Methamphetamine: Methamphetamine: What Professionals What Professionals

Need to KnowNeed to Know

Jackie McReynoldsWashington State

University Vancouver

What is What is Methamphetamine?Methamphetamine?

A very powerful stimulantA very powerful stimulant A highly addictive, synthetic A highly addictive, synthetic

drugdrug A powder or crystallized formA powder or crystallized form Can be taken orally (tablet), Can be taken orally (tablet),

injected, or inhaled (smoked), injected, or inhaled (smoked), absorbed through skinabsorbed through skin

Addiction PotentialAddiction Potential

42% of first time users go on to 2nd use.

84% of 2nd time users go on to develop regular use.

OHSU.Org 0

1020

3040

50

6070

80

90100

Go on to2nd use

2nd timeusersthatdevelopregularuse

Physiological ImpactPhysiological Impact Increased metabolic rate, heart rate, and

blood pressure (blood flow restricted as vessels contract)

Body temperature rises (sweat glands shut down; more prevalent in men than women)

Body energy surges, excessive activity may result

Loss of appetite as digestive tract slows down

Extreme euphoria within 5-20 minutes Enhanced sociability Increased sexual arousal; loss of inhibitions

Phases of Meth UsePhases of Meth Use Rush (5-30 minutes): all about

pleasure High (4-16 hours): aggressive &

argumentative Binge (3-15 days): hyperactivity Tweaking (most dangerous):

hallucinations Crash (1-3 days): mostly asleep Normal (2-14 days): back to a

slightly deteriorated normal state Withdrawal (30-90 days):

depression, lethargy, cravings, suicidal tendencies

Negative Side Effects: Negative Side Effects: Immediate and Long-termImmediate and Long-term

Stroke Cardiac arrhythmia Stomach cramps Convulsions & shaking Significant weight loss Lung disorders similar to asbestos exposure Insomnia Chronic sinus infections; deviated septum Paranoia and hallucinations; high-level anxiety;

aggression Brain damage; risk factor for development of

Parkinson’s Skin rashes and dental decay; burns Poor personal hygiene (bathing is physically

uncomfortable)

The Faces of MethThe Faces of Meth

Homemade Meth Homemade Meth IngredientsIngredients

Pseudoephedrine Red phosphorous

(matches) Drain cleaner Sulfuric acid Paint thinner Iodine Freon

Driveway cleaner Lye Acetone (nail polish

remover) Methanol (brake fluid) Ammonia Ether Lithium metal

(batteries) Pesticide Anhydrous ammonia

Shake and Bake MethShake and Bake Meth

“Parents who are addicted to drugs have a primary commitment to chemicals, not to their children.”

Beckwith, 1989

Meth MouthMeth Mouth

Meth BugsMeth Bugs

How Does Meth Impact How Does Meth Impact Brain Function?Brain Function?

Immediately begins to change brain chemistry Damages neurons more severely in ways that other

drugs do not Not all areas of the brain affected: centers for

reward, memory, and judgment are most heavily impacted

Profound changes in dopamine and seratonin systems

PET scans resemble Parkinson’s patients Brain chemistry resembles paranoid schizophrenics In children, integration of sensory-based functions is

most vulnerable

The Brain Chemistry The Brain Chemistry EffectEffect

Nerve Cell DamageNerve Cell Damage

PET Scan of Meth UserPET Scan of Meth User

Loss of Memory, Emotion, Loss of Memory, Emotion, and Reward Systems in the and Reward Systems in the

Meth BrainMeth Brain

Brain Scans: Healthy vs. a Brain Scans: Healthy vs. a 15-year user of Meth15-year user of Meth

How Does Meth Hurt How Does Meth Hurt Children?Children?

Double Jeopardy for Double Jeopardy for ChildrenChildren

Children are at risk due to prenatal exposure and postnatal environmental effects Poverty Chaotic and dangerous lifestyles Symptoms of psychopathology (personality

disorders, depressive symptoms) History of sexual abuse Domestic violence

Developmental Developmental VulnerabilitiesVulnerabilities Immature organ systems, faster

metabolic rates, weaker immune systems

Eat more food, drink more fluids, and breathe more air per pound of body weight

Typical behaviors expose them to more hazards

Increased potential for cerebral damage (strokes, brain lesions)

Digestive DifficultiesDigestive Difficulties Permanent brain damage causes

difficulty in glucose metabolism (12-17 mo. to repair some)

Stomach lining is weakened by high levels of acidity, leading to gastritis

H pylori bacterial infection ensues

Symptoms may include an aversion to food, acid reflux-like symptoms, abdominal cramps, ulcer-like symptoms

Treatment for H pyloriTreatment for H pylori

No safe protocol documented for children For adults a three-pronged approach:

Amoxicillin or other antibiotic Bismuth (i.e., Pepto: some risk of Reye

syndrome) Metronidazole (i.e., Pepcid)

Hypersensitive to taste and smell: go for blandLactose intolerance: move to soy-based products

IDEAL StudyIDEAL Study The Infant Development, Environment and

Lifestyle (IDEAL Study: Dr. Barry Lester of Brown University)

Clinical outcomes:- smaller head size- evidence of feeding difficulties- sleep disturbances- delays in development domains- ADD- early and multiple interventions produce positive outcomes (healthcare, mental health, social services)

Pre-Natal Meth ExposurePre-Natal Meth Exposure Easily crosses the placenta;

metabolized differently by fetal brain; brain is more sensitive

Constricts blood flow, restricting oxygen and slowing growth

Linked to a greater incidence of multiple births, prematurity, and low birth-weight

Pregnant women and new mothers are less likely to seek help than other addicted women

