What are methamphetamine’s risks?
Methamphetamine is a stimulant that can be snorted, smoked, or injected.
It is less expensive and possibly more addictive than cocaine or heroin.
It first became popular as a recreational drug in the 1960s, and acquired
many street names, including meth, crystal, speed, ice, and crank.
Methamphetamine use reached epidemic proportions in Japan as early
as a decade after World War II, and it is still Japan’s most
popular illicit drug. In the United States, methamphetamine use burgeoned
in Hawaii and quickly spread to the West Coast. It is now a countrywide
problem, not at all limited to big cities. The highest rates of abuse
are found in rural Idaho, Utah, and Iowa.
About 1 in 25 Americans has tried methamphetamine, and the reasons for
its popularity are obvious: It boosts energy, induces euphoria, and suppresses
appetite. In one study of methamphetamine use in Iowa, women used it
to escape their troubles, cope with family problems, improve concentration,
increase strength, and lose weight.
But when used habitually, methamphetamine has adverse effects that range
from mild to disastrous. Common psychiatric symptoms are insomnia, irritability,
and aggressive behavior. The drug causes intellectual deficits, anxiety,
and depression. Chronic users become disorganized and unable to cope
with everyday problems. The risk of developing psychotic symptoms — hallucinations
and delusions — is very high. Despair and suicidal thinking can
set in when the stimulant effect wears off. During intoxication, the
body (and probably brain) temperature rises, sometimes resulting in convulsions.
Methamphetamine can damage blood vessels in the brain, causing strokes.
High fevers or collapse of the circulatory system can cause death.
This drug has become frighteningly popular among gay and bisexual men,
where it has been linked to an increase in unsafe sex practices. Methamphetamine
use — and needle sharing — have been linked to a spike in
HIV and hepatitis C infections in this population.
Methamphetamine also harms important nerve pathways, perhaps irreversibly.
The drug delivers euphoria by releasing the neurotransmitter dopamine
in the brain’s reward system. Overstimulation eventually damages
or destroys the nerve cells in these circuits, impairing dopamine transport
and reducing the efficiency of dopamine receptors; the reward system
is, in a sense, worn out. The brain recovers somewhat after months of
abstinence, but problems often remain. Former methamphetamine addicts
may suffer from chronic apathy and anhedonia (inability to experience
pleasure) for years.
Unlike cocaine, methamphetamine is not smuggled into the United States
by drug traffickers. Illicit manufacturers use easily available ingredients
to quickly set up crude laboratories and move on when they are threatened.
Production releases poisonous gases and results in toxic waste that is
often dumped down household drains, in a backyard, or at a roadside.
Over-the-counter cold medicines (ephedrine and pseudoephedrine) are commonly
used in production, which is one reason for federal and state restrictions
on their sale.
There are no simple solutions to this growing health problem. Like all
drug abuse, methamphetamine addiction is difficult to treat. Standard
substance abuse treatment methods such as education, behavior therapy,
individual and family counseling, and support groups may be effective
for some. Methamphetamine abusers often use other illicit drugs as well,
a problem that can be addressed as part of a comprehensive program.
Perhaps the best hope is that, as scientists learn more about what is going
wrong in the brains of addicts, they will develop drug treatments to correct
the flawed biology that fosters addiction. But despite the growing body
of research in this area, reliable treatments are probably still years
November 2005 Update
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