Methamphetamine: The Great American Tragedy
I am at the midpoint of my month as the hospitalist at Los Angeles County-USC Medical Center. I have worked as a physician through the Aids epidemic, worked to fight multi-drug resistant Tuberculosis, alcoholic liver disease, and increasing rates of stomach and lung cancer in our young folks. This month, however, my heart is breaking over how Meth is taking over. Methamphetamine use is becoming one of our biggest American tragedies. This blog has been in my mind for a year I've finally sat down to write it out. Here is my tough love blog.
Most of us on Dailystrength know someone who has struggled with Meth and I hope you know our hospitals and emergency rooms are packed with Meth users.
Some background: In the United States medical use of amphetamines began in 1932, when amphetamines (marketed as Benzedrine) was used as a treatment for asthma, narcolepsy, ADHD, appetite suppression and schizophrenia among other things.
Why it caught on? The widespread use of Meth stems largely from its potential to produce euphoria, reduce fatigue, enhance performance, suppress appetite, and induce weight loss among other things. Unlike cocaine and heroin, which are plant derived, Methamphetamine is easily prepared from simple chemical precursors. The more recently available "ice" is created from ephedrine and pseudoephedrine by reduction to its beta-hydroxyl group to form methamphetamine hydrochloride. Domestic and Mexican "superlabs" can produce 10 pounds plus of high purity Meth within a 24 hour period.
How many folks are using? Instead of bombarding you with numbers, I've selected the statistics most striking to me. In 2004, 12 million Americans reported having used Methamphetamine at least once. Emergency rooms, jails and treatment centers are packed with Meth users. In 2003, the percentage of male arrestees testing positive for Meth was 40% in Honolulu, 33% in San Diego and 28% in Los Angeles. The number of new users of Meth increased 250% between 1996 and 2002. In Hawaii 80 to 90% of child abuse cases involve Meth use in one or both parents.
Who uses Methamphetamine? Unlike other drugs, Methamphetamine appeals equally to both genders. Although traditionally used by white, working class males 18 to 34 years of age on the West Coast and College students the demographics are now much broader. Native Americans and Hispanics are using Meth in growing numbers however relatively few African Americans are regular users of Methamphetamines.
What are the "risk factors" for Meth abuse and dependence? Early onset of stimulant use, multiple-substance abuse, daily cigarette smoking between 13 and 17 years of age, depression, ADHD, the manic phase of bipolar disorder, obesity and a desire to enhance sexual pleasure and known risk factors for Methamphetamine abuse and dependence.
What is a stimulant and how does Meth work? Stimulants are powerful modulators of Dopamine activity. Stimulants are grouped into two distinct classes based on mechanism of action. 1) The first group consists of the "uptake blockers" and includes cocaine and Ritalin. 2) The second group is the "releasers" which include the amphetamine analogs like methamphetamine, dextroamphetamine, and MDMA or Ecstasy.
Is Meth more addictive than other stimulants? Yes. Compared to other stimulants, the progression to meth addiction is accelerated. Meth use is characterized by frequent ingestion (8-10 times a day) and users who initially snorted or smoked meth often find they need to administer the drug intravenously to achieve the desired effects. There are differences in neurotoxicity between Meth and other stimulants. Methamphetamine use damages neurons that inhibit dopamine and serotonin pathways while cocaine is not toxic to these neurons. Because of this, the lack of mental energy, dysphoria and depression experienced during withdrawal is more severe and protracted in Meth than with other stimulants. What is STARTLING is that many of the effects of Meth withdrawal (impairment in thinking and performance for example) are present up to three years AFTER quitting.
Treatment, does anything work? In addition to the standard 90 day inpatient rehab facilities that have proven effective, psychosocial therapy (cognitive behavioral therapy) as an outpatient can help. Additionally, there are some pharmacological therapies that show promise. The SSRI antidepressants (Zoloft and Paxil) were studied for Meth withdrawal but were NOT found to be beneficial. Three medications, however, are effective: Mirtazapine (Remeron), Buproprion and Ritalin with several additional therapies currently being studied.
What are we seeing in the hospital? Just this month I have seen patients with dilated cardiomyopathy (heart failure) from Meth with one awaiting heart transplant as his only option for life. We see patients on Meth with active psychosis and the effects of violence are seen every day in our ER and jail ward. Chronic Meth users complain to me of dizziness, nausea, fatigue, hair loss and sores where they have scratched the skin down to the bone. Let's not forget about "Meth mouth", and I have seen every variation of dead and decayed teeth, and even jaw osteonecrosis ("dead jawbone")in a 20 year old woman who looked nothing like her drivers license picture from 2 years prior.
If Meth has wreaked havoc on you or someone you know, please share your story. Spread the word.
Dr O.
