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

mr peabody

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"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, 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."


The meth addiction epidemic*

INTEGRIS | 24 Sep 2020

Deaths associated with meth use are climbing in Oklahoma and in many other states, an alarming trend that public health officials are struggling to explain. 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.

Writing about the increase in cases of meth addiction in recent times, The New York Times said, "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."

But 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.

While state and local officials are right to concentrate on opioids, which accounted for nearly 70 percent of overdose deaths in 2017, the CDC warns that the dangers of cocaine, meth and other illicit drugs should not be ignored.

Meth never went away

Methamphetamine is once again scouring communities and ruining lives. According to a report on DrugAbuse.org, overdose deaths involving meth more than quadrupled from 2011 to 2017 in the U.S. Admissions to treatment facilities for meth are up 17%.

Hospitalizations related to meth also jumped by about 245% from 2008 to 2015. What’s more, 70 percent of law enforcement agencies in the Midwest and West still rank meth as their biggest drug threat.

The CDC goes on to show that 14,000 cocaine users and 10,000 meth users died in the United States in 2017, an increase of more than a third compared with 2016 and triple the number of deaths in 2012.

The meth epidemic isn’t just nationwide. In Oklahoma, more and more meth cases are being investigated or treated as well. In fact, according to the Oklahoma Bureau of Narcotics (OBN), there were 335 drug deaths in Oklahoma involving methamphetamine in 2018.

In 2018, the OBN told CNN that the number of lethal meth overdoses in the state has more than doubled in recent years, rising from 140 in 2012 to 335 deaths in 2016. In 2017, there were 327 meth overdose deaths.

Mark Woodward, the spokesman with the OBN, told CNN that while everyone was focused on the opioid epidemic, Oklahoma’s single most deadly individual drug was methamphetamine.



The ugly face of meth

Methamphetamine is a highly addictive stimulant drug that gives users powerful feelings of euphoria and energy when it’s abused. Because it is so addictive, meth is extremely difficult to stop using once a person has developed a habit of regular use.

Methamphetamine is a stimulant that is smoked, snorted, injected or even eaten. It can be made from cheap ingredients like over-the-counter cold medicine and household chemicals, but the results of meth addiction are shocking.

DrugAbuse.org said that long term use of meth can cause addiction due to how quickly drug users become tolerant of the pleasurable effects of the drug. As they take more and more to reach that high, they can start to show signs of addiction like significant anxiety, confusion, insomnia, mood disturbances and violent behavior. They also suffer from hallucinations and delusions and psychotic behaviors.

Methamphetamine is neurotoxic and can damage dopamine and serotonin neurons in the brain and usually includes toxic substances. Some studies show that long term meth use also leads to some irreversible changes in the brain associated with emotion and memory and could lead to a number of side effects like paranoia, irritability, increased sexual promiscuity, skin sores, rotting teeth, skin infections, premature aging and more.

Many long term meth users have what is called “meth mouth,” or severe tooth decay. One reason is that meth oftentimes includes acidic ingredients that eat away the enamel—ingredients like drain cleaner, battery acid or hydrochloric acid.

Users often neglect to take care of their teeth while high as well, and some crave sugary drinks, which leads to more oral hygiene problems.

Of course, the biggest risk to meth users is overdose death, which is on the rise throughout America.

*From the article here :
 
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mr peabody

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How meth almost made me a killer*

@Vexanize

Don't even try to argue with me about this shit, as meth literally almost made me into a monster.

Now, I've done meth a few times and was fine, but when I used it only TWICE in a week, I went completely psychotic for days and I'm finally coming back to reality.

It all started when I got some exo's that were "MDMA and MDA" but turned out to be cut with meth. I took five double stacked, as I thought I could handle a high dose of psychedelics. Cut to the most terrifying moment in my life. I'm going to copy and paste what I wrote a few hours after it happened...

"So I've had strange experiences before where I hear a strange deep croaking sound or my friends would feel something chasing them if they were in the woods. But, I think it's finally starting to attack and it's scaring the hell out of me, every single way it moved and basically shapeshifted just screams skin walker to me.

