METHAMPHETAMINE USE: REASONS, RISKS, AND PRACTICAL INTERVENTIONS

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METHAMPHETAMINE USE REASONS,
RISKS, AND PRACTICAL INTERVENTIONS

• presented by
• Neva Chauppette, Psy.D.
• P.O. Box 6234, Woodland Hills, CA 91365-6234
• CA Psychologist License PSY14524
• [phone] (voicemail/pager)- [phone]
  (cell) - [phone] (fax)
• NCHAUPPETT_at_aol.com (E-Mail)

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ROUTES OF ADMINISTRATION FIVE ROUTES LISTED IN
DESCENDING ORDER 1) Inhaling -- (7 to 10
seconds) 2) Injecting -- (15-30 secs.)
intravenously (IV or slamming)
(3-5 mins.) intramuscular (IM or muscling)
(3-5 mins.) subcutaneously (skin
popping) 3) Snorting --
(3-5 minutes) mucosal exposure 4) Contact
-- (3-5 minutes) "dropping acid"
(10-15 minutes) morphine
suppositories 5) Oral -- (20-30 minutes)
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ICE (aka crystal, meth, ice, JIB, glass, Tina,
P, etc.)

• Classification Central Nervous System stimulant
  type Synthetic Illegal. It is a freebase form
  of methamphetamine. It is odorless, colorless,
  resembles rock salt or a chip of ice or quartz
  rock.

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ICE (aka crystal, meth, ice, JIB, glass, Tina,
P, etc.)

• Method of use Inhaled by smoking
• Duration of action 8 24 hours
• Detection in urine screening 48-72 hours 2-3
  days

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ICE (aka crystal, meth, ice, JIB, glass, Tina,
P, etc.)

• At a low dose
• Increased alertness, wakefulness, elevation of
  mood, mild euphoria, increase in athletic
  performance, decrease in fatigue, increased
  energy, or may cause increased irritability,
  restlessness, insomnia, anxiety, panic.

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ICE (aka crystal, meth, ice, JIB, glass, Tina,
P, etc.)

• At a high dose
• Euphoria, can induce a pattern of psychosis
  marked by confused, disorganized behaviors,
  irritability, fear, paranoia, hallucinations,
  increased aggressiveness and antisocial
  behaviors.
• Note Violence and hostility are more severe.

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ICE (aka crystal, meth, ice, JIB, glass, Tina,
P, etc.)

• Physical symptoms Puts body in overdrive,
  increased pulse, blood pressure, respiration, and
  temperature, and dilate pupils. Can cause a
  stroke, heart attack, or kidney failure.

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ICE (aka crystal, meth, ice, JIB, glass, Tina,
P, etc.)

• Withdrawal symptoms Disorientation, confusion,
  apathy, irritability, itching, depression that
  may be so severe that suicide occurs. Long
  periods of sleep and increased appetite occurs
  because while the user was on a run taking
  drugs for one or more days they did not sleep or
  eat.

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ICE (aka crystal, meth, ice, JIB, glass, Tina,
P, etc.)

• In some cases more severe with hallucinations,
  paranoid ideation and toxic psychosis. Recovery
  from psychosis may be complete for some,
  however, there has been no improvement after 2
  years with medications.
• Overdose Agitation, hostility, hallucinations,
  convulsions, high temperature, possible death.

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POWDER(aka Crank, speed, glass, hot ice, among
other slang terms)

• Classification Central Nervous System Stimulant
• Type Synthetic Illegal - Methamphetamine is
  amphetamine to which 1 methyl group has been
  added thus it is more potent and can cross the
  blood brain barrier more rapidly than
  amphetamine. May be cut with toxic substances
  like cyanide or strychnine

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POWDER(aka Crank, speed, glass, hot ice, among
other slang terms)

• Method of use Intravenous, snorting
• Duration of Action 4-6 hours
• Detection in Urine Screening 48-72 hours after
  use (2-3 days)

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POWDER(aka Crank, speed, glass, hot ice, among
other slang terms)

• At a low dose
• Increased alertness, wakefulness, elevation of
  mood, mild euphoria, increase in athletic
  performance, decrease in fatigue, increased
  energy, or may cause increased irritability,
  restlessness, insomnia, anxiety, panic.