Categories: News
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My little Sunflower grew up too fast when she found meth. She got pregnant at 17 and lived with me until her baby girl was 2, that was when I found the meth hid under the babies socks. She took off with my Grandaughter and stayed with my ex-husband. He didn't believe me. Well the meth showed it's ugly head. Our Sunflower ran away for 4 years. Sunflower left her daughter with her Dad and Step Mom. None of us knew if she was alive or dead. She finally came back and went to treatment, got a job and went to school. We all praised God for her safe return and recovery. Well I guess it was too much. Her Dad and step-Mom kicked her out and I took her in. Her 6 yr. old was still in her Dad's custody. She said she would live with me and her sister and step-dad, he happens to be a police officer. Well, she moved in her stuff but only spent maybe 4 nights here out of 4 weeks. She was visiting her Daughter at her Dad's and left a digital camera over there when she left. Her Dad checked it out and saw pictures of a totally different family. He called the police on her and reported the camera as possibly stolen. It was, she was arressted and for the first time put in jail. She called me from jail...I was devastated...I can't put it in words....my world stopped and I fell off. It was a felony and there was no bail. She would call with terror in her voice. I wanted to jump through the phone and just BE THERE to HOLD my GIRL! After the first day it costs my phone $14.35 per 15 min. so I wasn't able to talk to her after that first day. She got out in 3 days. She called to say I'm coming home Mom and my husband the cop was angry...she heard him and almost didn't come home. I cried so hard, my husband called and told her to come home. She was welcome. She did! I held her so tight I thought I would pull her back inside me where I knew she was always going to be with me again safe, warm, fed and loved. I couldn't she pushed away and said, I need a shower and I need to go to the store. Oh-Oh, I knew she would be leaving soon and this time it might be forever! I asked her if she was coming back and she said, "Yes, Mom. Nobody wants me!" I begged,""I do Nanny! Please stay here, don't go!" She left and did not come back. My other daughter said,"Mom, she left. She knows the cops are after her and she feels betrayed by her own family because Dad called the police." I thanked God for the brief time that I had to hold her, kiss her, tell her how very much I loved her, I will always love her, there would always be a place for her here, a home with a warm bed and a lot of love, I played with her hair and tickled her again, we talked about when she was little, she even got to see her little poodle she picked out when she was in 4th grade. The 7lb poodle, Simba died after she left. She loved Simba so much and would have hated to have missed seeing him again to say Goodbye, he was such an old dog. I think he was waiting for Sunflower too. So many blessings. I will keep praying for your family and all the other families affected by meth, especially the Mother's. Always keep the faith. They are God's children and He is with them always. He allowed us to share the joy of knowing them and loving them. I will always be thankful for every minute I have been blessed with our Sunflower.
By sunshinehug January 1, 2009 3:01am
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I need help, I broke up with my man of 10 years because of his Meth addiction. He brought me flowers yesterday and tonight I went to his house and ended up sleeping with him. He crashed like he used to when i knew he was coming off the drug. I was going to leave and got curious about his activities and went threw his phone...he has been talking to a girl about naked twister and showers. Now I am afraid he could have something and has given it to me. Plus I went threw his jacket and found three Meth pipes and two baggies of Meth. What a fool! I feel like such an idiot!!
By fullambermoon December 30, 2008 1:57am
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This is awful. It's in Nebraska too. My husband's cousin's were users too. And the "meth mouth" is a problem for my nephew from the Seattle area. It's an eye-opener that's for sure. Thanks for calling attention to this.
There are diseases and there are self-induced diseases. This is an obviously preventable example of self-induced issues! Like alcoholism -- the last legal drug -- the things that folks will do -- I guess -- to relieve stress in the name of fun is always amazing.
What really attracts folks?
By FeelingRough December 21, 2008 12:34pm
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My nephew was an addict. It's ruined him. He has recovered, but is living aimlessly best I can tell.
By FeelingRough December 21, 2008 12:29pm
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We are in a major winter storm in our state. I wonder where my homeless daughter is sleeping? Sometimes she sleeps in cars. It is well below freezing temperatures for over a week. It gets harsh out there. One day she told me she was passed out in a car on a dirt road and someone reported her as dead in her car. She woke up to paramedics and police.
At that point she still had her license and insurance, although she should not have been driving. That is gone now, too.
Jail may be a good thing if she is convicted on burglary charges.
I know I have to remain strong, but it is not easy.
By balibird December 20, 2008 1:59pm
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To LaVivre- it sounds like all the major markers. A couple thats involved with meth create a whirlwind of risky and "inappropriate" sexual activity, lack of responsible behavior and reliability, emotional instability. Although these are also hallmarks of bipolar disorder, if you're seeing a married couple exhibiting the same behaviors at the same time, I'd put my money on drugs over disorder. Drugs follow a predictable pattern of dosing, peaking, crashing (or re-administering). If two people happen to be at the same high or low simultaneously, it's far more likely that their drug use is in synch, rather than their bipolar disorder synching up.