Basically, I went outside to smoke some weed as normal. I was on the 2nd story of my house on the deck, which usually makes me feel pretty safe. But, as I went on to the 3rd bowl I heard a light rustling of leaves, like a racoon that quickly morphed into an aggressive and erratic behavior. The rustling got louder like it grew in size to that of a human. But, even though it was humanoid and even made a small groan that sounded like it was hungry, the way the sound of it moving could dart across my left to right ear, almost like it's moving faster than a cheetah but almost more articulate and precise with it's movements.

I then started telling myself that I'm on the second floor so it can't hurt me. But then what I've feared would happen, happened. It quickly darted over to me from what I'm guessing was like 30 yards in a few seconds. It then quickly scurried up the pillars of my deck (idk if skin walkers can climb) and then pounced onto the wood with a disturbingly loud thud. I accepted death at this moment as I was helpless and realized - this thing is so much stronger than me. But, for some reason it jumped off almost hesitant to kill me. It scurried around and then hurdled my fence with no effort or grunts. It then darted around my entire backyard within seconds.

I'm really fucking scared and I don't know what to do. I want to go out tonight and look for it so I can video tape that bitch. "If I die, then the video will be on my phone, and there will finally be proof of this evil." When nightfall came the next day (I hadn't slept) it felt like it was a Wendigo spirit trying to possess me, making me hear whispers and screams. It felt like something was digging into my head and amplifying my emotions. I then got some sleep and the next day it felt like it was gone. When night struck I could feel this being again. This time it was giving me intrusive thoughts of killing my family and imagining the taste and texture of human flesh. It went away again, so I fell asleep.

The next night I went upstairs to cook, but there is a glass door leading to my deck where the encounter happened. I swear to God I saw its hand outside, it had sharp claws and a pale skin tone. I was terrified as I could feel the pure dread and fear going through my body. I then looked up what Wendigo is, and found that "Wendigo psychosis" is a real condition that meth was basically simulating. As this psychosis wears off, I feel uneasy and angry at almost everything. I'm just so glad this is over."


I want this information to be out in the public as a warning to anyone planning to abuse this drug.

*Reprinted with permission from the author, @Vexanize

 
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mr peabody

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Medication-assisted treatment for meth addiction found effective in new study*

by Brian Mann | NPR | 14 Jan 2021

For the first time, a medication regime has been found effective for some patients with meth addiction in a large, placebo-controlled trial.

It's welcome news for those working with the growing number of people struggling with meth addiction.

"It's progress and it's quite significant," says Dr. Nora Volkow, director of the National Institute on Drug Addiction, which funded the two-year clinical trial involving roughly 400 patients.

The study was published Wednesday in The New England Journal of Medicine.

Unlike opioid addiction, for which medication-assisted treatment is the standard of care, no medication has been approved by the Food and Drug Administration for use with meth.

In the research trial, patients in clinics around the U.S. suffering from methamphetamine use disorder were treated for 12 weeks with a combination of medications — naltrexone and bupropion — or placebo. The treatment helped 13.4% of patients with their addiction, compared with 2.5% of the placebo group.

While a success rate of just over 11% may not sound like a home run, Volkow noted that other medications used to treat brain disorders, including mental illness and addiction, often have similar response rates in patients. This medication therapy provides another tool for doctors to try with patients.

"As we understand the complexity of the human brain, it becomes very much of a magical thinking that one pill will solve the problem of addiction," she says.

The project's lead researcher, Dr. Madhukar Trivedi at the University of Texas Southwestern Medical Center, says the findings were strong enough to give new hope to people struggling with methamphetamine use disorder.

"Patients who are struggling with meth use disorder should definitely have a conversation with their treating physicians to consider whether this option is something they should try," Trivedi said in a statement.

Lara Ray, a psychologist who studies medical treatments for addiction at UCLA and was not involved with this research, says the study changes the treatment landscape for roughly 1.6 million Americans who are addicted to methamphetamines.

"So far we have come up empty," Ray says. "I believe this clinical trial is really a breakthrough in many ways, because there have been so many failed trials."

The treatment regimen in the trial combined two medications that have been studied separately for treating methamphetamine addiction with limited success.

