatric co-morbidity

SOURCE: Rawson, Richard PhD. (2018) Stimulant Use Among Patients on Medication for Opioid Use Disorder (MOUD)” Do We Have Any Answers?
 Key Points with Clinical
Implications

 Powerful reflexive, conditioned cravings

 Requires behavior change
 Avoid drug using friends
 Treatment session can trigger cravings
 Cognitive Impairment
 With currently active users, memory is impaired
 Long therapy session are pointless
 Provide simple, redundant, information
 Schedule. Write it down.

SOURCE: Rawson, Richard PhD. (2018) Stimulant Use Among Patients on Medication for Opioid Use Disorder (MOUD)” Do We Have Any Answers?
 Methamphetamine Use
& Pregnancy
 Studies suggest that stimulant use and physical effects of the use can cause
miscarriages.

 Methamphetamine use can cause a greater chance of premature delivery

prior to 37 weeks

 Babies born with poor growth

 Low birth weight

 Increase in blood pressure during pregnancy

 Placental eruption

 SIDS Sudden Infant Death Syndrome

 Methamphetamine Use
& Pregnancy
Continued…

 Babies can experience withdrawal when mother

used excessively in last trimester
 Symptoms include trouble eating, sleeping
problems
 Poor muscle control
 Breathing problems
 Children exposed to methamphetamine in
embryo could have a higher chance of having a
child with learning difficulties and behavior
problems
• Danger of children being exposed to toxic fumes
• Children are more at risk than adults to environmental hazards, as
their bodies are immature
• Risk of explosion, fire, and chemical burns
• Exposure to weapons, finished drugs, and unsanitary conditions
 More Impacts on
Families
• Increase in child abuse and neglect cases
• Increased risk for substance abuse among children in later life
• A rise in domestic disputes
• Incarceration
• Trauma
• Greater risk of family cycle of abuse increasing
Approaches in Working with Women
Who Use Methamphetamines

 Cognitive Behavioral Therapy

 Individual Counseling
 Weekly sessions on Women’s Health related issues
 Trauma Groups
 Mindful Parenting/Temperance
 Contingency Management
 Mental Health Counseling
 Motivational Interviewing
 Peer relationship vs. authority
 Different life experiences of women in recovery and
staff
 Being able to share about domestic violence and
other issues openly
 What Treatments Are Effective
for Stimulant Use Users?

 Stimulant use and addiction is a complex problem involving

biological changes in the brain as well as a myriad of social,
familial, and environmental factors
 Treatment strategies need to assess the psychological, social,
and pharmacological aspects of the patient’s drug use

SOURCE: National Institute on Drug Abuse, 2016

 Is there an Effective Treatment
for Methamphetamine Abuse?

 Cognitive behavioral interventions designed to help modify the patient's

thinking, expectancies, and behaviors
 CBT and MI Motivational interviewing increase skills in coping with various life
stressors.
 Methamphetamine recovery support groups also appear to be effective
adjuncts to behavioral interventions that can lead to long-term drug-free
recovery.
 Resources
Addiction Treatment Approaches: Nova Recovery Center. (n.d.). Retrieved July 5, 2019, from
https://novarecoverycenter.com/treatment-programs/#

Congressional Research Service. (n.d.). Retrieved July 3, 2019, from https://crsreports.congress.gov/

KJRH -TV | Tulsa | Channel 2. (2011, December 07). Retrieved July 16, 2019, from
https://www.youtube.com/watch?v=yjCwXqHZ8mE

Freese E., Thomas, PhD. (2019). Stimulant Use Disorder: Therapeutic Approaches and Considerations.

History.com Editors. (2017, June 07). History of Meth. Retrieved July 5, 2019, from
https://www.history.com/topics/crime/history-of-meth

National Institute on Drug Abuse. (n.d.). National Institute on Drug Abuse (NIDA). Retrieved July 5, 2019,
from https://www.drugabuse.gov/

National Institute on Drug Abuse (NIDA/NIH). (2016, February 08). Retrieved July 16, 2019, from
https://www.youtube.com/watch?v=TTMNXzL4O4s

Quinn, D., CGC. (2018, March 1). Methamphetamine. Retrieved July 3, 2019, from
https://mothertobaby.org/fact-sheets/methamphetamine/

Rawson, Richard PhD. (2018) Stimulant Use Among Patients on Medication for Opioid Use Disorder
(MOUD)” Do We Have Any Answers?

Thompson, P., Dr. (n.d.). Eroding the Mind [Photograph]. University of California, Los Angeles, Los
Angeles.

Vestal, C. (2019, May 16). It's not just opioids. Deaths from cocaine and meth are surging. Retrieved May
24, 2019, from https://www.pbs.org/newshour/health/its-not-just-opioids-deaths-from-cocaine-and-
meth-are-surging
Thank you!