Children whose mothers abused methamphetamine (meth) during pregnancy show brain abnormalities that may be more severe than that of children exposed to alcohol prenatally, according to a study in the March 17 issue of The Journal of Neuroscience. While researchers have long known that drug abuse during pregnancy can alter fetal brain development, this finding shows the potential impact of meth. Identifying vulnerable brain structures may help predict particular learning and behavioral problems in meth-exposed children.
________________________________________
“We know that alcohol exposure is toxic to the developing fetus and can result in lifelong brain, cognitive, and behavioral problems,” said Elizabeth Sowell, PhD, of the University of California, Los Angeles, who led the research team. “In this study, we show that the effects of prenatal meth exposure, or the combination of meth and alcohol exposure, may actually be worse. Our findings stress the importance of drug abuse treatment for pregnant women,” Sowell said. A structure called the caudate nucleus, which is important for learning and memory, motor control, and motivation, was one of the regions more reduced by meth than alcohol exposure.
Of the more than 16 million Americans over the age of 12 who have used meth, about 19,000 are pregnant women, according to data from the National Surveys on Drug Use and Health. About half of women who say they used meth during pregnancy also used alcohol, so isolating the effects of meth on the developing brain is difficult.
Sowell’s team evaluated the specific effects of prenatal meth-exposure by comparing brain scans of 61 children: 21 with prenatal meth and alcohol exposure, 13 with heavy alcohol exposure only, and 27 unexposed. Structural magnetic resonance imaging (MRI) showed that the sizes and shapes of certain brain structures varied depending on prenatal drug exposure.
Previous studies have shown that certain brain structures are smaller in alcohol-exposed children. In this study, the authors found these brain regions in meth-exposed children were similar to the alcohol-exposed children, and in some areas were smaller still. Some brain regions were larger than normal. An abnormal volume increase was noted in meth-exposed children in a region called the cingulate cortex, which is associated with control and conflict resolution.
The researchers were also able to predict a child’s past exposure to drugs based on brain images and IQ information. Detailed data about vulnerable brain structures may eventually be used to diagnose children with cognitive or behavioral problems but without well-documented histories of drug exposure. Christian Beaulieu, PhD, of the University of Alberta in Canada, who was unaffiliated with the study, said this finding will help researchers understand which brain areas are most sensitive to injury during development.
“Ultimately, the goal would be to come up with strategies to first, minimize brain damage in the womb, and second, to improve the child’s cognitive performance,” Beaulieu said.
.

Source: Society for Neuroscience, March 17 2010

According to experimental scientists a common antipsychotic drug used in emergency rooms to treat methamphetamine overdose can damage nerve cells in an area of the brain known to regulate movement.
Investigators from the Boston University School of Medicine used a rat model to determine that only the combination of the medication, haloperidol, and methamphetamine causes the destructive effects, not either one alone.
Senior author Bryan Yamamoto, PhD, and his team suspect the damage results from the exaggerated stimulation of cells by the amino acid glutamate, which proves toxic to cells producing the neurotransmitter gamma-aminobutyric acid (GABA).
Their results are published in the May 30 issue of The Journal of Neuroscience.
“This work in laboratory animals raises immediate concerns that a standard treatment for methamphetamine overdose in humans might worsen drug abuse-related brain injuries,” says William Carlezon, PhD, at Harvard’s McLean Hospital, who was not affiliated with the study.
“A crucial next step is to determine how atypical antipsychotic medications would affect methamphetamine toxicity in the same model.”
The rats in the experiment were injected with either methamphetamine or a saline solution over a period of eight hours. When the rats were given haloperidol before and nearly halfway through the eight-hour period, Yamamoto and his colleagues noted more than a fivefold rise in base levels of glutamate in the substantia nigra, a part of the brain known to play a role in movement disorders such as Huntington’s disease.
After examining the long-term effects of the combination, they found that glutamate concentrations in the substantia nigra were twice as high in methamphetamine-treated rats as in saline-treated ones two days after injections.
Yamamoto and his colleagues were able to link this rise in glutamate to the death of GABA-containing cells in one part of the substantia nigra. This may predispose some people who have been treated for a methamphetamine overdose to seizures and the development of movement disorders, they say, although the study did not measure movement specifically.
In addition to future studies of other antipsychotic medications, says Yamamoto, “we hope to examine if the loss of cells results in abnormal involuntary movements resembling Tourette’s syndrome and Huntington’s disease.”

Source: Society for Neuroscience May 30th 2007

What do suffering a traumatic brain injury and using club drugs have in common? University of Florida researchers say both may trigger a similar chemical chain reaction in the brain, leading to cell death, memory loss and potentially
irreversible brain damage.

A series of studies at UF over the past five years has shown using the
popular club drug Ecstasy, also called MDMA, and other forms of
methamphetamine lead to the same type of brain changes, cell loss and
protein fluctuations in the brain that occur after a person endures a
sharp blow to the head, according to recent findings.

“Using methamphetamine is like inflicting a traumatic brain injury on
yourself,” said Firas Kobeissy, a postdoctoral associate in the College
of Medicine department of psychiatry. “We found that a lot of brain
cells are being injured by these drugs. That’s alarming to society now.
People don’t seem to take club drugs as seriously as drugs such as
heroin or cocaine.”

Working with UF researchers Dr. Mark Gold, chief of the division of
addiction medicine at UF’s McKnight Brain Institute and one of the
country’s leading experts on addiction medicine, and Kevin Wang,
director of the UF Center for Neuroproteomics and Biomarkers Research,
Kobeissy compared what happened in the brains of rats given large doses
of methamphetamine with what happened to those that had suffered a
traumatic brain injury.

The group’s research has already shown how traumatic brain injury
affects brain cells in rats. They found similar damage in the rats
exposed to methamphetamine. In the brain, club drugs set off a chain of
events that injures brain cells. The drugs seem to damage certain
proteins in the brain, which causes protein levels to fluctuate. When
proteins are damaged, brain cells could die. In addition, as some
proteins change under the influence of methamphetamine, they also begin
to cause inflammation in the brain, which can be deadly, Kobeissy said.

Kobeissy and other researchers in Gold’s lab are using novel protein
analysis methods to understand how drug abuse alters the brain. Looking
specifically at proteins in the rat cortex, UF researchers discovered
that about 12 percent of the proteins in this region of the brain showed
the same kinds of changes after either methamphetamine use or traumatic
brain injury. There are about 30,000 proteins in the brain so such a
significant parallel indicates that a similar mechanism is at work after
both traumatic brain injury and methamphetamine abuse, Kobeissy said.

“Sometimes people go to the clubs and take three tablets of Ecstasy or
speed,” Kobeissy said. “That may be a toxic dose for them. Toxic effects
can be seen for methamphetamine, Ecstasy and traumatic injury in
different areas of the brain.”

About 1.3 million people over the age of 12 reported using
methamphetamine in the previous month, according to the 2006 National
Survey on Drug Use and Health. In 2004, more than 12 million Americans
reported having tried the drug, the survey’s findings show.

People often think the effects of drugs of abuse wear off in the body
the same way common medications do, but that may not be the case, Gold
said.

“These data and the previous four years of data suggest some drugs,
especially methamphetamine, cause changes that are not readily
reversible,” Gold said. “Future research is necessary for us to
determine when or if methamphetamine-related brain changes reverse
themselves.”

Gold and Dennis Steindler, director of UF’s McKnight Brain Institute and
an expert on stem cells, are planning studies to find out if stem cells
can be applied to repair drug-related brain damage.

