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METH | Meth users nearly twice as likely to have two or more chronic medical conditions

mr peabody

Moderator: Music Discussion, PM
Staff member
Aug 31, 2016
Frostbite Falls, MN

Cheap and powerful 'meth 2.0' is ravaging communities and slowly killing its victims*

by Christine Vestal | Pew/Stateline | 2 Nov 2019

The opioid epidemic appears to be subsiding in the northwest corner of South Carolina, a region known as Upstate. Some refer to this area as the Upcountry. Nationwide, the number of opioid-related overdose deaths is declining slightly. But a new variety of methamphetamine is taking its place as the No. 1 drug of abuse.

By most accounts, meth is much harder to quit. And the latest version of the illicit drug flooding the nation is cheaper than ever before.

Primarily imported from Mexico, “meth 2.0” is stronger, cheaper and far more plentiful than the old home-cooked variety. And with historic levels of funding from the federal government focused exclusively on fighting opioid addiction, states and counties are scrambling to find resources to combat this most recent drug plague.

In the small city of Greenville, Faces and Voices of Recovery staff work around the clock to provide a place people struggling with meth addiction can come to talk. CEO Rich Jones spends many evenings and weekends fundraising because little federal or state money exists to provide the kind of long-term support people in recovery from meth addiction need, he said.

Across town, Rebecca Maddox runs Phoenix Center’s Serenity Village, a women’s residential addiction treatment facility. The center receives substantial funding from Medicaid because patients are either pregnant or have custody of their children and therefore qualify for the federal-state health plan for low-income people.

She said federal funding for the center has remained flat for more than a decade, except for recent money targeted for treating opioid addiction. But data showed that opioid use was declining in Greenville, so “we didn’t get any of that money this year,” she said.

Sixty-three percent of the 81 women admitted to Serenity Village last year were treated for meth addiction. They include Haas, who is staying at the center with her three children.

When her heroin addiction caused her to lose everything, including her children, Haas said she decided to quit. Feeling sick and depressed as she came off the powerful drug, “some friends gave me meth and told me it would make me feel better,” she recalled. “It made my sickness go away, or maybe I just didn’t care about it anymore.”

For a time, Haas got her kids back. But within weeks, meth began to take an even bigger toll on Haas’ life. She lost custody of her oldest kids again, yet she said she still found it impossible to quit. After losing custody of her youngest, who just turned 1, she said she "knew it was time to quit."

She checked into Serenity Village, and for the first few weeks she "struggled every minute of the day. But now, after nearly three months, 'the pull' is starting to fade."

“When I get that pull,” she said, “I know I need to find someone who will tell me to play that tape again about what’s going to happen to me and my kids if I pick up,” she said, meaning if she started to use again. “I just need to find somebody to talk to.”

Harder to stop

Pickens County, about 20 miles west of Greenville, has been hit hard by the meth surge.

Tucked into the foothills of the Blue Ridge Mountains and home to Clemson University, Pickens County is a destination for wealthy retirees who build multimillion-dollar homes on the shores of Lake Keowee and other scenic spots.

But jobs have been scarce and wages low ever since the cotton mills closed in the 1990s, creating stress and anxiety for many residents. That and its proximity to drug trafficking routes – it is less than 20 miles off Interstate 85, the main artery to Atlanta – have contributed to soaring meth use.

Between 2016 and 2017, the number of people seeking treatment for meth addiction nearly doubled in Pickens and the other nine counties in the Upstate region, according to data from the state drug and alcohol agency.

In the midlands and coastal regions of the state, including Charleston, opioid addiction and overdose deaths remain the biggest threat, according to state data.

At Cafe Connections, a “coffeehouse ministry” in the town of Pickens, much of the talk is about families whose lives have been shattered by meth. The drug offers boundless energy to work extra shifts or clean the house – until it turns ugly.

“I can see on a personal basis what meth and other drugs are doing to our community. Homelessness wasn’t a problem in Pickens a few years ago. Now, it’s a big problem,” said Ann Corbin, who runs the cafe with her husband, Steve, and with support from the East Pickens Baptist Church and volunteers. Coffee, sweets and conversation are free at the cafe, a big airy former drugstore with cafe tables and cushy upholstered couches and chairs clustered along brightly painted walls.

"Everyone here knows someone who uses meth or has lost a family member to its ravages," Corbin said. "People have set aside long-held prejudices against drug users to focus on helping families who have been destroyed by meth."

The leap in deaths has been dramatic. The Pickens County coroner, Kandy Kelley, said 25 people died of a drug overdose in the county last year, topped by 39 as of September this year, mostly from a combination of meth, opioids and other substances.

At Behavioral Health Services of Pickens County, a state-funded drug treatment center a few doors down from the cafe, more people are seeking treatment for meth addiction than ever before, Executive Director Angela Farmer said. And those in treatment are having a much tougher time quitting.

Farmer, a licensed counselor and Pickens native, has seen a lot of changes in the habits of Pickens drug users over the 22 years she’s worked here.

"More meth users are injecting the drug than smoking or snorting it as they did in the past," Farmer said, "and people are starting to use it at a younger age."

“Our patients are struggling a lot more and they relapse more, and it takes them longer to engage in treatment,”
Farmer said. “Most of our patients are compliant with their treatment for opioids, but they find it harder to stop using meth.”

With roughly 2,400 clients in a county of 120,000, Behavioral Health Services, which occupies nearly a full block of offices on Main Street, is bursting at its seams.

The county’s 50-year-old jail also is overflowing. In November, a new facility will open, providing more than triple the current jail’s capacity. And its staff will include an addiction treatment practitioner and a mental health counselor, thanks to a grant from the U.S. Justice Department.

“We haven’t been able to respond to as many of the drug-related crimes as we would like in the last couple of years, because we haven’t had anywhere to put them,” Pickens County Sheriff Rick Clark said. “It’s always a balancing act.”

Clark and other law enforcement officials say most of the meth supply in the region comes from Atlanta, where illicit labs convert liquid methamphetamine from Mexico into crystal powder for dealers to distribute across the South.

Not the ‘pretty people’

Nationwide, the advancing meth scourge has yet to capture the kind of public response the opioid epidemic was, even though the nationwide spike in meth-related deaths in the past two years was steeper than the spike in opioid deaths two decades ago when that crisis began.

In the first decade of the opioid epidemic, the number of overdose deaths rose fourfold, from 3,400 in 1999 to 13,500 in 2009, based on a Stateline analysis of data from the U.S. Centers for Disease Control and Prevention. With the advent of cheap and powerful imported meth, the spike in deaths has been much sharper. Meth overdose deaths increased fourfold in half as much time, from 2,600 in 2012 to 10,300 in 2017.

Still, meth users are less likely to die of an overdose than users of painkillers and heroin. Instead, meth kills most of its victims slowly.

Opioids cause relatively little physical damage to chronic users, unless they take too high a dose. But meth takes a severe mental and physical toll on chronic users, destroying their appearance and substantially shortening their lives.

“If you want to know whether a town has a meth problem, just go to Walmart and take a look around,” Pickens Chief Deputy Chad Brooks said. "Its symptoms are unmistakable: rotting teeth, skin lesions, extreme weight loss and premature aging."

The CDC only records meth-related overdose deaths – typically heart failure or stroke – resulting from using too much of the drug in a short period. It doesn’t include deaths from long-term use.

"Despite the nation’s growing recognition because of the opioid crisis that addiction is a disease," Sheriff Clark said, "society still tends to look down on meth users."

“I hate to say this,”
Clark said, “but the reason we’re not hearing as much about the meth problem at the national level is that we don’t have as many pretty people dying of meth as we do with opioids.”

‘Rapid downhill course’

On average, patients addicted to meth require at least 90 days of intensive counseling and therapy to get started on recovery. And even then, nearly all of them can be expected to relapse multiple times before reaching sustained recovery, treatment experts say.

“Crystal meth accelerates the reward circuits in the brain more powerfully than any other drug we have,” said Dr. Paul Earley, an addiction physician in Georgia and the board president of the American Society of Addiction Medicine.

“There’s no doubt that it causes the most rapid downhill course of any drug."

“With heroin, some people can go on using the drug for 30 or 40 years without medical problems, as long as they dose it right,”
the doctor said. “But with meth, 100% of people who use the drug experience severe and rapid physical deterioration.”

The Federal Drug Administration has approved three medications for the treatment of opioid addiction. Research is underway on meth addiction medications. Behavioral Health Services is one of seven sites funded by the National Institute on Drug Abuse in a study of the effectiveness of two drugs – extended-release bupropion sold as Wellbutrin and extended-release naltrexone sold as injectable Vivitrol – in easing detoxification and promoting recovery from meth addiction.

Farmer said Wellbutrin, a mild stimulant, seemed to alleviate the depression and exhaustion that typically occurs when people are coming off meth. She didn’t see as much evidence for Vivitrol warding off cravings.

But so far, no medications have been clinically proven to be effective in the treatment of meth addiction.

“If someone is addicted to opioids, they can get medication-assisted treatment pretty quickly,” said Charlie Stinson, executive director of GateWay Counseling Center, a state-funded treatment center in Clinton, another hard-hit Upstate town.

“The problem is if they kick that addiction and start using meth, they can be out of luck when they decide it’s time for treatment.”

*From the article here :
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mr peabody

Moderator: Music Discussion, PM
Staff member
Aug 31, 2016
Frostbite Falls, MN
Meth and cardiovascular pathology

Sharlene Kaye, Johan Duflou, Rebecca Mcketin, Shane Darke

There is sufficient clinical evidence to suggest that meth can have adverse and potentially fatal effects on the cardiovascular system. The existing literature suggests that: (1) meth users are at elevated risk of cardiac pathology; (2) risk is not likely to be limited to the duration of use, because of the chronic pathology associated with meth use; (3) the risk of cardiac pathology is greatest among chronic meth users; (4) pre‐existing cardiac pathology, due to meth use or other factors, increases the risk of an acute cardiac event; and (5) meth use is likely to exacerbate the risk of cardiac pathology from other causes, and may therefore lead to premature mortality.



Iboga accumulates in the body. It remains in the body for more than 4 weeks. This means that all the drops you take in a 5-week period will accumulate and remain in your body until they slowly wear off. If the dose you take exceeds 10 drops a day, physical and psychological effects can occur. Be aware of that some people respond very sensitively to a few drops only. It is important to listen to the signs of your body at all times, and adjust your dosage accordingly. Do not take the iboga tincture before going to sleep. The plant gives you energy and might cause insomnia.

Whilst treating yourself with iboga, it is advisable to keep stimulants—such as coffee—to a minimum, as well as tobacco or certain herbs. Your receptors will become very sensitive and you may have an unexpectedly strong reaction to them. It is strongly discouraged to combine iboga with other psychedelics. Iboga should never be combined with anti-depressant medication such as SSRI's. Such a combination would be very dangerous.

Doctors and treatment providers have found that daily low doses of iboga seem to work better for meth addiction than the mind-blowing "flood doses" used on opiate addicts.

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mr peabody

Moderator: Music Discussion, PM
Staff member
Aug 31, 2016
Frostbite Falls, MN

"I’ve seen things you people wouldn’t believe. Attack ships on fire off the shoulder of Orion.
I watched C-beams glitter in the dark near the Tannhäuser Gate. All those moments... will
be lost in time, like… tears in rain...

Meth is the most common drug in overdose deaths in 19 states*

by Mike Stobbe | Associated Press | Oct 24 2019

Fentanyl is driving drug overdose deaths in the U.S. overall, but in nearly half of the country, it's a different story. Meth is the bigger killer, a new government report shows.

Nationwide, most deaths still involve opioid drugs like fentanyl and heroin. But in 2017, the stimulant meth was the drug most frequently involved in deaths in four regions that include 19 states west of the Mississippi.

The report released Friday by the Centers for Disease Control and Prevention is the agency's first geographic breakdown of deaths by drug. It's based on 2017 figures when there were more than 70,000 overdose deaths in the U.S., two-thirds of them involving opioids.

Fentanyl was involved in 39% of the deaths that year, followed by heroin, 23%, and cocaine, 21%. Those drugs top the list in the eastern part of the country.