For many, it's not simply the meth (or any amphetamine, and some other psychostims) that's at the root of the addiction- but the mixture of sex and stimulants. The stimulants cause an increase in libido, plus a profound effect on ones usual sexual inhibitions. Then comes the cycle of increasingly risky sexual behavior, which on it's own is a high, combined with the high from the stimulant... and eventually you have a situation where the user is chasing more and more stimulation, seeking out new and novel experiences, because the old ones aren't as stimulating anymore- and none of it is as stimulating as it is when one is sober. In later stages, one is just trying to re-experience the euphoria they experienced earlier in their experimentation of drugs/sex, and it's a goal that's impossible to attain. Married couples can get much worse. If they are working in tandem with each other, the sexual world has far more opportunities for a couple.
You asked how you can be sure. If you aren't opposed to invading privacy (and you shouldnt be if there are children involved, or the risk of danger to others), you can always pluck a hair from a comb, or freshly fallen in a sink...or... get creative. There are mailorder hair drug tests that will give you the answer. It'd be better if you stepped in before the law or the courts do.
By deusXmchna December 20, 2008 12:18pm
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I'm afraid my child is on meth. How can I be sure? They went off their bipolar meds two years ago, and since then has become sexually inappropriate, (they are married), lost an incredible amount of weight, has become an unreliable spouse, and a dangerous parent who is currently losing their children and marriage to their bizarre behavior and hostile and violent outbursts.
By LaVivre December 18, 2008 1:45pm
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It's interesting. The DEA, with the help of media scaring the pants off of everyone, spent a few years shutting down all of the "mom & pop" labs that were producing product that came in between ~12%-75% purity. That was before it was adulterated. Since the DEA sweeps, the Mexican cartel has taken over production and distribution channels- and they've done it with PhD chemists. Now, optically clear crystals of near 100% purity are widely available. Crystals of enormous size (3"+, resembling quartz) are available at street level. It's cheaper for the cartels to just sell the stuff as is, rather than putting time and effort into cutting. In the usual harm reduction model, adulterants are bad news- potentially toxic, a variable the average user can't accurately predict or compensate for. Now theres a problem pf the high purity. Psychosis can often set in at the same time as euphoria can because of the massive doses. Anyway, I find it odd that so much effort was put into the public scare of the neighborhood "meth lab" (often consisting of a couple 2 liter bottles)- and now so little is being done about the cartels bringing in wickedly high purity meth and heroin (the heroin is almost always cut though, but that's another thread). A conspiracy theorist might think that the DEA was clearing out competition....
(and now its harder to purchase a 24c box of Sudafed during allergy season than it is to purchase near pharmaceutically pure methamphetamine)
By deusXmchna December 17, 2008 12:25pm
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Dr. O,
This topic reminded me of a news article I recently read about how Doc's are considering prescribing Stimulants to normal people to help boost their brain! I was astounded when I read it. I totally disagree with throwing stimulants at people so they can be better at work, school, etc. It can backfire on them, and let alone the addiction factor.
http://news.yahoo.com/s/ap/2008120...
Stimulants can backfire if given to someone with the wrong brain chemistry. People need MORE SLEEP! Americans are sleep-deprived more than ever now. How is a Doc truly going to judge whether a person is well-rested and needs a stimulant??
We are too focused on 'Want it Now' and this type of activity in our lives will lead us to be stressed out and eventually Heart Disease, etc, etc...
Stimulants do NOT work for all people...it's not a fix-all. They don't even work for some type of ADD'ers.
Thought I'd share! Thanks Dr. O for all your wonderful insights!
By TLCDaisy December 14, 2008 11:23pm
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I want to invite any parents of addicts to please join our Parents of Addicts group. There is also a Family and Friends of Addicts group that has been helpful to me.
By EthelM December 10, 2008 3:10pm
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I agree with TLeigh. My son is a Heroin addict which started with Oxycontin. It has practically destoyed his life. I as his Mom have suffered greatly. All drug addictions in my opinion, are the worst things that can happen to anyone. Once that line is crossed it is almost impossible to cross back over.
By EthelM December 10, 2008 3:01pm
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I have never done Meth, but I know people whose lives and the people around them were all but destroyed because of it. I am a recovering addict to pain medicine, and I just need to say that ANY addiction to ANYTHING takes over your life and you lower yourself to do anything to get that drug. I know Meth is 1 of the worst drugs out there, but ANY addiction that takes away your SELF is terrible. ADDICTION is definately an epidemic these days.
By TLeigh December 5, 2008 9:24am
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if you want to know what an effect meth has on children, ask a school-teacher....my stepson's 2nd grade teacher finally got up the nerve to ask me if his birth mother used drugs while pregnant and I told her I am as sure as I can be, since I wasn't with her .....but since I raised the boy I know all too well what types of emotional and maybe phsical issues he dealt with.