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POWDER (aka Crank, speed, glass, hot ice, among
other slang terms)

• At a high dose
• Euphoria, can induce a pattern of psychosis
  marked by confused, disorganized behaviors,
  irritability, fear, paranoia, hallucinations,
  increased aggressiveness and antisocial
  behaviors.

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POWDER (aka Crank, speed, glass, hot ice, among
other slang terms)

• Physical symptoms Puts body in overdrive,
  increased pulse, blood pressure, respiration, and
  temperature, and dilate pupils. Can cause a
  stroke, heart attack, or kidney failure.

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POWDER(aka Crank, speed, glass, hot ice, among
other slang terms)

• Withdrawal symptoms Disorientation, confusion,
  apathy, irritability, itching, depression that
  may be so severe that suicide occurs. Long
  periods of sleep and increased appetite occurs
  because while the user was on a run taking
  drugs for one or more days they did not sleep or
  eat.
• Overdose Agitation, hostility, hallucinations,
  convulsions, high temperature, possible death.

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• Chronic methamphetamine abusers exhibit symptoms
  that can include violent behavior, anxiety,
  confusion, and insomnia.
• They also can display a number of psychotic
  features, including paranoia, auditory
  hallucinations, mood disturbances, and delusions
  (for example, the sensation of insects
  crawling/running on the skin also known as
  formication).
• The paranoia can result in suicidal and homicidal
  thoughts.

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DENTAL HEALTH

• Reduced blood supply causes tissues to break down
• With repeated shrinking, the blood vessels dont
  recover and tissues die
• Causes dry mouth. Saliva neutralizes acids in the
  mouth. Less saliva means more acid. Acid eats
  away at the minerals in tooth enamel and cause
  holes or weak spots that turn into cavities.

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RESPIRATORY SYSTEM

• Crystal relaxes air passages and opens them up
• This increases the intake of oxygen so that the
  body can fight harder or run faster
• Materials used to cut crystal can block blood
  vessels in the lungs
• Long term use can permanently reduce the amount
  of air the lungs can take in

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CIRCULATORY SYSTEM

• The rush and high begin when the drug reaches
  the brain
• The heart beats faster and harder
• Veins and arteries constrict (get smaller)
• Smaller veins and arteries reduce blood flow and
  increase blood pressure

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CIRCULATORY SYSTEM

• The blood clots more easily to stop bleeding.
  (The body has the perception that it might be
  hurt/injured)
• Issues to consider
• Heart beat gets out of rhythm
• High blood pressure can lead to increased risk of
  heart attack
• Germs (from injecting) can infect the lining of
  the heart (endocarditis)

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KIDNEYS

• The kidneys filter the blood and get rid of fluid
  wastes through urine. Crystal is filtered by,
  then excreted through the kidneys. They also
  balance the acid level in the bodys fluids.
• Issues to consider
• Crystal constricts blood vessels in the kidneys
• With less blood flow, the kidneys produce less
  urine

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KIDNEYS

• Issues to consider
• Toxic wastes get recycled back into the
  bloodstream
• When toxic blood reaches the brain, the person
  can get headaches and get confused
• Urine becomes very concentrated and sits in the
  bladder. This can result in bladder infections.
  The kidneys can get inflamed.

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• CO-OCCURRING
• PSYCHIATRIC DISORDERS

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BULIMIA

• Why an eating disorder?
• Need for control
• Excessively preoccupied with body size and shape
• Meets the individuals needs (inappropriate
  desired results of body size/shape) in an
  accelerated, often dangerous way.

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BULIMIA

• Bulimia is characterized by a secretive cycle of
  binge eating followed by purging.
• Bulimia includes eating large amounts of
  food--more than most people would eat in one
  meal--in short periods of time, then getting rid
  of the food and calories through vomiting,
  laxative abuse, or over-exercising.