UF researchers are also trying to uncover all the various ways drugs
damage and kill brain cells. During their protein analysis, researchers
discovered that oxidation was damaging some proteins, throwing the
molecules chemically off balance.

“When proteins are oxidized they are not functional,” Kobeissy said.
“When proteins are not working, the cell cannot function.”

Neurologist Dr. Jean Lud Cadet, chief of the molecular neuropsychiatry
branch of the National Institute on Drug Abuse, said analyzing proteins
is important to understanding how drugs such as methamphetamine affect
the brain.

“I think saying the results of methamphetamine abuse are comparable to
the results of a traumatic brain injury is a new idea,” Cadet said. “I
agree with (the findings). Our own work shows that methamphetamine is
pretty toxic to the brains of animals. In humans, imaging studies of
patients who use methamphetamine chronically show abnormalities in the
brain.

“Abuse of methamphetamine is very dangerous.”

This research was presented at a Society for Neuroscience conference
held recently in San Diego.

Source: Science Daily (Nov. 29, 2007)

Children and adolescents who abuse alcohol or are sexually active are more likely to take methamphetamines (MA), also known as ‘meth’ or ‘speed’. New research reveals the risk factors associated with MA use, in both low-risk children (those who don’t take drugs) and high-risk children (those who have taken other drugs or who have ever attended juvenile detention centres).

MA is a stimulant, usually smoked, snorted or injected. It produces sensations of euphoria, lowered inhibitions, feelings of invincibility, increased wakefulness, heightened sexual experiences, and hyperactivity resulting from increased energy for extended periods of time. According to the lead author of this study, Terry P. Klassen of the University of Alberta, Canada, “MA is produced, or ‘cooked’, quickly, reasonably simply, and cheaply by using legal and readily available ingredients with recipes that can be found on the internet”.
Because of the low cost, ready availability and legal status of the drug, long-term use can be a serious problem. In order to assess the risk factors that are associated with people using MA, Klassen and his team carried out an analysis of twelve different medical studies, combining their results to get a bigger picture of the MA problem. They said, “Within the low-risk group, there were some clear patterns of risk factors associated with MA use. A history of engaging in behaviors such as sexual activity, alcohol consumption and smoking was significantly associated with MA use among low-risk youth. Engaging in these kinds of behaviors may be a gateway for MA use or vice versa. A homosexual or bisexual lifestyle is also a risk factor.”
Amongst high-risk youth, the risk factors the authors identified were, “growing up in an unstable family environment (e.g., family history of crime, alcohol use and drug use) and having received treatment for psychiatric conditions. Among high-risk youth, being female was also a risk factor”.

Source: BMC Pediatrics (2008, October 29). Methamphetamine Abuse Linked To Underage Sex, Smoking And Drinking. ScienceDaily. Retrieved November 12, 2009, from http://www.sciencedaily.com

University of Washington researchers say that animal studies show that methamphetamine use causes lasting changes in the brain’s dopamine system, making it especially difficult for users to stop using the drug.
HealthDay News reported April 9 that researcher Nigel Bamford and colleagues found that long-term methamphetamine use depressed the synaptic dopamine-release system in the corticostriatal area of the brain — a condition that gets temporarily reversed when a dose of methamphetamine is administered.
Researchers said that methamphetamine appears to cause long-term changes in certain dopamine receptors and with the neurotransmitter acetylcholine. The findings “might provide a synaptic basis that underlies addiction and habit learning and their long-term maintenance,” Bamford and colleagues wrote.
Source: April 10, 2008 issue of the journal Neuron.

Research Summary
Animal studies show that amphetamines are converted into free radicals in the brain, which in turn can cause brain damage, HealthDay News reported April 13.
University of Toronto researchers said the mouse studies could explain how methamphetamine causes brain damage, even after the drug has been metabolized out of the body. The study authors said the enzyme prostaglandin H synthase (PHS) appears to play a role in converting amphetamines into free radicals, which can cause neurodegenerative diseases like Parkinson’s and Alzheimer’s.
Source: April 2006 issue of the FASEB (Federation of American Societies for Experimental Biology) Journal.

Methamphetamine Abuse Linked To Underage Sex, Smoking And Drinking

Children and adolescents who abuse alcohol or are sexually active are more likely to take methamphetamines (MA), also known as ‘meth’ or ‘speed’. New research reveals the risk factors associated with MA use, in both low-risk children (those who don’t take drugs) and high-risk children (those who have taken other drugs or who have ever attended juvenile detention centres).

MA is a stimulant, usually smoked, snorted or injected. It produces sensations of euphoria, lowered inhibitions, feelings of invincibility, increased wakefulness, heightened sexual experiences, and hyperactivity resulting from increased energy for extended periods of time. According to the lead author of this study, Terry P. Klassen of the University of Alberta, Canada, “MA is produced, or ‘cooked’, quickly, reasonably simply, and cheaply by using legal and readily available ingredients with recipes that can be found on the internet”.
Because of the low cost, ready availability and legal status of the drug, long-term use can be a serious problem. In order to assess the risk factors that are associated with people using MA, Klassen and his team carried out an analysis of twelve different medical studies, combining their results to get a bigger picture of the MA problem. They said, “Within the low-risk group, there were some clear patterns of risk factors associated with MA use. A history of engaging in behaviors such as sexual activity, alcohol consumption and smoking was significantly associated with MA use among low-risk youth. Engaging in these kinds of behaviors may be a gateway for MA use or vice versa. A homosexual or bisexual lifestyle is also a risk factor.”
Amongst high-risk youth, the risk factors the authors identified were, “growing up in an unstable family environment (e.g., family history of crime, alcohol use and drug use) and having received treatment for psychiatric conditions. Among high-risk youth, being female was also a risk factor”.

Source: BMC Pediatrics (2008, October 29). Methamphetamine Abuse Linked To Underage Sex, Smoking And Drinking. ScienceDaily. Retrieved November 12, 2009, from http://www.sciencedaily.com

Individual case reports have suggested a link between heart attack and amphetamine abuse, but this is believed to be the first epidemiological study of a large group of people on the issue, said Dr. Arthur Westover, assistant professor of psychiatry at
UT Southwestern and the study’s lead author.
  
“Most people aren’t surprised that methamphetamines and amphetamines are bad for your health,” Dr. Westover said. “But we are concerned because heart attacks in the young are rare and can be very debilitating or deadly.”

Amphetamines are stimulants that can be used to treat medical conditions such as attention-deficient disorder. They are illegally abused as recreational drugs or performance enhancers.

The researchers note that abuse of methamphetamine, a type of amphetamine often sold illegally, is increasing in most major U.S. cities.

In Texas, the researchers found greater amphetamine abuse in the north and Panhandle regions.

“This paper sounds a warning to amphetamine abusers, alerts emergency department personnel to look for amphetamine abuse in young heart attack patients, and it allows us to focus preventive efforts in geographical areas where the problems are greatest,” said Dr. Robert W. Haley, chief of epidemiology at UT Southwestern and senior author of the study. Dr. Haley holds the U.S. Armed Forces Veterans Distinguished Chair for Medical Research, Honoring America’s Gulf War Veterans.
“We’re also concerned that the number of amphetamine-related heart attacks could be increasing,” Dr. Westover said. “We’d rather raise the warning flag now than later. Hopefully, we can decrease the number of people who suffer heart attacks as the result of amphetamine abuse.”
Amphetamines may contribute to heart attacks by increasing heart rate and blood pressure and by causing inflammation and artery spasms that limit blood to the heart muscle. More research is needed to determine the exact mechanism of how amphetamines work on the heart, he said.
The current research could help doctors determine the cause of heart attacks in young adults, as well as treatment. Doctors recognizing an amphetamine-caused heart attack might choose not to administer a beta-blocker medication, a common treatment for heart attack, because it could interact with methamphetamine to make the heart attack worse.

