Treatment of the methamphetamine addict must also include thorough health examination and treatment. The damage caused by the abuse of this drug is quite comprehensive, extending beyond impact of the Central Nervous System (CNS), including serious medical problems in the cardiovascular, respiratory, and even digestive systems. (n4) The extent of the actual medical damage varies greatly due to the presence of several variables in both the addict and in the production of the substance. Because of these serious medical associations, addicts should be referred to appropriate medical practitioners for evaluation and treatment. (n5) In addition, numerous other non-emergency medical conditions will need attention, since the physical wellness of the person has been greatly assaulted by the entire course of the addiction (e.g., dental care). In particular, sexually transmitted diseases (including and especially HIV/AIDS) have a high correlation with methamphetamine abuse. (n6)
Clinically, there is hope for treating methamphetamine addiction. For example, studies have consistently shown improvement among methamphetamine users that enter standard chemical dependence treatment programs. (n7) There have also been some indications that using donepezil can address some of the "brain cholinergic neurone damage" caused by methamphetamine abuse, "thereby potentially impairing cognitive function." (n8) Therefore, and despite the overwhelming challenges of conquering such a chemical dependency (n9), there is ample reason for hope. This cannot be overemphasized in the presence of popular assertions (even from government or law enforcement officials) that 'meth addicts can't be helped.' In Carol Falkowski's words,
"For those of us in the addiction field this statement is sadly reminiscent of what people said about alcoholics 60 years ago, and about crack addicts in the 1980s." (n10)Falkowski then relates "primary research-based principles of addiction treatment," the most important for our purposes being:
Medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use. ... Effective treatment addresses the multiple needs of the individual: drug use and the associated medical psychological, legal, social and vocational problems. Addiction and co-existing mental disorders should be treated in an integrated way. (n11)These principles have direct implication for how community programs can be an integral part of methamphetamine addiction recovery.
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1 Please refer to: American Psychiatric
Association: DSM-IV: Diagnostic & Statistical Manual of MentalDisorders. 4th ed. (Washington, DC:
American Psychiatric Association; 1994). Especially helpful are the
DSM-IV criteria for amphetamine intoxication and withdrawal, which
list physical symptoms and known variables associated with the
presence of amphetamine related disorders.
2 Judith B. Cohen, et al. “Abuse and Violence History of Men and Women in Treatment for Methamphetamine Dependence.” American Journal on Addiction. 2003; 12:382. The categories of violence used in the study included: forced sexual acts, various forms of coercion, and physical abuse. The authors also point to the failure to address these disorders that extend beyond the chemical addition as responsible for “lower retention rates and treatment outcomes.” (383)
3 Therefore, "Depending upon the severity of symptoms, symptomatic treatment can be delayed to clarify the etiology." Michael Larson, "Amphetamine-Related Psychiatric Disorders." available at: http://www.emedicine.com/med/topic3114.htm . Accessed May 19, 2005. Michael Larson is the Clinical Instructor, Department of Child and Adolescent Psychiatry, at Harvard University.
4 Some associations include: hypertension, arrhythmia, arterial aneurysms (cardiovascular); seizures, choreoathetoid movement disorders, cerebrovascular accidents, spontaneous cerebral hemorrhaging (CNS); barotrauma, noncardiogenic pulmonary edema, pulmonary hypertension (respiratory); as well as associations with the presence of "giant" ulcers, ischemic colitis, and renal failure. See Robert Derlert, “Clinical” in op. cit. For duration and intensity of symptoms in abstinence, see the initial conclusions of Thomas Newton, et al., “Methamphetamine Abstinence Syndrome: Preliminary Findings” in The American Journal on Addictions 2004; 13:248-255.
5 See the helpful discussion in Larson, op cit., especially sections 6-8: "Treatment", "Medication," and "Followup."
6 This is an especially portentous area of concern. See, for instance, Antonio Urbina and Kristina Jones, "Crystal Methamphetamine, Its Analogues, and HIV Infection: Medical and Psychiatric Aspects of a New Epidemic" Clinical Infectious Diseases, March 15 2004: 38, 890-894; or Fred Molitor et al., "Methamphetamine Use and Sexual and Injection Risk Behaviors Among Out-of-Treatment Injection Drug Users," American Journal of Drug and Alcohol Abuse. 1999, 25(3): 475-493.
7 Yih-Ing Hiser et al., "Longitudinal Patterns of Treatment Utilization and Outcomes Among Methamphetamine Abusers: A Growth Curve Modeling Approach," Journal of Drug Issues (Fall 2003), 921-938. See also, Margaret Maglione et al., "Residential Treatment of Methamphetamine Users," Addiction Research (2000: 8,1), 65-79.
8 Diana Jovanovski and Konstantine K. Zakzanis, "Donepezil in a chronic drug user—a potential treatment?," Human Psychopharmacology: Clinical and Experimental (2003: 18), 561-564.
9 One further challenging aspect of methamphetamine addiction recovery is hallucinatory flashbacks called 'spontaneous recurrence,' which seem to be related to stress in the person's life. See K. Yui et al., "Spontaneous recurrence of methampetamine psychosis: increased sensitivity to stress associated with noradrenergic hyperactivity and dopaminergic change," European Archives of Psychiatry and Clinical Neuroscience (1999: 249), 103–111.
10 Falkowski, "Methamphetamine Across America," 31.
11 ibid.
