Amphetamine Maintanence Therapy... Why not?

I struggle to understand why, in New Zealand, opiate addicts can get suboxone and methadone to help fight their addiction, but meth addicts get jack shit. Meth is just as addictive, if not more addictive than opiates, it causes a lot of damage to people and society, and yet nothing's really being done about it. Almost makes me wish I got into heroin rather than meth!

Drug counselling can only go so far... I think a medical intervention is also needed. How 'bout offering us meth addicts dextroamphetamine, dispensed and closely monitored, just like methadone. I'm sure it will do a lot to help with the meth epidemic which this country has been facing for years.

 

Unfortunately theres no equivalent for methadone or bupe for the amphetamine class of substances. Methadone and bupe block the euphoric effects of other opiates through various modes of action. The scripting of dexamphetamine for meth abusers would probably just add to the users existing tolerance as dex has the same abuse potential and does nothing to block the use of meth.

 

There aint amphetamine maintenance therapy because you cant be physically dependent or addicted to amphetamines. You can develop a mental addiction of course, and when you stop using you get a rebound effect, the opposite of up. But there aint no actual physical dependance. Amphetamines aint physically addictive and thats why they dont offer replacement therapy for them like they do for opiates, which are physically addictive.

I wouldnt say meth is more addictive than opiates. Ive done both and while the mental stress from a meth come down is definately some suicidal type of hell I have never ever suffered like I did with heroin withdrawals, from any type of uppers abuse. When you add a physical AND mental addiction which is wat you get with opiates it is double the pain of somethin like a comedown or recovery from amp/meth.

I kno that in ur country there is much less opiates than we got in the US so i know its a big problem for yall there. Im just sayin that as far as addiction goes , that is the reason why. Ppl dont see there to be a need for a replacelent drug since there aint no physical addiction or actual withdrawals from it. I know there is effects of stoppin meth and amphetamines. But its a rebound effect, not a withdrawal. your body dont depend on it, you dont go into a medical withdrawal. I aint sayin you dont feel nothing when you quit amp's, but im just saying it aint the same thing as a withdrawal from a drugs thats physically addictive, and ppl already got a hard enough time accepting opiate maintenance therapy for heroin addicts and that actually is based on a physical need, so there aint no way in hell society would accept a maintenance program for amp's, u feel me.

 

^ Have you ever been addicted to meth? Using at least a gram a day for two years or more, like I have? The withdrawals from a meth addiction are utter hell... personally I'd rather suffer through all the physical symptoms of heroin withdrawal than the suicidal depression, the fatigue, the anhedonia, and all the other neurological problems of meth withdrawals, which can last for months or even years after the acute stage has passed. NZ meth tends to be a lot more pure and potent than meth elsewhere.

And before you ask, I do know what physical withdrawals are like. I have a 6 year benzo dependence (people often say benzos are the worst to quit), and I've tried stopping cold turkey several times. It gave me massive seizures and landed me in hospital, but I'd still take that over meth withdrawals any day!

 

I totally agree P!

If you were in the US I'm sure you could find a sympathetic enough doctor to get scripted d-amphetamine!

Maybe. I've heard of it. If you found a true addiction specialist, they would be happy to give you d-amp to try to kick meth. If not P, I'll be an addiction specialist and I'll hook it up!

The truth of the matter is, you taking d-amp is a brighter, more stable reality than smoking meth. I know myself and I would be the same way on meth, I could easily get bad with it if I didn't know how to have some self restraint (I think I'm at a much better place now with self restraint ) so yeah, between the two, I would much rather have d-amp if I was going on maintenance.

I totally think you should be allowed d-amp! Call *every* addiction specialist psychiatrist in NZ see if it's a possibility! You have a good medical diagnosis behind why this is a good idea.

Hopefully a doctor will see through to the truth.

LaceyK - I know you mean the best. For real. However, meth can be just as addictive as heroin. It has a very direct effect on dopamine. Heroin has more of an indirect effect on dopamine, but an effect nonetheless.

The actue WD of heroin might be worse, but I bet you the PAWS of meth is much worse.