The results could have broad implications in the general population, Dr. Westover said. Texas ranks 27th among all states in use of methamphetamine among 18- to 25-year-old adults, according to a 2006 government report.

“We’re talking about a state that is near the middle of prevalence of methamphetamine use in the United States, so it’s possible that the number of heart attacks in young adults in other states with a much higher prevalence of amphetamine abuse may be higher as well,” said Dr. Westover, who is a National Institutes of Health Multidisciplinary Clinical Research Scholar at UT Southwestern.
Dr. Paul Nakonezny, assistant professor of clinical sciences and psychiatry at
UT Southwestern, was also involved in the study.

The work was supported by a North and Central Texas Clinical and Translational Science Initiative grant from the National Center for Research Resources, a component of the National Institutes of Health.

A drug used to tranquillize horses, called ketamine, is gaining popularity within the dance scene in a number of countries throughout the world. That´s according to a recent report by the United Nations Office of Drugs and Crime, which warned that long-term use of ketamine use can have serious effects on the brain, the kidneys and internal organs.

Now the most abused drug by so called “clubbers” in Hong Kong, ketamine is gaining popularity across southern China. Its use is spreading throughout East Asia as well as Australia, Europe and North America. But because ketamine is a legal substance – and therefore not controlled – the true extent of its use is unclear and probably underestimated.

Nicknamed ‘Special K’, ketamine can be taken in powder, liquid or tablet form but is often mixed with other drugs or alcohol. Sometimes ketamine is laced with synthetic drugs such as methamphetamine and then sold as ecstasy because it commands a higher price than straight ketamine.

“It is a new candy for the youth “, explains UNODC expert Jeremy Douglas, who cautioned that people can be easily fooled. “Sometimes they know they’re using ketamine, sometimes they don’t”. Uncertainty about the content of tablets sold as “ecstasy” is of concern and poses particular risk.

The effect of the drug depends on the dose. With low doses, party-goers may feel euphoric, have psychedelic experiences and high levels of energy, but high doses might plunge the user into an out-of-body or near-death experience known as the “K-hole.” “It’s an anaesthetic so it can put someone in a catatonic state, a different state of being. Perception of the body, time and reality is severely altered,” Douglas said.

Long-term use may impair the memory and cognitive functions, and damage the kidneys and internal organs.

The emergence of ketamine on the synthetic drug scene has gone unnoticed in many parts of the world. Unlike illicit drugs, the trade in ketamine is not internationally controlled. This makes it hard to get a clear picture of how the drug is being diverted for illicit purposes. “We’re seeing the use of ketamine taking off, but it’s up to Member States and national governments to control it. Anyway, it seems that the use is growing both in developing countries and in the west”, Douglas says.

Source: CADCA Coalitions Online 13th Nov.2008

Research Summary
Children exposed to methamphetamine during pregnancy may suffer from altered brain development, Reuters reported April 15.
Researchers at the University of Hawaii, Honolulu assessed the brain structure of children who were exposed to methamphetamine during pregnancy and found that they had up to 4 percent less diffusion of molecules in brain white matter than those who were not exposed.
While it is unclear how methamphetamine exposure leads to lower brain diffusion, author Linda Chang said the condition usually indicates that nerve fibers are compacted.
“Methamphetamine use is an increasing problem among women of childbearing age, leading to an increasing number of children with prenatal meth exposure,” Chang said. “But until now, the effects of prenatal meth exposure on the developing brain of a child were little known.”
Source: Neurology. April 15, 2009

In a study published online by the Journal of Substance Abuse Treatment, UC Davis researchers report that it takes at least a year for former methamphetamine users to regain impulse control. The results tell recovering substance abusers, their families and drug-treatment specialists that it can take an extended period of time for the brain functions critical to recovery to improve.

“Recovery from meth abuse does not happen overnight,” said Ruth Salo, lead author of the study and a UC Davis assistant professor of psychiatry and behavioral sciences. “It may take a year – or even longer – for cognitive processes such as impulse control and attentional focus to improve. Treatment programs need to consider this when monitoring recovering addicts’ progress during their early periods of abstinence.”

Salo specializes in the behavioral, neuropsychiatric and cognitive outcomes of methamphetamine addiction – a particularly difficult condition to treat, primarily due to prolonged, intense cravings for the drug. During her career, she has worked with hundreds of methamphetamine addicts.

“All of them want to know if there is hope,” Salo said. “We used to think most, if not all, effects of meth addiction were permanent. This study adds to the growing evidence that this assumption is not true. I can confidently tell patients that the longer they stay in a structured rehabilitation program and remain drug free, the more likely it is that they will recover some important brain functions.”

For the current study, Salo used the widely-validated, computer-based Stroop attention test to measure the abilities of 65 recovering methamphetamine abusers to use cognitive control – or direct their attention to specific tasks while ignoring distractors. Study participants had been abstinent for a minimum of three weeks and a maximum of 10 years, and they had previously used the drug for periods ranging from 24 months to 28 years. The data for the 65 individuals were compared to Stroop attention test data from 33 participants who had never used methamphetamine.

“The test taps into something people do in everyday life: make choices in the face of conflicting impulses that can promote a strong but detrimental tendency,” Salo explained. “For meth users, impairments in this decision-making ability might make them more likely to spend a paycheck on the immediate satisfaction of getting high rather than on the longer-term satisfaction gained by paying rent or buying groceries.”

The study analyzed cognitive control in terms of the amount of time since methamphetamine was last used as well as total time spent using the drug. The researchers found that those who were recently abstinent (three weeks to six months) performed significantly worse on the Stroop test than those who had been abstinent one year or longer. In addition, there was no statistical difference between test results for those abstinent at least one year and non-drug using controls. Longer-term methamphetamine use was associated with worse test scores. Similarly, longer-term abstinence was connected to improved test performance.

According to Salo, the new study mirrors previous magnetic resonance imaging (MRI) studies she and her colleagues published in 2005 showing a partial normalization of chemicals in selected brain regions after one year of methamphetamine abstinence.

“Together, the studies provide strong evidence that, eventually, meth abusers in recovery may be able to make better decisions and regain the impulse control that was lost during their drug use period,” she said.

Salo said that more research is needed to determine just how the brain recovers from methamphetamine addiction and if behavioral treatments can hasten that recovery. She plans to continue neuroimaging studies to further define the brain functions affected by the drug. Her ultimate goal is to provide information essential to refining treatment programs for this population of drug users.

“Meth use worldwide is pandemic,” she said, referring to the estimated 35 million people who have used the neurotoxic stimulant or similar drugs. “Recovery is difficult, but possible. The point of my research is to better understand the neural and behavioral consequences of this toxic drug along with the brain and behavior changes that are possible with long-term abstinence.”
Source: Journal of Substance Abuse Treatment, Ruth Salo et al 1st July 2009

An Alabama doctor who lost a brother to methamphetamine addiction has formed a support group called “After he died, I started looking into it as a physician, as a scientist”, said Dr. Mary Holley, an obstetrician in Albertville. “What is this drug that destroyed his life in just two years?”

Holley formed the group last year and there now are chapters in Tennessee, Georgia, Oklahoma, Missouri, and Ohio.

The group works with churches to form addiction-support groups. In addition, the MAMa website offers information that explains the dangers of meth.

“People don’t realize what this drug is doing,” Holley said. “One look at the brain scan in my pamphlets will change that attitude.”

