Methamphetamine Use: Harm Reduction Strategies

1. Methamphetamine Use: Harm Reduction Strategies Facilitated by: Neva Chauppette, Psy.D. CA License PSY14524 P.O. Box 6234, Woodland Hills, CA 91365 (818) 439-7080 www.drchauppette.com

2. Application of Harm Reduction • Stage of Change • Precontemplation • Contemplation • Relapse – Lapse • Recovery vs. Abstinence • The components of addiction

3. Provider Competenceand Comfort • Uniqueness of methamphetamine requires provider’s to: • Accept harm reduction as treatment • Develop competence and comfort discussing sexual behavior • Recognize time sensitivity issues • Post Exposure Prophylaxis (PEP) • Plan B

4. Two Pathways: Mode of Administration andSexual Risk-Taking Behaviors • Harm Reduction strategies specific to mode of administration of the methamphetamine • PEP (within 72 hours for 28 days – 80% reduction) • Friends La Brea – AHF – 323-463-1601 • AHF Men’s Wellness Centers • Hollywood 866-339-2525 • Westside 888-836-5943 • West Adams 888-836-5946 • Harm Reduction strategies specific to client’s sexual behaviors under the influence of methamphetamine • PEP and Plan B

5. Modes of Administration:Swallowing • 20-30 minutes to feel effects to “get off” • This method of administration has the least risks. The body has a safety mechanism for dangerous substances that are swallowed, called vomiting! • Meth can be put in a drink, like water, soda or juice, or put in gel caps and taken orally. “Parachuting” is placing meth in a piece of toilet paper and swallowing it.

6. Modes of Administration:Swallowing • Harm Reduction Techniques: Drugs are absorbed more slowly through the gut therefore the effects of the drugs tend to be less extreme. • Madonna and Child: A bath bead is hollowed and cleaned out, meth is placed in the center of the bead surrounded by pulverized ecstasy in a clear gelatin capsule then swallowed. The “X” is released first followed by the meth, and the combination of the two drugs is quite a high.

7. Modes of Administration:Smoking • 7-10 seconds to feel effects. • Drug enters blood stream through the lungs. • Smoke irritates the lungs, which can lead to breathing difficulties, coughing and possibly can be carcinogenic. • Harm Reduction Techniques: Remember the time to get off from smoking is quicker and more intense and the tendency is to become addicted quicker.  

8. Modes of Administration:Shooting Up • 15-30 seconds to feel effects. • Meth is injected directly into the veins, commonly known as the “slamming”. • Abscesses and skin infection can develop at the injection site. • Injecting into the vein bypasses all of the body’s defenses to protect the blood stream. • Sharing needles can transmit HIV, Hepatitis B and C. • If air bubbles are in the needle they can travel through the veins to the heart and cause the heart to stop.  

9. Modes of Administration:Snorting • 3-5 minutes to feel effects. • Most common method of use. • Snorting tends to destroy the tissue in the nose. The lining of the nasal passages is fairly delicate and can be injured leading to nose bleeds, sinus trouble, and in some cases permanent damage to the nasal structure. • Sharing inhaling instruments transmits all types of germs from the common cold or flu to Hepatitis C and HIV. • Harm Reduction Techniques: Don’t share snorting equipment. If sharing, clean off inhaling instruments between uses.

10. Modes of Administration:“Booty Bump” • 10-15 minutes to feel effects. • A syringe without a needle is used to pump a liquid solution of meth into the rectum. The drug is absorbed by the blood vessels in the lining of the rectum. In some places the lining of the rectum is only 1 cell thick. • Meth can act as an analgesic and when placed in the rectum anal sex becomes less painful. Therefore sex can be more aggressive, last longer and increase the risk of ripping or tearing of the lining.

11. Modes of Administration:“Booty Bump” • High Risk - possible damage to the mucous membranes, burning or tearing of the tissue in the rectum, which increases risk of HIV transmission. • Harm Reduction Techniques: If you booty bump and have receptive anal sex (bottom) make sure he is wearing a condom. Increasing the amount of lube you use will decrease friction and reduce ripping and tearing of the rectal lining.

12. Modes of Administration:“Hot Railing” • 7-10 seconds to feel effects. • A glass tube (stem) is heated until the tip is red hot, and then placed over a bump (small pile of the drug / similar to a line) and the vapor is inhaled through the nose. • Risk factors similar to smoking, vapor can be carcinogenic. • Tube used for railing can transmit Hepatitis C or HIV assuming blood is present. • Harm Reduction Techniques:. Don’t share your stem and if you have to wash the stem between uses.  

13. Sex • It can often lead to uninhibited, disconnected, sometimes violent, and often unprotected sex that meth abusers (“tweakers”) obsess about, hunting for orgasms as they would a gram of meth. For men who are meth addicts, their desire is increased for sex, but their ability to perform is often reduced. • “Crystal dick” is the inability to maintain or achieve an erection as a result of meth use. For women, there may be an increase in pregnancies and/or STDs, obstetric complications due to poor prenatal care, involvement with abusive partners, and domestic violence due to paranoia and sexual preoccupation.  

14. HARM REDUCTION STRATEGIES:Sexual Risk-Taking • Time sensitive: PEP and Plan B • See Sexual Risk-Taking Form • Screen and treat STIs and vaccinate for HPV, HAV, HBV • Avoid douching or enemas • Timing of sex (i.e., menses, illness, etc.)

15. HARM REDUCTION STRATEGIES:Sexual • Ejaculation outside the body • Don’t use ejaculation as lubrication - “felching” and “snowballing” • Avoid felching/rimming w/o barriers • “Sounding” – equipment cleaning, no sharing • “Natural Harvest” – no abrasions, no cuts, gum disease, etc. • “Serosorting” – positive with positive