Aripiprazole for the treatment of methamphetamine dependence

Methamphetamines (Meth) cause a wide array of problems with its users, a lot of which are permanent. Meth’s affects range from neurological issues, alertness, paranoia, and aggression. It also leads to psychological and physical disorders. Because Meth is a stimulant, it can cause the user to be up for days and even weeks at a time causing stress to the body and can result in over exerting oneself and inevitably something will give. Personal problems from users will be talked about, as well as scientific studies on the Meth epidemic.

Meth was originally used for medical purposes; it was used to help treat narcolepsy (wanting to sleep), obesity (being overweight), and Attention Deficit Disorder (not being able to stay focused) also known as ADD. Meth is such a preferred drug because of how the effects work, the user will get a long lasting high from a small amount as well as receive more energy and alertness without having to eat and sleep. The user will also experience hyperactivity, irritability, malnutrition, shortness of breath and thoughts of suicide do to depression when they start coming down from the high. Excessive use of Meth will cause lung and kidney disorders, as well as damage to the liver and brain which can cause issues of psychological problems and even having a stroke.

During the time of the user trying to get off of the drug they will start to experience increased depression, being sad about everything, and have a huge craving for more. Meth is a very controlling drug and can so many effects on the users brain that they will lose themselves to meth and allow it to take over their life. One of the worst parts of meth is that the family and friends of the user suffer from its affects mentally as the user suffers physically. The innocence of children is the worst part of meth abuse. As the parent smokes meth, the children in the house are subject to the second hand smoke and inevitably susceptible to the effects meth has on them. Due to all the highs and lows the meth user has, the children are also subject to the abuse, neglect, and the emotional toll from their drug addicted guardian. One of the worst parts of meth abuse with children in the home is that the guardian will get into the drug so much that they will start spending money on meth rather than buying their children clothes, shoes, or any of the basic necessities of their children. About twenty percent of raids had children in the home, this abuse and neglect causes a flooding of children on our social service systems in many areas. Meth can be ingested orally, injected, smoked, and snorted.

With all the various styles of taking the drug, there are also various types of diseases attributed to some of the methods. One of the worst is by injecting the meth directly into a vein; it can cause the user to contract HIV, as well as, hepatitis B or C. It will also make the user more susceptible to collapsed veins due to excessive needle use. Due to the intensity that meth has on the inner workings of the body, the user may suffer from spasms in the heart, hypothermia, hypertension, and convulsions that are direct results of the increased in their heart rate and energy. Snorting the drug can cause several sinus infections, and smoking it causes lung deficiencies as well. Meth also has a lot of short term and long term effects, some already talked about and some not. The central nervous system (CNS) can be affected by various side effects of even small amounts of meth; such as, increased wakefulness, increased physical activity, decreased appetite, increased respiration, hyperthermia, and euphoria. Other CNS effects include irritability, insomnia, confusion, tremors, convulsions, anxiety, paranoia, and aggressiveness; hyperthermia and convulsions can result in death.

On the other side of that coin there are also long term affects that the user deals with such as increased heart rate and blood pressure and can cause irreversible damage to blood vessels in the brain, producing strokes as well as respiratory problems, irregular heartbeat, and extreme anorexia; its use can result in cardiovascular collapse and death. More than 26 million people in the United States use meth and most of the users are teenagers. It is also the most destructive drug, killing or seriously injuring over 1.5 million people each year. The battle against this drug is bring in tougher laws so that law enforcement can try and eliminate the use and help save lives. One of the newer laws is that any drug that contains pseudoephedrine has to have a doctor’s prescription, so that it will be harder to get and slow down or stop the manufacturing process of meth. Part of the reason that meth is so bad is that it causes irritability, anxiety, irregular heart rate, an increase in physical activity, and an increase in heart rate. These affects are dangerous on many levels.

Due to the impaired state while using meth, when a user is irritable they start to lose patience for others. This is dangerous because users don’t understand the amount of force they use if they were to hit someone, or worse, what the consequence would be if they were to have a deadly weapon. Anxiety is also a big issue with users; they feel that they are invincible and they want something to do. Some users have gone as far as believing they can fly; so they jump off a building or out a window. The irregular heart rate can be deadly if you have any type of minor heart disease. Finally, the increase in physical activity puts others in danger, as well as the user, especially if there are motor vehicles, weapons, or any other dangerous item they can get hurt on.

Part of the reason that meth is also very hard on the body is that when taken it can cause an eight to twelve hour insomnia period. This time of insomnia is when the users are typically more violent, and when the insomnia starts to wear off they get very tired and depressed. The issue with this feeling is that the user will then dose again, to feel better and so on and so forth. Meth users that do this have been known to be up in excess of three to five days.