Holley, a Christian, said a religious approach to treating drug addiction is more effective than law enforcement. “Law enforcement is helpless. They can’t possibly bust every lab. They can’t keep them in jail long enough for them to heal,” Holley said. “Education is helpless. They lack the resources and the moral authority to change the situation.”

Holley said that when speaking with young people, she found that, “20 percent of meth users are basically healthy kids who made a bad decision. About 75 percent are broken, hurting people, abused and battered as kids.

This publication summarizes current knowledge about rates of use, methods of action, effects, and acute and long-term dangers of two important classes of drugs of abuse. Hallucinogenic drugs, which include LSD and mescaline, act on the serotonin system to produce profound distortions of the user’s sense of reality. The dissociative drugs include the anesthetic agents PCP and ketamine and the cough suppressant dextromethorphan, all of which cause feelings of separation from the body. Ketamine use has increased thiwt in recent years; in addition to its conscious abuse, it has also been given to unsuspecting victims to incapacitate them for sexual assaults.

Drug  trafficking groups are using the Internet to distribute the “date rape” drug, GHB, and its derivative drugs, GBL and 1, 4 Butanediol 1,4 BD.) GHB, GBL and 1,4 BD are abused to produce euphoria, intoxication and hallucinogenic states, and for their alleged role as a muscle growth hormone. These substances are also used as “date rape” drugs, acting as central nervous system depressants, which cause drowsiness, dizziness, nausea, loss of inhibition, memory loss and visual disturbances. Higher doses of these substances will cause unconsciousness, seizures, severe respiratory depression, coma and even death. DEA has documented 72 deaths relating to GHB and its derivatives.

A new brain-imaging study at the U.S. Department of Energy’s Brookhaven National Laboratory indicates that some of the damage  caused by methamphetamine, a drug abused by ever-increasing numbers of Americans, can be reversed by prolonged abstinence from the drug. The results appear in the December 1, 2001 issue of The Journal of Neuroscience.

“Methamphetamine is a particularly problematic, highly addictive drug,” said Nora Volkow, who led the study with Linda Chang. Their team had previously shown that methamphetamine abusers have significantly depleted levels of dopamine transporters. These proteins, found on the terminals of some brain cells, recycle dopamine, a brain chemical associated with pleasure and reward and also essential for movement. The study also found that meth abusers had impaired cognitive and motor function. “These changes could mean that meth abusers would be predisposed to such neurodegenerative disorders as Parkinson’s disease, which is also characterized by problem with dopamine and motor function,” Volkow said. “It depends in part on whether the damage is reversible.” To help answer this question, Volkow and her team used positron emission tomography, or PET scanning, to measure the level of dopamine transporters in methamphetamine abusers after varying periods of abstinence. One group of 12 methamphetamine abusers was scanned within 6 months of taking the drug, and, for 5 of these subjects who managed to stay drug-free, the scan was repeated after 9 months of abstinence. Another group of 5 methamphetamine abusers was studied only after 9 months of abstinence. All subjects were compared with normal controls.

For each scan, each study volunteer was given an injection carrying a radiotracer, a radioactive chemical “tag” designed to bind to dopamine transporters in the brain. The researchers then scanned the subjects’ brains using a PET camera, which picks up the radioactive signal of the tracer bound to the transporters. The strength of the signal indicates the number of transporters. The scientists also looked for improvements in cognitive and motor function after abstinence by administering a battery of neuropsychological tests. These included tests of fine and gross motor function and tests of attention and memory. The main finding was that, in methamphetamine abusers who were able to stay drug-free for at least 9 months, dopamine transporter levels showed significant improvement, approaching the level observed in control subjects. In abusers studied within 6 and after 9 months, the longer the period between the first and second evaluation, the larger the increase in dopamine transporter levels. Cognitive and motor function showed a trend toward improvement on some tests, but these changes were not statistically significant.

“The increase in dopamine transporter levels with prolonged abstinence indicates that the terminals of dopamine secreting cells, which are thought to be damaged by methamphetamine abuse, are able to regenerate,” Volkow said. Another possibility is that other,  undamaged terminals are able to branch out and make up for the loss. “These findings have implications for the treatment of methamphetamine abusers because they suggest that protracted abstinence and proper rehabilitation may reverse some of the meth  induced alterations in dopamine cells,” Volkow said. “Unfortunately, we did not see a parallel improvement in function.” The recovery of dopamine transporters may not have been sufficient to completely make up for the damage to the dopamine terminals, she suggested. Additionally, other systems necessary for neuropsychological function might also be damaged by the drug   and less able to recover. Also, Volkow noted, the sample sizes were small. “Further study in larger samples is required to assess whether recovery of dopamine transporters with protracted abstinence is associated with recovery of neuropsychological function,” she said.

New research suggests that individuals who stop using methamphetamine may experience brain abnormalities similar to those seen in people with depression and anxiety disorders, according to a Jan. 5 press release from the National Institute on Drug Abuse (NIDA).

For the study, Dr. Edythe London and colleagues at the University of California at Los Angeles, the University of  California Irvine, and NIDA’s Intramural Research Program used positron emission tomography (PET) to image brain activity in methamphetamine users. .The researchers compared the glucose metabolism in the brains of 18 people who did not use the drug to the brain activity of 17 individuals addicted to methamphetamine for an average of 10 years, but who had stopped using the drug for four to seven days before the test. After reviewing the PET scans, the researchers found that in methamphetamine users, the glucose metabolism was lower in brain regions linked to depressive disorders, depressed mood and sadness, but higher in brain regions linked to anxiety and drug cravings.

In addition, questionnaires given to all participants showed that methamphetamine users had higher ratings of depression and anxiety than non users. Based on the study’s results, the researchers recommended that practitioners provide therapy for depression and anxiety in order to improve the success rate for methamphetamine users receiving addiction treatment. The study’s findings are published in the January 2004 issue of the Archives of  General Psychiatry.

The methamphetamine problem may have grown so huge in Cowlitz County that an average of more than a baby a day born at St. John Medical Center might have the drug in their systems.

As local doctors and mental health experts try to get a handle on the growing problem — including a Friday appeal to U.S. Rep. Brian Baird, D-Vancouver, for help — a new study could point to an even graver need to attack the problem.

Already, doctors have identified between 10 percent and 20 percent of babies born at St. John with meth in their systems. Many of those babies start their lives going through drug withdrawal.

But if Dr. Aidan deRenne’s suspicions are correct, twice that many — perhaps between 30 percent and 40 percent — of the 1,200 babies born at St. John Medical Center each year are exposed to meth during their final six months in the womb.

DeRenne and Dr. Shawn Aaron, a PeaceHealth doctor who heads the local association of family physicians, will collect samples of the first bowel movements of all babies born at St. John during a six-month period. Unlike blood or urine, those early stools retain measurable traces of any drugs the mother used during the final six months of the pregnancy, deRenne said.

“I think (the number of drug babies) is just going to blow us away,” said deRenne, a pediatrician at Child and Adolescent Clinic and head of the local pediatrician association. “We’ve got a bigger problem than we really know right now.”

He based his estimate on his own experience with patients, discussions with other doctors, maternity nurses and drug-prevention experts, and the results of similar tests conducted elsewhere.

“I hope I’m wrong, let me put it that way,” he said. “Both Shawn and I were so tired of seeing drug-addicted babies up in our NICU (neonatal intensive care unit).”

The way the study is designed, it can’t tie the positive drug tests in the babies to individual women, deRenne said. Instead, the lab simply will test one sample per baby born at the hospital to determine how many had drugs in their system when they left the womb. Because the tests are anonymous and don’t require a medical procedure, new mothers won’t have to consent to the testing.

