Name That Drug

Name that drug      

73% of Wasco County child abuse cases are ______ related. 99% of first-time ______ users are hooked after the first try. ______ use among Oregon females under 17 and under increased by 57% over the past 5 years. The life expectancy of a habitual ______ user is as little as 5 years. Five pounds of toxic waste material is produced in the manufacture of every one pound of ______ ______ is tied to almost every property and identity theft crimes in Oregon.

meth is very hot right now 

8;43pm Guess who was expelled from school and will be living w/ me in the fall (much to my chagrin)?

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8:54pm your boy brother?!

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8:54pm the same. as a result, I'm thinking of renaming my house 'thunderdome'.

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8:55pm You be his manager and set up a cage fighting arena in the basement at least make some money

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8:55pm I wish. stoners don't make very good cage fighters. I should get him on meth first

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8:56pm yes! Meth is Very hot right now.

YouTube - Cocaine,Marijuana,Crack, Meth ,Heroin Changes ... Face of addiction - The effects of crystal meth. 00:44 From ... 5 min www.youtube.com/watch?v=hzP-4N2Qfs0 www.youtube.com/watch?v=hzP-4N2Qfs0

Background: Street Names Methamphetamine

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Speed Meth Chalk

Methamphetamine Hydrochloride (Crystalline)

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Crystal Meth Glass Ice

drug class Stimulant »Speed up signals to the brain” Cocaine Amphetamines – Methampetamines Methcathinone Methylphenidate Anorectic Drugs Khat Amphetamines, Caffeine, Nicotine Cocaine Excite, arouse, increase alertness, elevate mood.

( Drugs in American Society, 7th edition, Erich Goode, McGraw-Hill, 2008. Chapter 1)

Methamphetamine amphetamine was a drug in search of a disease”

Methamphetamine, in all its forms (po, snort, IV, smoked), is highly addictive and toxic. Effects of meth similar to cocaine except onset is slower & duration is longer – remains in CNS Metabolism Cocaine almost completely metabolizedMeth -large % of drug remains unchanged in the body

Mechanism of action chemical formula C10H15N molecular mass 149.233 g/mol. triggers a cascading release of norepinephrine, dopamine and serotonin. to a lesser extent methamphetamine acts as a dopaminergic and adrenergic reuptake inhibitor and in high concentrations as a monamine oxidase inhibitor stimulates the mesolimbic reward pathway, causing euphoria and excitement, it is prone to abuse and addiction.

HIV JournalView:

Top 10 HIV Clinical Developments of 2007 David Alain Wohl, M.D.

University of North Carolina, AIDS Research and Treatment Unit Newsworthy New Drugs Presenting for Care Too Late and With Too Few CD4+ Cells Myocardial Infarctions: The Role of PIs and NNRTIs Metabolic Results From the A5142 Study -- Assumptions Gone Wild Sperm Washing Works Screening for Abacavir Hypersensitivity The Sad Failure of a Promising HIV Vaccine Crystal Meth Is Evil Survival With HIV: Great Expectations Risk of Cancer Is Related to Immune Function

www.thebodypro.com/content/art45308.html

Short term effects Increased attention Decreased fatigue Increased activity Decreased appetite Euphoria and rush Increased respiration Hyperthermia http://www.stopmethaddiction.com/effects-of-meth.htm

long-term effects of meth use

Dependence Addiction psychosis Paranoia Hallucinations Mood disturbances Repetitive motor activity Stroke Weight loss

Withdrawal Users may become obsessed or perform repetitive tasks such as cleaning, hand-washing, or assembling and disassembling objects. Withdrawal is characterized by excessive sleeping, eating and depression-like symptoms, often accompanied by anxiety and drug-craving. Users often take one or more benzodiazepines as a means of "coming down".

Clinical Presentation: meth 

variety of cardiovascular problems.  rapid HR, irregular heartbeat, increased b/p, and irreversible, stroke-producing damage to small blood vessels in the brain.  Hyperthermia and convulsions occur with methamphetamine overdoses, and if not treated immediately, can result in death.

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Chronic abuse  inflammation of the heart lining, and among  users who inject the drug, damaged blood vessels and skin abscesses.  episodes of violent behavior, paranoia, anxiety, confusion, and insomnia.  Heavy users also show progressive social and occupational deterioration.  Psychotic symptoms can sometimes persist for months or years after use has ceased.

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Acute lead poisoning  production uses lead acetate as a reagent.  Production errors may therefore result in methamphetamine contaminated with lead.

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Fetal exposure  prenatal complications, increased rates of premature delivery  altered neonatal behavioral patterns, such as abnormal reflexes and extreme irritability  may be linked also to congenital deformities

Big Picture clinical presentation Global Regional Community Interpersonal Individual

"Treatment response is poorer among methamphetamine abusers than among cocaine abusers-fewer meth abusers could remain drug free, …..methamphetamine abusers are twice as likely as cocaine abusers to require some kind of medical treatment.. ….methamphetamine abusers are more debilitated and show paranoia and hallucinations. There is more violence associated with meth”…… http://www.drugabuse.gov/NIDA_notes/NNvol11N5/Escalating.html

Management: Chemical Dependency Treatment Chemical Dependency Program (e.g. Matrix Model) Contingency management program with rewards for patients with negative urine drug screens Medications which may offer benefit

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Fluoxetine and Bupropion may reduce short-term cravings Imipramine improves compliance with therapy

References

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Cretzmeyer (2003) J Subst Abuse Treat 24:267