A heartbroken mum yesterday warned that Britain faces a new epidemic after banned party drug GBL was blamed for killing two friends within hours.

Carl Fearon, 24, was found dead at his flat at about 1pm on Saturday afternoon.

Just eight hours later, mum-of-one Lynette Nock, 28, died at a memorial wake held by his friends.

The two pals are believed to have taken deadly GBL, a solvent found in paint strippers and chillingly known on the club scene as “coma in a bottle”.

The tragedy comes exactly three years after medical student Hester Stewart, 21, was found dead at a house in Brighton after a party.

Police found a bottle of GBL next to her body.

Hester’s mum Maryon Stewart, who went on to launch drug awareness charity the Angelus Foundation, said yesterday: “They are not drugs, they are chemicals and when you take them you’re playing Russian Roulette with your life.

“But you can’t control something like paint stripper because it has legitimate uses. When you ban one of these things probably a dozen others pop up to replace it.

“Last year 49 new substances appeared and no one really knows what’s in them. This is a major epidemic.

 “The Home Office should be taking responsibility to protect young people and raise awareness. There were directives from Europe 18 months before Hester died but nothing was done.’

 “Sadly, the message has still not filtered through and the same thing has happened and I’m deeply saddened.”

Electrical engineer Carl was found dead at his flat in Birmingham . Friends said he collapsed after taking GBL the previous night.

When word of his death spread, pals hosted a wake at a house in the city on Saturday night at which accountant Lynette collapsed.

Neighbour Emma Heath, 24, said: “I heard they put it in a Fanta bottle and several of them ended up being taken to hospital.” Lynette’s heartbroken father Dave, 69, yesterday paid tribute to his daughter and called for something to be done about GBL, describing it as “a lethal drug, a killer”. He says he fears Lynette’s drink may have been spiked, adding: “If Lynette had GBL in her system, did she and the others at that party ingest it without knowing what they were taking? Was it that their drink was spiked? From what I’ve read, this GBL has no taste and no smell.”

Det Insp Andy Hawkins said: “We believe the controlled substance Gamma-Butyrolactone, or GBL, may have been used as a drug at the gathering.” A spokesman for drugs charity FRANK said: “GBL is a dangerous drug with sedative and anaesthetic effects that can produce feelings of euphoria and can cause drowsiness. “It can kill.”

“It can do almost anything”: Analysis by drugs policy expert Dr Jonathan Cave

THE body converts GBL to date rape drug GHB, and because of how it is converted, GBL takes effect more quickly. It’s often advertised as a nutritional supplement but is harmful. GBL is unpredictable because it can do almost anything. It can have a mild effect, give people a headache or in some cases do a lot worse. It’s not directly toxic but the people to whom it is toxic won’t know until they take it. Some get addicted and take it 24 hours a day.

GBL, or Gamma-Butyrolactone, is known as “coma in a bottle”. It is used as paint stripper and was banned for consumption in 2009.

GBL is odourless and tasteless when diluted and is sold online for as little as 50p a shot.

The effect is similar to ecstasy but there is a high risk of overdosing.  Some users say it feels as if their muscles are being torn apart.  Medics say it kills six a year, damages organs and leads to psychosis.  It is related to banned date rape drug GHB.

Source:  www.Mirror.co.uk  2 May 2012

In the first worldwide study of its kind, scientists from Toronto’s Centre for Addiction and Mental Health (CAMH) found evidence that heavy methamphetamine users might have a higher risk of developing schizophrenia. This finding was based on a large study comparing the risk among methamphetamine users not only to a group that did not use drugs, but also to heavy users of other drugs.

The report will be published online on Nov. 8, 2011, at AJP in Advance, the advance edition of the American Journal of Psychiatry, the official journal of the American Psychiatric Association.

Methamphetamine and other amphetamine-type stimulants are the second most common type of illicit drug used worldwide.

“We found that people hospitalized for methamphetamine dependence who did not have a diagnosis of schizophrenia or psychotic symptoms at the start of our study period had an approximately 1.5 to 3.0-fold risk of subsequently being diagnosed with schizophrenia, compared with groups of patients who used cocaine, alcohol or opioid drugs,” says Dr. Russ Callaghan, the CAMH scientist who led the study. Dr. Callaghan also found that the increased risk of schizophrenia in methamphetamine users was similar to that of heavy users of cannabis.