The results could help attract grant money or other funding to help the community’s pregnant women get off drugs and to treat children harmed by their mothers’ drug use, said deRenne and Dr. Phyllis Cavens, a partner at Child and Adolescent.

The study should begin in about a month and collect roughly 600 samples. The cost of lab tests will make up most of the study’s cost, pegged at up to $30,000. Kaiser Permanente is paying for the lab work and PeaceHealth is contributing staff time, deRenne said.

Cavens and other medical and mental health officials invited Baird, who already has pushed for funding to fight meth, to the Friday discussion for several health-related issues, including soliciting his help in finding ways to halt the epidemic of meth-addicted babies. “Meth is our number-one community issue,” said Eric Yakovich, chief executive officer for Lower Columbia Mental Health Center in Longview. “It just dominates the use of our resources here in this county.”

Baird pledged more work on the problem and talked about the idea of finding more money to help children harmed by the meth epidemic, which he called “social corrosion.”

He said he speaks to students about the drug’s perils every chance he gets, but many teens roll their eyes. Still, he warns them, “It’s a decision basically to end your life, if you start (using) methamphetamines.”

Source: By Eric Apalategui www.tdn.com Sep 19, 2004

PHILADELPHIA (Reuters) – Gay men who combine the drugs crystal meth and Viagra run a greater chance of getting sexually transmitted diseases than nonusers, according to a study released on Wednesday.

Figures show men who have sex with other men and use both crystal methamphetamines and the erectile dysfunction drug Viagra were six times more likely to contract syphilis than those who do not use either, a researcher said at a national conference on sexually transmitted disease prevention.

The findings published in Philadelphia come as the use of the two drugs are on the rise among gay men. The use of crystal meth has been highlighted by gay advocates as endemic at bath houses, which have seen a resurgence in recent years after drug cocktails have helped people live with HIV (news – web sites).

With the national incidence of syphillis increasing over the past three years, the San Francisco Department of Public Health (news – web sites) study found gay men were at the highest risk of contracting STDs. The gay community has been the focus of prevention efforts by U.S. health care authorities including the Centers for Disease Control and Prevention (news – web sites).

“The increased threat of syphillis and other STDs among gay and bisexual men is being driven in part by a troubling combination of drug use and complacency,” said Dr. Ronald Valdiserri, deputy director of HIV, STD and tuberculosis prevention programs at the federal center.

“The CDC is very concerned about this data,” he added. “We have a real challenge here dealing with the American public that is clearly uncomfortable talking about sexually transmitted infections.”

Crystal meth use also makes men more likely to have unprotected sex with other men, according to the CDC. The research found 16% of 388 gay men took the drug the last time they had anal sex, and that users were twice as likely to have unprotected sex as nonusers .

CDC data shows the national incidence of primary and secondary syphilis rose last year to 7,082 from 6,862 in 2002. Since a national upturn began in 2000, the overall infection rate has jumped 18%, with a 65% rise among men but a 50% decline among women.

Among gay men, the incidence of syphilis multiplied 12 times between 1999 and 2003, the CDC found.
Source www.dpna.org online 15.03.04

Injured methamphetamine users are more likely to be admitted to the hospital, stay longer, and have higher hospital costs, says a study in the August issue of the Archives of Surgery.

Researchers at The Queen’s Medical Center in Honolulu examined the records of 212 patients, aged 18 to 55, admitted to the hospital’s trauma center in 2002. Of those 212 patients, 57 tested positive for amphetamine or methamphetamine use. Those who tested positive were more likely to have an intentional self-inflicted injury or intentional assault-related injury than those who tested negative (37% vs. 22%).

The patients who tested positive were more likely to be older (average age 33.6 years vs. 29.9 years), and more likely to be admitted to the hospital (91% vs. 70%). Those who tested positive also were more likely to have longer hospital stays (2.7 days vs. 1.7 days) and much higher average hospital costs ($15,617 vs. $11,600).

“Our study demonstrated an increased use of hospital resources, measured by hospital LOS (length of stay) and charges, in the minimally injured adult trauma patients who tested positive for methamphetatmine. This can be explained by the physiological and psychological effects of the drug,” the study authors wrote.

Hawaii has one of the highest rates of methamphetamine use in the United States. The study said that 40% of people arrested in Honolulu test positive for methamphetamine, which can cause aggressive and erratic behavior. After a high, which can last six to 12 hours or more, methamphetamine users can suffer severe exhaustion.
Source: TUESDAY, Aug. 10 2004 (Health Day News)

Researchers say that the onset, pattern, and duration of the “highs” produced by cocaine and methamphetamine differ significantly — findings that could have implications for development of anti-addiction medications.

The authors from the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA found that cocaine-using research subjects reported a quicker peak and decline of their “high” than methamphetamine users. The body’s cardiovascular system responds quickly to both drugs, but physical responses to cocaine also decline more quickly than with meth use.

“These differences help explain patterns of use by addicts. Methamphetamine users, for instance, report using the drug daily throughout each day, while cocaine users typically engage in binges that occur most often in the evening,” said lead study author Thomas F. Newton. “In addition, the study results may impact development of medication treatments for addiction to these two very different stimulants.”

OCALA – Methamphetamine abuse continues to spread, despite new laws and public education campaigns aimed at stamping it out. Now, medical researchers are warning that meth is not only addictive, it literally causes brain damage – all the more so when mixed with an HIV infection.

Both methamphetamine abuse and HIV infection distort different parts of the brain, diminishing thought processes such as memory, problem-solving and attention span, researchers at the HIV Neurobehavioral Research Center of the University of California-San Diego report in this month’s American Journal of Psychiatry.

Dr. Jay Rubin, a neurologist in Ocala, said the findings agree with what doctors already know about drugs and other stresses on the brain.

“Things like cocaine abuse can cause strokes,” Rubin said. “There may be some certain areas of the brain that are probably more susceptible to damage. It’s known, for instance, that suffocation or near-suffocation causes damage in the parts of the brain like the hippocampus.”

Ocala Police Maj. Guy K. Howie, who commands Marion County’s multi-agency drug enforcement team, said the findings likewise bear out with his own observations of the growing numbers of local meth abusers.

“It doesn’t surprise me at all,” he said. “When you talk to somebody that’s on meth, you know. You watch the way they talk, the way they twitch. And I’ve known some to be up for two to three days at a time. All of the toxic chemicals used to make it has got to do something to both the body and the brain.”

The researchers in San Diego analyzed brain scans of 103 adults divided into four groups: meth abusers, HIV-positive, HIV-positive meth abusers and a control group with neither problem. They also tested each group on their attention span and memory, the speed at which they mentally process information, their ability to learn, verbal skills, motor skills and other brain functions.

Methamphetamine abuse, they found, is related to swelling of the parietal cortex, which helps people understand and pay attention to their surroundings, as well as the basal ganglia, which is linked to motor skills and motivation.

HIV, on the other hand, appears to shrink three parts of the brain: the cerebral cortex, which plays a role in higher thinking, reasoning and memory; the hippocampus, involved in learning and memory; and the basal ganglia.

Both meth abuse and HIV appear to damage the brain separately, and cause the most damage when paired together.

“In HIV-infected people, the . . . impairments are associated with decreased employment and vocational abilities, difficulties with medication management, impaired driving performance and problems with general activities of daily living, such as managing money,” Terry Jernigan, leader of the research team, explained in a released statement.

While the impact of meth is less understood, “abusers of the drug have impaired decision-making abilities,” he said. “These could potentially affect treatment and relapse prevention efforts, as well as things like money management and driving performance.”