Mothers who are clean during the 3rd trimester reduce fetal involvement significantly

Special NeedsSpecial Needs

Attachment intervention Medication (chronic and

short-term) Hydration and tube

feeding Cardiac monitoring Foster care placement Therapeutic child care

Minimizing Stress for Minimizing Stress for InfantsInfants

Provide a quiet, calm environment with minimal noise & bright lights

Ensure warmth and comfort by bundling the child in blankets

Encourage habituation by providing sucking opportunity with a pacifier

Initiate gentle rocking or soothing motions to help achieve neurobehavioral organization

Limit exposure to cigarette smoke

Working With Young Working With Young Children up to Two Years of Children up to Two Years of

AgeAge 6-18 months of age is referred to as a “honeymoon” period of development for drug- exposed children

All external measures may well indicate the child is symptom-free

Toward the end of this period (18-24 months), speech and language difficulties may appear

Appropriate interventions need to occur as difficulties emerge

Interventions: Infants and Interventions: Infants and ToddlersToddlers

Design quiet environments with limited sensory stimulation

Implementation of an emotionally centered, attachment focused program (Circle of Security; Promoting First Relationships)

Consistency in schedule, adult contacts, physical stimulation

Use of sign language Referral for sensory integration

therapy; sensory screening

Children 3 Years and Children 3 Years and OlderOlder Attention deficit may become more pronounced as more

demands are placed on the child in group settings May have difficulty controlling emotions and social

exchanges Problems adjusting to a changing environment Spatial learning and memory (object recognition) are

deficient Tendencies toward aggressive behavior, hypervigilance,

and parentification Type II diabetes and high blood pressure are common Unstable family units exacerbate problems

Preschool (young school-Preschool (young school-aged) Psychosocial aged) Psychosocial ProblemsProblems Low self-esteem Core boundary issues Regressive behaviors Fear and anxiety Food and object hoarding Grief and loss behaviors Influence of family disruption

Initiative (guilt): Preschool Industry (inferiority): School age

Why environmental Why environmental organization?organization?

Dangers of Home Dangers of Home VisitsVisits

Recognizing a Meth Recognizing a Meth HouseHouse Unusual odors (ammonia, ether,

cat urine, rotten eggs, or old mayonnaise)

Covered windows Strange ventilation Elaborate security Dead vegetation Excessive/unusual trash Frequent visitors and/or

deliveries Uncharacteristic display of

wealth Round-the-clock activity, followed

by quiet days

Recognizing Meth Recognizing Meth ProductionProduction An unusually large supply of

main meth ingredients in the home or trash- blister packs of cold meds (Sudafed or comparable), batteries, camp fuel, and others

Presence of equipment or apparatus used to make meth- stained coffee filters, funnels, turkey basters, improvised glassware, tubing

Treatment & Treatment & RecommendationsRecommendations

What About Treatment?What About Treatment? Communities are unprepared

for treatment of meth addicts (effective 40-50%)

Meth addicts are particularly challenging:*poor engagement rates*high drop-out rates*high relapse rates*protracted depression,

paranoia, anxiety Some emerging info on

histamine effect (OHSU) First 4-6 months of treatment

are most critical to recovery

Does Treatment Work?Does Treatment Work?

The Matrix Model of The Matrix Model of TreatmentTreatment

Combines the following aspects:- individual counseling (non-judgmental and non-confrontational)- cognitive behavioral therapy- motivational interviewing- family education program- regular u.a. (once per week)- aspects of the traditional 12-step program

Rawson, R. (1996)

ResourcesResources Am. Assn. of Retired Persons, aarp.org/grandparents/ Drug Endangered Children (DEC), nationaldec.org Children of Alcoholic Families www.coaf.org Natl. Inst. On Drug Abuse: nida.nih.gov Zero to Three, Zerotothree.org ACE Study (child impact), ChildTrauma.org Circle of Security, Circleofsecurity.org Through the Eyes of a Child, University of Wisconsin

fact sheets DSHS:

www1.dshs.gov/kinshipcare/raisingchildren.shtml Vol. 12(2) 2007 of Child Maltreatment,

http://cmx.sagepub.com/archive/ Brown Center for the Study of Children at Risk,

www.brown.edu/Departments/Children_at_Risk/Home

Other Useful Web Other Useful Web ResourcesResources

Govt. Meth Resources: Methresources.gov

Montana Meth Project: Montanameth.org

Alcoholics Anonymous :alcoholics-Alcoholics Anonymous :alcoholics-anonymous.org anonymous.org

Al-Anon/Alateen al-anon.alateen.orgAl-Anon/Alateen al-anon.alateen.org Narcotics Anonymous: na.orgNarcotics Anonymous: na.org

Other Non-fiction Other Non-fiction ReadingReading

Addict in the Family by Beverly Conyers Painted Rocks by Kimberly Ann Freel The Year of Magical Thinking by Joan Didion The Way We Are, an essay by Thomas Lynch

(included in Bodies in Motion and at Rest) Under the Influence by Katherine Ketcham & James

R. Milan What About the Kids: Raising Your Children Before,

During and After Divorce by Judith Wallerstein and Sandra Blakeslee

Beautiful Boy: A Father’s Journey Through His Son’s Meth Addiction by David and Nic Sheff

Tweaked: A Crystal Meth Memoir, by Patrick Moore

Presenter Contact InfoPresenter Contact Info

Jackie McReynolds, M.S. Senior Instructor/Academic Coordinator Dept. of Human Development Washington State University Vancouver, WA 98686-9600 360-546-9740 mcreynol@vancouver.wsu.edu FAX: 360-546-9076