A BAD HABIT THATS HARD TO BREAK
Meth dependence is a difficult disorder to treat. Withdrawal from meth dependence is characterized by a protracted anhedonia and dysphoria that is accompanied by severe craving for the drug. Craving frequently occurs in response to exposure to conditioned cues (stimuli present during past episodes of meth use and euphoria). Such cues evoke powerful craving for meth via classical conditioning principles. The likelihood of continued meth smoking or injecting appears to be, in part, related to the strength of the craving experienced from these craving-generating cues. The withdrawal dysphoria present in the context of ubiquitous meth availability and ubiquitous conditioned cues can produce a very pernicious dependence; indeed, inpatient hospitalization may be indicated to treat long-term meth dependence, at least in initial stages of detoxification. Medically managed inpatient care is expensive, however, and widespread meth abuse has appeared in impoverished populations with very limited access to such inpatient resources.
*Information provided by UCLA Integrated Substance Abuse Programs
Treatment for Methamphetamine Addiction
The effectiveness of treatment generally increases when the program draws on a variety of components. Because of the inability of many meth users to recognize problems related to their drug use, techniques that promote change in patients' thinking, expectations, and behaviors are emphasized.
The length of the treatment program also is important. Many users have a tendency to quickly drop out of treatment, but those who continue in treatment can achieve long-term, drug-free recovery.
Strategies to prevent relapse may include drug education, family and group therapies, and self-help groups. These strategies often include teaching abusers to identify behaviors that put them in situations where they are at high risk for using meth. This form of treatment provides a structure for actively involving patients in treatment and helping them stay off meth.
Treatment is often provided in intensive outpatient programs. Therapies may be combined with techniques to strengthen coping skills for stress and with medications, as needed. The clinical challenges related to paranoia, psychosis, agitation, and severe craving usually require knowledge and skills beyond those involved in traditional alcohol treatment.
More research is needed to focus on concerns related to sexual behavior, weight issues, and ongoing paranoia. Studies examining special treatment issues associated with pregnant women, women with small children, the gay community, and homeless populations also are needed.
Psychosocial Treatments
There are no medications currently approved for the treatment of methamphetamine addicted patients. However, research has shown that effective psychosocial treatments for treating cocaine users are also appropriate in treating methamphetamine use.
Research studies have examined differences in characteristics and treatment outcomes among methamphetamine users by route of administration, which include:
Intranasal (snorting)
Sinusitis, loss of sense of smell, congestion, atrophy of nasal mucosa, nosebleeds, perforation or necrosis of the nasal septus, hoarseness, problems swallowing, and throat ailments.
Smoking
Hoarseness, problems swallowing, throat ailments, and a productive cough with black sputum.
Injecting
HIV, hepatitis, tuberculosis, lung infections, pneumonia, bacterial or viral endocarditis (inflammation of the lining of the heart), cellulitis, wound abscesses, sepsis (the toxic spreading of infection), thrombosis (blood clot), renal infarction (partial or whole kidney death), and thrombophlebitis (inflammation of a vein wall).
Injection use is associated with considerably more detrimental health and psychological problems than non-injection routes. One study found that methamphetamine injectors are a high-risk group exhibiting more severe pathologies and poorer treatment prognoses than smokers and intranasal users. However, smokers also had poor treatment engagement, retention and completion rates when compared to intranasal users. A Japanese study found differences between smokers and injectors. Injectors used methamphetamine for longer periods of time, had lower levels of education, had more extensive criminal records, and experienced more auditory hallucinations compared to methamphetamine smokers. A study conducted in the United States in 2000 found that methamphetamine injectors reported experiencing more adverse consequences related to health, legal and psychological factors as compared to non-injectors.
Psychiatric and Emotional Issues in Methamphetamine Withdrawal
Psychotic Symptoms
Methamphetamine use is known to cause psychotic symptoms. Most typical is paranoid thinking or paranoid delusions. Users become terrified that the police are after them or that they are being watched and someone is listening to them. These fears may be associated with panic reactions. This combination makes it difficult for these individuals to feel safe leaving their home. Methamphetamine users sometimes experience other psychotic symptoms such as auditory, visual and tactile hallucinations.
Depression
The other common psychiatric issue faced by people withdrawing from methamphetamine is depression. Methamphetamine impacts the dopamine system, which controls the feeling of pleasure. When methamphetamine is removed from the
user’s body abruptly, the result is significant feelings of depression.
Neurocognitive
The neurocognitive impact of methamphetamine dependence is well-documented. Asindividuals withdraw from methamphetamine, key among the symptoms they experience are feelings of confusion, difficulty thinking or concentrating, and problems remembering things. Evidence is also mounting that, particularly early in the recovery process, users may have trouble making effective decisions due to methamphetamine’s impact on the prefrontal cortex. Helping clients create a structure for themselves that includes scheduling their time can help reduce the need to think through complicated issues or to make important decisions.
Environment for Methamphetamine Withdrawal
Because methamphetamine detoxification is not medically dangerous, people do notnecessarily need a hospital stay unless they are a danger to themselves or others or are so agitated or cognitively impaired that they cannot safely travel to the treatment center.
In these cases, psychiatric hospitalization is indicated. In most instances, however, detox
can occur in a residential program or in an intensive outpatient or partial hospitalization
treatment program.
Recovering from methamphetamine addiction is a life-long challenge. Very few people addicted to methamphetamine are able to successfully stop using permanently the first time they try. Even when people enter treatment, it is not easy for them to stop using methamphetamine and stay off the drug. For some individuals addicted to methamphetamine, learning how to remain off the drug is learning a new skill, like riding a bicycle. Nobody learns to ride a bicycle without falling off a few times (and sometimes more than a few times).
*Information taken from the California Department of Alcohol and Drug Programs