The findings are especially significant given the risky sexual behavior and contaminated needles that tend to link meth abuse with HIV infection, according to Nora D. Volkow, director of the National Institute on Drug Abuse (NIDA).

They are also significant given the rate at which meth use is gaining. A recent survey by the National Association of Counties revealed that the white crystalline drug poses a bigger problem for law enforcement agencies across 45 states than cocaine, heroine or marijuana.

In Marion County, Howie said, police have identified 21 meth labs compared to three at this time in 2004. They have also confiscated 1,584 grams of the drug, compared to 475 grams at this time last year. The 12 cases of meth possession in 2005 – not including the labs – represents an increase as well.

“It’s starting to get popular among teenagers, but it’s more popular with the 20- to 30-year-old crowd,” Howie said. “There are a lot of people in their 40s using it, too.”

Relatively cheap, highly addictive and too-often mistaken as harmless, meth cuts across most economic classes but has been more popular with whites than blacks, Howie said. Abusers of the white, crystalline drug usually develop pock marks on the skin, and scabs that result from scratching.

Lately, meth trafficking has been up locally while production has dropped slightly – but only slightly, Howie said. “That’s because we put several of the people cooking it in jail.”

Beating the epidemic is going to require continued, aggressive education about the drug’s effects and addictiveness, he said – otherwise, “This is going to just take over like crack did in the 1980s.”

The San Francisco Health Department is offering cash rewards to methamphetamine users who quit using the drug and stay clean, the reported.

Payments of up to $40 per week have been given to meth users who quit. Program participants are required to visit a clinic three times weekly for a drug test; clean urines are rewarded with a check, and participants are not even required to go to counselling as part of the deal, even if they fail a drug test.

“Here I am getting clean, I feel better and I’m getting something for it,” said said former meth addict Robert Bowers. “That means something.”

Experts say that many addicts respond very well to rewards, even small ones, that acknowledge their progress toward sobriety. “You’re using the exact same technique that parents use with their children every day,” said Nancy Petry of the University of Connecticut School of Medicine. “It’s behaviour modification and behaviour shaping.”

The 12-week San Francisco program has had 159 participants since November 2004; backers see it as an effective and inexpensive alternative for those who can’t get into treatment or are on waiting lists.

A recent UCLA study found that a cash voucher program for meth addicts was actually more effective in producing clean urine tests than a therapy program lacking a reward component. “Clearly, it wasn’t the money,” said UCLA researcher Steven Shoptaw. “It was the fact that somebody recognized them.”

Every week in Great Falls, Montana, a baby is born who tests positive for methamphetamine. Meth babies spend their first weeks asleep, some barely waking to feed. Within four to six weeks, they begin crying uncontrollably, irritated by normal sounds and lights. But just like their babies, addicted parents have plenty of problems to overcome even after kicking the habit. Meth’s pull is like no other drug. Because it permanently alters the brain’s chemistry, treatment takes two years, not 12 weeks. Addicts don’t feed themselves, let alone their kids. They go days without sleeping and then crash. Breastfeeding babies share meth with their moms. If someone is cooking meth in the house, babies are exposed to hazardous and explosive chemicals.

Researchers at the University at Buffalo have presented the first evidence that the addictive drug methamphetamine, or meth, also commonly known as “speed” or “crystal,” increases production of a docking protein that promotes the spread of the HIV-1 virus in infected users.

The investigators found that meth increases expression of a receptor called DC-SIGN, a “virus-attachment factor,” allowing more of the virus to invade the immune system.

“This finding shows that using meth is doubly dangerous,” said Madhavan P.N. Nair, Ph.D., first author on the study, published in the online version of the Journal of Neuroimmune Pharmacology. The study will appear in print in the September issue of the journal.

“Meth reduces inhibitions, thus increasing the likelihood of risky sexual behavior and the potential to introduce the virus into the body, and at the same time allows more virus to get into the cell,” said Nair, professor of medicine and a specialist in immunology in the UB School of Medicine and Biomedical Sciences.

His research centers on dendritic cells, which serve as the first line of defense again pathogens, and two receptors on these cells — HIV binding/attachment receptors (DC-SIGN) and the meth-specific dopamine receptor. Dendritic cells overloaded with virus due to the action of methamphetamine can overwhelm the T cells, the major target of HIV, and disrupt the immune response, promoting HIV infection.

“Now that we have identified the target receptor, we can develop ways to block that receptor and decrease the viral spread,” said Nair. “We have to approach this disease from as many different perspectives as possible.

“If we could prevent the upregulation of the meth-specific dopamine receptor by blocking it, we may be able to prevent the interaction of meth with its specific receptors, thereby inhibiting the virus attachment receptor,” said Nair.

“Right now, we don’t know how the virus-attachment receptor and meth-specific receptors interact with each other, leading to the progression of HIV disease in meth-using HIV-infected subjects. That is the next question we want to answer.

“Since meth mediates its effects through interacting with dopamine receptors present on the cells, and meth increases DC-SIGN, which are the HIV attachment receptors, use of dopamine receptor blockers during HIV infection in meth users could be beneficial therapeutically to reduce HIV infection in these high-risk populations,” Nair said.

Additional researchers on the publication, all from the UB Department of Medicine, are Supriya Mahajan, Ph.D., research assistant professor; Donald Sykes, Ph.D., research associate professor; Meghana V. Bapardekar, Ph.D., postdoctoral associate, and Jessica L. Reynolds, Ph.D., research assistant professor.

Anja C Huizink, assistant professor¹, Robert F Ferdinand, psychiatrist¹, Jan van der Ende, assistant professor¹, Frank C Verhulst, professor¹

¹ Department of Child and Adolescent Psychiatry, Erasmus Medical Center Rotterdam/Sophia Children’s Hospital, PO Box 2060, 3000 CB Rotterdam, Netherlands

Correspondence to: A C Huizink a.c.huizink@erasmusmc.nl

Abstract

Objective To investigate whether using ecstasy (3,4-methylenedioxymethamphetamine, MDMA) is preceded by symptoms of behavioural and emotional problems in childhood and early adolescence.

Design Prospective, longitudinal, population based study

Setting:The Dutch province of Zuid-Holland. Participants: A sample of 1580 individuals, followed up across a 14 year period, from childhood into adulthood.

Main outcome measures The first assessment took place in 1983 before MDMA appeared as a recreational drug in the Netherlands and included the child behaviour checklist to obtain standardised parents’ reports of their children’s behavioural and emotional problems. Use of the drug was assessed with the composite international diagnostic interview 14 years later.

Results Eight syndrome scales of childhood behaviour were examined. Scores in the deviant range for the scales designated as anxious or depressed in childhood were significantly related to use of MDMA in adolescents and adults, resulting in an increased risk (hazard ratio 2.22, 95% confidence interval 1.20 to 4.11, P = 0.01).

Conclusions Individuals with childhood symptoms of anxiety and depression may have an increased tendency to use MDMA in adolescence or young adulthood. Its effects are supposed to include enhanced feelings of bonding with other people, euphoria, or relaxation

A new health education campaign launching in the Phoenix area seeks to respond to data from the Partnership for a Drug-Free America (PDFA) that finds usage rates of methamphetamine and Ecstasy among Phoenix-area teens are above national averages. The campaign unveiled today by the Partnership – with support from the Partnership for a Drug-Free Arizona, the Arizona Chapter of the American Academy of Pediatrics (AzAAP) and Consumer Healthcare Products Association (CHPA) – is dedicated to reducing methamphetamine and Ecstasy use among teens in the Phoenix area. The campaign consists of a pediatrician-driven media outreach effort designed to educate parents and teens about the dangerous health consequences of these drugs, and includes an intensive public service advertising campaign in the Phoenix market. Phoenix is one of two U.S. cities where the campaign is being introduced.