Methamphetamine was No. 4 nationwide, cited in 13% of overdose deaths. But in the four western regions, it was No. 1, at 21% to 38%.

Previous CDC reports have charted meth's increasing toll, noting that it rose from eighth to fourth in just four years.

The new report found dramatic differences in the 10 regions. For example, In New England, fentanyl had the highest adjusted overdose death rate and meth was a distant 10th on the list. In the region that includes the mountain states and the Dakotas, meth was No. 1 and fentanyl was sixth.

Most of the meth in the U.S. is made in Mexico and smuggled across the border — U.S. production has actually been declining in recent years, according to the U.S. Drug Enforcement Agency. Its availability has held at high levels in recent years in areas of the Southwest, and has increased in some areas of the Midwest, the agency's field offices report.

Final 2018 data has not yet been released, but preliminary figures suggest that overdose deaths involving meth increased.

The CDC report is based on a search of overdose death certificates for the name of drugs. In many cases, a person was taking multiple drugs.

Since the report is the first of its kind, how meth factored into overdose deaths regionally in the past isn't known.

"New Mexico has seen a shift. For years, black tar heroin was the biggest problem, then prescription painkillers," said Dr. Michael Landen of the state's health department. State meth deaths went from 150 in 2017 to 194 last year, vaulting meth to the top.

"It's really been the first time we've seen that," said Landen.

He attributed the surge in meth to its wide availability and low cost, and said he worried it could get worse. "While there are programs to deal with fentanyl and heroin overdoses, there's not much in place to prevent meth deaths," he said.

"I think we're going to be caught off guard with methamphetamine deaths, and we have to get our act together," he said.

*From the article here :
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mr peabody

Moderator: Music Discussion, PM
Staff member
Aug 31, 2016
Frostbite Falls, MN

"Then I saw something on the other side of all that, something bright and luminous. I knew I had to get there, but I was stuck in all this shit
and noise, and the terrible things I've done to people, and the even worse things people have done to me. And every time I'd try to get out,
I'd get sucked right back in, and I'd feel that rage rising up again, and I would do anything to make it stop! It's like, do I have to die?!
And then this very clear voice said: "Don't die. Forgive."

Meth, not fentanyl, driving overdose deaths in the western US

by Erin Schumaker | ABC | Oct 25 2019

Although fentanyl use remain a pressing concern in the United States, a government report that details regional differences in drug overdose deaths shows that in much of the country, methamphetamine is a bigger killer.

In the majority of states west of the Mississippi River, methamphetamine was the most common drug implicated in drug overdose deaths, according to the report, which utilized data from 2017, the latest available, and which was released Friday by the Centers for Disease Control and Prevention.

In states east of the Mississippi River that trend was reversed, with fentanyl the most common drug implicated in overdose deaths in 2017.

"What's interesting is that the patterns are different across the U.S.," said Dr. Holly Hedegaard, an epidemiologist at the CDC's National Center for Health Statistics and co-author of the report.

Hedegaard noted that since the report is a one-year snapshot of overdose deaths, it doesn't provide insight into whether fentanyl deaths are rising or falling in the western U.S.

"We have to recognize that the drug problem isn't the same across the entire U.S.," Hedegaard added.

While the report didn't examine potential underpinnings of those drug overdoses patterns, Dr. Zachary Dezman, an assistant professor of emergency medicine at University of Maryland School of Medicine, who was not associated with the report, pointed to regional variation in substance use throughout history.

"Like all culture, it varies from region to region and is a a result of history, demand, law enforcement," Dezman said.

In Baltimore, where Dezman is an emergency physician, heroin has been the most commonly misused substance among residents for decades, he explained, adding that since meth use in the U.S. started in California, that could explain the drug's stronger regional foothold.

"Meth can be made cheaply using materials found on most farms," Dezman said. "A large amount of toxic waste is produced in the process, so meth is more often produced in rural or isolated areas where it is easier to hide from the authorities."

For people who use methamphetamines, treatment and resources are slim. Opioid addiction can be treated with the medications buprenophine or methadone, and opioid overdoses can be reversed with the drug naloxone. "There's no FDA-approved medication for methamphetamine treatment, nor any overdose reversal drug to revive people," Dezman explained. "Developing such a treatment is a top research priority for the National Institute on Drug Abuse," he added.

Despite the regional implications of the report, fentanyl is still driving the nation's opioid crisis. The potent opioid, the most frequently cited substance in drug overdose deaths, was involved in 39% of those cases in 2017.

"Clearly, fentanyl continues to be a problem," Hedegaard said.

In comparison, nationwide, heroin was involved in 23% of overdose deaths, cocaine was involved in 21% and methamphetamines were involved in 13%.

The nation's drug overdose death rate has more than tripled since 1999, with 70,000 cases in 2017, according to the CDC.

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mr peabody

Moderator: Music Discussion, PM
Staff member
Aug 31, 2016
Frostbite Falls, MN

Meth involved in one-third of all drug-related deaths in the western US*

Filter | Nov 7 2019

In July 2019, the Center for Disease Control and Prevention (CDC) released preliminary data suggesting that national overdose deaths slightly declined in 2018 for the first time in 20 years. But on a state-by-state level, that’s not the case. While the parts of the United States with the highest rates of opioid-involved deaths, like Appalachia, are seeing overall drops in fatalities, the western part of the country is seeing an escalating crisis.

Researchers have suspected that methamphetamine has been involved in growing numbers of deaths in these regions, but because of the drug’s inclusion in broad data categories, like “psychostimulants with the potential for abuse,” they’ve had difficulty proving it.

A new report by the CDC was able to get around this issue. The researchers behind a study published on October 25, 2019 circumvented the usual roadblocks to identifying the exact drug, or drugs, determined to be involved in deaths by using a “literal text search” of death certificates for the specific mention of certain drugs.

Their research indicates that meth, specifically, was involved in around one-third of all drug-related deaths in western states in 2017. Using regions defined by the Department of Health and Human Services Regions to locate deaths, the researchers found that Region 9, a group of states including California, Nevada, Arizona, and Hawaii, saw 2,741 meth-involved deaths, involved in 37 percent of all drug fatalities across the four states.

In contrast, heroin was involved in 16 percent of drug-involved deaths in the area. The deaths across these states occurred occurred at a rate of a 5.2 per 100,000 people, with a higher meth-involved death rate than in any other HHS region—though the fentanyl-involved death rate was still far higher.

The findings are important but not necessarily groundbreaking. The report notes that the stark contrast between the western United States and the Northeast, for example, has been shown elsewhere. In 2017, methamphetamine was far more likely to be involved in seizures among folks in the West census region (46 percent) versus the Northeast census region (2 percent).

Media outlets are now beginning to ring the alarm bells about the role of meth use in driving fatalities. But public officials’ albeit-understandable preoccupation with opioid-involved deaths has long veiled this issue.

The CDC data, once more, underscores how myopically focusing on the harms of one drug can allow the harms associated with another to swell.

*From the article here :
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mr peabody

Moderator: Music Discussion, PM
Staff member
Aug 31, 2016
Frostbite Falls, MN

Stevon Williams (right), a homeless veteran, describes the effects of the “goofball,” a potent
combo of meth and fentanyl.

Bay area death toll from drug overdoses passes 10,000*

by Erin Allday and Kevin Fagan | SF Chronicle | Nov 30 2019

More than 10,000 people have died across the Bay Area in the drug overdose epidemic, but the main killer hasn’t been prescription painkillers for several years — methamphetamine is now the biggest cause of deaths, and overdoses on the super-potent opioid fentanyl are spiking.

Nationally, millions of people have died in the opioid overdose crisis, using prescription painkillers and similar street drugs like heroin and fentanyl.

The Bay Area was never as hard hit as other parts of the country by prescription opioid overdoses. But it has endured an epidemic of deaths from a variety of other street drugs that is continuing to evolve and concern public health officials.

A Chronicle analysis of data from the California Department of Public Health found that 10,005 people have died in the nine Bay Area counties since the state began tracking overdose deaths in 2006, though that number is almost certainly an undercount of actual drug deaths.

The data also show that methamphetamine is now the leading cause of overdose deaths in the state. That statistic is reflected in the Bay Area, where meth overdose rates have tripled over the past decade while deaths from prescription opioids have dropped.

The methamphetamine crisis is a new-old problem, public health officials said. Meth was widespread in the 1990s and it never really went away, but the number of people now dying from it — and from dangerous combinations of methamphetamine and potent opioids like fentanyl — is new, and alarming.

“It’s the new speedball,” said 58-year-old Stevon Williams, a homeless Air Force veteran in San Francisco, describing the “goofball,” which is replacing the old combination of cocaine and heroin. “That combo of meth and fentanyl does the same thing. A lot of people like that.”

Though the public health data demonstrates shifting drug-use trends across the state, it is less precise at capturing overdose deaths caused by multiple drugs. Indeed, the state data as a whole is more subjective than most public health experts would like. It’s dependent upon how coroners and others label the cause of death, and some deaths are investigated much more thoroughly than others.

“It’s important when we’re thinking about overdose deaths that what we’re looking at isn’t necessarily the truth with a capital T,” said Dr. Matt Willis, public health officer for Marin County. “There’s a lot of bias built into the reporting.”

But the data backs up what health care providers, addiction experts and users themselves are experiencing firsthand: Drug overdoses, even in communities spared from the worst of the opioid epidemic, are a public health crisis.

Variations among counties: The data was obtained from the California Opioid Overdose Surveillance Dashboard, and the Chronicle analysis is a unique examination of the drug overdose epidemic in the Bay Area as a region.

The Bay Area consistently has had somewhat lower rates of prescription opioid overdose deaths than the rest of the state, especially compared with some rural counties in Northern California where rates were 10 or 20 times higher. But for all drug overdoses, the Bay Area as a whole comes in close to the state average, about 10 to 12 deaths per 100,000 people per year.

And that rate has been climbing — by about 21% since 2010.

Some local counties are notably higher than others. San Francisco has the highest rates of drug overdose deaths — about 23 per 100,000 in 2018. The North Bay counties of Sonoma and Solano also have higher death rates than the Bay Area average, about 15 per 100,000.

Santa Clara and San Mateo have the lowest rates, around eight deaths per 100,000 last year.

“There are marked differences in relatively small geographic areas. I couldn’t tell you why,” said Dr. Scott Morrow, public health officer for San Mateo County.

Drug overdose deaths have been up and down over the past decade in the Bay Area, but they reached a decade high 13 deaths per 100,000 residents in 2018, according to preliminary state data.

The overall death toll doesn’t tell the whole story, though.

Prescription overdose death rates have fallen slightly in the Bay Area, but deaths from heroin have been steadily increasing. And deaths from fentanyl — a synthetic opioid about 50 times more potent than heroin — have exploded in the past four years.

Opioids as a whole are still bigger killers than methamphetamine alone. But meth stands apart as the single largest killer. And that has public health officials concerned — and confused.

“Meth is not usually a very deadly drug,” said Dr. Daniel Ciccarone, a national drug use and policy expert at UCSF.

Opioids, and especially fentanyl, are so deadly because they can quickly shut down the respiratory system. Methamphetamine kills by essentially overstimulating the heart or the brain, leading to a heart attack or stroke. But in the past, only people who already had cardiovascular issues were at risk of overdoing it with meth — now, younger, otherwise healthy people are dying too.

"With meth overdose death rates climbing, it begs multiple questions," Ciccarone said. "Are more people using meth? Is the drug itself different and more potent? Does combining meth with fentanyl make it deadlier?"

Ciccarone said investigations of the drug supply have found that the meth sold in the United States is indeed stronger than what people were using a 10 or 20 years ago, when meth was primarily made in backyard labs. It’s now manufactured by global drug cartels.

“We have a drug coming in that’s at 90% purity and much higher potency. But we need more studies to say if the meth is more deadly,” Ciccarone said.

Deadly combinations

Combining drugs, especially meth with an opioid like fentanyl, is especially concerning to public health officials. It’s difficult to track those deaths, and dual addictions are more complicated to treat.

