Methamphetamine how it influences the brain and behavior of users
Download
1 / 54

methamphetamine: how it influences the brain and behavior of users - PowerPoint PPT Presentation


  • 268 Views
  • Uploaded on

Methamphetamine: How it Influences the Brain and Behavior of Users . Richard A. Rawson, Ph.D Adjunct Associate Professor Semel Institute for Neuroscience and Human Behavior David Geffen School of Medicine University of California at Los Angeles www.uclaisap.org [email protected]

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'methamphetamine: how it influences the brain and behavior of users' - paul


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Methamphetamine how it influences the brain and behavior of users l.jpg

Methamphetamine: How it Influences the Brain and Behavior of Users

Richard A. Rawson, Ph.D

Adjunct Associate Professor

Semel Institute for Neuroscience and Human Behavior

David Geffen School of Medicine

University of California at Los Angeles

www.uclaisap.org

[email protected]

Supported by:

National Institute on Drug Abuse (NIDA)

Pacific Southwest Technology Transfer Center (SAMHSA)


Methamphetamine l.jpg
Methamphetamine Users

  • Methamphetamine is a powerful central nervous system stimulant that strongly activates multiple systems in the brain. Methamphetamine is closely related chemically to amphetamine, but the central nervous system effects of methamphetamine are greater.


Methamphetamine speed l.jpg
Methamphetamine: Speed Users

  • Methamphetamine powder ranging in color from white, yellow, orange, pink, or brown.

  • Color variations are due to differences in chemicals used to produce it and the expertise of the cooker.

  • Other names: shabu, crystal, crystal meth, crank, tina, yaba


Methamphetamine ice l.jpg
Methamphetamine: Ice Users

High purity methamphetamine crystals or coarse powder ranging from translucent to white, sometimes with a green, blue, or pink tinge.



Primary amphetamine methamphetamine teds admission rates 1992 per 100 000 aged 12 and over l.jpg

> 58 Users

35 - 58

12 - 35

< 12

No data

Primary Amphetamine/Methamphetamine TEDS Admission Rates: 1992(per 100,000 aged 12 and over)


Primary amphetamine methamphetamine teds admission rates 1997 per 100 000 aged 12 and over l.jpg

> 58 Users

35 - 58

12 - 35

< 12

No data

Primary Amphetamine/Methamphetamine TEDS Admission Rates: 1997(per 100,000 aged 12 and over)

< 12


Primary amphetamine methamphetamine admission rates by state 2002 l.jpg

3-27 Users

28 - 54

200 or more

150 or more

100 or more

55 or more

Primary Amphetamine/Methamphetamine Admission Rates by State: 2002

Admissions per 100,000 population aged 12 and over


Slide9 l.jpg

Figure 1. Methamphetamine/Amphetamine Treatment Admission Rate per 100,000 Population Aged 12 or Older: 1992-2002

Source: 2002 SAMHSA Treatment Episode Data Set (TEDS).



Meth epidemic less drama more long term risk danger l.jpg
Meth Epidemic; less drama, more long term risk/danger Related Visit by Calendar Year

  • Cocaine/Crack epidemic hit fast (in NYC 1986-87, as well as other major east coast cities); overnight emergency, tremendous media attention.

  • Big federal response (Reagan and Bush I). High visibility deaths, stigmatization as a ghetto drug.

  • Dramatic decreases in indicators by early 1990s, except in inner cites of east coast.

  • Crack epidemic: Rapid onset; Rapid decrease

  • Meth epidemic: Slow west to east spread. No decrease in western cities. Use becomes endemic?


Methamphetamine a growing menace in rural america l.jpg
Methamphetamine: A Growing Menace in Rural America Related Visit by Calendar Year

  • In 1998, rural areas nationwide reported 949 methamphetamine labs.

  • Last year, 9,385 were reported.

  • This year, 4,589 rural labs had been reported as of July 26.

  • Source: El Paso Intelligence Center (EPIC), U.S. DEA


Anhydrous ammonia tank tips officers to possible meth lab l.jpg
Anhydrous Ammonia Tank Tips Officers to Possible Meth Lab Related Visit by Calendar Year

5/4/04 Omaha, Neb. – A large

anhydrous ammonia tank

helped Sarpy County

Sheriff’s deputies bust

a suspected

methamphetamine

lab Tuesday.

