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Methamphetamine: What Professionals Need to Know. Jackie McReynolds Washington State University Vancouver. What is Methamphetamine?. A very powerful stimulant A highly addictive, synthetic drug A powder or crystallized form
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Methamphetamine: What Professionals Need to Know Jackie McReynolds Washington State University Vancouver
What is Methamphetamine? • A very powerful stimulant • A highly addictive, synthetic drug • A powder or crystallized form • Can be taken orally (tablet), injected, or inhaled (smoked), absorbed through skin
Addiction Potential • 42% of first time users go on to 2nd use. • 84% of 2nd time users go on to develop regular use. OHSU.Org
Physiological 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 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: Immediate 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)
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 Homemade Meth Ingredients
“Parents who are addicted to drugs have a primary commitment to chemicals, not to their children.” Beckwith, 1989
How Does Meth Impact 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
Loss of Memory, Emotion, and Reward Systems in the Meth Brain
Double Jeopardy for Children • 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 Vulnerabilities • 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 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 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 bland Lactose intolerance: move to soy-based products
IDEAL 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 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 Needs • Attachment intervention • Medication (chronic and short-term) • Hydration and tube feeding • Cardiac monitoring • Foster care placement • Therapeutic child care
Minimizing Stress for Infants • 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 Children up to Two Years of Age • 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 Toddlers • 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 Older • 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-aged) Psychosocial Problems • 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
Recognizing a Meth House • 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 Production • 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
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
The Matrix Model of Treatment • 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)
Resources • 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 Resources • Govt. Meth Resources: Methresources.gov • Montana Meth Project: Montanameth.org • Alcoholics Anonymous :alcoholics-anonymous.org • Al-Anon/Alateen al-anon.alateen.org • Narcotics Anonymous: na.org
Other Non-fiction Reading • 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 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