To establish this association, the researchers examined California hospital records of patients admitted between 1990 and 2000 with diagnosis of dependence or abuse for several major abused drugs: methamphetamine, cannabis, alcohol, cocaine or opioids. They also included a control group of patients with appendicitis and no drug use. The methamphetamine group had 42,412 cases, while cannabis had 23,335.

Records were excluded if patients were dependent on more than one drug or had a diagnosis of schizophrenia or drug-induced psychosis during their initial hospitalization. Readmission records within California hospitals were analyzed for up to 10 years after the initial admission. The researchers then identified patients who were readmitted with a schizophrenia diagnosis in each drug group.

There has been a longstanding debate as to whether there is a connection between methamphetamine use and schizophrenia. Many Japanese clinicians have long believed that methamphetamine might cause a schizophrenia-like illness, based on their observations of high rates of psychosis among methamphetamine users admitted to psychiatric hospitals. However, they lacked long-term follow-up studies of methamphetamine users initially free of psychosis. In North America, this link has mostly been discounted, as psychiatrists believed that the psychosis was already present and undiagnosed in these methamphetamine users.

“We really do not understand how these drugs might increase schizophrenia risk,” says Dr. Stephen Kish, senior scientist and head of CAMH’s Human Brain Laboratory. “Perhaps repeated use of methamphetamine and cannabis in some susceptible individuals can trigger latent schizophrenia by sensitizing the brain to dopamine, a brain chemical thought to be associated with psychosis.” Dr. Kish also cautions that the findings do not apply to patients who take much lower and controlled doses of amphetamines or cannabis for medical purposes.

Since this is the first such study showing this potential link, the researchers emphasize that the results need to be confirmed in additional research involving long-term follow-up studies of methamphetamine users.

“We hope that understanding the nature of the drug addiction-schizophrenia relationship will help in developing better therapies for both conditions,” says Dr. Callaghan.

In an earlier study using California hospital records, the researchers found evidence for a possible association between heavy methamphetamine use and Parkinson’s disease.

Source:www.eurekalert.org.  8th Nov. 2011

In the first worldwide study of its kind, scientists from Toronto’s Centre for Addiction and Mental Health (CAMH) found evidence that heavy methamphetamine users might have a higher risk of developing schizophrenia. This finding was based on a large study comparing the risk among methamphetamine users not only to a group that did not use drugs, but also to heavy users of other drugs.

 The report will be published online on Nov. 8, 2011, at AJP in Advance, the advance edition of the American Journal of Psychiatry, the official journal of the American Psychiatric Association.

Methamphetamine and other amphetamine-type stimulants are the second most common type of illicit drug used worldwide.

“We found that people hospitalized for methamphetamine dependence who did not have a diagnosis of schizophrenia or psychotic symptoms at the start of our study period had an approximately 1.5 to 3.0-fold risk of subsequently being diagnosed with schizophrenia, compared with groups of patients who used cocaine, alcohol or opioid drugs,” says Dr. Russ Callaghan, the CAMH scientist who led the study. Dr. Callaghan also found that the increased risk of schizophrenia in methamphetamine users was similar to that of heavy users of cannabis.

To establish this association, the researchers examined California hospital records of patients admitted between 1990 and 2000 with diagnosis of dependence or abuse for several major abused drugs: methamphetamine, cannabis, alcohol, cocaine or opioids. They also included a control group of patients with appendicitis and no drug use. The methamphetamine group had 42,412 cases, while cannabis had 23,335.

Records were excluded if patients were dependent on more than one drug or had a diagnosis of schizophrenia or drug-induced psychosis during their initial hospitalization. Readmission records within California hospitals were analyzed for up to 10 years after the initial admission. The researchers then identified patients who were readmitted with a schizophrenia diagnosis in each drug group.

There has been a longstanding debate as to whether there is a connection between methamphetamine use and schizophrenia. Many Japanese clinicians have long believed that methamphetamine might cause a schizophrenia-like illness, based on their observations of high rates of psychosis among methamphetamine users admitted to psychiatric hospitals. However, they lacked long-term follow-up studies of methamphetamine users initially free of psychosis. In North America, this link has mostly been discounted, as psychiatrists believed that the psychosis was already present and undiagnosed in these methamphetamine users.