Patients received injections of extended-release naltrexone and oral doses of bupropion. Naltrexone, which is already used for treating opioid addiction, blocks opioid receptors in the brain and is proven to reduce cravings in some patients. Bupropion is often used to treat depression.

Researchers say it's not entirely clear why these drugs worked more effectively in tandem.

Volkow says one theory is that naltrexone reduced physiological cravings for meth, while buproprion's "antidepressant effects" eased the anxiety people experience when they stop using. Unless treated, that emotional distress can trigger a relapse.

Ray says the success rate of the naltrexone-buproprion combination may be improved as doctors refine the method and when supported with other treatments, including behavioral therapy.

This clinical trial was successful enough that the National Institute on Drug Addiction's Volkow says she expects to move forward toward securing FDA approval. Meanwhile, she predicts some clinicians helping people in recovery will begin using the treatment immediately.

"Doctors are going to be reading about it and may prescribe the medications off-label to their patients," Volkow says. The trial did not reveal significant side effects.

This new medical treatment strategy arrives at a time when addiction to methamphetamines has come roaring back, fueled by cheap imports from Mexico.

"It's almost like methamphetamines are falling from the sky right now, with the amount that's coming through the border and on boats and planes," says Matthew Donahue with the U.S. Drug Enforcement Administration.

According to the DEA, seizures of meth on the Southwestern border with Mexico have more than doubled in the last two years, to more than 170,000 pounds. Donahue acknowledged that effort hasn't put a dent in the supply.

"We see it down in Alabama, Mississippi and the Kentucky area where it's really taken off," Donahue says. He added that lack of medical treatments for those addicted to meth has complicated efforts to curb demand for the drug.

The human cost has been catastrophic. Researchers say overdose deaths linked to meth increased fourfold over the last decade.

In a public health alert issued last month, the Centers for Disease Control and Prevention warned meth fatalities spiked again more than 30% during the pandemic.

Even users who don't overdose often experience damage to the heart and other tissues, and can see their lives spiral out of control.

Jessica Martinez began using the drug when she paid her way through college as a sex worker. "I was shooting up every day, sometimes two to three times a day," she says.

Martinez, who has been in recovery for two years, now works with a Washington, D.C.-based group called HIPS helping others with meth addiction. She says when she started her recovery, it was hard in part because there were no medical treatments to help with cravings and withdrawal.

"For heroin users, there's methadone, there's suboxone. I just wonder why we haven't researched treatments for this drug yet," she says.

Martinez says she's hopeful more of her clients will now be able to get medical treatment for their meth addiction, rather than wind up caught in the criminal justice system. "It's about evidence-based care, it's about empathy and it's about survivability," she says.

*From the article here :
 
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mr peabody

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‘It was all while on meth’*

by Nate Gartrell | The Mercury News | 27 Sep 2019

Before accepting a sentence of 25 years to life in prison, Richmond murder defendant Seth Sears offered a detailed courtroom confession, admitting to shooting his friend, Neil Akin, in a crime Sears attributed to his own use of methamphetamine.

“I really don’t understand why I made the decision to kill him, I really don’t,” Sears said.

Sears, 39, shot Akin, 24, in September 2015, inside Sears’ Richmond apartment, where Akin was staying. Sears originally pleaded not guilty and fought the charges for years. But then he shocked everyone, including his attorney, by deciding to plead guilty and accept a life sentence just days into his August trial.

In his sentencing hearing Friday morning, Sears addressed the court, apologized to Akin’s family, and said he wanted to explain exactly what led to the crime. He said he and Akin were friends, and that Akin and a woman — a prosecution witness named Summer — had helped Sears get off heroin “by substituting methamphetamine.”

Sears said that by 2015, he became a heavy meth user and, “was in full-blown speed psychosis.”

“I thought people were following me, I thought people were recording my home with audio and video, and I thought people were recording me through my cellphone,” Sears said.

The day of the homicide Sears was up around 2:30 a.m., when he said he wanted to fix himself a meal. He said he believed Akin was blocking the door to the refrigerator, and that Akin pushed him out of the way, and smirked at him when he tried to open the door. Sears was offended by the smirk, he said.