Purposely taking methamphetamine with fentanyl, one hit after the other, is like juggling dynamite - but hard-core addicts say they need it. The high of the methamphetamine sometimes needs counteracting with the chill-out effect of the fentanyl, they say. Or alternately, the deeply sedated state caused by fentanyl has to be offset by the rush of meth.

“Speed a lot of times gets you geeked out, with your heart racing and your head pounding, and then fentanyl evens you out,” said Shauna Arteago, 45, who has been homeless but currently lives in a San Francisco single-room apartment. “I smoke them one at a time, and you’ve got to be careful because fentanyl can kill you. I’ve overdosed three times, the last time a few months ago.”

Those who work daily with addicts in the street don’t need statistics to tell them the overdose problem is growing — particularly among the homeless.

Capt. Carl Fabbri, commander of the Tenderloin Police Station, said he often feels like he’s shoveling sand into tides when he and his officers try to intervene with addicts on the street, and it’s heartbreaking.

“We’ve made progress on the dealers, but the victims - the users? It’s almost out of our hands, there are so many,” he said. “It is terribly sad.”

A 39-year-old homeless longtime addict who goes by the street name of Country fired up a bubble — pipe load — of meth near the Ferry Building and said overdoses and addictions in the street “have gotten off the hook in the last year or so.”

“It’s so much more than ever, and I’ve seen it all,” he said.

“I makes me sad seeing so many people do so much drugs out here, but we’re stuck. We need help. You think we all want to be addicted to this crap? No way.”

San Francisco public health officials, who have been collecting data on overdose deaths involving more than one drug, say their analyses show that overdose rates with both meth and fentanyl have more than doubled in just the past two years.

A decade ago, meth was only causing a dozen or so deaths a year and fentanyl wasn’t even tracked. In 2018, roughly 50 people died with both drugs in their system — dozens more died from one or the other.

“The reality is that most drug use is poly drug use. It’s not unusual for people to be using more than one drug,” said Dr. Phillip Coffin, director of substance use research for the San Francisco Department of Public Health.

"Combining meth and fentanyl may be especially risky for a lot of reasons, among them that meth, in particular, leads to 'chaotic behavior' that may prevent people from practicing safer drug practices," he said.

For example, harm-reduction experts advise than anyone using fentanyl start with a small dose, and that they never get high alone, so that if they overdose someone can treat them with Narcan. But if they’re using meth too, people may not be thinking clearly enough to take those precautions.

The “goofball” is not just a San Francisco problem. What’s not clear from data and anecdotal information is how often people are choosing to combine meth with an opioid verus being “poisoned” by fentanyl that is sometimes added to other drugs without users knowing it, public health officials say.

Fentanyl isn’t necessarily pervasive in all Bay Area counties just yet — or at least, it’s not being identified as a cause of death. But not all counties have the laboratory resources to test for the specific opioid found in a person after death. When fentanyl is identified in an overdose, it’s often impossible to know whether the person chose to use it or took it by accident.

“The combination of opioids and stimulants is common,” said Dr. Ori Tzvieli, deputy health officer with Contra Costa County. “But did they die because they were a meth addict and they ended up buying some with fentanyl in it? Or did they die because they’re someone with an opioid overuse disorder who’s using fentanyl now?”

*From the article here :
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mr peabody

Moderator: Music Discussion, PM
Staff member
Aug 31, 2016
Frostbite Falls, MN

Deaths involving meth are rising fast*

by Abby Goodnough | New York Times | Dec 17 2019

The teenager had pink cheeks from the cold and a matter-of-fact tone as she explained why she had started using methamphetamine after becoming homeless last year.

“Having nowhere to sleep, nothing to eat — that’s where meth comes into play,” said the girl, 17, who asked to be identified by her nickname, Rose. “Those things aren’t a problem if you’re using.”

She stopped two months ago, she said, after smoking so much meth over a 24-hour period that she hallucinated and nearly jumped off a bridge. Deaths associated with meth use are climbing here in Oklahoma and in many other states, an alarming trend for a nation battered by the opioid epidemic, and one that public health officials are struggling to fully explain.

The meth problem has sneaked up on state and national leaders. In Oklahoma, meth and related drugs, including prescription stimulants, now play a role in more deaths than all opioids combined, including painkillers, heroin and fentanyl, according to the Centers for Disease Control and Prevention.

The spending package that lawmakers agreed on this week includes legislation from Senators Jeanne Shaheen, Democrat of New Hampshire, and Rob Portman, Republican of Ohio, that would allow states to address the resurgence of meth and cocaine by using some of the billions of dollars that Congress had appropriated to combat opioid addiction.

Meth use first ballooned in the United States from the 1990s into the early 2000s, when it was often made in small home labs with pseudoephedrine, the main ingredient in many drugstore cold medicines. But today’s meth, largely imported from Mexico, is far more potent.

“It’s way different from the meth people were using 20 years ago,” said Dr. Jason Beaman, the chairman of psychiatry and behavioral sciences at the Center for Health Sciences at Oklahoma State University. “It’s like they were drinking Mountain Dew and now they are injecting Red Bull.”

Nationally, since late last year, meth has turned up in more deaths than opioid painkillers like oxycodone and hydrocodone. In 14 of the 35 states that report overdose deaths to the federal government on a monthly basis, meth is also involved in more deaths than fentanyl, by far the most potent opioid.

Provisional data from the C.D.C. shows there were about 13,000 deaths involving meth nationwide in 2018, more than twice as many as in 2015. That is still far fewer than opioid deaths over all, which passed 47,000, but the pace is accelerating while opioid fatalities have flattened.

The most recent federal data, for example, estimates that from May 2018 to May 2019 there were 25 percent more deaths involving meth and other drugs in its class than in the previous year, compared with 9 percent more deaths involving fentanyl and other synthetic opioids. Deaths involving meth have been concentrated in the western United States but are moving eastward, even to regions that meth barely touched in the past, like New England.

“This is the one thing that keeps me awake at night,” said Dr. Brett P. Giroir, assistant secretary for health at the Health and Human Services Department, at a conference on stimulant abuse on Monday. “Within a few short months, and you can model it any way you want, meth will be secondary only to fentanyl, in terms of overdose deaths.”

Unlike with opioids, there is no way to reverse the effects of a meth overdose, just as there is no medication approved to treat meth addiction and the cravings it creates. "For now, treatment for meth addiction consists largely of behavioral therapies," said Dr. Nora Volkow, the director of the National Institute on Drug Abuse.

For many here in Oklahoma, what treatments do exist are out of reach. Most poor adults in the state do not qualify for Medicaid coverage that would help those with meth addiction gain access to treatment, because the state has chosen not to expand the program under the Affordable Care Act. And while Oklahoma has won a windfall of money — $355 million — from lawsuits against opioid manufacturers, much of it is specifically for fighting opioid addiction.

“We know there is funding coming in for the opioid problem,” said Mimi Tarrasch, the chief officer of Women in Recovery, an alternative sentencing program in Tulsa. “But what I see, and what our community continues to see, is really a lot of addiction to methamphetamine.”

Meth is still not considered nearly as deadly as heroin or synthetic fentanyl, the latter of which has killed tens of thousands of Americans over the past five years, often within minutes, by depressing their breathing. Instead, meth stimulates the central nervous system, causing agitation, sleeplessness, psychosis and gradual damage to the heart, brain and other organs.

“Basically your blood pressure goes up so high that you can rupture your aorta or have a stroke,” said Dr. Andrew Herring, an emergency medicine and addiction specialist in Oakland, Calif.

In many cases, opioids are contributing to meth deaths, as people use both types of drugs together. Opioids were found to play a role in about half of the deaths involving meth in 2017, the most recent year for which detailed toxicology results are available.

Some experts think the number is probably larger. Dr. Daniel Ciccarone, a professor at the University of California, San Francisco, who studies patterns of drug use, said he suspected some coroners and medical examiners were not checking the blood of overdose victims for dozens of fentanyl analogues, which have chemical structures similar to fentanyl but require specialized toxicology testing.

"Meth-related deaths may also be rising simply because the number of users is rising," Dr. Ciccarone said, "including those with underlying heart or other problems."

“It’s embarrassing that we don’t have the answer at our fingertips, and we should,”
Dr. Ciccarone said at the stimulant abuse conference.

Research suggests that in some cases, fear of dying from fentanyl is compelling people to use meth instead. Others are using meth as an upper to rouse themselves after using opioids, which have a sedative effect, or to help with opioid withdrawal. Still others are turning to meth for a high even as they take anti-craving medications to recover from opioid addiction.

"Combining meth and fentanyl could be the most dangerous move of all, although researchers are still trying to figure out how the drugs work together." said Dr. Giroir.

“We definitely want to dissuade people from the notion that somehow a downer and an upper cancel each other out,” he said. “Early data suggests the combination is probably more deadly than the sum of its parts.”

Some deaths involving meth are due to the risky or violent behavior it can cause, not the drug itself. Rose and her 19-year-old boyfriend, stopping to talk to a reporter one morning on their way to a drop-in center where they hoped to shower, said they knew of a man who had hanged himself after a meth-fueled fight with his girlfriend.

Last year in Tulsa, a 25-year-old man with schizophrenia died after he shattered the glass door of a downtown bank while on meth and two police officers, who had been pursuing him, shot him with a Taser 27 times. His autopsy report said the likely cause of death was cardiac arrest “due to methamphetamine toxicity in the setting of physical exertion/restraint,” with cardiovascular disease as a contributing factor. The man’s relatives say excessive force by the police was to blame and are planning to sue, said Damario Solomon-Simmons, a lawyer for the family.

Many autopsies of Oklahoma residents whose deaths involved meth also found heart problems. In one typical case, a 48-year-old receptionist was found dead in a hotel room in May, her body withered to 77 pounds, her heart diseased. The cause of death was found to be acute methamphetamine toxicity.

Dr. Beaman, who sees patients at a psychiatric crisis center here in Tulsa, said psychosis and other mental conditions caused by meth use were taking up more and more resources. In June alone, he said, more than half of the admissions to the crisis center were related to meth.

“I can’t treat people with schizophrenia,” Dr. Beaman said, “because I’m spending all my time treating people who are using meth.”

Shayla Divelbiss, 29, of Glenpool, Okla., considers herself lucky to be in good health now after using meth for six years, during which she ignored a thyroid condition and went days at a time without sleep. After waiting two harrowing months for a bed at 12 & 12, a treatment center for the poor and uninsured, she was able to stop.

“All the responsibilities of being a human just went out the window,” she said of her time on meth. “I quit cooking and eating. I had real bad anxiety. I was skin and bones.”

Daniel Raymond, the director of policy at the national Harm Reduction Coalition, said it was imperative to figure out exactly how meth users were dying so that cities and states could build public health strategies based on that knowledge. For now, those strategies include warning users about the risks of “overamping,” a word used to describe using too much meth, and the best ways to address it, like cooling down, drinking water and sleeping. Syringe exchanges have an important role for those who inject meth, he said, just as they do for opioid users.

At 12 & 12, a former hotel on the outskirts of Tulsa, 64 percent of the clients are addicted to meth, said Bryan Day, the chief executive. State lawmakers have agreed to give the center more money next year to add beds for meth patients and increase their average stay, which is about 30 days. He estimated that 4,000 people in the state need treatment for meth addiction but are not receiving it.

“My belief is that their judgment for a period of time is very, very skewed, leading to frightening choices and decisions and impulses,” Mr. Day said. “The brain takes time to heal. We don’t want to shortchange this population.”

*From the article here:


Ibogaine is an indole alkaloid isolated from the root bark of the African tree Tabernanthe Iboga, known to cause Long QT Syndrome (LQTS) — a dangerous condition that can lead to cardiac arrhythmia and death. But the risk is manageable. Dr. Bruno Chaves of Brazil has performed over 1200 treatments with ibogaine in hospital without a single adverse event. 62% of those treated by Bruno remain abstinent long term. Dr. Chaves is currently accepting new patients for treatment in hospital in São Paulo. For more information, contact Dr. Chaves directly : [email protected]
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mr peabody

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Aug 31, 2016
Frostbite Falls, MN

Helping your child through difficult times

by Richard Capriola | The Fix | 2 Dec 2020

All too often when we look beyond a child’s drinking or drug use we discover their struggle to manage intolerable thoughts, feelings or memories is a core issue that needs treatment.