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BULIMIA

• Symptoms include
• Repeated episodes of binging and purging
• Feeling out of control during a binge and eating
  beyond the point of comfortable fullness
• Purging after a binge, (typically by self-induced
  vomiting, abuse of laxatives, diet pills and/or
  diuretics, excessive exercise, or fasting)
• Frequent dieting
• Extreme concern with body weight and shape

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• SEX ADDICTION

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Ten Signs of Sexual Addiction

• Out of control behavior
• escalating frequency
• escalating dangerousness

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Ten Signs of Sexual Addiction

• Consequences - escalating and compounding
  consequences
• impaired or decreased job performance due to
  preoccupation, absenteeism
• STD, unwanted pregnancies

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Ten Signs of Sexual Addiction

• possible arrests - lewd/lascivious conduct
• marital/monogamous relationships are
  jeopardized/lost

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Ten Signs of Sexual Addiction

• Inability to stop - self perpetuation of behavior
  once guilt and shame are fused
• Self-destructive or high risk - as frequency of
  "using" goes up, so too does the need for drama
  danger to add to the "rush"

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Ten Signs of Sexual Addiction

• Effort/desire to limit the sexual behavior -
  limit sexual behavior to only certain types, with
  certain partners, etc.
• Sexual obsession/fantasy - when things are
  uncomfortable or problematic, this is the mental
  place sex addicts go to

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Ten Signs of Sexual Addiction

• Increased amounts - it is equivalent to
  physiological need (tolerance) and the desire to
  achieve the same effect can only be reached with
  increasing frequency, intensity, etc. of acts
• Mood swings - sex is used as a fix to alter "bad"
  mood states but ultimately is bad itself due to
  the guilt/shame

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Ten Signs of Sexual Addiction

• Increased time - preoccupation with obtaining,
  using and recovering from sexual fix
• Neglect - as disease progresses, so does the
  pervasiveness of the neglect

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PSYCHOSIS

• The essential features of a substance-induced
  psychotic disorder are prominent hallucinations
  or delusions that are judged to be due to the
  direct physiological effects of a substance
  (i.e., methamphetamine).

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PSYCHOSIS

• Psychotic disorders can occur in association with
  intoxication with various types of substances
  such as alcohol, amphetamine and related
  substances (methamphetamine) cannabis, cocaine,
  hallucinogens, inhalants opiods, sedatives,
  hypnotics, and anxiolytics.

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PSYCHOSIS

• Psychotic disorders can occur in association with
  withdrawal from the following classes of
  substances alcohol, sedatives, hypnotics, and
  anxiolytics.
• For example, smoking a high dose of cocaine may
  produce psychosis within minutes, whereas days or
  weeks of high dose alcohol or sedative use may be
  required to produce psychosis. Hallucinations
  may occur in any modality.

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PSYCHOSIS

• Psychotic disorders induced by intoxication with
  methamphetamine and cocaine share similar
  clinical features. Persecutory delusions may
  rapidly develop shortly after use of the drug.
• Distortion of body image and misperception of
  peoples faces may occur. The hallucination of
  bugs or vermin crawling in or under the skin
  (formication) can lead to scratching and
  extensive skin damage.

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PSYCHOSIS

• Substances such as methamphetamine have been
  reported to evoke temporary psychotic states that
  can sometimes persist for weeks or longer despite
  abstinence and treatment with neuroleptics.

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PSYCHOSIS

• For drugs of abuse, there must be evidence from
  history, physical examination, or laboratory
  findings of intoxication or withdrawal. Once
  initiated, the psychotic symptoms may continue as
  long as the substance use continues.
• Because the withdrawal state can vary, the onset
  of psychotic symptoms can occur up to 4 weeks
  after the cessation of substance use
• (American Psychiatric Association Diagnostic and
  Statistical Manual of Mental Disorders, Fourth
  Edition. Washington, DC, American Psychiatric
  Association)

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TREATMENT INTERVENTIONS

• Cognitive behavioral interventions
• At this time the most effective treatments for
  methamphetamine addiction are cognitive
  behavioral interventions.
• These approaches are designed to help modify the
  patient's thinking, expectancies, and behaviors
  and to increase skills in coping with various
  life stressors.

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TREATMENT INTERVENTIONS

• Support groups Recovery support groups also
  appear to be effective adjuncts to behavioral
  interventions that can lead to long-term
  drug-free recovery.

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TREATMENT INTERVENTIONS

• Pharmacological approaches There are currently
  no particular pharmacological treatments for
  dependence on amphetamine or amphetamine-like
  drugs such as methamphetamine.
• The current pharmacological approach is borrowed
  from experience with treatment of cocaine
  dependence.