“I got mad. I told him he had an hour to apologize,” Sears said. “He never apologized, and I shot him.”

After the homicide, Sears said he came to the horrible realization that he had hallucinated the whole thing, except for the part where he shot Akin.

“I don’t think he really smirked. It was just a hallucination, and I shot him in his sleep,” Sears said. He later added, “Akin didn’t deserve what I did to him. He was nothing but a good friend to me.”

Before Sears’ remarks, he listened to tearful statements from Akin’s parents and brother, as well as a song called “Dancing in the Sky,” which Akin’s mother played to honor her son’s memory.

“I believe 25-to-life nowhere near touches the tip for you. I believe you’re a monster and you should be locked away for the rest of your natural-born life,” said George Akin, Neil Akin’s father. “I hope every night, my son visits you in your sleep. … The main thing I wish, Seth, is that I live another 25 years to see you walk out of the prison.”

After the crime, Sears said he called Summer to help him get rid of Neil Akin’s body. He said he wrapped the body in plastic, kept it in his home for days and then eventually dumped it in Oakland with the help of a man he refused to name.

“I tried to get away with this. … It was all while on meth,” Sears said.

Sears said at the time of the murder he thought “guns were cool” but has since changed his mind. He also said he has been sober since May 2016.

“After taking the life of someone with a gun, I really don’t think guns should be in our society,” Sears said during cross-examination. “It’s way too easy. It’s like pushing a button.”

Sears ended his statement with a message to Akin’s family.

“I just want to offer my deepest apologies to the family. … There’s no way I can ever make up for what I’ve done,” he said. “It’s just a tragedy, and I’m really sorry.”

“Thank you,”
replied Akin’s mother from the courtroom gallery.

*From the article here :
 

mr peabody

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Methamphetamine overdose deaths rise sharply nationwide

JAMA Psychiatry | National Institutes of Health | 21 Jan 2021

Methamphetamine overdose deaths surged in an eight-year period in the United States, according to a study that will published today in JAMA Psychiatry. The analysis revealed rapid rises across all racial and ethnic groups, but American Indians and Alaska Natives had the highest death rates overall. The research was conducted at the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

Deaths involving methamphetamines more than quadrupled among non-Hispanic American Indians and Alaska Natives from 2011-2018 overall, with sharp increases for both men and women in that group. The findings highlight the urgent need to develop culturally tailored, gender-specific prevention and treatment strategies for methamphetamine use disorder to meet the unique needs of those who are most vulnerable to the growing overdose crisis. Long-term decreased access to education, high rates of poverty and discrimination in the delivery of health services are among factors thought to contribute to health disparities for American Indians and Alaska Natives.

“While much attention is focused on the opioid crisis, a methamphetamine crisis has been quietly, but actively, gaining steam—particularly among American Indians and Alaska Natives, who are disproportionately affected by a number of health conditions,” said Nora D. Volkow, M.D., NIDA director and a senior author of the study. “American Indian and Alaska Native populations experience structural disadvantages but have cultural strengths that can be leveraged to prevent methamphetamine use and improve health outcomes for those living with addiction.”

Shared decision-making between patient and health care provider and a holistic approach to wellness are deeply rooted traditions among some American Indian and Alaska Native groups and exist in the Indian health care system. Traditional practices, such as talking circles, in which all members of a group can provide an uninterrupted perspective, and ceremonies, such as smudging, have been integrated into the health practices of many Tribal communities. Leveraging traditions may offer a unique and culturally resonant way to promote resilience to help prevent drug use among young people. Development and implementation of other culturally appropriate and community-based prevention; targeting youth and families with positive early intervention strategies; and provider and community education may also aid prevention efforts among this population.

The study found markedly high death rates among non-Hispanic American Indians and Alaska Natives, as well as a pattern of higher overdose death rates in men compared to women within each racial/ethnic group. However, non-Hispanic American Indian and Alaska Native women had higher rates than non-Hispanic Black, Asian, or Hispanic men during 2012-2018, underscoring the exceptionally high overdose rates in American Indian and Alaska Native populations. The results also revealed that non-Hispanic Blacks had the sharpest increases in overdose death rates during 2011-2018. This represents a worrying trend in a group that had previously experienced very low rates of methamphetamine overdose deaths.