Meth doesn't appeal to everyone, but its lure can be just as strong as heroin. Both drugs are deserving of maintenance.

Some countries even have proponents of Cocaine Maintenance Therapy! Cocaine has very little "physical dependency" associated with it, so meth definitely deserves a maintenance therapy for sure.

I wouldnt say meth is more addictive than opiates.

It varies person to person, but trust me: it can be. Smoking methamphetamine is very addictive compared to most other drugs.

^ Have you ever been addicted to meth? Using at least a gram a day for two years or more, like I have? The withdrawals from a meth addiction are utter hell... personally I'd rather suffer through all the physical symptoms of heroin withdrawal than the suicidal depression, the fatigue, the anhedonia, and all the other neurological problems of meth withdrawals, which can last for months or even years after the acute stage has passed. NZ meth tends to be a lot more pure and potent than meth elsewhere.

And before you ask, I do know what physical withdrawals are like. I have a 6 year benzo dependence (people often say benzos are the worst to quit), and I've tried stopping cold turkey several times. It gave me massive seizures and landed me in hospital, but I'd still take that over meth withdrawals any day!

P - I believe you. If you hang in there, and see many addiction specialists, I think one of them might be able to help you out.

Having a diagnosis helps. This lays the groundwork for why medication is necessary to help stabilize the patient's life. This is almost an essential part of recovery, at least it was for me (and using heroin and quitting). I can completely feel you with what you're describing with meth addiction. The one time I tried it I didn't really have much of a comedown, but I've seen the meth comedown in other people, just from one dose...I can only imagine what someone must go through to keep such a cycle up for a year or two.

You're a courageous person P! I think if you go after what you know you need to kick this habit I think you'll get it! I really do have faith you can do this.

If I was addicted to meth, I would hunt down a doctor to prescribe me d-amp. Absolutely. If I lived in NZ I would come help you! But alas, I don't, and I don't even have the resources to move even an inch closer!

But trust me, even if you had a crack or cocaine addiction, I think a DRI* pharmaceutical replacement (like ritalin, or wellbutrin) is totally in line too. Just an example.

Good luck P!

* DRI: Dopamine Reuptake Inhibitor, cocaine's main effect is mediated through DRI.

 

^ Thanks CH. I've been recently prescribed bupropion (Wellbutrin), which seems to be helping with the cravings. But the rest of the PAWS symptoms remain, and have pretty much brought my life to a halt. I do have a diagnosis - Polysubstance Dependence (Methamphetamine & Benzodiazepines).

I'm not directing this at you or Lacey, but a lot of people don't get the difference between the comedown and withdrawals. The comedown usually lasts a couple of days at most, after you use. It's like a hangover from drinking alcohol, but with different symptoms. Withdrawals develop after regular heavy use... and trust me, they make the comedown a walk in the park! Then there's the post acute withdrawals (PAWS) which seem like a never-ending struggle.

 

Ppl dont see there to be a need for a replacelent drug since there aint no physical addiction or actual withdrawals from it. I know there is effects of stoppin meth and amphetamines. But its a rebound effect, not a withdrawal. your body dont depend on it, you dont go into a medical withdrawal.

Sorry, but this is plain wrong. You don't seem to realise that there are two types of withdrawals: physical (like from heroin or benzos) and psychological (like from meth or crack). The rebound effect is the comedown - which is different to the withdrawals! Once you start using meth heavily and regularly, your body does depend on it. I depended on it to get out of bed in the morning, to do my daily activities, and just to feel human. Any methamphetamine addict will agree with this. Check out the "Methamphetamine: Serious Discussion" thread in TDS to hear some of the stories.

 

An old g/f used to use alot of coke and liked my Adderall script alot. I was trying to get her to slow down on her coke use and amps helped, I guess. She went right to her general doctor and explained the situation [he knew about her coke issues] and got a fat script for Adderall.

Although IMO after using/abusing Adderall for awhile she was worse of than before. Do they script amp's at all in New Zealand? If they do you might find a doctor willing to script it off-label.