I have been a mental health and addictions counselor for over two decades. I’ve treated adults and adolescents diagnosed with serious psychiatric and substance abuse issues at one of the nation’s premier psychiatric hospitals. After informing parents of their child’s substance abuse history the most frequent response I heard from them was “I had no idea this was going on.” Or if they suspected their child was using a substance, they were shocked at how extensive it was.

Adolescent substance abuse continues to invade too many of our families, leaving parents confused and without a roadmap to guide them in finding help for their child. Today, more than 40 percent of seniors and one-third of tenth graders are vaping a substance like marijuana. Twenty percent of teens report abusing prescription drugs like Xanax, Ritalin and Adderall.

As the parent of an addicted child, feelings of helplessness, blame and fear can drown out any sense of hope. But in the pages of my book The Addicted Child: A Parent’s Guide to Adolescent Substance Abuse they receive the information and resources needed to help their child through assessment, treatment and recovery.

Alcohol and drugs have the power to change a child’s brain and influence behaviors so I include a chapter on the neuroscience of substance abuse. In non-technical language parents learn how substances work in the adolescent brain.

Because the best treatment starts with a comprehensive assessment there’s a chapter explaining which assessments are critical for a proper diagnosis. These assessments go beyond looking just at a child’s history of using substances. All too often when we look beyond a child’s drinking or drug use we discover their struggle to manage intolerable thoughts, feelings or memories is a core issue that needs treatment. While not every child using alcohol or drugs has an underlying psychological issue, for those that do, treating the alcohol or drug problem without treating the mental health issue can be a treatment plan doomed to fail.

Other chapters in The Addicted Child address issues such as eating disorders, self-injury, gaming and cell phone use which often accompany a child’s use of substances. Parents learn the warning signs for these disorders and the warning signs that often accompany alcohol and drug use. Parents also learn which drugs are invading today’s adolescent population and how to recognize them.

Parents often need guidance when looking for treatment options. There is no “one size fits all” treatment approach to addiction. For this reason, I have included chapters explaining the important principles of adolescent substance abuse treatment and various treatment options available for families. There is also a chapter listing helpful resources for parents.

Very few things are more destructive to a family than having someone, especially a child, addicted to alcohol or drugs. While working on an adolescent treatment unit I met parents struggling to understand and accept their child’s psychiatric and substance use issues. For most of these families it was a heart-breaking experience. Sadly, many families do not have the financial resources to send their child to a nationally acclaimed hospital like the Menninger Clinic in Houston. Their desperate search for help often leaves them feeling alone and without a roadmap to guide them through the process of their child’s assessment and treatment. It’s for these families that I wrote my book, The Addicted Child: A Parent’s Guide to Adolescent Substance Abuse. You can find The Addicted Child on Amazon and at the following website: https://www.helptheaddictedchild.com

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mr peabody

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Aug 31, 2016
Frostbite Falls, MN

The rise in meth overdoses, explained*

By German Lopez | Vox | Jan 9 2020

America’s drug overdose crisis is still largely dominated by opioid overdose deaths. But stimulants, especially methamphetamine, are poised for a comeback.

Provisional federal data suggests that national overdose deaths linked to psychostimulants, such as meth, spiked by more than 21 percent from 2017 to 2018.

A recent research letter published in JAMA Network Open analyzing more than 1 million drug testing results from routine health care settings found positive hits for meth were up nearly 487 percent from 2013 to 2019, and positive hits for cocaine were up nearly 21 percent.

Experts worry that the numbers for stimulants could foreshadow a larger epidemic — a potential “fourth wave” in the overdose crisis that’s killed more than 700,000 people in the US since 1999.

“Every opioid epidemic in American history has been followed by a stimulant epidemic,” Stanford drug policy expert Keith Humphreys told me.

The numbers for meth and cocaine are still dwarfed by opioids. In 2018, there were more than 13,000 estimated overdose deaths linked to stimulants, particularly meth, and more than 15,700 linked to cocaine, according to the provisional data. Meanwhile, there were nearly 48,000 overdose deaths linked to opioids. Synthetic opioids excluding methadone — a category that mainly captures fentanyl — were associated with more than double the fatal overdoses linked to cocaine or meth alone. (There’s some overlap between drugs in the figures, because overdoses can involve multiple drugs.)

But there are reasons to believe the crisis is broader than just opioids. A 2018 study in Science found that, while drug overdose deaths spiked in the 1990s and 2000s with the opioid epidemic, there has been “exponential growth” in overdose deaths since 1979. That suggests that America’s drug problem is getting worse in general, regardless of which drug is involved.

“My question: Why are we as a country vulnerable to all of these drugs?” Nora Volkow, director of the National Institute on Drug Abuse, told me. “What has happened that has made it possible for these drugs to take hold in a dramatic way?”

The answers to those questions could require a shift in how America approaches drugs, focusing not just on the substances making headlines but also addiction more broadly and the causes of addiction. It would mean building a comprehensive addiction treatment system that’s equipped to deal with all kinds of drugs. And it could require looking at issues that aren’t seemingly drug-related at first, like whether socioeconomic and cultural forces are driving people to use more drugs.

Drug epidemics are often cyclical

In the 1960s and ’70s, heroin was the big drug of public concern. In the 1980s, it was crack cocaine. In the 1990s and early 2000s, it was meth. Over the past decade and a half, opioid painkillers, heroin, and then fentanyl became the center of America’s drug problem.

It’s not clear if the next phase is here yet — opioids are still a huge problem — but the worry is stimulants will start to pick up if opioids plateau and fall.

“The drugs are driven by fads, a little bit of fashion,” Volkow said. “So you have eras when you have a flourishing of a particular drug and then another one takes over.”

There are now reports of drug cartels producing and shipping more meth than before across the US-Mexico border — a shift from the homegrown market of the 1990s and 2000s. And in general, illicit drugs have become cheaper and, in some cases, more potent over time. Federal data tracking the street price and potency of the drugs tells the story: In 1986, for example, meth was on average $575 per pure gram and on average at 52 percent purity; in 2012, it was $194 per pure gram and 91 percent purity. The price drop is similar for other drugs, though purity levels have fluctuated depending on the substance.

This makes it cheaper for someone to start using drugs. The central focus of the US war on drugs for decades has been to prevent this — by fighting drug traffickers and dealers — but it’s failed as drug cartels have consistently remained ahead of the authorities, bolstered by new technologies and globalization making it cheaper and easier to ship drugs around the world.

New demand for drugs is also a major factor for new epidemics — as people could, for example, want to supplant or enhance their opioid use with stimulants. Maybe they mix opioids with cocaine (a “speedball”) or meth (a “goofball”) because they like the mixed effects. Maybe they use stimulants after heroin or fentanyl to wake themselves up. Maybe they want to stop using opioids, whether due to the risk of overdose or some other reason, and believe stimulants are a better option.

“People get tired of it — have been there, done that, and move on,” Steven Shoptaw, a psychologist and researcher at UCLA, told me. “There is some of that with all addictions. Some people walk away from opioid addiction, which is great. But then they walk away from it by using stimulants.”

Humphreys noted an important factor in this cycle: “Probably more Americans than ever know a drug dealer.” As millions of Americans have misused and gotten addicted to opioids, they’ve established ties with drug dealers that they didn’t have before. That makes it easier to go from heroin or fentanyl to meth or cocaine.

Underlying all of this, Volkow argued, is a sense that something deeper has gone wrong in society. She pointed to the research by Princeton economists Anne Case and Angus Deaton showing that there’s been a rise in “deaths of despair” — drug overdoses, but also alcohol-related mortality and suicides. Case and Deaton have pinned the rise on all sorts of issues, including the collapse of economic opportunities in much of the country, a growing sense of social isolation, and untreated mental health issues.

“If all of these social factors were there, and we didn’t have the supply of drugs, of course people would not be dying of overdoses,” Volkow said. “But it is the confluence of the widespread markets of drugs — that are very accessible and very potent — and the social-cultural factors that are making people despair and seek out these drugs as a way of escaping.”

Not every place in the US is following the same drug trends. According to the Science study and the provisional federal data, meth has historically been more popular in the southwest, while fentanyl has been more widespread in the northeast. Researchers have warned that could change if, for example, fentanyl reaches California in a big way. But it goes to show that what looks like a national epidemic or trendline could also be regional epidemics, with different populations and demographics, separately rising and falling.

Simply building up America’s addiction treatment system isn’t enough to address all of the country’s drug problems. What kinds of treatment are done and how different drugs are treated also matter. And in the case of stimulants, treatment is probably going to produce disappointing results unless treatment facilities adopt an approach many are averse to and until researchers uncover better approaches.

“We do have a problem in the US of tending to think of one drug at a time,” Humphreys said. “During the ’90s, everyone was worried about meth, but there were plenty of people dying of alcohol. During the ’80s, crack cocaine, even though plenty of people were dying of heroin.”

The recent rise in stimulant deaths, though, suggests that America remains unprepared.

*From the article here :
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mr peabody

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Aug 31, 2016
Frostbite Falls, MN

Researchers have identified a potentially effective treatment for meth addiction.

Naltrexone a promising treatment for meth addiction*

UCLA | Science Daily

A study of Naltrexone's effect on methamphetamine users has found that this medication is a very promising treatment for meth addiction, researchers report.

"The results were about as good as you could hope for," said Lara Ray, a UCLA associate professor of psychology, director of the UCLA Addictions Laboratory and lead author of the new study.

The study, published in the journal Neuropsychopharmacology, was the first in the U.S. to evaluate Naltrexone for treating meth addiction. Researchers analyzed 22 men and eight women who use methamphetamine an average of three to four days a week.

During a four-day hospital stay, each person was each given either Naltrexone -- 25 milligrams the first two days, 50 milligrams on days three and four -- or a placebo daily. Ten days later, the subjects were readmitted to the hospital for four more days; those who had taken Naltrexone earlier were given placebos, and vice versa.

On the last day of each hospital visit, all participants were given intravenous doses of meth. Three hours later, the researchers asked how they felt and how much they wanted more of the drug.

The scientists found that Naltrexone significantly reduced the subjects' craving for methamphetamine, and that it made them less aroused by meth: Subjects' heart rates and pulse readings both were significantly higher when they were given the placebo than when they took Naltrexone. In addition, participants taking Naltrexone had lower heart rates and pulses when they were presented with their drug paraphernalia than those who were given placebos.

Ray said the results indicated that Naltrexone reduced the rewarding effects of the drug -- those taking Naltrexone did not find meth to be as pleasurable and were much less likely to want more of it.

Naltrexone was well tolerated and had very minimal side effects. The researchers found that men and women both were helped by taking Naltrexone, although the positive effect on men was slightly smaller. It made no difference whether the participants were given Naltrexone during their first hospital stay or their second.

Methamphetamine use disorder is a serious psychiatric condition that can cause psychosis and brain damage, and for which no FDA-approved medication exists. An estimated 12 million Americans have used meth, nearly 400,000 of whom are addicted to it, according to recent estimates.

Although the new study is promising, it needs to be backed up by clinical trials, said Ray, who is also a member of the UCLA Brain Research Institute. The next step in evaluating Naltrexone's effectiveness for treating people addicted to meth is already underway: the National Institute on Drug Abuse is sponsoring clinical trials.

*From the article here:

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mr peabody

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Aug 31, 2016
Frostbite Falls, MN

Meth-induced psychosis: As meth use increases, so does risk*

by Susan Samples | Jan 3 2020

Those who struggle with substance use disorders in West Michigan are increasingly turning to crystal meth.

But this isn’t the one-pot meth made in rural basements a decade ago.

This meth is much more potent, and it comes from traffickers in Mexico.

As its use in West Michigan grows, so does the risk of meth-induced psychosis and the violence it sometimes generates.

In one recent potentially meth-related case, a man died after a scuffle with his girlfriend in a Kalamazoo County home.

The sheriff’s department declined to confirm if meth played a role, but the girlfriend’s sister was certain the drug was a factor.

