Methamphetamine: A 2005 Update

1. Methamphetamine: A 2005 Update Richard A. Rawson, Ph.D. UCLA Integrated Substance Abuse Programs Los Angeles, California rrawson@mednet.ucla.edu

2. Speed • It is 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

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

4. According to surveys and estimates by WHO and UNDCP, methamphetamine is the most widely used illicit drug in the world except for cannabis. World wide it is estimated there are over 42 million regular users of methamphetamine, as compared to approximately 15 million heroin users and 10 million cocaine users Scope of the Methamphetamine Problem Worldwide

5. IHS-Wide RPMS PCC Outpatient Encounters for Amphetamine Related Visit by Calendar Year

6. The Eastward Spread of Methamphetamine

9. Methamphetamine: A Growing Menace in Rural America • 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

10. Stove Top Labs • The active ingredient in making methamphetamine is ephedrine or pseudoephedrine, commonly found in over the counter cold remedies.

11. Meth Lab Seizures • A small percentage of labs seized are labeled “Super Labs” and are capable of producing over 10 lbs per batch. • Super Labs are operated by Mexican National Drug Trafficking Organizations (MNDTO’s), and supply the majority of meth to the market.

12. Clandestine Meth Lab Equipment

14. A Major Reason People Take a Drug is they Like What It Does to Their Brains

17. Methamphetamine abusers have abnormal brain activity

18. FOOD 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

19. Effects of Drugs on Dopamine Levels COCAINE AMPHETAMINE Accumbens 1100 Accumbens 400 1000 900 DA 800 DA 300 DOPAC 700 DOPAC % of Basal Release HVA HVA 600 % of Basal Release 500 200 400 300 100 200 100 0 0 0 1 2 3 4 5 hr Time After Amphetamine Time After Cocaine MORPHINE NICOTINE 250 Accumbens 250 Dose (mg/kg) 200 Accumbens 0.5 200 Caudate 1.0 2.5 % of Basal Release 150 % of Basal Release 10 150 100 0 1 2 3 hr 100 0 1 2 3 4 5 hr 0 0 0 1 2 3 4 5hr Time After Nicotine Time After Morphine Source: Di Chiara and Imperato

20. Methamphetamine Addiction The brains of people addicted to Methamphetamine are different than those of non-addicts

25. Cocaine and Methamphetamine Effects Compared Cocaine Methamphetamine

26. Prolonged Drug Use Changes the Brain In Fundamental and Long-Lasting Ways

27. Sample Characteristics 305 Adolescents (13-18 years old) Average Age ~ 16yrs old (sd=1.138) Gender: 70.2% Males Ethnicity: 55.3% White & 33.1% Latino

28. Age Distribution

29. Ethnic Identification

30. Drug Use History (Ever Used?) N=272

31. Drug Use History (Ever Used) *Missing responses

32. Drug Use by Gender

33. Drug Use by Age *P<.05

34. Drug Use by Ethnicity *P<.05

35. Parental & Peer Factors • Family dysfunction was high for both groups. • 64.3% reported parental drug use. • 60.2% had divorced or separated parents. • 40% lived in single-headed households (mothers only). • Involvement with drug-using peers was high (65.9%).

36. Social Problems by Drug Use

37. Psychological Distress by Drug Use *P<.05

38. Treatment Response by Drug Use

39. Overall Treatment Response

40. Drug Use at Discharge • More than 50% of the sample reported using drugs or alcohol in the previous 30 days at discharge. • 50% reported using their Drug of choice • 20% reported using alcohol • 15% reported using other drugs (not DOC)

41. Women and Meth

42. Meth and Women: Typical gender ratio of heroin users in treatment : 3 men to 1 woman Typical gender ratio of cocaine users in treatment : 2 men to 1 woman Typical gender ratio of methamphetamine users in treatment : 1 man to 1 woman * *among large clinical research populations

43. Drug Use by Gender

44. Self-Reported Reasons for Starting Methamphetamine Use

45. Self-Reported Reasons for Starting Methamphetamine Use

47. My sexual drive is increased by the use of … (Rawson et al., 2002)

48. My sexual pleasure is enhanced by the use of … (Rawson et al., 2002)

49. My sexual performance is improved by the use of … (Rawson et al., 2002)

50. CSAT Methamphetamine Treatment Project: Cross-Site Sample Description • 1,016 clients • Average age was 32.8 years • 55% female • 60% Caucasian • 12.2 years of education on average • 16% currently married • 31% awaiting charges, trial, or sentencing