Peace,
Seedless

 

If you get the right doctor, anything is possible. Some reasoning could be that the coke use was an attempt at self medication for an underlying adhd issue which then they thought that a proper controlled script of amphetamines could resolve an uncontrolled self medication using unregulated street stimulants.

 

Do they script amp's at all in New Zealand? If they do you might find a doctor willing to script it off-label.

Yep, mostly for ADHD. The doctors I've seen have been very reluctant to prescribe that for off-label purposes, sadly.

 

Sweet P - maybe you are actually ADHD? There's two different types, "hyperactive" and "inattentive".

Even if you're not, maybe you can pretend like you are?

Glad to hear wellbutrin is helping you out. I was on it for a while.

Let us know how it goes for you.

 

My doctor totally ruled out ADHD for me just because I'm an avid reader. 8)

 

Sweet P - maybe you are actually ADHD? There's two different types, "hyperactive" and "inattentive".

Even if you're not, maybe you can pretend like you are?

Nah, I've done more psychological tests than I can count and ADHD was never indicated. I doubt I'd be able to fake it either... with my history of drug abuse throughout my medical files, I'm sure the doctor would see through me like a wet t-shirt.

My doctor totally ruled out ADHD for me just because I'm an avid reader.

WTF? I know people diagnosed with ADHD who are avid readers. Granted, their ritalin or dexies may help them to read, but still... that's pretty dumb of your doctor to rule it out just because of that.

 

Well good luck P! I think you deserve it for maintenance, and at least you're being honest with your doctor. If I have to come open practice in NZ let me know!

 

Sweet P, you conveniently ignored the part of my post that you quoted where I said that meth IS psychologically addictive. I noticed that in alot of your posts lately you seem to lash out at ppl alot so I dont take it personal, but anybody reading my post could clearly see that I obviously know that addiction can be physical , mental, or both. Its jus straight up silly to accuse me of not knowing that, becuz thats wat I based my entire comment on, the difference between opiates and meth and how one is physically and psychologically addictive while the other is psychologically addictive , with psycho-somatic effects in the body that is caused by the mental addiction, which is different from a actual physical dependence.

Anyways, Ill explain my comment again, and maybe this time u will understand the point I was making better now that I cleared that up for u.

Medically and scientifically, meth is not physically addictive.
It IS addictive psychologically and has psycho somatic addiction issues.

Now, The reason that meth dont have a replacement therapy option is because it aint physically addictive. Your body does not physically become dependent to it in the same way it does for some other drugs that are physically addictive. There fore, replacement, which right now is only approved for physically addictive drugs, aint seen as a option by many doctors and experts.

I aint sure why u chose to turn it into a silly-ass debate about which drug is worse, becuz there aint no point to that, and you yourself asked a question that I answered. I didnt say I agree with that answer or that its right, but I just explained to u the reason for the situation u asked about.

Replacement therapy is intended to replace a drug that the body is physically dependent on.

Because meth aint physically addicting and dont cause a physical dependence, replacement therapy aint considered to be a appropriate treatment.

Its extremely simple, and impossible to look at that as bein anything but me stating the facts. Please dont take it as my opinion or as me saying that is a good thing. Im just reporting to u the logical answer that u did not consider. When i say that replacement therapy aint available for meth becuz it dont cause physical dependence, I aint saying that is how it SHOULD be, Im just explaining to you why it IS that way.

The world already got so much disgust and dis-taste for addiction period. It was hard enough to get the public to accept the idea of methadone or suboxone maintenance for opiates, and those are for drugs that cause a medical, physical dependence and need. And still there is LOTS of people who still dont accept it and see that as totally insane, who cant accept the idea of a physical need.

SO- With the way people feels about opiate replacement, when there is a legit, physical need, there aint no way they will accept a drug replacement when the need is psychological. society is ignorant and prejudiced in general.

if they cant understand a physical need for a replacement (opiates) they sure as hell aint gonna understand a mental one like u suggest for amphetamines. If to them physical aint "enough" of a need, then to them, a psychological need would just be "all in your head" and they would never consider it for a second.