“We really do not understand how these drugs might increase schizophrenia risk,” says Dr. Stephen Kish, senior scientist and head of CAMH’s Human Brain Laboratory. “Perhaps repeated use of methamphetamine and cannabis in some susceptible individuals can trigger latent schizophrenia by sensitizing the brain to dopamine, a brain chemical thought to be associated with psychosis.” Dr. Kish also cautions that the findings do not apply to patients who take much lower and controlled doses of amphetamines or cannabis for medical purposes.

Since this is the first such study showing this potential link, the researchers emphasize that the results need to be confirmed in additional research involving long-term follow-up studies of methamphetamine users.

“We hope that understanding the nature of the drug addiction-schizophrenia relationship will help in developing better therapies for both conditions,” says Dr. Callaghan.

In an earlier study using California hospital records, the researchers found evidence for a possible association between heavy methamphetamine use and Parkinson’s disease.

Source:www.eurekalert.org.  8th Nov. 2011

• Note that this study shows that methamphetamine used during pregnancy can be found in the hair of neonates, suggesting it crosses the placental barrier with effects that are not completely understood.
• Advise patients who ask that drug abuse during pregnancy can be detrimental to the fetus, with a range of physical and intellectual sequelae, as well as hazardous to the mother.

It represents the first direct evidence in humans that crystal meth, which is a growing drug-abuse problem in North America, can cross the placenta and affect the growing fetus, according to Facundo Garcia-Bournissen, M.D., of the Motherisk program at the Hospital for Sick Children.
Researchers at the program have been testing hair samples from parents and adults across Canada for several years, usually when there is clinical suspicion of drug abuse on the part of parents, Dr. Garcia-Bournissen and colleagues reported in the online issue of Archives of Disease in Childhood.
From June 1997 through December 2005, the database accumulated results of 34,278 tests for drugs in hair, representing 8,270 people. Nearly 60% (or 4,926) of these people were positive for at least one drug of abuse, the researchers said.
In a retrospective analysis, Dr. Garcia-Bournissen and colleagues examined the incidence of methamphetamine in hair samples:

• The first methamphetamine was found in hair in 2003, when six samples tested positive, with a slight increase in 2004, with eight cases.
• There were 372 cases in 2005 and the researchers said preliminary data for 2006 indicates that the surge has not stopped.
• The study identified 11 mother-neonate pairs in which each was positive for methamphetamine.
• Also, one newborn was negative, although the mother was positive.

The median methamphetamine values in the mother-baby pairs were 1.75 ng/mg for the mothers and 1.63 ng/mg for the newborns. Dr. Garcia-Bournissen and colleagues said.
The median concentrations were not significantly different, “suggesting that the transplacental transfer of methamphetamine is extensive,” the researchers said. On an individual level, maternal and neonatal drug levels correlated significantly (at P=0.003, using Spearman’s rho test, with r=0.8).
Interestingly, among the 171 subjects who were positive for methamphetamine and whose hair was tested for other drugs, 83.5% were positive for at least one other drug, usually cocaine, Dr. Garcia-Bournissen and colleagues found.
In contrast, among the 1,053 subjects negative for methamphetamine but positive for some other drug, only 38% were positive for more than one drug, they said.
“Positive exposure to methamphetamine strongly suggests that the person is a polydrug user, which may have important implications for fetal safety,” the researchers said.
The effects of the drug on the exposed child remain unclear, Dr. Garcia-Bournissen and colleagues noted, although there is some evidence that “children exposed in utero to methamphetamine are at risk of developmental problems, because of either the effect of direct exposure to the drug during pregnancy or growing in the environment associated with parental methamphetamine misuse, or probably both.”
Because the study was retrospective and anonymous, clinical information on the exposed infants is not available, the researchers said.

Source: www.medpage.today.com 2nd Nov. 2006

Researchers at the University of California, Los Angeles, found that some of the brain regions of meth-exposed children were even smaller than in alcohol-exposed children. One such region is the caudate nucleus, which plays a role in learning, memory, motor control, and motivation.

“Our findings stress the importance of drug abuse treatment for pregnant women,” said research team leader Elizabeth Sowell.

According to Sowell and her colleagues, being able to identify which brain structures are affected in meth-exposed children may help predict the specific types of leaning and behavioral problems that will afflict these children.

 Source:  The Journal of Neuroscience. March 17 2011

Source: Society for Neuroscience, March 17 2010

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.

“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.

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.

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

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

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)

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.”

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.”

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.”

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.

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

“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

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

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.

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

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

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)