“The disturbing number of teens in the Phoenix area who already are experimenting with these drugs makes this a health problem that must be addressed,’ said Dr. Peggy Stemmler, president of the AzAAP, a key partner in the new health education campaign. “Paediatricians are in a unique position to help close the gap between perception and reality about the real consequences of these drugs.”

In the Phoenix area, 14 paediatricians will serve as primary spokespeople for the media communications effort. Campaign coordinators believe the voice of the medical community will resonate with parents in particular in order to motivate them to take an active role in persuading their teens not to use these drugs. HMA Public Relations, a local public relations agency, will coordinate media efforts for paediatricians participating locally.

“More than one of every three teens in the Phoenix area has been offered Ecstasy or ‘meth,’ and teen use of both drugs is above national averages,” said Steve Pasierb, president and CEO of the Partnership, the national non profit organization best known for its media-based drug education campaigns. “Phoenix needs the facts about the real risks of using these drugs if we’re going to turn those numbers around.” The Partnership is providing the local effort with hard-hitting public service ads for television, radio, print and Internet, as well as with research to measure the impact of the effort.

Top-line findings of the Partnership for a Drug-Free America’s study include:

* 13 percent of Phoenix-area teenagers report having used methamphetamine (meth), compared to nine percent of all teens nationwide; 13 percent report having used Ecstasy, compared to 11 percent of all teens nationwide;
* 33 percent of teens report having been offered methamphetamine, and 35 percent report being offered Ecstasy;
* 61 percent of teens report knowing someone who uses Ecstasy, and half (50 percent) report knowing someone who uses methamphetamine; and
* Just one to two percent of Phoenix-area parents surveyed (one percent for Ecstasy, two percent for meth) agree that it’s possible their kids may have tried these drugs.

“Survey data also show parents and teens underestimate the specific health risks of these drugs,’ said Pasierb. “Risk-related attitudes correlate strongly with trends in drug use; for example, when teenagers see greater risks associated with a particular drug, use of that drug declines, Unfortunately, the opposite holds true as well, so the time is right for a concerted intervention to reverse the trends were seeing in Phoenix.”

Methamphetamine is an addictive stimulant. Often called ‘speed’ or ‘crystal’, meth is a crystal-like, powdered substance that sometimes comes in large rock-like chunks. Meth is usually white or slightly yellow, depending on the purity. The drug can be taken orally, injected, snorted or smoked. Once a threat largely in the American southwest, production and use of the drug, which is cheaper and longer lasting than cocaine, has moved steadily eastward in recent years, finding willing users in a generation unlikely to remember the phrase, ‘speed kills’. Long-term use and/or high doses of methamphetamine can bring on full-blown toxic psychosis, often exhibited as violent, aggressive behaviour. Ecstasy–chemically known as 3-4 methylenedioxymethamphetamine, or MDMA – is a psychoactive drug with amphetamine-like and hallucinogenic properties. It can be extremely dangerous, especially in high doses. Usually taken orally in pill form, the drug accelerates the release of serotonin in the brain and provides users with an intense high, characterized by feelings of love and acceptance, as well as a general sense of well being, decreased anxiety and enhanced sensitivity to touch. Ecstasy can cause dramatic increases in body temperature, muscle breakdown, and kidney and cardiovascular system failure, as reported in some fatalities.
Source: Press release, Partnership For Drug Free America June 200

Ads warning about the dangers of smoking pot or taking Ecstasy can persuade young people stay away from drugs, according to a study released by an advocacy group.A survey of teens conducted for the Partnership for a Drug Free America found kids who see or hear anti drug ads at least once a day are less likely to do drugs than youngsters who don’t see or hear ads frequently. Teens who got a daily dose of the anti drug message were nearly 40 percent less likely to try methamphetamine and about 30 percent less likely to use Ecstasy, the study found. When asked about marijuana, kids who said they saw the ads regularly were nearly 15 percent less likely to smoke pot.

The partnership produces most of the anti drug messages for the White House. Among them: one featuring a young man visiting the site where his brother was killed by a driver under the influence of marijuana. The difficulty is getting kids to see the ads and pay attention to them. A University of Pennsylvania study released last year found the ads are largely ignored by teens.

A spokesman for the government’s drug policy office, Tom Riley said the partnership changed the tone of the ads in the last year to make them harder hitting and punchier. The ads also play up the negative consequences of drugs more, he said.
“These ads have taught millions of teens the truth that marijuana is a harmful drug,” said Riley.

Barry McCaffrey drug czar during the Clinton administration said the anti drug ads are having a profound impact in a fundamental way, affecting not just adolescents but adults” as well including parents, pediatricians and teachers. The drop in drug use proves the ads are a key part in the battle, he said.
Source: Sunday Partnership for Drug free America 2003

UK DRUG DEATHS SOAR

LONDON: British deaths from ecstasy, cocaine and amphetamines have rocketed 47 per cent in the past year.The toll topped 1500 for the first time, fuelled by a rise in so-called “recreational hard drugs taken by weekend users.
Ecstasy, cocaine and speed are increasingly used by young people who take cocktails of drugs every weekend.The findings emerged in a study of coroners reports which suggested stronger tablets, easier availability, falling prices and the growing popularity of drug cocktails were behind the rising death toll.
Dr Fabrizio Schifano, who led the research at the European Centre for Addiction Studies at St George’s Hospital Medical School in South London, said recreational users did not see themselves as addicts or considered they were at risk of dying’  Schifana said.
Many weekend users took a cocktail of drugs and alcohol in sessions of up to 12  hours.In dozens of fatal cases, the victims also smoked cannabis.Cocaine was involved in 147 deaths lost year, a 47 per cent rise on 2001, Amphetamines were linked to 53 deaths, a 60 per cent rise. There were 64 ecstasy-related deaths, up 34 per cent.
Dr Schifono so that even a small amount of a drug could kill a hardened user who had built up a tolerance over months or years. In a process called “reverse tolerance”, the user suddenly become acutely sensitive and died.The first death in Britain from a new synthetic form of morphine called Oxycontin was recorded ast year.Called “hillbilly heroin” it has killed hundreds in the US.Overal drug-related deaths rose by about 6 per cent on 2001 last year – from 1495 to 1583, About 45 per cent were due to heroin, morphine and other drugs.The greatest increase in drug-related deaths were in West London. Brcdgend and Glamorgan Volleys, West Yorkshire, Nottinghamshire, North Northumberland and East Lancashire.

Inbred strains of rats differ in how aggressively they seek cocaine after a few weeks of use, researchers say.

The finding, posted online Jan. 18 by Psychopharmacology, is another piece of evidence that genetics plays a role in the relapse of drug-seeking behavior in humans, says Dr. Paul J. Kruzich, behavioural neuroscientist at the Medical College of Georgia and lead study author.

It also fingers glutamate, a neurotransmitter involved in learning and memory, as an accomplice in stirring the cravings and uncontrollable urges that drive some drug users to use again, he says.

“Given the right environmental stimuli, all persons addicted to psychostimulants can relapse, but potentially some people are a little more susceptible than others … it’s all about gene-environment interaction,” says Dr. Kruzich.

He took two strains of inbred rats – Fischer 344 and Lewis – with known genetic differences, enabled each to self-adminster cocaine for 14 days, then took the drug away for a week but not the levers the animals used to access it.

During that hiatus, he adminstered a drug that stimulates glutamate receptors, possible targets for drugs of abuse.

He found that the F344 strain worked harder to get cocaine than the Lewis rats following treatment with the glutamate drug, suggesting they were more susceptible to relapse.