Thats why it dont happen and aint available at least as far as i could imagine. no matter the personal feelings u got about which drugs is worse and so on, wat the hell ever, it aint gonna change the fact that one drug causes physical dependence and one dont, and replacement therapy is based on the idea of substituting the physical addiction with a less harmful drug. so if there aint a physical need there then people aint gonna see the need for a replacement. Im sorry that hearing that offended you personally and caused u to start arguing with me, but I hope that u can relax a little bit and free ur self from the pain of addiction, becuz its obviously takin a toll on ur emotional balance. Good luck....

 

PS-I understand that after using meth for a long time ur body 'depends' on it, without a doubt that is true, how ever, that is NOT a physical dependence. When u stop using meth and feel all the opposite effects u felt while high on meth, it is definately a physical reaction, but its a rebound effect-your body bouncin back to the other extreme after being in a over stimulated state for so long. Having a tolerance to meth and feeling exhausted and not able to get out of bed, etc, without it, is a physical effect, but that dont mean that meth causes physical dependence. It looks like u saw me sayin that there aint no physical dependence, and thought i was sayin there is no physical effects of stopping. Of course u feel somethin in ur body when u stop, of course after bein up for so long, u gonna feel down when u stop. That feeling aint a withdrawal caused by a physical dependence thought. that is all I was tryin to explain to u.

 

Lacey: I wasn't lashing out, offended or arguing with you. I was just challenging some of the things you were saying that didn't sound right (e.g. you said "there are no actual withdrawals" when in fact there are). My whole point is this... why should people who get physically addicted to drugs receive maintenance treatment, but those who get psychologically addicted don't? Here's what Wikipedia says about Heroin withdrawal:

Although withdrawal may be very unpleasant, opioid withdrawal is seldom fatal, whereas complications related to withdrawal from benzodiazepines, barbiturates and alcohol (such as psychosis, suicidal depression, epileptic seizures, cardiac arrest, and delirium tremens) can prove hazardous and are potentially life-threatening.

Unpleasant, but seldom fatal. Just like psychological withdrawals (I knew a guy who blew his head off with a shotgun cos he couldn't handle his withdrawals from meth). I know methadone and suboxone stop you getting dopesick and all, but are physical withdrawals really that much worse than psychological ones? Meth addicts are forced to suffer through depression, anhedonia, suicidal thoughts, irritability, anxiety, panic attacks, and more. Why can't we get a maintanance program to help with them? Studies have shown that chronic meth use actually changes the physical and neurological structure of the brain!

I'm not saying one is worse than the other. I'm just saying they are both horrible in their own ways. I've been curled up in bed for days while withdrawing from meth, crying my eyes out and wanting to die because of all the shit that I was going through. And you (or society) still don't think I should get medical help, cos I'm not "physically dependant" and I don't get dopesick. It's like a doctor refusing to treat a patient with depression, but instead treating a patient who has a high fever.

 

All i was sayin is that there is a difference between physical withdrawals CAUSED BY PHYSICAL DEPENDENCE than the feelings you experience after quitting meth. I absolutely didnt say there aint no physical effects from stoppin amp's. But I did say that they dont come from the body actually withdrawaling from a physical dependence. It aint becuz im just pickin on technicalities...its that they are 2 different things with different causes, and some undeucated folks think that there is physical withdrawal from all drugs that ppl can develop addictions to, which aint true. Coke and crack are 2 other examples of drugs that you dont develop a physical dependence on-your body gets used to the drug, you get a tolerance, you feel the opposite effects of the high when you stop--but it aint the same as the effects of a physical withdrawal. i hope that explains my point better.