“She can’t handle it. She just can’t handle the drug,” said the sister of the girlfriend, referring to her sister’s use of methamphetamine. “She hallucinates — thinks she’s seeing something, and she’s not.”

On Sunday afternoon, deputies were called to the home in the 5500 block of Electra Street in Comstock Township – a neighborhood in which meth has carved a foothold.

They found Lyle Hess, 38, dead from an undetermined cause.

Deputies initially arrested and booked Hess’s girlfriend on suspicion of murder. But prosecutors never officially charged her, and she was released from jail.

Investigators are awaiting the results of Hess’s autopsy, including toxicology testing, to determine his exact cause of death after which they’ll submit the case to the prosecutor for potential criminal charges.

The sister of the girlfriend said, if her sister caused Hess’s death, it was accidental and likely the result of mental health issues exacerbated by her use of methamphetamine.

“When she’s on meth, she’s 20 times worse than her normal self. She thinks everybody’s out to get her,” said the girlfriend's sister.


Michael Wolff, a clinical neuropsychologist at BRAINS Counseling in Grand Rapids, said his industry has long recognized that stimulants like meth and cocaine can cause psychosis.

“Using a chemical like methamphetamine that releases dopamine into their system in unusually strong doses gives them symptoms of schizophrenia,” said Wolff. “Paranoia comes into play — visual and auditory hallucinations, irritability, anger, confusion, sleep difficulties...”

Chronic, heavy use of meth is more likely to result in psychosis, though one dose can trigger it.

Wolff said meth can cause even a mild-mannered, non-aggressive person to become violent. He has witnessed it firsthand.

“I, unfortunately, have a very close family member who was addicted to meth and spent years in and out of prison… and has actually gone through that paranoia, and the threatening and aggressive behavior,” recalled Wolff.

"Meth users with psychotic symptoms will often lash out in their own defense because they wrongly believe people are out to hurt them."


William Paul Jones, the suspect in a deadly home invasion in early December, allegedly thought people were following him when he burst through the back door of a stranger’s home in Kalamazoo County.

Chris Neal and family

Chris Neal, the young dad and Navy veteran who lived at the home with his wife and young daughter, told dispatchers that Jones told them to lock the door and call 911.

Neal heroically told his wife and daughter – who survived the ordeal – to hide upstairs.

When police arrived, they found Jones holding Neal hostage behind a closed door in a first-floor bedroom.

Police reported that Jones, who at one point said he did not believe the officers were truly police, began shooting through the door and wall without warning.

The gunshots struck three officers.

They survived, but Jones shot and killed Chris Neal.

*From the article here :
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mr peabody

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Aug 31, 2016
Frostbite Falls, MN

Why a drug that fueled the Nazi war machine now plagues America

by Richard Gunderman | The Conversation | 10 Feb 2020

Although I am teaching a course at Indiana University this semester on the opioid epidemic, I can’t get meth out of my mind.

A colleague of mine was recently carjacked. He was forced to drive at extreme speed through the city and escaped with his life only by intentionally crashing his car. My colleague told me he believes his gun-wielding assailant was suffering an acute psychosis related to meth use.

Opioids may get most of the media attention these days, but meth has hardly gone away. Law enforcement seizures of meth are surging in the U.S., up 142% between 2017 and 2018. Overdose deaths in 2017 were seven times higher than in 2007.

Just what is meth, and why is it such a grave threat to health?

The health effects of meth

Methamphetamine, a powerful stimulant of the central nervous system, has some legitimate medical uses, such as the treatment of attention deficit hyperactivity disorder. But it is widely trafficked and purchased for recreational consumption, often as crystal meth.

Recreational meth users smoke, snort, ingest or inject the drug. Smoking and injection seem to give the greatest rush, but the effect doesn’t last as long. Users often report euphoria, increased alertness and reduced appetite; chronic users may experience paranoia, delusions and unpredictable mood swings. Addicts may exhibit a “binge and crash” pattern, and many try to maintain the rush with continuous consumption.

Chances of addiction are high, and symptoms from withdrawal can linger for months. Treatment is complicated, particularly because many meth users are often also using cocaine, heroin or alcohol.

Meth is directly toxic to the brain; developmental delays are common in meth babies. In adults, it’s associated with an increased risk for Parkinson’s disease. Addicts age at an accelerated pace, and commonly acquire “meth mouth” – tooth loss, tooth decay and tooth blackening.

Those who overdose may develop psychosis or abnormal heart rhythms. Unlike opioid overdoses, which can quickly be resolved if the drug Naloxone is available, meth overdoses have no “reversal” agent. Instead, the meth is suctioned from the stomach. Anti-psychotics can help with psychosis, and anti-hypertensive drugs can reduce acutely elevated blood pressure.

Meth’s dark history

During World War II, meth played a sinister role in the Nazi war machine.

The military, along with German civilians, used a commercial form of the drug – made in Berlin and marketed under the trade name Pervitin – to stay awake, alert and energized.

With Pervitin, factory workers and homemakers alike found they could work longer and harder. Troops called it “tank chocolate” or “pilot’s salt.” Pervitin fueled the Nazis during their “blitzkrieg” invasion of France in 1940.

Wrote one German commander about Pervitin: “Everyone fresh and cheerful, excellent discipline.” Later his assessment became less rosy: “After taking four tablets, double vision and seeing colors.”

The toll meth took on the Germans was immense. It provoked war crimes, stoked psychosis and triggered suicide.

As the war progressed, Adolf Hitler received ever-increasing doses of the drug.

No one should be surprised. After all, the German name Pervitin is related to the word pervert (“ill-turned”). It means corrupted or distorted. Meth, as the Nazis discovered, distorts our nature and turns us away from what we are meant to be.

Now, 75 years after the war, and still without an effective drug therapy, a meaningful response to meth requires three things. We in the U.S. must recognize the true scope of the problem. We must make sure meth users have access to counseling and behavioral therapy.

Most of all, our society needs to help individuals and families discover healthier ways to find meaning in life.

*From the article here: https://theconversation.com/a-nazi-...th-is-making-a-disturbing-reappearance-129593

Nazis dosed their soldiers with performance-boosting superdrug*

by Mindy Weisberger | LIVE SCIENCE | 25 June 2019

The remarkable endurance of German and Allied soldiers during World War II had a secret ingredient: performance-enhancing drugs.

During the 1940s, Nazi troops were liberally supplied with a methamphetamine called Pervitin, while American and British soldiers stayed alert with the help of the amphetamine Benzedrine.

Medical officers on both sides distributed these stimulants — and others, such as cocaine — to keep weary soldiers awake for days at a time; to enable troops to perform longer under punishing conditions; and to deaden the horrific and debilitating effects of shell shock and PTSD.

As this officially sanctioned "pharmaceutical arms race" unfolded, soldiers who took these drugs were pushed beyond the limits of their normal capabilities; but the long-term impacts of drug use were largely ignored by military medical officials, PBS representatives said in a statement.

Amphetamines affect the central nervous system, according to the National Institutes of Health (NIH). They induce a sense of euphoria, increase alertness and decrease appetite, the National Institute on Drug Abuse (NIDA) reported. For meth, more of the drug in a single dose directly floods the brain, as compared with other amphetamines, meaning meth is longer-lasting and potentially more harmful to the central nervous system, according to NIDA.

"Drugged, fearless and berserk"

The German methamphetamine Pervitin was initially marketed in the 1930s as a recreational pick-me-up, and scientists were experimenting with Pervitin before the war to see how long student users could stay awake and still perform well on exams, said World War II historian and documentary consultant James Holland.

Pervitin, a form of crystal meth, was distributed to German soldiers
by military medical officials during World War II.

By 1940, Pervitin was widely distributed among pilots in the Luftwaffe (the Nazi air force) to prime them for the rigors of long missions, or to ward off sleeplessness and hunger if their planes were shot down, Holland told Live Science.

That was the year of the Blitz — the Nazis' relentless and devastating bombing attack against Britain — an initiative fueled by massive quantities of speed, Holland said.

Records from the British War Office estimated that over the three months of the Blitz — from April to June 1940 — about 35 million Pervitin tablets were sent to 3 million German soldiers, seamen and pilots, Nicolas Rasmussen, a professor in the School of Humanities and Languages at the University of New South Wales in Australia, reported in 2011 in The Journal of Interdisciplinary History.

Following this infusion of drugs, Wehrmacht soldiers (as the troops in Nazi Germany were called) marched and fought for 10 consecutive days, trapping and defeating the British army at Dunkirk in a decisive military victory, PBS representatives said in the statement.

In Britain, rumors swirled about dive-bombing Nazi pilots with a superhuman resistance to g-forces through drugs, and newspapers described sightings of German paratroopers who were "heavily drugged, fearless and berserk," according to Rasmussen.

"By the end of the second World War, you saw increasing knowledge of the side effects of these drugs. What you don't see is what to do with people once they become hooked — that's something that had to be learned the hard way in the years that followed," Holland told Live Science.

"The full extent of addiction and how harmful they can be was not properly understood," Holland says. "At the end of the war, there was very little help offered for people who became addicted."

*From the article here: https://www.livescience.com/65788-world-war-ii-nazis-methamphetamines.html

How meth became a key part of Nazi military strategy

by Peter Andreas | Time | 7 Jan 2020

In The Art of War, Sun Tzu wrote "speed is the essence of war.” While he of course did not have amphetamines in mind, he would no doubt have been impressed by their powerful war-facilitating psychoactive effects.

Amphetamines are a group of synthetic drugs that stimulate the central nervous system, reducing fatigue and appetite and increasing wakefulness and a sense of well-being. The quintessential drug of the modern industrial age, amphetamines arrived relatively late in the history of mind-altering substances—commercialized just in time for mass consumption during World War II by the leading industrial powers. That war was not only the most destructive war in human history but also the most pharmacologically enhanced. It was literally sped up by speed.

Few drugs have received a bigger stimulus from war. As Lester Grinspoon and Peter Hedblom wrote in their classic 1975 study The Speed Culture, “World War II probably gave the greatest impetus to date to legal medically authorized as well as illicit black market abuse of these pills on a worldwide scale.”

Japanese, American and British forces consumed large amounts of amphetamines, but the Germans were the most enthusiastic early adopters, pioneering pill-popping on the battlefield during the initial phases of the war.

Nazi ideology was fundamentalist in its antidrug stance. Social use of drugs was considered both a sign of personal weakness and a symbol of the country’s moral decay in the wake of a traumatic and humiliating defeat in World War I.

But as Norman Ohler shows in Blitzed: Drugs in Nazi Germany, meth was the privileged exception. While other drugs were banned or discouraged, meth was touted as a miracle product when it appeared on the market in the late 1930s. Indeed, the little pill was the perfect Nazi drug: “Germany, awake!” the Nazis had commanded. Energizing and confidence boosting, meth played into the Third Reich’s obsession with physical and mental superiority. In sharp contrast to drugs such as heroin or alcohol, meth were not about escapist pleasure. Rather, they were taken for hyper-alertness and vigilance. Aryans, who were the embodiment of human perfection in Nazi ideology, could now even aspire to be superhuman—and such superhumans could be turned into supersoldiers. “We don’t need weak people,” Hitler declared, “We want only the strong!” Weak people took drugs such as opium to escape; strong people took meth to feel even stronger.

The German chemist Friedrich Hauschild had been aware of the American amphetamine Benzedrine ever since the drug has been used as a doping product in the Olympic Games in Berlin in 1936. The following year he managed to synthesize methamphetamine, a close cousin of amphetamine, while working for Temmler-Werke, a Berlin-based pharmaceutical company. Temmler-Werke began selling meth under the brand name Pervitin in the winter of 1937. Partly thanks to the company’s aggressive advertising campaign, Pervitin became well known within a few months. The tablets were wildly popular and could be purchased without a prescription in pharmacies. One could even buy boxed chocolates spiked with meth. But the drug’s most important use was yet to come.

Dr. Otto F. Ranke, director of the Research Institute of Defense Physiology, had high hopes that Pervitin would prove advantageous on the battlefield. His goal was to defeat the enemy with chemically enhanced soldiers, soldiers who could give Germany a military edge by fighting harder and longer than their opponents. After testing the drug on a group of medical officers, Ranke believed the Pervitin would be “an excellent substance for rousing a weary squad…We may grasp what far-reaching military significance it would have if we managed to remove the natural tiredness using medical methods.”