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TREATMENT INTERVENTIONS

• Medications for cocaine dependence Amantadine
  (Symmetrel) and propranolol (Inderal) appear
  promising for the treatment of patients who
  present with cocaine withdrawal symptoms. This
  may have indications for treatment of
  methamphetamine dependence.

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TREATMENT INTERVENTIONS

• Antedepressant medications are helpful in
  combating the depressive symptoms frequently seen
  in methamphetamine users who recently have become
  abstinent.

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TREATMENT INTERVENTIONS

• Overdose There are some established protocols
  that emergency room physicians use to treat
  individuals who have had a methamphetamine
  overdose.
• Because hyperthermia and convulsions are common
  and often fatal complications of such overdoses,
  emergency room treatment focuses on the immediate
  physical symptoms. Overdose patients are cooled
  off in ice baths, and anticonvulsant drugs may be
  administered also.

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STAGES OF CHANGE MODEL
?
Precontemplation ? may/may not be aware of
need to change avoids topic knows little about
it
? ?
Contemplation ? considers increasing the
advantages and decreasing the disadvantages of
change
?
? Preparation ?
making a commitment to change and creating a
plan
?
? Action ? implementing the plan
revising the plan as needed may relapse

?
? Maintenance continue to
make significant changes (that were implemented
during the action stage) the changes
becomes more habitual implement strategies to
assist in the
prevention of slips or relapse
Relapse
part of the change process can be used as a
learning tool via behavioral analysis Adapted
from Prochaska and DiClemente, 1984,2002
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RESOURCES

• ? http//www.crystalmeth.org/
• Crystal Meth Anonymous is a fellowship of men and
  women for whom all drugs, specifically Crystal
  Meth, have become a problem. The only requirement
  for membership is a desire to stay clean and lead
  a sober life. There are no dues or membership
  lists each group is expected to be
  self-supporting through its own contributions.
• ? http//www.soberrecovery.com/links/crystalmeth.
  html
• Drug Addiction Alcoholism Help and Information --
  Dual Diagnosis Sober Living Bi-Polar Opiate
  Detox--12 Step Groups Troubled Teens
  Treatment Programs

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RESOURCES

• http//www.drug-rehabilitation.com/resources.htm
• Support Systems Homes drug and alcohol
  rehabilitation programs offer a wide range of
  substance abuse treatment services. Accredited,
  state licensed alcohol and drug detoxification,
  residential drug and alcohol treatment, day and
  outpatient substance abuse treatment programs,
  and have 18 sober living environments located
  throughout California.

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RESOURCES

• ? http//www.crystalrecovery.com
• ? http//www.drugandalcoholrehab.net/methamphetam
  ine.htm
• Methamphetamine addiction treatment centers and
  methamphetamine rehabilitation programs offering
  comprehensive rehabilitation programs for
  methamphetamine addiction and methamphetamine
  abuse.

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RESOURCES

• National Council on Sexaholics Anonymous
• Sexual Addiction P.O. Box 300
• Compulsivity Simi Valley, CA 93062
• 770-989-9754 [phone] or
• www.ncsac.org [phone]
• Sex Love Addicts
• Recovering Couples Anonymous
• Anonymous P.O.Box 338, New Town Branch
• c/o General Services Norwood, MA 02062
• P.O. Box 11872 323) 957-4881
• St. Louis, MO 63105 www.slaafws.org
• [phone]
• (toll-free 877-742-7349 ext.1234) www.sexhelp.co
  m
• Culver City 310-322-7857 (Dr. Patrick Carnes)
• www.recovering-couples.org

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RESOURCES
Recovery Online www.onlinerecovery.org/index.h
tml www.cybersexualaddiction.com Sex Addicts
Anonymous P.O. Box 70749 Houston, TX
77270 [phone] or [phone]
loc www.sexaa.org S-Anon International
Sexual Compulsives Anonymous 170 Sunset Blvd.
520 4391 Sunset Blvd. Suite P.O. Box 5117 Los
Angeles, CA 90029 Sherman Oaks, CA 91413 (310)
859-5585 [phone] www.sca-recovery.org www
.sanon.org