Anyways, I really wasnt sayin that i dont believe that addicts of uppers dont deserve a replacement therapy and i went out of my way to repeat that several times in my post. But society dont understand addiction. To them, the physical withdrawals of opiates or benzos are just a shitty feeling that people should just kick theirself in the ass, deal with, and get thru it. A physical need is the most convincing arguement for replacement therapy to most uneducated people.

but if they cant barely understand that, then they aint gonna understand replacement for a psychological reason. When u stop meth theres a rebound syndrome, but as a big picture the majority of the meth addiction is psychological and psycho somatic. Which is just as tough to deal with as any other, they all bad in their own way. Becuz opiate addiction is equally physical and psychological, and the actual physical NEED is so tied in with the psychological shit, stupid people understand opiate addictions more. its easier for them to comprehend "the body needs it" than "the mind needs it and causes the body to also feel that it needs it." So, thats why i was sayin society wouldnt accept ur idea , at least not right now. maybe int he future ppl will be more aware but right now it aint gonna happen just becuz there is too many ppl who dont understand how addictions work for it to ever be seen as a logical treatment. We still a long way from havin people understand compassionate and empathetic addiction treatment. the fact that ppl can even get suboxone or methadone is still like a gift from the gods IMO, considerin how many people dont even understand how necessary they can be, even still in these times. so meth replacement is a long way off.

It aint how i feel...its just how most drug ignorant people do. I really dont have a opinion on it honestly, but i can definately say i dont agree with the idea that meth addiction is less than another addiction. Shit, you got the "big 3" heroin, meth, and crack, the "king addictions", they are all tied in their own ways. no arguing that. And I aint even sayin that psych. withdrawal is less worse than physical. Just that replacement therapy is intended for physical withdrawals by the powers that are in control, so its simple to understand why it dont exist. Maybe aint right that shit is that way, but it is easy to see the reason for it if you think about it for a few seconds.

even becuz i say that tho, i hope it is still clear that I think that people who refuse to recognize psychological addiction as legit are on the wrong track. ignorance in all forms is the enemy of progress in the world of drugs and workin for them to be accepted.

Just for the record tho-all the things u listed , depression, total lack of motivation, suicide or suicidal thoughts, panic attacks, extreme, debilitating anxiety, and all that shit is all a part of opiate w/d's too. when you add that to the physical effects, the only word that even comes close to describing a fraction of it is devastating. Ive heard of lots of people, here and in the junkie world that i use to live in, that killed themselvs when withdrawl got too intense for them. when you get a good habit goin, once you are doin 30, 40, 50 bags a day (That would equal out to about 3, 4, or 5 grams a day habit if u aint familiar with the "bag" measure) the w/ds aint nothing to joke at. Ive experienced some completely crushing meth comedowns after binging out for days and while I aint been addicted to it I do know enough from havin that taste that it definately is soul-draining, dont get me wrong.

If you imagine all the horrible mental effects, the honest-to-god wishing you would just die, and the way that the withdrawal makes u so mentally fucked up that you truly believe that you cant possibly make it thru this shit, the extreme irritation that makes you feel like violently brutally torturing and murdering every person that looks at you, the panic attacks that strike u without notice, the obsessive, looping thoughts that u get caught in and cant excape and makes u feel like u goin insane, all that shit is somethin that dope and meth users definately got in common when they quit. Imagine that while you feel all that you are havin diarrhea and vomiting repeatedly, 6, 7, 8 times in a row at the same time as your intenstines are havin a seizure on you...sittin on the toilet with a bucket to catch the throw up, for hours at a time....your legs and arms crawling all over with restless leg syndrome but its in your whole body, like little electric shocks is zapping your muscles and you just keep twitching and feel like the inside of your muscles is "tickling" and you have you keep punching yourself in the arms and legs to try and make the crawling feeling go away....The seizures that some users have when they quit (Thank god i wasnt one of them, but i have known 2 close friends who did) every bone and muscle and fiber in your body aching like you just took the worst beating of your life times a hundred, sweating buckets all day and night while u get chills of ice cold freezing death all over and cant warm up to save your life and as soon as you finally get all wrapped up in blankets you are burnin up like a 107 degree fever and stripping down naked covered with sweat only to freeze again back and forth all day and night....And you cant take a shower, becuz even tho you cant stand your own stink, the feeling of water on your skin feels like somebody took a belt sander to your body so there aint no way you can tolerate the water on your skin.