Methamphetamine use is linked to a range of serious health risks, including overdose deaths. Unlike for opioids, there are currently no FDA-approved medications for treating methamphetamine use disorder or reversing overdoses. However, behavioral therapies such as contingency management therapy can be effective in reducing harms associated with use of the drug, and a recent clinical trial reported significant therapeutic benefits with the combination of naltrexone with bupropion in patients with methamphetamine use disorders.

Recent national data show that most people who use methamphetamine are between 25 and 54 years old, so the investigators limited their analysis to this age group. When they examined data from this population as a whole, they found a surge in overdose deaths. Deaths involving meth rose from 2 to 10 per 100,000 men, and from 1 to 5 per 100,000 women. This represents a more than five-fold increase from 2011 to 2018.

“Identifying populations that have a higher rate of methamphetamine overdose is a crucial step toward curbing the underlying methamphetamine crisis,” said Dr. Han. “By focusing on the unique needs of individuals and developing culturally tailored interventions, we can begin to move away from one-size-fits-all approaches and toward more effective, tailored interventions.”

 
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ControlDaddy

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If I understand correctly, the most effective treatment modality is repeated low dose of ibogaine for meth addiction. This is not available in the US, although there are repeated low dose ketamine therapies for depression now.

Any suggestions, or experiences, that can be shared on what an American might do to get this treatment would be helpful. I have some money saved and may be able to afford to do the therapy overseas.

thanks!
 
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mr peabody

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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 Dr. Chaves 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]
 

mr peabody

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Dr. Jonathan Brett and clinical Dr. Elizabeth Knock at St Vincent’s Hospital are running a clinical trial
to investigate the effects of psilocybin in therapy for meth addiction.

Psilocybin for meth users: Sydney trial aims to conquer addiction*

by Kate Aubusson | Sydney Morning Herald | 22 Mar 2021

A world-first clinical trial in Sydney aims to find out if giving psychedelics to people who use methamphetamines can help conquer their addiction.

Researchers at St Vincent’s Hospital in Darlinghurst will use psilocybin – the active ingredient in magic mushrooms – to turbocharge therapy for patients dependent on “meth” or “ice.”

Head researcher Dr Jonathan Brett, staff specialist in clinical pharmacology, toxicology and addiction medicine at St Vincent’s is acutely aware of the pressures to conduct such a trial within the most rigorous ethical and scientific boundaries.

“You can’t just give it a crack and see how it goes,” Dr Brett said.

“We wouldn’t at all be encouraging people to try this at home … it needs an established treatment protocol behind it.”

All participants will have at least three counselling sessions with specialised therapists before they get anywhere near psilocybin.

They’ll build a therapeutic relationship, understand their addictive patterns and have a clear understanding of what they hope to get out of treatment.

Participants then take their 25mg capsule of pharmaceutical grade psychedelic under supervision, followed by three or more therapy sessions.

“It’s good bang for your buck,” co-researcher, clinical psychologist Dr Elizabeth Knock said, referring to the treatment’s two-to-three-month time frame.

“That is a short period of psychosocial treatment, which is what excites me about this research – the potential to speed up, enhance or maximise on the conversations that we have as counsellors with these patients.”

The dosage used seems to be the optimal amount to avoid unwanted side effects – such as hallucinations – but still trigger a psychedelic effect, she said.

“It is really about people feeling freer to tell stories in their heads without being tied down to their value,” Dr Knock said.

“It’s this internal psychological and spiritual experience that people describe as transformative … they describe being transported back to childhood or back to where they can have conversations with people and resolve situations.”

One way to think about it, Dr Brett said, is to imagine the mind as a landscape of rolling hills, valleys and troughs.

“The troughs represent deeply held values and you can really get stuck in those troughs which is where the addiction sustains itself. Psilocybin allows the valleys to be flattened and people to shift their values more freely,” he said.

