INTRODUCTION

Meth, speed, tweek, crank, jib, go fast, crystal meth, glass, ice…..many different names for one very dangerous substance, methamphetamine.

Meth is a central nervous system stimulant from the amphetamine group of drugs. Like other parts of the country, Saskatchewan is seeing an increase in the street use of meth, particularly the smokable form, crystal meth. While meth can also be snorted, swallowed or injected, smoking produces an almost instantaneous high, faster than snorting or swallowing, and more convenient than injecting.

The high from meth is very similar to that derived from crack cocaine, but one that lasts considerably longer. Users describe a rich and profound sense of pleasure from meth and feel confident, powerful, successful, sexy and joyful. But it does not last. The faster and more intense the high, the faster and more devastating the crash. Users try for another rush by taking a second dose, with two distinct patterns of abuse emerging—chronic periodic use or binging. In either case, physical and psychological dependence result.

Like all stimulants, meth speeds up the mind, but it also speeds up the body in ways that can become life threatening. Blood pressure, heart and breathing rates, body temperature and perspiration all increase, putting the user at risk for stroke, brain damage and seizures. Similar to a natural “flight or fight” response, the user feels alert, restless and excited. But unfortunately, visual and auditory hallucinations, or violent, paranoid and repetitive behaviours are also common.

However you look at it, the dangers of methamphetamine use clearly outweigh any benefits. Anyone thinking of experimenting with this dangerous drug, must really think again!

AVAILABILITY

The problem with meth is that it is so easily manufactured from commonly available ingredients in over the counter cough and cold medicines like ephedrine and pseudo-ephedrine. Some provinces have moved to more strictly controlling access to these medicines in pharmacies to reduce the manufacturing of methamphetamine.

Methamphetamine comes in tablets or capsules that can be taken orally. They also appear as off-white crystals, chunks and powders, which may be snorted (sniffed) or injected. Smokable meth looks like shaved glass slivers or clear rock salt.

METH AND THE MIND

Meth is more quickly and more completely absorbed by the brain than other amphetamines. This is why the high is faster and more intense. Meth acts on what is known as the brain’s “reward pathway.” It causes an increase in the release of chemicals in the brain, neurotransmitters called dopamine, noradrenaline and serotonin. Neurotransmitters are “messenger chemicals,” that enable one nerve to communicate with another nerve. Meth dramatically increases the rate of this communication, speeding up the body and the mind.

Addiction to meth results from a couple of processes. First, the user, after a rapid crash, tries to create the high through repeated dosages. But repeated (chronic) use causes a kind of brain damage—the neurotransmitters become exhausted and impaired. This means that a user who quits has difficulty finding even normal pleasure in ordinary activities. The temptation to use again can be overwhelming, contributing to both physical and psychological dependence.

SHORT TERM EFFECTS

In smaller doses, meth causes the user to feel alert and energetic. Fatigue and sleepiness vanish. As mentioned previously, breathing and heart rates increase, while the appetite decreases and the pupils dilate. Users often experience dry mouth and sleeping problems. Excessive perspiration may result in dehydration.

At higher doses, the user experiences euphoria, rich and profound pleasure accompanied by incessant talking, overconfidence and exuberant joy. Visual and auditory hallucinations are also common. Some users experience feelings of power and superiority. Some become hostile, aggressive and violent.

Some of the more unpleasant side effects include nausea, vomiting or diarrhea, blurred vision, dizziness, anxiety, headache, sweating, irregular heartbeat and chest pain. Others develop sores and itchy skin that can lead to scratching, further sores and infection.

Overdose can cause delusions, hallucinations, high fever, delirium, seizures, coma, stroke, heart failure and death. Seizures are the most common cause of death in meth users. Of course, using meth along with alcohol and other drugs is even more dangerous.

Regular meth users, even at low doses, develop tolerance to the drug very quickly. As their body adapts to the drug, they need larger doses to feel the same effects. Cravings can be very intense. They continue to use meth to avoid the crash they experience when the drug wears off.

LONG TERM EFFECTS

Long term use of meth can cause chronic sleep problems, depression , mood swings, irregular heartbeat, high blood pressure, weight loss, constipation and diarrhea.

High doses, in the long term, can lead to a schizophrenia-like disorder involving violence or paranoia, repetitive behaviour patterns and visual or tactile hallucinations, especially the sensation of insects or parasites crawling on the skin. Other serious, long term effects include nerve damage, and chronic psychosis. Most, but certainly not all, of these problems disappear a few days or weeks after drug use stops.

Meth users who inject the drug with shared needles risk getting hepatitis and AIDS. Injected particles that do not dissolve in water damage blood vessels, kidneys, lungs and brain tissue.

Of course, chronic meth users are likely to develop serious personal problems. Using drugs can become more important than family and friends, work or school, despite financial, spiritual and legal problems. Young people who use meth for extended periods may not learn how to solve problems, handle their emotions, or learn to cope. As a result, they are likely to develop very disorganized, chaotic lifestyles, and may become very isolated socially.