Ranke himself was a daily user, as detailed in his wartime medical diary and letters: “With Pervitin you can go on working for 36 to 50 hours without feeling any noticeable fatigue.” This allowed Ranke to work days at a time with no sleep. And his correspondence indicated that a growing number of officers were doing the same thing—popping pills to manage the demands of their jobs.

Wehrmacht medical officers administered Pervitin to soldiers of the Third Tank Division during the occupation of Czecholslovakia in 1938. But the invasion of Poland in September 1939 served as the first real military test of the drug in the field. Germany overran its eastern neighbor by October, with 100,000 Polish soldiers killed in the attack. The invasion introduced a new form of industrialized warfare, Blitzkrieg. This “lightning war” emphasized speed and surprise, catching the enemy off guard by the unprecedented quickness of the mechanized attack and advance. The weak link in the Blitzkrieg strategy was the soldiers, who were humans rather than machines and as such suffered from fatigue. They required regular rest and sleep, which, of course, slowed down the military advance. That is where Pervitin came in—part of the speed of the Blitzkrieg literally came from speed. As medical historian Peter Steinkamp puts it, “Blitzkrieg was guided by meth, if not to say founded on meth.”

In late 1939 and early 1940, Leo Conti, the “Reich Health Führer,” and others sounded the alarm bells about the risk of Pervitin, resulting in the drug being made available by prescription only. But these warnings largely fell on deaf ears, and the new regulations were widely ignored. Use of the drug continued to grow. At the Temmler-Werke factory, production revved into overdrive, pressing as many as 833,000 tablets per day. Between April and July 1940, German servicemen received more than 35 million methamphetamine tablets. The drug was even dispensed to pilots and tank crews in the form of chocolate bars known as Fliegerschokolade (flyer’s chocolate) and Panzerschokolade (tanker’s chocolate).

Armies had long consumed various psychoactive substances, but this was the first large-scale use of a synthetic performance-enhancing drug. Historian Shelby Stanton comments: “They dispensed it to the line troops. Ninety percent of their army had to march on foot, day and night. It was more important for them to keep punching during the Blitzkrieg than to get a good night’s sleep. The whole damn army was hopped up. It was one of the secrets of Blitzkrieg.”

The Blitzkreig depended on speed, relentlessly pushing ahead with tank troops, day and night. In April 1940, it quickly led to the fall of Denmark and Norway. The next month, the troops moved on to Holland, Belgium, and finally France. German tanks covered 240 miles of challenging terrain, including the Ardennes Forest, in 11 days, bypassing the entrenched British and French forces, who had mistakenly assumed the Ardennes was impassable. Paratroopers sometimes landed ahead of the advance, causing chaos behind enemy lines; the British press described these soldiers as “heavily drugged, fearless and berserk.”

General Heinz Guderian, an expert in tank warfare and leader of the invasion, gave the order to speed ahead to the French border: “I demand that you go sleepless for at least three nights if that should be necessary.” When they crossed into France, French reinforcements had yet to arrive, and their defenses were overwhelmed by the German attack.

I was dumbfounded,” Churchill wrote in his memoirs. “I had never expected to have to face…the overrunning of the whole communications and countryside by an irresistible incursion of armoured vehicles…I admit it was one of the greatest surprises I have had in my life.” The speed of the attack was jaw-dropping. High on Pervitin, German tank and artillery drivers covered ground night and day, almost without stopping. Foreign commanders and civilians alike were caught entirely off guard.

Some users reported negative side effects of the drug. During the French invasion, these included a lieutenant colonel with the Panzer Ersatz Division I, who experienced heart pains after taking Pervitin four times daily for as many weeks; the commander of the Twelfth Tank Division, who rushed to a military hospital due to the heart attacked he suffered an hour after taking one pill; and several officers who suffered heart attacks while off duty after taking Pervitin.

Amid growing worries about the addictive potential and negative side effects of overusing the drug, the German military began to cut back on allocations of meth by the end of 1940. Consumption declined sharply in 1941 and 1942, when the medical establishment formally acknowledged that amphetamines were addictive.

Nevertheless, the drug continued to be dispensed on both the western and eastern fronts. Temmler-Wenke, the maker of the drug, remained as profitable as ever, despite rising awareness of meth's negative health effects.

Adapted from Killer High: A History of War in Six Drugs by Peter Andreas

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mr peabody

Moderator: Music Discussion, PM
Staff member
Aug 31, 2016
Frostbite Falls, MN

Powerful new form of meth ravaging the US*

By Timothy Williams | New York Times | 28 March 2020

Home deliveries from the local food bank now require a police escort. A shop owner has started to carrying her gun to work. And the local constable, who rarely ever had to pull his weapon in the past, has drawn it a dozen times over the past year. All because people hooked on meth have threatened them.

For years, opioid addiction ravaged Louisa, KY and its neighbors in Appalachia. But the sudden return of meth — in a powerful new form — has brought a sharply different set of problems to this small Kentucky town on the West Virginia border.

If pain pills left residents struggling to help many family members deal with the risk of overdose, meth has bred fear and division in the community of 2,500, as a growing number of users have begun living on the streets.

“Half the people want to take them to the river and tie something around their neck,” said the town’s mayor, Harold Slone, adding, “We hadn’t seen that level of anger before.”

Opioids, heroin and fentanyl remain abundant, cheap and deadly in this part of Kentucky. In 2017, the rate of fatal opioid overdoses in the state was nearly twice the national average. But the sudden abundance of meth reflects a new reality in Louisa and elsewhere: A very public push to end opioid abuse has unwittingly ushered in the return of crystal meth.

In Concord, N.H., which was ravaged by opioids, the police say meth now accounts for 60 percent of all drug seizures. In Texas, Hawaii, Oklahoma and Colorado, overdoses from methamphetamine surpassed those from opioids in 2018. And in Mississippi late last year, the police discovered 140 pounds of meth in one of that state’s largest drug busts.

“Meth, that’s our drug now,” said Dennis Lowe, commander of a law enforcement task force in central and southeastern Ohio, which was also a center of the opioid epidemic. “In the past, it was easy for us to find opioids for sale on the street. Now we have to go look for it. With meth, users are walking around with ounces of it, where a few years ago, it might have been a gram or two.”

Doctors and hospitals have unwittingly accelerated the switch to methamphetamine by significantly reducing their patients’ access to pain medication; opioid users, increasingly fearful about overdosing on heroin and fentanyl, have been desperate for a substitute.

A powerful Mexican organized crime syndicate, the Sinaloa drug cartel, has sought to fill the vacuum by targeting Appalachia, federal drug officials say. The traffickers follow the same business model that allowed them to inundate the nation with heroin: make meth potent and sell it cheap to ensure a steady customer base, and ultimately, mass addiction.

The inexpensive, purer class of meth now available in many places is so powerful that some people who have used it say it caused extended hallucinations, leading them to commit serious crimes, or lose track of time altogether.

“There are no memories — it’s just ‘high time,’” said Dakota Scott, 32, a recovering drug user who lives near Louisa. She said much of her recall had been blotted out after she used methamphetamine. “It makes you feel like you can do anything. You’re invincible.”

But the drug exacts a devastating psychological toll on chronic users and substantially shortens their lives because of the strain it places on the heart and circulatory system. It can also lead to sleeplessness and intense paranoia. Users often scar their faces and arms because they feel itchy and scratch themselves.

In Louisa, where a drug rehabilitation center called Addiction Recovery Care has become one of the largest private employers in town, the number of opioid deaths has been on the decline, according to state data, as the use of pain pills and heroin has diminished.

But Tim Robinson, the center’s chief executive, feared that the drop might lead to a loss of federal and state treatment money, just as it is needed to combat the growing meth crisis. Kentucky’s expansion of Medicaid in 2014 helped fund Addiction Recovery Care’s growth; it operates outpatient and inpatient medical and counseling services and houses recovering drug users.

“We need to understand that some of our success is because we have just changed the crisis, and meth doesn’t kill people as quick. There’s a really strong fear that we’re going to declare victory and back off when we should be doubling down, because it’s about to be a whole lot worse,” Mr. Robinson said.

The region where Kentucky meets Ohio and West Virginia has served as a harbinger of national drug trends. Pain pills like OxyContin, stimulants known as bath salts, prescription anti-anxiety medications like Xanax and, more recently, heroin and fentanyl were all adopted by drug users here before gaining wider use nationally.

Pain pills have been popular in the region since at least the 1960s, when coal miners began to use them to help cope with their grueling work. In 2011, Kentucky doctors wrote 137 opioid prescriptions for every 100 residents, far higher than the national average.

Methamphetamine has also been available in Appalachia for decades, but until recently, it had been mostly made in backyards and basements and varied widely in strength.

But the new Mexican variant is often mixed with cocaine, and increasingly, with fentanyl. Law enforcement officials said cartels mix in those ingredients because fentanyl is inexpensive to produce, enhances the effects of meth and appears to cause faster addiction.

Meth users around Louisa sometimes add their own dangerous ingredients, including wasp repellent, which users say produces a more intense high.

Kentucky State Police officer Michael Murriell said "police officers have become more wary when making traffic stops or when approaching people — a conspicuous change from their interactions with pain pill abusers, who rarely argued or resisted arrest."

“Everything we do is different now,”
he said. “We have to be more careful.”

State police said that in some communities around Louisa, nearly eight in 10 arrests are related to meth use. The local court docket is full of meth-related crimes — mostly shoplifting, burglary or assault, but occasionally attempted murder.

The seat of Lawrence County, Louisa is similar to many small towns in the rolling hills of Eastern Kentucky. Some of the nearby coal mines still operate, though many have been abandoned for years, their massive belt conveyor equipment left to rust amid scarred brown hillsides. But the downtown is well-kept and quiet, with few visible signs that it has been at the heart of a series of drug plagues.

Residents, however, say people addicted to meth are altering the town in ways both obvious and imperceptible.

Chris Wilson, a local pastor, said a close childhood friend had recently appeared at his church. The man had lost nearly half of his body weight since they had last seen each other. When his friend asked for a ride to the next county over, Mr. Wilson agreed, even though he suspected the man was looking for meth.

“I said, ‘David, I can get you help.’ He said, ‘You don’t understand. There is no help,’” Mr. Wilson said.

Mr. Slone, the town’s mayor, said that although some residents of Louisa have acted with anger to the meth addicts in their midst, others have focused on trying to feed and clothe them and get them treatment.

But even charity comes with risks in the new environment. Rachel Wheeler, who operates a local food bank ministry, said volunteers now have to be far more cautious when making home deliveries, in case there’s a meth user in the house. Police officers have started escorting volunteers on some deliveries, or making the deliveries themselves.

Kimber Skaggs, who operates Kimber’s Country Market in nearby Blaine, Ky., said she had become adept at discerning the difference between customers who were high on pain pills and those on meth. Opioid users are often quiet and move and speak slowly, she said, while those on meth are often jumpy, scratch at their sores and behave erratically.

Daniel Castle, the town’s constable — an elected local law enforcement position in Kentucky — said his job has become progressively more dangerous as the new form of meth took hold and opioid use waned.

“You’ve got an energized addict versus a lethargic addict,” Mr. Castle said. “I’ve had multiple foot chases in the past year, and it’s all related to meth. I’ve never had someone on opiates run from me.”

Mr. Castle said he does not know a single family in Louisa untouched by opiate or meth addiction.

“I know individuals, friends of mine, who are losing touch with reality,” he said. “And I fear we haven’t reached a tipping point. It’s going to get worse before it gets better, because we have not stopped the flow of meth coming in.”

*From the article here :
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mr peabody

Moderator: Music Discussion, PM
Staff member
Aug 31, 2016
Frostbite Falls, MN

Artist Riley Stolte, a former meth user, poses with some of her paintings.

A medication for meth use?*

by Sydney Brownstone and Scott Greenstone | Seattle Times | 13 Jul 2020

Artist Riley Stolte grew up in Seattle around family members who struggled with substance use disorders.