The trial will recruit 15 participants in August from among patients over 25-years-old who are already seeking treatment for meth addiction at St Vincent’s.

“These will be people who may have tried to achieve their goals but have not had success,” Dr Brett said.

The eligibility screening process will be strict. Patients can’t be taking any medication that may interact with the psychedelic, and will need to see a nurse, an addiction specialist and their psychiatrist before they are accepted.

Anyone with a history of schizophrenia or bipolar disorder or a family history of either will be excluded.

“We won’t start with heavy users,” Dr Brett said. “They’ll be people who use over a long weekend or Fridays to Mondays. That is the safest place to start this research. If it’s safe and feasible in that population then we can expand it.”

The trial – funded by the National Centre for Clinical Research on Emerging Drugs – will use functional magnetic resonance imaging (fMRI) to measure brain activity before and after the psilocybin-augmented therapy.

The trial will focus on the default mode network – regions of the brain that activate when we’re awake but not focused on any particular task of mental exercise.

The network is responsible for introspection and mental time travel to experiences, and central to defining who we are, Dr Brett said, and previous research suggest psilocybin stabilises this network.

“We are looking for evidence of causation: that this treatment is effective for this reason,” he said.

The history of psychedelic research has been dogged by controversy since entering the mainstream in the 1930s.

“There were some very well-intentioned researchers, but they weren’t necessarily up to today’s standards,” Dr Brett said.

Then the political war on drugs in the 1970s stoked fear of the drugs among the public, and overzealous psychedelic researchers performed experiments that compromised the integrity of the field, he said.

The researchers stressed they are not suggesting psilocybin is a standalone treatment.

“We must tread very carefully and follow the ethical and scientific processes,” Dr Brett said.

Last Wednesday, the federal government launched $15 million in grants for clinical trials to investigate whether psychedelic drugs could be potential breakthrough therapies for mental illnesses.

The announcement followed an interim decision by the Therapeutic Goods Administration in February that rejected a push to allow psychiatrists to prescribe MDMA and psilocybin led by not-for-profit organisation Mind Medicine Australia.

President of the Royal Australian and New Zealand College of Psychiatrists Associate Professor John Allan welcomed the funding and the TGA’s decision.

“Research into medicines containing psychedelic substances should only occur under research trial conditions that include oversight by an institutional research ethics committee and careful monitoring and reporting of effectiveness and safety outcomes,” Associate Professor Allan said.

“Trials like these will hopefully improve our knowledge, providing the evidence-based research to comprehensively assess the efficacy, safety and effectiveness of psychedelic therapies to inform future potential use in psychiatric practice.”

*From the article here :
 
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mr peabody

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At last, some help for meth addiction

Studies show that a behavioral treatment works well and that two medications may also be useful.

by Claudia Wallis | Scientific American | 1 Apr 2021

A decade ago I traveled on assignment to a Rocky Mountain rehab facility where the rich and famous go to dry out and confront their drug habits. It offered every imaginable therapy to its well-heeled clientele and claimed strong results. But I will never forget what the director of operations told me about the clinic's biggest failure: “Our results with meth addicts are dismal,” he admitted.

Poor results remain all too typical for what is more formally known as methamphetamine use disorder. About one million people in the U.S. are addicted to meth, a powerful stimulant that—smoked, snorted, injected or swallowed—ruins lives and contributed to more than 12,000 overdose deaths in 2018. Fatal overdoses appear to have spiked by nearly 35 percent during the COVID pandemic. Unlike people battling alcoholism or opioid misuse, meth users have no approved medications to help them shake their habit. And most behavioral therapies fail.

But this tragic picture at last may be changing. A recent study found that a regimen of two medications helped some users stay off the drug. In addition, a psychosocial intervention called contingency management (CM) has been shown to be especially effective and, while not widely available, is now the first-line therapy for people seeking treatment for meth or cocaine addiction within the U.S. Department of Veterans Affairs health system.