There is some evidence that meth affects memory, as well. But the brain damage that occurs with long term use is likely due to improperly prepared meth that contains compounds that are toxic to the brain. Brain and other organ damage occurs secondary to increased blood pressure, stroke and elevated body temperature. Many chronic users die from seizures.

PREGNANCY AND METH

Babies born to meth users are more likely to be premature, have low birth weight and experience withdrawal symptoms like agitation and drowsiness. This can result in extended hospital stays in intensive care neo-natal units in order to safely withdraw the baby from the drug that was passed to it during pregnancy. Withdrawal, for very small babies, can be life threatening.

Meth babies have a significantly increased risk of birth defects and are known to suffer from tremors and bouts of inconsolable crying for hours on end. They tend to be more asocial than non-addicted babies, and have a great deal of difficulty bonding with the mother or others. This lack of bonding creates the potential for other social, psychological and learning problems for the child, as it grows.

Because drug use is often more important to the user than anything else in life, their babies and children are at an increased risk of child abuse and neglect. Meth can be passed to the baby through breast milk.

WITHDRAWAL

When withdrawing from meth, a user can expect to experience extreme tiredness, disturbed sleep, anxiety, hunger, depression, confusion, suicidal thoughts, and of course severe craving.

THINGS TO LOOK FOR

Parents and other concerned individuals may suspect that a friend or family member is using meth. The short and long term effects presented earlier in this booklet should give you some clues with regard to behaviour to look for. Here is a list of some of the common signs of meth use:

• Hyperactivity (including excitement, rapid speech, excessively happy or joyful)
• Paranoia or suspiciousness
• Aggressive behaviour, violence
• Increased pulse rate, rapid breathing, fever (sweating)
• Dilated (large) pupils
• Runny or bleeding nose
• Injection sites or other damage to the skin (sores and scratch marks)
• Burn marks on the lips, face and hands
• Depressed mood
• Sleeplessness
• Loss of appetite
• Tremors
• Seizures
• Scattered, disorganized thinking, ideas of being all powerful

It’s important that parents and loved ones not hesitate to go for help and advice, and to investigate the assessment and treatment options available.

WHAT IS A CRAVING?

Very simply, a craving is a strong desire or an intense longing for something.

In the addictions context, a craving is a strong urge to return to alcohol or drug use. Almost all chemically addicted people will experience a craving some time in the recovery process. You should not feel ashamed if you experience cravings—they are very normal and can be managed.

LEVELS OF CRAVINGS

Cravings can be experienced at many levels of intensity, from mild cravings that are easy to ignore, to extreme cravings that dominate your thinking, and everything in between.

Mild Cravings
These are typically cravings that come and go. Most people can ignore or ‘turn off’ a mild craving and carry on with everyday life. Mild cravings generally do not affect how a person functions. After the craving goes away, there is little to no effect noticed.

Moderate Cravings
These cravings tend to come and take hold, to some extent. They can be ‘turned off,’ but only with concerted effort. Moderate cravings tend to come back, as well, and again, a lot of effort is needed to get rid of them. Even after these cravings go away, there are usually some lasting effects on the recovering person.

Severe Cravings
Severe cravings hit the recovering person very hard. They tend to not go away, even with extra effort and training. Severe cravings persist relentlessly and have an extreme impact on a person’s everyday life. When these cravings occur, it is essential to reach out for help - a person must do whatever necessary to not return to using.

SETUPS FOR CRAVING

There are a number of factors, or triggers that make a recovering person more susceptible to experiencing cravings. These are called “setups,” as they tend to set you up for a fall if you don’t learn how to identify them and manage them. Some are simply a part, or a result of having been an addicted person. Others are ways of thinking or behaving that you can learn to change.

Physical Setups

• Damage to the body (such as the brain) that occurred during chemical abuse
• Poor nutrition
• Lack of exercise
• Fatigue
• Other physical illnesses
• Use of prescription medication

Psychological Setups

• Euphoric recall (positive memory of early experiences of getting high)
• Awfulizing sobriety (believing nothing good has come from sobriety, yet)
• Anxiety
• Unrealistic expectations of sobriety
• Substitute compulsions (like gambling)
• Denial/evasion

Social Setups

• Poor communication patterns
• Conflict (internal or external)
• Social isolation
• Addition Centered Lifestyle (still hang out in the bar, surround yourself with people who enable your behaviour)

EARLY INTERVENTION PLAN FOR CRAVING

1. Recognize the craving and accept that this is normal.
   “I’m having a craving. I haven’t done anything wrong. This is normal.”

2. Make a decision to not act on the craving.
   “No matter what happens, I’m not going to use. Using will only make things worse.”

3. If you are in a high-risk or potentially harmful place, get yourself out immediately.
   Go to a place of safety.

4. Try using medications as directed or relaxation techniques to turn off the craving.
   First make sure you’re in a safe place. Concentrate on your breathing, taking long, deep, slow breaths. Use relaxation tapes or visualize a calm, serene safe place.

5. Talk to someone safe, someone who understands.

6. Use the H.A.L.T. checklist
   “Am I Hungry? Angry? Lonely? Tired?”

Addiction Services in the Regina Qu’Appelle Health Region