I want to say to the grandparent, who's story I just read here, my step son is now 28 and fine...for the most part. I want to tell you it is worth it to not give up; I understand what you are going through, with the roller coaster of emotions and problems. My life, my husband's and my stepson's would have been much easier if (forgive me) the birth mother would have died, or at least stayed out of his life 100%...Instead, she would show up every so often, not for long, and always for selfish reasons, but long enough to mess up my stepson's head.
I am going to ask you, as a grandparent, or caretaker of a such a child, something very difficult:
Please be careful how you talk about the child's parent.....it does hurt them deeply when they hear someone speak ill of their mother or father.....
This was the single-most difficult thing I faced in raising our wonderful child. When he was old enough and the questions came, I tried to explain to him that she has a sickness, and I did my best to not make it sound like she is "bad" or didn't love him. Sometimes, this took the every ounce of strength I could muster, but it is well worth it. I myself, am a recovered drug addict, so I know what it is like to be so helpless to change... It is a disease and we need to change the way we look at drug addiction . It is not something to be dealt with in jails, it needs to be dealt with medical intervention as well as multi layered psychological help....medication, cognitive behavior therapy, many things. Keep in mind that 12 step programs just don't help everyone with an addiction.
I take methadone. There, I said it. I had an opiate addiction, and I am very lucky to have methadone because I can function and work and raise someone's child.....etc. (I am going to ask you to be open minded about what I just said because so many people fear my life saving medication)
I feel more sorry for a meth addict, because I don't know of a treatment for that which is as effective. It must be a miserable and scary thing to be addicted to.
Please , everyone, educate yourself about addiction with facts. Don't just jump on the bandwagon of "The War on Drugs" or "Just Say No". Clearly those approaches don't work. We need to de-stigmatize addiction and treat the victims with support and understanding. Not to say you should become an enabler.
Talk to your children early in life about the dangers of addiction. It truly is The Great American Tragedy.
By ThisToo November 30, 2008 3:52pm
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I will state from experience.... never even try it once because you will always have the craving. ALWAYS.
I was able to stop I believe for one reason only, I'm pregnant.
Even after 5 months I still have cravings, dreams, and simply have to stay FAR FAR AWAY.
my little sister got popped with a meth charge and that didnt even change me. its the worst/best drug ever.
i hate it and i love it.
By MyMyMyMichelle November 26, 2008 11:48am
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Wow these responses really enforce the pain of this drug. We can only hope that those who are considering dabbling in meth can read some of these stories...UGH...what a nightmare.
By DrOrrange November 24, 2008 12:21am
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My 25 year old daughter is awaiting trial for a vehicle theft charge. This will be her second time in prison and she is looking at 2 to 5 years. She started using meth when she was 18 years old. It's been hard trying to help her since she is an adult and would not voluntarily go into rehab. This was a beautiful child with lots of potential and the opportunities to be almost anything that she wanted to be as an adult. Unfortunately, meth became her whole life. That and criminal ways and immoral behavior. This discussion is aptly named "the Great American Tragedy" as it can happen to anyone - no matter their social status, ethnic background or what their home environment was. As parents we are devastated at the degree to which she has caused havoc in her life.
By sheryleyes November 23, 2008 5:37pm
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Unfortunatly many people use the meth as a form of self medication for underlying problems.
By tahoesjewel November 22, 2008 1:24pm
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My son is a meth user and although has a fulltime job and is intelligent he cannot see he is an addict. He says he cannot get off the drug although he has tried. He has Bipolar which I believe makes it harder for him. Any advice on what I can do or say?
By azzyjean November 22, 2008 8:03am
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The problem is getting worst in Australia. Had a stay in a Private Hospital for medication withdrawals and I spoke to many young men being treat for Meth addiction. They were all on Atypical antipsychotics for schizophrenia and pychotic disorder. Lovely young people who explained the nightmare of meth addiction and their physical experiences whilst on a high. Our public Hospitals are inundated on the weekends with Meth users having psychotic episodes. At least with experimental drugs like speed, hammer and pot there wasn't that extreme addiction or severe mental health complications. All we can do is educate our young to the dangers of Meth. Frustrates the heck out me the destruction in young lives.
By Rigil13 November 22, 2008 12:00am
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I've personally known 3 people that have died as a direct result of meth. When I hear about it from other people the number goes up into the 20's. One girl was a diabetic and her boyfriend knew that. Time escaped her and she couldn't distinguish having a reaction or her low blood sugar. She didn't eat,sleep or take her glucose and did not take her insulin on time. Meth leaves everybody exposed to dangers and long term effects because by the time they might recognize somethings wrong with meth, they are already addicted. May she rest in peace.
By SmileyGator November 21, 2008 2:46pm