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There’s no question that opioid-type drugs like heroin and Vicodin® (hydrocodone) and oxycontin ®(oxycodone) have been a nationwide nightmare.
Here in the Midwest though, methamphetamine is at least as big a problem. We’ve had a lot of trouble with opioids here too. I don’t want to make it sound like that epidemic missed us.
It’s just that methamphetamine (“meth” or “speed”) is hitting us harder than a lot of other places. And in fact, national statistics show that in the U.S., rural areas are where speed is at its highest level.
Meth has been around for a long time. It’s pretty easy to make if you know what you’re
doing. It used to be made here because there were lots of places you could hide a meth lab out in the woods.
And even though most of the methamphetamine around now comes from Mexico, there’s still a fair amount of it being made locally.
People refer to methamphetamine as “speed” because that’s what it does. It speeds you up, gives you energy. You don’t have to (can’t) sleep and you can just go and go and go.
You feel high and all-powerful.
But the results of long-term methamphetamine use are scary to see.
Lots of times friends and family don’t realize what’s happening to someone they love until they’re way down the road to addiction with speed.
So today’s post is aimed at the people around the meth user, to help them understand what’s going on. In my next post I’ll talk about long term effects and what can help.
Only 30 but looked twice that age
Patty S had areas on her head where her limp hair was either thin or missing. Skinny. Clothes hung on her like they belonged to somebody else.
Her face was covered with dark scabs, oozing sores and raw areas that looked like fresh wounds. So were the backs of her hands and what little I could see of her arms.
Her cheeks were sunken due to missing teeth. And when Patty opened her mouth to talk, I could see that her gums and what few teeth she had left were black.
In other words, methamphetamine had taken her over.
What does methamphetamine do FOR the user?
You hear a lot about all the awful things that can happen as a result of using one drug or the other. And when you hear all the scare stories it’s easy to wonder why on earth someone would use it?
But I think it’s important to understand why people start using it, so you can understand how nice people can get so messed up in their drug use that they end up looking like Patty.
She was a middle school math teacher before meth took over her life. When her son was killed in a car accident she had no energy, cried all the time and could barely get out of the house.
She was in danger of losing her job when a friend gave her something to give her a “little energy” and get her back on her feet.
Meth.
Patty knew about methamphetamine and thought she understood its dangers. But like everybody else who goes on to get addicted to a drug, she figured she wouldn’t get hooked. She was above that.
What she didn’t realize is how incredibly addictive the drug is and that it doesn’t take much or many sessions with meth to find out you can’t stop..
Methamphetamine is a stimulant drug
Meth is an “upper.” It gives you energy. You don’t sleep when you’re actively using. You feel like there's nothing in the world that you can't do. You have more stamina. Some users say it makes sex better, that you feel everything more.
A lot of people know a little about amphetamine, a cousin of methamphetamine. As drugs like Vyvanse®and Adderall ®it’s used to treat attention deficit disorder (ADD and ADHD).
Amphetamine can be (and is) abused a lot. Students, especially college students, use Adderall to help them stay awake to study.
And there’s no question that amphetamine causes a lot of trouble on its own. But methamphetamine is stronger and can result in scarier problems and after fewer times of using than amphetamine.
Physically what does meth do TO the user?
I think we’ve all heard of the “fight or flight” feeling that happens when you’re suddenly excited – either in a “I’ll handle this” (fight) way or a “get out of here fast” (flight) way.
And this "fight" part of the nervous system is what kicks in. Blood vessels tighten up so your blood pressure rises too. Basically, your body is ready for action.
Another thing that happens is your pupils open wide, which means you can see more of the action around you when light is dim.
Tightening of blood vessels is called “Vasocontriction.” And besides raising your blood pressure it can cause other changes. You can have a stroke or heart attack, for example.
Blood vessels in your mouth can stay clamped down. And when that happens, you don’t get enough blood to the salivary glands – this is where saliva is formed. So your mouth gets super dry.
The teeth rot because they aren’t covered in spit, which is supposed to help rinse them off. The gums also start drying out and can get infected. That’s why my patient was missing so many teeth and had such ugly gums.
If the blood vessels to your skin stay tight long enough, the skin becomes dry and itchy and is easily torn.
This is one of the reasons Patty S. had sores on her face. There’s another reason that contributes to this too which I’ll talk about with brain changes.
And of course, there’s always the issues of how you use the drug. You can inject, smoke, snort the drug. Each different way of using carries a different type of risk which I won’t talk about now, but will spend more time on in a future post.
So physically there’s a lot of bad stuff that happens when you use speed. But, being a shrink, what happens to the brain and the rest of the nervous system is what worries me most.
Brain chemistry with methamphetamine
All addictive drugs give us pleasure – at least at first - or we wouldn’t use them. And the
brain chemical that’s associated with pleasure is dopamine (DA).
When you use a drug it causes DA levels to increase in parts of the brain. And when DA goes up, the enjoyment does too.
Methamphetamine causes the brain of the user to use up huge amounts of DA, more than other stimulants like cocaine. Plus, the drug itself hangs around in the brain and body longer than does cocaine so it keeps working on the person longer.
But so much dopamine gets used that it’s hard for the brain to make more to replace what’s been used up. And when the DA is low, the person feels low, tired, maybe depressed.
This means they want to use again, so they’ll stop feeling so bad.
And again.
And again, because they just don’t feel good. So they use again because nothing else makes them feel better.
Mood changes from speed
I see a lot of meth users. Usually they will have managed somehow, to stop using for a while. Maybe from being in a detox center. Maybe from being hospitalized or in jail. But for whatever reason they’re not using.
But they feel very depressed and just can’t seem to shake it off. They’d like some help just feeling normal again. Sometimes it seems like there are permanent changes in the brain.
Some people start hallucinating or get really paranoid when they’re on speed. Usually these aren’t people who come to my office. More often terrified family members or the police bring them in to the hospital.
Most of the time people will start feeling better after about a week, although not everyone is this lucky. The hallucinations slowly die out. The depression gets better. But they probably won't feel “normal” again for a much longer period of time.
And methamphetamine can cause some really weird movements. Usually they don’t seem to have any useful purpose. We call them “automatisms.” That is, they’re “automatic” and the person may not even realize they’re doing it.
Sometimes these can be scratching movements with the fingers. The person can do them so much that they wear through the skin. This is another reason Patty had all those sores that I could see on her face and hands.
So what do we do about the person who’s using speed?
I’m going to spend the next post or maybe two, talking about what can happen to somebody who uses speed and how we try to help.
We don’t have any medications that are as good for speed as we have for heroin or Vicodin®. And we have a lot of trouble helping the meth addict, but we can help.
So for now, the most important message is, don’t start. It’s a really hard habit to kick.
More next time.
Image of flasks by @CanStockPhoto Inc /Mirage3
Image of emaciated user by @CanStockPhoto Inc /NomadSoul 1
Image of dopamine molecule by @CanStockPhoto Inc/nexusby
Image of brain by @CanStockPhoto Inc/Pikovit