Amphetamines

Crystal methamphetamine (crystal meth) is a powerful central nervous stimulant with highly addictive properties. I find it very troubling how prevalent this drug is among young people.

Prevalence in Vancouver

A sample of street youth and young adults aged 14 – 30 years in 2000 in Vancouver found that 71% had tried methamphetamine at least once in their lifetime, and 57% had used it more than 10 times (Maxwell & Rutkowski, 2008).  Throughout my experience of working in addiction, I have found it a lot more common for young people to have tried crystal meth.

Effects of Crystal Meth

Physiological Effects: increased energy and alertness / diarrhea and nausea /excessive sweating /loss of appetite, insomnia, tremors, jaw-clenching / increased libido /increased blood pressure, body temperature, heart rate, blood sugar levels /constriction of the walls of the arteries /insomnia

Users describe what the crystal meth high is like as similar to cocaine, only lasting for a longer period of time. There is an almost instant euphoria, followed by an increase in energy and alertness that can last for up to 12 hours.

Psychological Effects: instant euphoria / paranoia /hallucinations and delusions /severe anxiety /thoughts of homicide or suicide / agitation, irritability, talkativeness, panic, compulsive fascination with repetitive tasks, violence, confusion

The most common hallucination and delusion on crystal meth that are seeing bugs, and feeling bugs crawl on skin which results in the user picking.  An avid crystal meth user may have sores all over their body especially on arms and face from picking their skin.  They may also experience extreme paranoia where they believe people are out to get them and for these individuals these hallucinations and delusions feel so real.  These individuals may go into a substance induced psychosis.

(National Institute of Drug Abuse, 2013)

Psychosis

Rates of psychosis among regular methamphetamine users were 11 x that seen among the general population. Over one in five regular methamphetamine users had experienced a clinically significant symptom of psychosis in the past year, and psychosis was not restricted to those who had a history of mental health disorders. Symptoms of psychosis tended to be brief, most lasting up to three hours.  However, it can last up to days, months, or years depending on the person’s mental health history and amphetamine use. Individuals who experience psychosis as a result of crystal meth use will be more likely for it to occur again and if they use other substances like marijuana they could be at risk of experiencing it again.

(National Institute of Drug Abuse, 2013)

Risk of Violence

Because these individuals may experience hallucinations, delusions, and be in a psychosis there is a risk for violence and aggression.  Remember, this paranoia feels so real to them. These individuals may be a risk to themselves and others. Levels of violent crime among methamphetamine users (12% in last year).  Alcohol use increased the likelihood of violent crime among methamphetamine users. Almost one-third of methamphetamine users were under the influence of methamphetamine the last time they committed a violent crime. Methamphetamine use was reported to make the person feel more alert, confident and aggressive while undertaking the violent crime.

(McKetin, McLaren & Kelly, 2005)

Treatment

Although the withdrawal from other substances like alcohol, benzodiapines, or opiates can be extremely dangerous, the detox from meth is rarely dangerous.  However, it is still tough and unpleasant.

The most frequently reported withdrawal symptoms are irritability (78%), aches and pains (58%), depressed mood (50%) and impaired social functioning (46%). Participants reported that symptoms persisted for between five days and three weeks.

Medication may be helpful in alleviating symptoms associated with withdrawal like sleep disturbances, anxiety, or depression. Short-term use of benzodiazepines and antipsychotics for control of irritability and agitation can be helpful, particularly in the inpatient setting.

The mainstay of treatment is supportive care and counselling.

(Cantwell & McBride, 1998)

My own thoughts

With any drug, you are playing with fire.  But especially with crystal meth.  The impacts it has on the brain and the lingering psychosis that occur are quite scary.  I urge clients to stay away from crystal meth because of what I have seen with clients experiencing psychosis. It is no fun.

References

Cantwell, B. & McBride, A. J. (1998). Self detoxification by amphetamine dependent patients: a pilot study. Drug and Alcohol Dependence, 49, 157–163.

Maxwell, J. C., & Rutkowski, B. A. (2008). The prevalence of methamphetamine and amphetamine abuse in   North America: a review of the indicators, 1992-2007. Drug And Alcohol Review, 27(3), 229–235. http://doi.org/10.1080/09595230801919460

McKetin, McLaren & Kelly (2005). The Sydney methamphetamine market: Patterns of supply, use, personal harms and social consequences. National Drug Law Enforcement Research Fund Monograph Series No. 13. Australasian Centre for Policing Research, Adelaide.

National Institute on Drug Abuse (2013). Research Report Series: Methanphetamine. Retrieved from https://d14rmgtrwzf5a.cloudfront.net/sites/default/files/methrrs.pdf

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