All addictions are tough to beat, but methamphetamine poses a particular challenge. A key way that researchers measure the addictive grip of a substance is to look at how much dopamine (a neurotransmitter associated with pleasure) floods into the brain's major reward center during use, based on animal studies. “Methamphetamine is the drug that produces the largest release,” says Nora Volkow, director of the National Institute on Drug Abuse. “An animal will go crazy pressing a lever in order to get the drug,” she adds. Another metric involves real-world human experience: When you try a new substance, what is the likelihood of becoming addicted? "In this respect, methamphetamine ranks along with heroin among the top addictive drugs,” Volkow says.

The medication study used two substances that target withdrawal. Bupropion, an antidepressant also prescribed for smoking cessation, raises dopamine levels in the brain and thus may buffer the misery of steep drops that occur when people stop using meth. "Naltrexone, the second medication, is an opioid blocker that has an effect on the reward circuit, potentially relieving cravings,” explains the study's lead author, Madhuka Trivedi, a psychiatrist at the University of Texas Southwestern Medical Center. In a trial with 403 heavy users of meth, a regimen of the two medications helped 14 percent stay off the drug, testing meth-free at least three quarters of the time over a six-week period. Only 3 percent of those given placebos achieved that level of abstinence.

Contingency management works on behavior by reinforcing abstinence with prizes. At VA clinics, addicted veterans submit a urine sample twice a week. If the sample is meth-free, they get to pull a slip of paper from a fishbowl. Half the slips show various dollar amounts that can be spent at VA shops, and the rest feature words of encouragement. Two clean samples in a row earn two draws from the fishbowl, three in a row earn three draws, and so on, up to a maximum of eight. But drug-positive urine means no prize. "The key is the immediacy of the reinforcement,” says Dominick DePhilippis, a clinical psychologist at the Corporal Michael J. Crescenz VA Medical Center in Philadelphia. "That is important," he notes, "because the rush of meth is also immediately reinforcing, whether it is the euphoric feeling that substance use brings or the escape from fatigue or unpleasant mood states of withdrawal."

A 2018 study with 2,060 VA patients, led by DePhilippis, found that over a 12-week period, participants, on average, showed up for 56 percent of their 24 sessions and that 91 percent of their urine samples were free of the targeted drug. According to a 2018 analysis of 50 trials involving nearly 7,000 patients with meth or cocaine habits, one person benefits from CM for every five treated.

DePhilippis's team is gathering data on CM's long-term efficacy for drug users. If results are good, perhaps more health insurers will overcome concerns about using financial rewards in treatment and cover the therapy. Volkow hopes that meth users will ultimately have a variety of treatments, including some that combine medication with behavioral therapy. "That is how diseases from depression to diabetes are treated. But we stigmatize addiction,” Volkow says, “and insurance is willing to pay much less than for another condition. There's a double standard.”

doi:10.1038/scientificamerican0421-21

 

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Practical strategies for families struggling with addiction

by Louise Stanger EdD LCSW | The FIX | 10 Nov 2020

This book will help you better understand what your loved one is going through while also offering realistic advice for approaching their addiction and how it affects your entire family.

We all have steps we can take to remediate, to change and transform.

Today I write from my heart based on my clinical knowledge and research in the behavioral health field and my own years of field experience. My latest book, Addiction in The Family: Helping Families Navigate Challenges, Emotions and Recovery is the guidebook I wish I had when I was first learning about substance use (addiction and mental health disorders) when I was a young woman.

Addiction and mental health are subjects that are close to my heart so much so that when the phone rings I always answer. Most of the time on the other end is a concerned person calling because they just don't know how to respond to a loved one or client who is spiraling out of control due to a substance use disorder.

I know those feelings because I grew up in a family where one never knew what would happen next, as addiction, mental illness, tragedy, and trauma prevailed.

When I was approached to write this book about substance use disorders and the family, I felt energized, honored, and humbled. Little did I know that I would be writing in the midst of a global pandemic and widespread racial and civil unrest. Both matters have great consequences, and not unlike addiction, can hold one hostage. However, we all have steps we can take to remediate, to change and transform.

Truth is, I was highly motivated to write—to make a difference. And now that it's written, I wish that someone could had given me this book when I was struggling to figure out what was going on in my own family, and provided me with guideposts that were easy to understand and use. I am humbled and grateful that I am able to do this for others through Addiction in the Family.