In March of 2006, the United States of America signed an Act that bans the sale of any over the counter drug that contain pseudoephedrine. Pseudoephedrine is the main ingredient in medication for sinus colds such as Sudafed. Sudafed is the medication that is used to produces the toxic drug methamphetamine. Within the act are rules and regulations for individuals and businesses. Businesses are to keep all medication within a locked storage box or behind the counter. When an individual purchases the medication, the seller has to keep a log record of the purchase with signatures for two years. Individuals buying this medication have to have a valid form of Identification and are only allowed to buy a certain limit per month. The Act requires that the limit be 9.0 grams or less per month.

When an individual is caught producing methamphetamine with in a location of children then that person get a harder sentence of an additional 20 years in prison. With the prison having more drug related inmates than any other crime the cost to support these individuals is expensive. The cost is anywhere from 10,000 dollars to 20,000 dollars per year. Withdrawals affect the individuals, their families and friends as well. The cost to run treatment programs range between 10,000 dollars to 15,000 dollars a year and 2,000 to 3,000 dollars for outpatient programs yearly. However, when individuals that have chronic illness that need these type of medication have trouble. If they pass this new law that states individuals need a doctor prescription can have great effects. The health cost to pay for a doctor for each visit and the prescription with individuals without health insurance can be expensive. In some scenarios the individuals that have these chronic illnesses may need to have more than the limited amount of 9 grams per month and with doctor prescription. Individuals with chronic diseases may have problems obtaining their medications because of the cost and limit on that form of medications.

The use of methamphetamine is associated with long-term biochemical and structural effects on the brain and significantly changes how the brain functions. The excessive production of dopamine causes neuropathological changes in the brain and has a neurotoxic effect on the brain cells that store dopamine and serotonin. These changes include decreases in the levels of dopamine transporters as well as decreases in the density of serotonin transporters in various parts of the brain. Studies have demonstrated that daily use of methamphetamine results in increased cell death in the brain, which would have a negative effect on prefrontal cortex functioning.

Changes in the activity of the dopamine system are associated with reduced motor skills and impaired verbal learning. Studies have also revealed that chronic use of methamphetamine causes severe structural and functional changes in those areas of the brain associated with emotion and memory,
which could explain many of the emotional and cognitive problems observed in chronic abusers of the substance. These neurological changes have given rise to deficits in execution memory which are manifested in a reduced ability to problem solve, increased impulsiveness and risky decision-making. Further dysfunctions include apathy, poor self-control and poor executive control. Over time, methamphetamine destroys the dopamine receptors in the brain, which has the effect of reducing the ability to feel pleasure. The use of methamphetamine has been proven by a number of studies to be associated with irreversible damage to the brain and, even though the neurotransmitters in the brain may recover over time, damage to cognitive abilities cannot be reversed.

Signs of meth addiction include physical, emotional, and psychological changes in the user. One sure sign of meth addiction is the user’s firm belief that they are unable to fully function when they are not on meth. Other signs of meth addiction include the user creating distance between themselves and those who love and care about them. This alienation will keep them emotionally remote, and thus result in feelings of depression and loneliness. Methamphetamine is a drug that does not allow much room for casual use. Users quickly become addicts. Often, the signs of meth addiction take a toll on the user’s health and their ability to tend to basic personal hygiene.

Chemicals are emitted from the skin of meth users, often producing strong and unpleasant odors. Meth use causes serious tooth decay. Use of methamphetamines can cause the teeth to become discolored, brittle, and even chip. The term often used to describe the oral effects of meth use is “meth mouth.” In those who use meth, the teeth become stained, deteriorate, and rot. This could be linked to the toxic chemicals in methamphetamine or side effects of the drug. Meth causes blood tissues to shrink and die, cutting off blood supply to the oral cavity and reducing saliva production, which aids in neutralizing harmful acids in the mouth.

Users often pick at imaginary bugs under their skin (meth bugs), causing open sores, infections, and scarring of the skin. The death of blood vessels
causes other visible signs of meth use. Because of the lack of blood flow to body tissue, including the skin, it is difficult and sometimes impossible for the body to repair itself from injury. As a result, the skin loses elasticity, and meth users often look more aged than their chronological years. Sores appear on the skin that may take a prolonged time to heal. In extreme cases, the sores may not heal at all. The sores are often because of skin picking, which is common among meth users.

Meth addicts may communicate with senseless and irrational babble and their speech may be impaired. They are prone to moodiness and violent outbursts. Please note that the presence of these symptoms and behaviors do not necessarily mean a person is a meth addict. There are other factors, such as mental illness or side effects from prescribed medication that can cause symptoms similar to those associated with signs of meth addiction. If you suspect meth use, it is recommended you contact a drug addiction treatment specialist.

Citations
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American Journal of Drug & Alcohol Abuse, 38(3), 251-259. doi:10.3109/00952990.2011.644000