By age 14, Stolte had started using drugs herself, and for the next 16 years battled heroin and methamphetamine addictions. That was until Stolte started taking Suboxone, an opioid-treatment medication that removed her desire for heroin.

But there wasn’t any medication like that for meth. And because meth helped Stolte focus on her art, she struggled to stop using it — even though, she says, it made her “psychotic.”

“I told myself in my head, ‘I can’t do my art or paint without a little meth,’” Stolte said. “And I believed that, too.”

The Seattle Times’ Project Homeless is funded by BECU, The Bernier McCaw Foundation, The Bill & Melinda Gates Foundation, Campion Foundation, the Paul Allen Family Foundation, Raikes Foundation, Schultz Family Foundation, Seattle Foundation, Starbucks and the University of Washington. The Seattle Times maintains editorial control over Project Homeless content.

Medications like Suboxone, which partially bind to the same opioid receptors in the brain as heroin without the high, are now considered a best practice for treating opioid-use disorder. But addiction to methamphetamine, which has rapidly overtaken heroin as the most common drug associated with overdose deaths in King County, has no equivalent drug treatment — conclusive research on it simply doesn’t exist.

Data from overdose deaths in King County shows that most involve a combination of opioids and stimulants, but deaths that involved methamphetamine hit a recorded high last year — 204, more than quadruple the number in 2013 when it began to rise. Local research shows that it’s harder for patients to get help and remain in treatment for opioid use disorder alone if they also struggle with methamphetamine.

The deaths are disproportionately striking King County’s Black, Indigenous and homeless populations. Nearly 20% of all King County overdose deaths involving stimulants in 2019 were among people reported to be homeless. Nearly 16% of people who died were Black, even though Black people represent less than 7% of King County. American Indians and Alaska Natives represented more than 3% of the deaths, though they make up less than a percentage point of the overall King County population.

Coronavirus has made the search for an effective treatment for methamphetamine use disorder even more urgent. Restrictions on travel have disrupted global drug production and supply chains, according to a United Nations report on drug trafficking trends published in May.

As some users in the United States find methamphetamine more expensive or harder to come by, a new report from health care workers and advocates argues now might be a prime opportunity to get people into treatment — and that it’s time for cities to fund the research looking for solutions, specifically to see whether drug-based treatment for methamphetamine use disorder could help people.

But not everyone is optimistic.

Promising signals, but nothing conclusive — yet

The lack of treatment options for methamphetamine users is frustrating for Dr. Richard Waters, medical director of Neighborcare Health’s Housing and Street Outreach Team. Nine years ago, when he started his residency in Seattle, meth use wasn’t widespread. But in the past six years, it’s skyrocketed alongside the West Coast’s homelessness crisis, during which some people living on the street have reported using meth as a survival tool to stay awake and protect themselves at night.

According to a 2019 survey of clients at syringe exchange programs across Washington, nearly half who used methamphetamine said they were interested in reducing or stopping their use.

“I’ve had patients come to my office and cry because they want to stop using meth, but … despite their strong desire to stop, they keep falling back in that cycle of craving use and then withdrawal,” Waters said.

International research has given some signs of hope for a meth treatment medication.

In Australia, where 1.4% of people over age 14 have reported using methamphetamine or amphetamine within the past year, finding treatments for methamphetamine addiction has become a government priority.

Dr. Krista Siefried, a clinical researcher with The National Centre for Clinical Research on Emerging Drugs (NCCRED), published an Australian government-supported study in March reviewing the evidence for drug treatment in methamphetamine and amphetamine use disorder. "The study looked at 43 different clinical trials testing 23 different medications, and found that five studies using a class of drugs known as psychostimulants showed 'promising signals' for possible treatment," Siefried said.

The two psychostimulants that had research available to look at were methylphenidate, known as Ritalin in the United States, and dextroamphetamine, a stimulant used to treat ADHD and narcolepsy.

While the trials didn’t show these drugs were successful at getting people to cut off their meth use completely, some studies had subjects who reported that they used meth less frequently or had fewer withdrawal symptoms.

Researchers’ findings weren’t particularly conclusive. Results were mixed and the studies measured and selected their outcomes differently, making them more difficult to analyze.

“We haven’t yet struck that medication substitute that we can say really works,” Siefried said. “We need more research.”

To that end, the Public Defender Association’s Yes to Drug User Health project put together a report with Seattle-based researchers, advocates and health care workers asking local government to invest in the kind of research that would further investigate stimulant substitution therapy.

Dr. Judith Tsui, one of the authors of the report and an associate professor at the University of Washington Department of Medicine, has proposed a clinical trial to look at whether long-acting methylphenidate could be effective for people who are already prescribed methadone to treat their opioid addiction.

Her interest in finding a potential drug treatment stemmed from her own experience as a primary care provider at a methadone clinic, where patients would show up with various medical complications associated with their meth use, like heart problems, dental problems and psychosis.

“I think as a physician I felt helpless not having more options to have to offer more patients who were struggling with their methamphetamine use disorder,” Tsui said.

Waters, of Neighborcare Health’s Housing and Street Outreach Team, supports the idea of a randomized controlled trial like the one Tsui is proposing.

“I think that would be perfect for what needs to happen,” Waters said. “There have been studies on methylphenidate before and the results offer a glimmer of hope.”

But some in the addiction medicine community are skeptical — including the doctor who treated Stolte’s meth use with ADHD medicine, Dr. Richard Ries.

Ries, founder of the Mental Health and Addiction Services Department at Harborview Medical Center, said that from years of working with patients and conducting and reviewing research, he’s only seen a very specific group of people benefit from medication: people with ADHD who are very committed to quitting their meth use and whose lives are otherwise relatively stable.

When Ries prescribed Stolte methylphenidate, or Ritalin, for her ADHD, she stopped using methamphetamine quickly.

“I noticed it right away pretty much. My thoughts slowed down, I felt kind of peaceful a little bit more — and less running around and creating ruckus in the psych ward,” Stolte said, laughing.

That was a year ago. On June 11, she woke up before 5 a.m. with a huge smile on her face. She’d been sober for a whole year, the first time since she was 14.

"But people with ADHD are most likely a minority among meth users, although percentages vary widely study to study," Ries said.

"One of the reasons Ries doesn’t expect a substitute to work is because the high from methamphetamine is so much more powerful and releases so much more dopamine than heroin or prescribed ADHD meds," Ries said.

“To put it in alcohol terms, you’ve got a person who’s drinking two fifths a day, and you say, ‘OK, we’re going to give you … two shots of alcohol,’” Ries said. “If you’re going to prescribe it and think that you’re going to substitute it, you’re going to have to find doctors somewhere who are willing to prescribe astonishing amounts.”

Safe supply

Dr. Caleb Banta-Green, a principal research scientist at the UW’s Alcohol and Drug Abuse Institute, convened a “meth summit” last year in Seattle to discuss interventions like the one Tsui has proposed studying. Banta-Green believes “there is some evidence for some medications that have had some benefits for some populations,” such as prescribing Ritalin for meth users with ADHD or mirtazapine for users with depression." Banta-Green says it deserves more research.

“Pinning all your hopes on one particular medication doesn’t make sense to me,” Banta-Green said. “There’s something there (with methylphenidate) … but it’s not as convincing, nearly, as what we’ve been seeing for opioids. And we’ve been looking for a long time.”

A more favored approach among research scientists doesn’t involve medicine at all. Called “contingency management,” it’s a system where patients get rewards for using drugs less frequently or stopping completely. "But while multiple studies have reported the approach’s success, it’s not as effective for people living homeless, who are eight times more likely than housed participants to drop out of the treatment," one of the leading researchers told The Seattle Times last year.

British Columbia is trying a different tack. In late March, fearing that the pandemic would make the street drug supply even more dangerous, British Columbia started allowing health care workers to provide prescriptions of replacement drugs to users of street drugs. The strategy, called “safe supply,” is intended to cut down on the number of overdoses for vulnerable people on the street, and for people who would be at risk of greater exposure to coronavirus through drug use.

Providence Healthcare’s Crosstown Clinic, in Vancouver, B.C., had already been prescribing long-acting dextroamphetamine to a small group of meth users since 2016.

“Many who have tried it have cut down on their use,” said Crosstown Clinic’s physician lead, Dr. Scott MacDonald. “We think it’s effective, [but] it doesn’t work for everybody in our population.”

"People looking for energy throughout the day tend to do better with the sustained-release dextroamphetamine tablets,"
MacDonald said, "rather than people looking for an immediate effect."

But while policymakers and health care workers debate treatments, Tsui stresses that the progress made in treating opioid use disorder could be undercut by failure to address co-occurring meth addictions.

“We have made great strides in improving access to opioid use disorder treatment,” Tsui said. “But if we cannot adequately address concurrent methamphetamine use, it may stand in the way of allowing patients to achieve their best treatment outcomes.”

*From the article here :
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mr peabody

Moderator: Music Discussion, PM
Staff member
Aug 31, 2016
Frostbite Falls, MN

Iboga appeared as an African warrior, and said he was there to help me. I immediately began thinking about my father, as I have much childhood trauma associated with him. Iboga clapped his hands, and my dad appeared. He looked drunk and had an angry expression on his face, with his fists in the air like he was about to beat me. Suddenly, Iboga clapped his hands again, and instantly my father was transformed into a scared little boy, around age eleven, crying about being beaten by his grandfather (his primary caregiver during his childhood). Then I felt the massive resentment I held towards my father uprooted out of me by Iboga.

Next, came my mother. Iboga did something very different this time: he transformed me into my mother, and all of a sudden I felt all the pain and suffering that I had caused her during my addiction through lying, stealing, manipulating. This vision humbled me to a level I had never felt before, and since then, I cannot bring myself to lie to her without bawling my eyes out, precisely because I was her and I felt all the pain I had caused her. Iboga allowed me to forgive myself for the pain I caused the woman who loved me more than anyone else in the world, but he emphasized that I must never again cause her that type of pain.

I remember my hallucinations. I saw shamans in my closed eye visuals, and a jaguar just staring into my eyes. The worst part was when I saw my mom crying. When I would use drugs, my mom would cry sometimes, but when I was high I didn't care. When I saw my mom crying, I felt so shitty, like I owe her for all her happiness that was lost.

I laid there and I had deep locked thoughts from my childhood, flashbacks of all the negative experiences I had, and realized exactly why I used drugs to begin with. I did also see open eye visuals. There was one moment where I saw a pair of non-human eyes floating above, then all of a sudden a long tongue dropped to my bed where the eyes were, this hallucination was very shocking. It was like the same shock experienced when you hear a loud and unexpected sound. Ibogaine had a lot of those moments. Ibogaine is like a stern teacher or parent teaching you a lesson, it is not fun and games. Towards the end, I felt very peaceful.

I was at peace with everything. I accepted my fate..., that I had died trying to save myself from a lifetime of misery, as well as everyone around me. The ibogaine was working a miracle and saving my life. It totally cleansed my body from every toxin I had put in it for 20 years. It defragmented my brain and allowed me to reboot. I was laying there like a dead man, and all of a sudden the power came back on.

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mr peabody

Moderator: Music Discussion, PM
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Aug 31, 2016
Frostbite Falls, MN

Clinical trial to evaluate psilocybin for the treatment of meth use disorder*

Psilocybin Alpha | 2 Sep 2020

Revive Therapeutics nas announced that the Company has entered into a Clinical Trial Agreement (CTA), with the Board of Regents of the University of Wisconsin System (UWS) to conduct a clinical study entitled, “Phase I Study of the Safety and Feasibility of Psilocybin in Adults with Methamphetamine Use Disorder.” Under the terms of the CTA, the Company has an exclusive option to obtain an exclusive, worldwide, royalty-bearing commercialization license to all rights, title and interest that UWS may have or obtain in any invention that results from the clinical study.

“We are delighted to be collaborating with clinical researchers at the University of Wisconsin to advance development of psilocybin as a possible treatment for methamphetamine use disorder,” said Michael Frank, Revive’s Chief Executive Officer. “We are building a pipeline of clinical-stage psychedelic-derived therapies for addiction disorders with a focus on psilocybin with unique dosage forms.”