SOURCE: TheOmahaChannel.com


Methamphetamine acute physical effects l.jpg
Methamphetamine Related Visit by Calendar YearAcute Physical Effects

Increases -Decreases

Heart rate Appetite

Blood pressure Sleep

Pupil size Reaction time

Respiration

Sensory acuity

Energy


Methamphetamine acute psychological effects l.jpg

Increases Related Visit by Calendar Year

Confidence

Alertness

Mood

Sex drive

Energy

Talkativeness

Decreases

Boredom

Loneliness

Timidity

MethamphetamineAcute Psychological Effects


Methamphetamine chronic physical effects l.jpg
Methamphetamine Related Visit by Calendar YearChronic Physical Effects

- Tremor - Sweating

- Weakness - Burned lips; sore nose

- Dry mouth - Oily skin/complexion

- Weight loss - Headaches

- Cough - Dental Problems

- Sinus infection - Anorexia


Slide19 l.jpg

METH Use Leads to Severe Tooth Decay Related Visit by Calendar Year

“METH Mouth”

Source: The New York Times, June 11, 2005.


Meth use in hawaii l.jpg
Meth Use in Hawaii Related Visit by Calendar Year

  • As of the middle of May, not even halfway through the year, the city medical examiner's office already recorded 38 deaths connected to crystal methamphetamine. So, we're well on the way to exceeding last year's total of 68.

  • Deaths:

  • 2005 (mid-May) - 38 deaths

  • 2004 - 68 deaths

  • 2003 - 56 deaths

  • 2002 - 62 deaths

  • 2001 - 54 deaths

  • 2000 - 34 deaths


Methamphetamine chronic psychological effects l.jpg
Methamphetamine Related Visit by Calendar YearChronic Psychological Effects

- Confusion - Irritability

- Concentration - Paranoia

- Hallucinations - Panic reactions

- Fatigue - Depression

- Memory loss - Anger

- Insomnia - Psychosis


Methamphetamine psychiatric consequences l.jpg
Methamphetamine Related Visit by Calendar YearPsychiatric Consequences

  • Paranoid reactions

  • Permanent memory loss

  • Depressive reactions

  • Hallucinations

  • Psychotic reactions

  • Panic disorders

  • Rapid addiction


Slide23 l.jpg

A Major Reason People Related Visit by Calendar Year

Take a Drug is they Like

What It Does to Their Brains


Slide26 l.jpg

FOOD Related Visit by Calendar Year

SEX

200

200

NAc shell

150

150

DA Concentration (% Baseline)

100

100

15

% of Basal DA Output

10

Empty

Copulation Frequency

50

Box

Feeding

5

0

0

Scr

Scr

Scr

Scr

0

60

120

180

Bas

Female 1 Present

Female 2 Present

Mounts

Time (min)

Sample

Number

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

Intromissions

Ejaculations

Source: Di Chiara et al.

Source: Fiorino and Phillips

Natural Rewards Elevate Dopamine Levels


Slide27 l.jpg

Effects of Drugs on Dopamine Release Related Visit by Calendar Year

1500

1000

500

0

COCAINE

METHAMPHETAMINE

Accumbens

400

Accumbens

DA

300

DOPAC

HVA

% of Basal Release

% Basal Release

200

100

0

0

1

2

3hr

Time After Cocaine

Time After Methamphetamine

250

NICOTINE

ETHANOL

250

Accumbens

Dose (g/kg ip)

200

Accumbens

200

Caudate

0.25

0.5

150

% of Basal Release

1

2.5

% of Basal Release

150

100

0

1

2

3 hr

100

0

0

0

1

2

3

4hr

Time After Nicotine

Time After Ethanol

Source: Shoblock and Sullivan; Di Chiara and Imperato


Slide28 l.jpg

Prolonged Drug Use Changes Related Visit by Calendar Year

the Brain In Fundamental

and Long-Lasting Ways


Decreased dopamine transporter binding in meth users resembles that in parkinson s disease patients l.jpg
Decreased dopamine transporter binding in METH users resembles that in Parkinson’s Disease patients

%ID/cc

Control Methamphetamine PD

Source: McCann U.D.. et al.,Journal of Neuroscience, 18, pp. 8417-8422, October 15, 1998.

.


Slide30 l.jpg

Partial Recovery of Brain Dopamine Transporters in Methamphetamine (METH)

Abuser After Protracted Abstinence

3

0

ml/gm

METH Abuser

(1 month detox)

Normal Control

METH Abuser

(24 months detox)

Source: Volkow, ND et al., Journal of Neuroscience 21, 9414-9418, 2001.