This book is Family Focused and practical in that it teaches one how to set boundaries, deal with strong emotions, and teach you the best ways to communicate with your loved one. It is hopeful and full of real-life examples to help you understand your experience.

The book is divided in to six easy-to-read chapters, which I invite you to skim or skip around. Each chapter is self-contained, offering education, real-life vignettes, talking points, and an easy self-care activity to try. The vignettes are based on real clients I have worked with, yet all personal information, names, and identifying characteristics have been changed to preserve and protect their privacy and confidentiality.

Chapter 1 explains what substance use disorders are and how they affect everybody. In chapter 2, we'll discuss the many behaviors and family roles that one may assume in the face of a substance use disorder. Here we'll explore the addictions arsenal of denial, blame, manipulation, and secrets, as well as the differences between codependency and prodependence, as we learn how to empower our loved ones in healthy ways.

Exploring treatment options is a mighty task. There are so many different options, and it's hard to know which is the right path to take. Chapter 3 will help you discover the many options available, and the benefits of consulting with an unbiased professional to help you make the right decision. We'll also explore ways to talk with a loved one about seeking help.

We all know life is messy; it's no surprise that the road to recovery is likewise full of speed bumps, hiccups, and green, yellow, and red lights. Chapter 4 offers insights as to the meaning of recovery, the emotional roadblocks to recovery, and how to grow as a family member and best support your loved one. Chapter 5 discusses the importance of self-care in the midst of a loved one's substance use disorder, and how to incorporate self-care into daily living. Finally, chapter 6 celebrates the hard work you and your loved one are doing, and sets the stage for building resiliency, celebrating yourself, and discovering joy.

Along the way, you'll be invited to experiment with some effective self-care activities, ranging from developing a gratitude practice, hitting pause, taking five, and breathing, to mindful meditation, walking, journaling, and being of service.

While Addiction in the Family focuses primarily on substance use disorders, it is also relevant for those whose loved ones experience process disorders (for example, digital, shopping, gambling, eating, or sex addictions), as well as those who experience co-occurring mental health disorders.

Thank you for reading, I am honored and humbled that you stopped by today. I invite you to share your journey with me. Please contact me at 619-507-1699, [email protected]. You have my word that I will always greet you with kindness and professionalism. It is my goal to inform, inspire, education, and help your family heal.

Addiction in the Family is available on Amazon.

 

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

by Robert Preidt | HealthDay News | 4 Jun 2021

Methamphetamine users are nearly twice as likely as non-users to have two or more chronic medical conditions. In addition, they were more than three times as likely to have mental illness, and more than four times as likely to have a substance use disorder involving drugs such as heroin, prescription stimulants, prescription opioids, cocaine and sedatives.

Many meth users have a combination of medical, mental and substance use issues, including all three at the same time, according to the report published June 3 in the Journal of General Internal Medicine.

The study also found that meth users had higher rates of liver disease (hepatitis or cirrhosis), lung disease (chronic obstructive pulmonary disease or asthma), and HIV/AIDS than non-users.

"Our results do not suggest that meth use causes most of these conditions, but they should inform clinicians that this population is at risk," said study co-author Joseph Palamar. He is a researcher at the Center for Drug Use and HIV/HCV Research (CDUHR) at NYU School of Global Public Health, in New York City.

Palamar said more study is needed to learn how dose and frequency of use relates to these conditions — for instance, occasional use on a night out versus chronic use that can lead to a host of adverse effects on the body.

"We also confirmed the well-known link between meth use and HIV, which can result from injection drug use or sexual transmission, but more research is needed to determine the extent to which meth use increases risk for [sexually transmitted diseases] due to the drug's libido-enhancing effects," Palamar added.

Study co-author Dr. Benjamin Han explained that meth use adds complexity to the already challenging care of adults with multiple chronic conditions.

"Integrated interventions that can address the multiple conditions people are living with, along with associated social risks, are needed for this population," added Han, a clinician-researcher at the University of California, San Diego, who is also a researcher at CDUHR.

*From the article here :
 
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