...And thats just a little sample of the delights of withdrawals.....When you add that onto the psychological shit, its just straight up hell, aint no other word for it....The effects from stopping meth is more like the body catching up to all the shit it didnt get to do while u used constantly, so u catch all the tiredness and fatigue and all that bizness, while it is 100% real and shitty its a different kind of response than the withdrawal caused by a physical dependence. Thats all i was sayin when I brought that up, not that there aint no symptoms or effects...just that there is no withdrawals in the official definition of a withdrawal.

 

^ I get your point. It sucks the way society still views methadone treatment, and I think it sucks even more that an amphetamine maintenance program will be unlikely to happen in the foreseeable future (although I know a few Bluelighter's who have been prescribed dexies for meth PAWS - unfortunately my doc won't prescribe them to me!).

And yeah, I've had physical withdrawals (I'm a benzo addict of 6-7 years, like I probably said earlier) so I know what they're like. I've lied awake in bed for nights, sweating, feeling restless, having muscle cramps, tremors, fatigue, nausea, and all of that shit. At my worst, I had seizures that nearly killed me... I was convulsing for too long, stopped breathing, and turned blue. The paramedics arrived just in time to shove an anti-convulsant up my ass!

Not trying to compare war stories... I'm just saying I get what you're saying. I'm past the acute withdrawals from meth (I know they're mainly psychological like you said, but that doesn't make it any easier!), and I'm now in the post acute withdrawal stage (PAWS) which could last for a while. That's what worries me... meth is a relatively new drug, and there haven't been many studies on the long term effects of heavy use. I also have no idea how long the PAWS will last for me. It could be several months, or it could be a year or more! Until then I'm feeling like I can't enjoy life or be naturally happy.

 

Actually Sweet P.. I agree with Lacey K here, she's right.

There are no major 'withdrawals' from methamphetamine; the neurochemical action of amphetamines do not necessitate a withdrawal-type of effect when stopping their use. You can 'fix' a methamphetamine 'withdrawal' by using copious amounts of opiates or other indirect-acting dopamine agonists (basically, other euphoric drugs.) You can't 'fix' a withdrawal from opiates except by taking more opiates; thereby, opiates become a class of drugs that is directly dependence causing, while amphetamines are not.

And the reason there isn't any type of maintenance for amphetamine and stimulant users is that stimulant users usually don't tend to be as prevalent as opioid users/addicts. The fact of the matter is, opioid addiction is a lot more common and a lot more pervasive. Stimulant use can wax and wane with the users emotional and psychological situation, while opioid use is pervasive throughout both the 'good' and 'bad' of a person's situations.

Opioid addiction is much worse than stimulant addiction in all regards, and since you've never experienced major problems with opioids Sweet P, I don't think you realize how much harder addiction to opioids is than addiction to stimulants.

I used opioids to basically get over the 'withdrawals' of methamphetamine because I was sick and tired of the comedowns from stimulants. Now I'm on MMT to treat my opioid dependence... and opioid dependence has been much worse for me and my life than stimulant addiction has.

Also, with 'stimulant maintenance' using dextro-amphetamine, a person still can use meth-amph on top of their dextro-amphetamine and get 'high.' With opioid-based replacement therapy, it's a lot harder for the maintenance patient to get 'high.' There is no 'blocking' effect with dextro-amphetamine, or any other stimulant for that matter (as methadone and bupe both have 'blocking' effects for other opioids.)

Although, with rigorous drug testing (such as GC/MS testing of urine for drug isomers to make sure you are not using other forms of racemic speed either), dex-amphetamine COULD be helpful for your condition; but most doctors won't take that risk of abuse/diversion especially with a patient who's an active amphetamine addict. Their licenses are on the line if they 'help' you with stimulant pharmacotherapy, this you have to understand.

To be honest, if not strictly regulated (i.e. going in for 2x or 3x daily controlled dosing at a pharmacy), you WILL most likely abuse your dex-amphetamine script and it WILL most likely become a problem... and I don't think there would be any pharmacies willing to hand out pills to you 3x a day and will most likely give you weekly scripts at best...

Your best bet would be to just switch to using opioids to get over the methamphetamine 'withdrawals' like I did and then get on MMT... hahaha just kidding. But using opioids would be much less harsh on your system,