Methamphetamine neurochemical mechanisms l.jpg
Methamphetamine: Neurochemical Mechanisms Methamphetamine (METH)

  • Methamphetamine enters the brain and is removed from the synapse by dopamine transporters


Methamphetamine neurochemical mechanisms38 l.jpg
Methamphetamine: Neurochemical Mechanisms Methamphetamine (METH)

  • Enters dopamine vesicles

  • Vesicles deplete themselves of dopamine


Methamphetamine neurochemical mechanisms40 l.jpg
Methamphetamine: Neurochemical Mechanisms Methamphetamine (METH)

  • Free-floating DA produces “free radicals” (neurotoxins), so it is forced out of the neuron.

  • The synapse is flooded with dopamine, producing a profound sense of pleasure.


Slide42 l.jpg

Their Methamphetamine (METH)Brains

have been

Re-Wired

by Drug Use

Because…


Slide44 l.jpg

Control Methamphetamine (METH) > MA

4

3

2

1

0


Slide45 l.jpg

5 Methamphetamine (METH)

4

3

2

1

0

MA >

Control


Is treatment for methamphetamine effective l.jpg
Is Treatment for Methamphetamine Effective? Methamphetamine (METH)

A major demand that competes for scarce community resources are for the treatment needs of those who have become addicted to methamphetamine (MA).


Meth treatment effectiveness l.jpg
Meth Treatment Effectiveness? Methamphetamine (METH)

A pervasive rumor has surfaced in many geographic areas with elevated MA problems:

  • MA users are virtually untreatable with negligible recovery rates.

  • Rates from 5% to less than 1% have been quoted in newspaper articles and reported in conferences.

    **The resulting conclusion is that spending money on treating MA users is futile and wasteful, BUT no data exists that supports these statistics**


Meth treatment statistics l.jpg
Meth Treatment Statistics Methamphetamine (METH)

During the 2002-2003 fiscal year:

  • 35,947 individuals were admitted to treatment in California under the Substance Abuse and Crime Prevention Act funding.

  • Of this group, 53% reported MA as their primary drug problem


Statistics l.jpg
Statistics Methamphetamine (METH)

Analysis of:

  • Drop out rates

  • Retention in treatment rates

  • Re-incarceration rates

  • Other measures of outcome

    All these measures indicate that MA users respond in an equivalent manner as individuals admitted for other drug abuse problems.


Urinalysis results l.jpg
Urinalysis Results Methamphetamine (METH)

  • Results of Ua Tests at Discharge, 6 months and 12 Months post admission **

    • Matrix GroupTAU Group

      D/C: 66% MA-free 65% MA-free

      6 Ms: 69% MA-free 67% MA-free

      12 Ms: 59% MA-free 55% MA-free

      **Over 80% follow up rate in both groups at all points


Clinical challenges of ma users l.jpg
Clinical Challenges of MA Users Methamphetamine (METH)

  • Poor treatment engagement rates

  • High drop out rates

  • Severe paranoia

  • High relapse rates

  • Ongoing episodes of psychosis

  • Severe craving

  • Protracted dysphoria

  • Anhedonia


Steps to address treatment needs of ma users l.jpg
Steps to Address Treatment Needs of MA Users Methamphetamine (METH)

  • Psychiatric/Professional Mental Health Staffing

  • Add Treatment Programming for Women Exposed to Violence and Their Kids

  • Training, Training, Training


Medications l.jpg
Medications Methamphetamine (METH)

  • Currently, there are no medications that can quickly and safely reverse life threatening MA overdose.

  • There are no medications that can reliably reduce paranoia and psychotic symptoms, that contribute to episodes of dangerous and violent behavior associated with MA use.


Special treatment consideration should be made for the following groups of individuals l.jpg
Special treatment consideration should be made for the following groups of individuals:

  • Female MA users (higher rates of depression; very high rates of previous and present sexual and physical abuse; responsibilities for children).

  • Injection MA users (very high rates of psychiatric symptoms; severe withdrawal syndromes; high rates of hepatitis).

  • MA users who take MA daily or in very high doses.

  • Homeless, chronically mentally ill and/or individuals with high levels of psychiatric symptoms at admission.

  • Individuals under the age of 21.

  • Gay men (at very high risk for HIV and hepatitis).


ad