“Maybe 12-step programs and faith-based programs will be enough to keep some people from relapsing,” says Dr. Kruzich. “For others we may have to come up with medical treatments we can use on top of those to keep them from taking drugs again.”

He says there are many different versions of the hundreds of genes that may play a role in increasing the risk of relapse.

It’s known that some people become addicted more quickly than others, some literally with their first use, he says. The hardest part is not getting people to stop taking drugs: that happens when they are checked in a clinic or put in jail. The real work is keeping them from relapsing when they are out of such restricted environs, he says.

“Something happens, either they see an old colleague they have used with, they go into an old environment, they have a huge stressor in life and they start to want the drug. They have drug hunger, what we call drug craving,” says Dr. Kruzich. “When it gets bad enough, they engage in drug-seeking behavior.”

His lab is working to identify the relapse trigger to use as a target for developing ways to curb craving and subsequent relapse.

His studies focus on an area of the brain called the nucleus accumbens core, a target for drugs of abuse long considered a pleasure center, Dr. Kruzich says. Drugs such as cocaine and methamphetamine stimulate release of dopamine in the nucleus accumbens. Dopamine is a neurotransmitter believed responsible for the euphoria that come with drug use. In fact, animals given dopamine blockers won’t self-adminster drugs of abuse, and dopamine has long been a focus of drug-abuse studies.

“These drugs impinge upon the reward centers of the brain that normally food, sex, survival and adaptation impinge upon,” says Dr. Kruzich. “When you are having that great piece of cheesecake and thinking, ‘Oh man,’ that is the kind of response these drugs of abuse are evoking but much more so than that cheesecake could ever do.”

Glutamate, also released in the nucleus accumbens core, may play an equally important role in drug relapse, he says. Drugs such as cocaine appear to alter glutamate neurotransmission in the core, which may contribute to the rewiring of the brain that occurs with drug use. “It’s not that these drugs just damage neurons, which they can, but they rewire the circuitry of the brain so no longer is your spouse or your job or other things in your life important to you. Your brain is tricked into thinking that drugs are the most important thing for your survival,” Dr. Kruzich says.

Unfortunately, drugs that restore glutamate function also produce seizures, so scientists are looking for an indirect approach to restore the misdirected rewiring.
Source: Psychopharmacology, posted online Jan. 18 2006. Toni Baker Medical College of Georgia http://www.mcg.edu

On June 22, 1998, ‘Wired for Addiction’ was presented as part of NIDA’s Frontiers in Neuroscience seminar series. The theme of these presentations centered on the neuronal remodeling that emerges after repeated substance use and withdrawal, with particular emphasis on the possibility of altered cognitive function as a consequence of the neural remodeling. Presentations were made by Drs. Ann Graybiel, Tony Grace, John Marshall, Janet
Neisewander, and Regina Carelli, and a summary and discussion was presented by Dr. Steve Grant of NIDA. Brief summaries of two presentations follow.

Chronic exposure to psychomotor stimulants may rewire your brain
Exposure to amphetamine and cocaine induces gene expression in cortico-basal ganglia circuits. Chronic intermittent exposure to the same drugs down-regulates some of the inducible change. After a course of chronic intermittent treatment and withdrawal of the drug, a subsequent challenge with the drug induces new patterns of gene expression in cortico-basal ganglia circuits. The repeated administration and withdrawal of cocaine induces both immediate early gene (lEG) expression after drug challenge in neurons that are not activated acutely, and an increase in the size of the area in which this response in observed. These findings raise the possibility that prolonged exposure to psychomotor stimulants produces enduring changes in brain wiring.

Ann Graybiel, Ph.D., Massachusetts Institute of Technology:

Neuronal interactions within the limbic system of rats: Alteration during amphetamine sensitization
Amphetamine exerts differential actions on neurons in the nucleus accumbens when given acutely versus repeatedly. The studies show that repeated amphetamine administration causes an increase in electrical coupling among nucleus accumbens neurons, which appears to be driven by an increase in prefrontal corticoaccumbens afferent activation. It is proposed that such a condition would lead to alteration of information flow within this system, resulting in a perseverance of behavioral action that may contribute to drug-seeking behavior in humans.

Anthony Grace, Ph.D., University of Pittsburgh

Recreational use of 3,4 methylenedioxyethylamphetamine (MDMA), more commonly known as “ecstasy” (and a variety of other names including “XTC”, “Adam” or “E”), is now well established. In Britain upwards of 500,000 people are said to use the drug each week (Harris Poll (1992) for “Reportage”, BBC2, 22 Jan 1993).

MDMA is a ring-substituted amphetamine with psychoactive properties. First synthesised in 1914 from methylenedioxyamphetamine (MDA), itself a drug of misuse (known as the “love drug”), it has been used in psychotherapy and was originally used as an appetite suppressant. The drug has ceased to be used medicinally and is now an established part of the illegal drug scene. It is banned in most countries. In the UK it is a class A drug as defined in Schedule 2 of the Misuse of Drugs Act 1971. It has no medicinal use in the UK and cannot be prescribed.

As well as MDA and MDMA, another variant, methylenedioxyethylamphetamine (MDEA, known as “eve”), which is similarly proscribed, is commonly encountered. All have similar pharmacological effects.
In the UK, MDMA is often taken by young people at discos and rave parties. Both involve dancing, but especially at the latter there is vigorous repetitive dancing in crowded rooms with a hot and humid atmosphere. The dangers of this activity are recognised to a certain extent as rooms to “chill out” are often available for people to rest in after periods of exertion. Toxic effects and the occasional death following ring substituted amphetamine misuse have been reported but postmortem data are lacking. In this paper we report on deaths associated with ring substituted amphetamine misuse and detail the postmortem findings.

Seven deaths have been investigated by the University of Sheffield Department of Forensic Pathology in the past three years, which were associated with ring substituted amphetamine misuse. All of the subjects were white men, between 20 and 25 years of age. Three of the victims collapsed at a rave or disco, two were found in bed, one in a collapsed state and one dead, one collapsed in the street, and one was admitted to hospital with progressive jaundice.

Abstract
Aims – To study the postmortem pathology associated with ring substituted amphetamine (amphetamine derivatives) misuse.

Methods
The postmortem findings in deaths associated with the ring substituted amphetamines 3,4-methylenedioxymethyl-amphetamine (MDMA, ecstasy) and 3,4-methylenedioxyethylamphetamine (MDEA, eve) were studied in seven young white men aged between 20 and 25 years.

Results
Striking changes were identified in the liver, which varied from foci of individual cell necrosis to centrilobular necrosis. In one case there was massive hepatic necrosis. Changes consistent with catecholamine induced myocardial damage were seen in five cases. In the brain perivascular haemorrhagic and hypoxic changes were identified in four cases. Overall, the changes in four cases were the same as those reported in heat stroke, although only two cases had a documented history of hyperthermia. Of these four cases, all had changes in their liver, three had changes in their brains, and three in their heart. Of the other three cases, one man died of fulminant liver failure, one of water intoxication and one probably from a cardiac arrhythmia associated with myocardial fibrosis.

Conclusions
These data suggest that there is more than one mechanism of damage in ring substituted amphetamine misuse, injury being caused by hyperthermia in some cases, but with ring substituted amphetamines also possibly having a toxic effect on the liver and other organs in the absence of hyperthermia.

C M Milroy J C Clark A R W Forrest Department of Clinical Chemistry, Royal Hallamshire Hospital, Sheffield – Department of Forensic Pathology, University of Sheffield
Source: (J Clin Pathol 1996;49:149-.153)