Christopher R. Nicholas, Ph.D., Assistant Professor at the University of Wisconsin School of Medicine and Public Health, and clinical psychologist at the school’s Program for Research Outreach Therapeutics and Education in the Addictions (“PROTEA”) in the Department of Family Medicine and Community Health, will serve as principal investigator for this initial safety study. The study will be conducted at the University of Wisconsin Schools of Medicine and Public Health and Pharmacy, which hold a Wisconsin special authorization and Drug Enforcement Administration license to perform clinical research with psilocybin. Members of the PROTEA team previously conducted research on the pharmacokinetics of high-dose psilocybin and are also currently investigating psilocybin as a treatment for opioid use disorder.

About methamphetamine use disorder

Methamphetamine use disorder occurs when someone experiences clinically significant impairment caused by the recurrent use of methamphetamine, including health problems, physical withdrawal, persistent or increasing use, and failure to meet major responsibilities at work, school or home. According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2018 National Survey on Drug Use and Health, there are approximately 1.1 million people aged 12 or older who have a methamphetamine use disorder in the U.S. Based on the most recent year for which data is available, the economic cost in the U.S. is approximately $23 billion, according to data from the Rand Corporation. There is no pharmaceutical treatment approved for methamphetamine dependence and the current treatment strategy is behavioral therapies, such as cognitive-behavioral and contingency management interventions.

*From the article here :
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mr peabody

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Aug 31, 2016
Frostbite Falls, MN

This is what meth-induced psychosis feels like

by Elizabeth Brico | VICE

I knew it was time to go to sleep when I started to see the insanity fleas. That's what I called the little black dots that jumped across my arms and burrowed into my flesh, tickling the underside of my skin. They usually started to appear after staying awake for three nights, which I was doing because I was spun out on meth. I was 16, and taking way too much of it with an addicted boyfriend.

"Meth psychosis is a severe reaction estimated to occur in about 40 percent of users—which far surpasses rates of substance-induced psychosis associated with other commonly misused drugs. It's caused by the overproduction of dopamine in the brain that is induced by meth," says Larissa Mooney, director of the UCLA Addiction Medicine Clinic. "In combination with other factors, like lack of sleep or a genetic predisposition to mental illness, this neurochemical surge can trigger a complete break from reality."

I experienced meth psychosis numerous times, and each break was different after the insanity fleas showed up. The first time, I hallucinated miniature people, about the size of my thumb, dancing and playing on the furniture in the house where I was getting high. The worst time, I believed that I had written the world into existence, and had to wage an epic war against evil shape-shifting wizards who morphed out of strangers everywhere I went. On other occasions I thought I was an alien, or had the ability to translate secret messages from dog barks, or had foreknowledge of an imminent nuclear attack on Seattle, where I lived. Each time was short—once I got some sleep, the psychosis waned. But those handful of hours were terrifying.

I managed to kick meth for good when I was 17. That was 2005, when the drug was being recognized nationally and internationally as a major problem. After that, the United States began tightening regulations around pseudoephedrine, an ingredient found in cold medicine that was being used to home-manufacture meth across the country. This led to a decline in meth use for several years. And in those years, rates of opioid addiction and opioid-related complications surged. The result? A hyper focus on what is now being termed the "opioid crisis," to the exclusion of other commonly misused drugs. But it appears that meth use is back on the rise, and with it a host of health and social problems that are going to become really hard to ignore if this upward trend continues.

This resurgence may be compounded, in part, by the fact that polydrug use is common among people with substance use disorders in general. "It's common for people to use substances together," Mooney says. "For example, someone might take a stimulant like meth, and a central nervous system depressant such as heroin to help alleviate the symptoms of the other substance. It's almost like using drugs for the opposite effect—if you're agitated you might take something more sedating to calm the anxiety."

But the rise in meth use is not just a side-effect of the opioid crisis. Manufacturers have found new ways to create meth and get it into the hands of drug users, including using phenylacetone (P2P) instead of pseudoephedrine to cook bulk batches, kind of like fictional school-teacher-turned-kingpin Walter White on Breaking Bad. Because meth doesn't share the same prescription distribution as opioids—pharmaceutical meth (Desoxyn) is only prescribed in cases of severe narcolepsy, ADD, and morbid obesity—its usage rate will likely never rival that of opioids. But SAMSHA found that in 2014 there were 569,000 people over the age of 12 using meth within the month prior to the survey. That's almost double the low point of meth use, which was 314,000 in 2008, and statistically similar to the "meth crisis" of the early 2000s. It also surpassed heroin use in the same year.

Meth misuse comes with health complications worse than hallucinations. For example, states and counties across the country are reporting an increase in meth-related deaths. In 2016, meth accounted for 7,663 overdose deaths in the United States, a significant jump from 4,900 the year before.

Mooney, who has published a number of studies focused on meth, says it "has the potential to affect all major organs, but especially the brain." She warns of potential long-term neurotoxicity, seizures, worsening of depression or anxiety, paranoia, violent behavior and, like I experienced, psychosis. It also accounts for more drug-related convictions than any other illegal drug, which means its impact hits hard at both the health and societal levels.

Paranoia or transient psychoses are among the most common serious side-effects of meth use. In fact, paranoia and psychotic behaviors are so strongly linked with meth in our social consciousness they've essentially become a joke. I've certainly told the story of babbling to a stranger about my liaisons with his other body as a dark-comedy bit. But what about those people who have a genetic vulnerability that predisposes them to long-term psychosis? People like my husband, Ricardo.

Last November, my husband took a hit of meth as a study aid. He has a maternal family history of schizoid personality disorders, and a previous history of marijuana-induced psychosis. He's absolutely the last person who should have ever taken meth, but he did—and he paid the price. Since late November 2017 until early May 2018, he's been in and out of psych wards in both Washington State and Florida, unable to differentiate his perceptions from reality.

"I thought I saw people lingering outside of the apartment and I heard people talking about me," he tells me, describing his version of the events that I witnessed firsthand. I remember him waking me throughout the night for weeks on end, convinced someone was outside the window with a gun aimed at him. I remember him begging me to call the police on the man only he could hear, who he insisted was screaming non-stop homicidal threats. I remember him hiding knives around our apartment, readying for a fight that would never come. I remember him giving up; standing in front of the window for hours, waiting for that bullet to tear through his chest.

My husband chose to take meth, but I know he never expected to spend six months in fear for his life. The next person who experiences that probably won't expect it either. Nor do the more than 7,000 people expect to die from a drug we aren't focusing on enough. We can't stop fighting on the opioid front, but we need to start recognizing that there are other factors when it comes to substance misuse in this country—and methamphetamine could be gearing up to be a major player once again.

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mr peabody

Moderator: Music Discussion, PM
Staff member
Aug 31, 2016
Frostbite Falls, MN

Packets of buprenorphine, which is used to treat opioid use disorder.

Stigma is killing people with substance use disorders*

by Richard Bottner, Christopher Moriates, and Matthew Stefanko | STAT | 2 Oct 2020

"It was dehumanizing,” Slade Skaggs told us about how health care providers treated him when he turned to them for help with his substance use disorder. “They made me feel like I was drug-seeking and that I was not deserving of their time or care.”

Fortunately, he finally got the help he needed and is now in recovery, serving as a peer-support specialist for others with substance use disorders.

Stigma — society’s negative attitudes and behaviors towards individuals because of their substance use disorders — propagated by people working in health care causes feelings of shame, limits access to care, and ultimately contributes to vicious cycles of addiction. This is particularly true for people living with opioid use disorder.

In the setting of Covid-19 and physical distancing, it is more important than ever to dismantle such stigma and develop effective continuums of care for vulnerable patients, including those with substance use disorders. In fact, economic uncertainty, social isolation, and burdened health care delivery systems contributed to a 42% increase in overdoses in the U.S. in May alone — the sharpest increase since 2016. Now is the time to improve attitudes toward and knowledge about substance use disorders among health care providers.

Historically, the medical community has not been supportive when treating people with substance use disorders. Stigmatizing patients with opioid use disorder deepens prejudicial feelings among health care providers such as fear, anger, or disgust. Such emotions result in discriminatory clinical care. A Massachusetts survey found that 24% of emergency, family, and internal medicine providers believed that their practices would attract undesirable patients if they treated individuals with opioid use disorder.

Also worrisome is the lack of faith physicians have toward using medication to treat opioid use disorder. Many do not think that treating this disorder with medication is any more effective than treatment without it, despite ample evidence that buprenorphine and methadone are highly effective and save lives. The belief that these medications do not work is built on a foundation of bias, not science.

Stigma from the provider community isn’t surprising. There are meaningful gaps — including limited quality measurement related to outcomes for people with substance use disorder, poor reimbursement practices for treating people with substance use disorders, and inadequate education of clinicians about how to best care for people struggling with addiction — that get in the way of the community coming to terms with the importance of treating individuals with substance use disorder with the highest quality medical care accompanied by genuine respect and compassion.

The Massachusetts study we mentioned earlier also showed that only 1 in 4 respondents who went to graduate medical school or social work school had received addiction-related training during medical education, a startling statistic relative to other chronic diseases.

Stigmatizing perceptions directed toward people with opioid use disorder actually increase during time spent in formal medical education, revealing the “hidden curriculum” of negative bias towards individuals with this condition. Stigmatizing language commonly used in medical records, such as “drug abuser,” influences the attitudes and prescribing behaviors of physicians, nurses, and other health care providers.

The impact of stigma on access to quality care and patient outcomes is significant. Because of the attitudes of health care professionals, people with opioid use disorder may defer seeking care for infections or other medical conditions until they are serious or life-threatening. Once they seek treatment, individuals are likely to downplay their substance use history out of fear that revealing it will affect the quality of the care they receive.

Clinicians must be educated and empowered to use patient-first and recovery-centered language, and to apply evidence-based medicine to their practice.

The first step is to widely share best practices that are likely to reduce the amount of stigma and bias experienced by people with opioid use disorder. There are simple things clinicians can do, such as replacing “drug addict” with “person with a substance use disorder” in conversations and in medical records, that have been shown to shape people’s perceptions and attitudes. One study conducted with more than 500 trained mental health and addiction clinicians found that those asked to read a patient vignette with the label “an individual with substance use disorder” were less likely than those who read vignettes containing the term “substance abuser” to say the patient was personally responsible for his or her illness and punitive action should be taken.

This should start in every U.S. health care organization today. “Every time a doctor talks to me in a way that allows them to look me in the eye and not be a paper on a clipboard, they’re reducing harm because all of a sudden I don’t feel shame,” says Skaggs in an interview we filmed with him. “I feel like I’m being treated as a human being worth loving.”

Beyond language, organizations should look closely at practices that may, purposely or inadvertently, result in discrimination toward patients with substance use disorders. Health care organizations must actively engage clinicians in professional development about substance use disorders and stigma; ensure that medications for opioid use disorder such as buprenorphine and methadone are part of the formulary and no barriers exist to initiating or continuing these lifesaving treatments; and support and advocate for institutional, state, and federal policy that allows for substance use disorders to be cared for as chronic medical conditions similar to diabetes or hypertension. Such systems improvements must be done within a health equity framework.

Another component of reducing stigma associated with substance use disorders is creating easily accessible tools to teach the basics around stigma reduction, such as the Reducing Stigma Educational Tools (ReSET) program we recently released. It features videos of Skaggs and other people with lived experiences related to substance use and stigma from the medical community. The two modules include pragmatic steps that any medical professional or health care trainee can take to improve care for this vulnerable group of patients. Shatterproof, the national nonprofit organization dedicated to transforming addiction treatment that one of us (M.S.) works for, recently launched a nationwide initiative to combat stigma.

Every organization has a role to play in controlling addiction, and this is especially true for the health care community.

There is no time to waste. The Covid-19 pandemic has not only made treatment and recovery support more difficult to access, but it is also intensifying the existing fear, uncertainty, and lack of social connection and cohesion that those with substance addictions already feel. The first, necessary, and immediate step to propelling solutions forward is looking inward at ourselves and our organizations to end stigma.

*From the article here :
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