Methamphetamine/GHB/Hallucinogens/Oxycodone

After Lynley Graham’s custody photo was posted to a police force’s Facebook page, horrified users were quick to discuss the harmful effects of hard drugs

Deep lines etched across a woman’s face and cheeks sunken to the bone – this one shocking image illustrates the effects of substance abuse.

Lynley Graham’s custody picture has been released by Humberside Police after she was jailed for 18 months for drug offences.
Graham was found in possession of class A drugs, including heroin and cocaine, and was subsequently charged with possessing a class A drug with intent to supply, Grimsby Live reports.

After the photo was posted to Humberside Police’s Facebook page on Wednesday, users were quick to discuss the 53-year-old’s weathered appearance.

Before and after pictures show a striking physical transformation.

One said: “I’m 64, I look young compared to her. Is she a lesson, perhaps, in what substance abuse can do to your skin?”

Another added: “Let’s hope some young people look at her and see what a life of drugs does apart from ruining entire families.”

Drug addiction and misuse contributed to more than 2,500 UK deaths in 2017.

Inhalants can cause damage to the kidneys, liver and bone marrow, and persistent drug consumption can result in abscesses, tooth decay – known as ‘meth mouth’ in the United States.

Other symptoms include premature ageing of the skin, often adding decades to someone’s appearance.

Rehabs.com, a US-based charity, has also published startling images of drug users to demonstrate the long-term toll narcotics have on one’s appearance.

Drugs can damage almost every system in the body; bloodshot eyes, dilated pupils, puffy faces and discoloured skin are all noticeable signs.

Some users suffer a rapid physical deterioration – with facial appearances sometimes ruined in just a matter of years.

Self-inflicted wounds, common among consumers of methamphetamine, can be caused by users picking at their skin to relieve the sensation of irritation – sometimes described as like crawling insects.

And a skeletal appearance can be the result of appetite-suppression.

Cocaine can commonly lead to chronic skin ulcers, pus-filled skin and the development of Buerger’s disease – an inflammation in small and medium-sized blood vessels.

Heroin has been known to dry the skin, leaving addicts with itchy and aged skin.

In May, Sir Angus Deaton, a world-leading economist, warned that drug abuse and alcoholism claim more lives of those in middle-age than heart disease.

‘Economic isolation’ is cited as one of the biggest contributors.

In 2017, a poll of 1,600 adults found that almost nine in ten said that seeing the physical effects of hard drugs made them less likely to take them.

The publication of such images is a common tactic among anti-addiction campaigners.

Scotland is experiencing its own drug crisis, with a 27 per cent rise in drug-related deaths, according to official statistics.

It puts Scotland’s drug mortality rate three times higher than the UK as a whole, and higher than any other country in the European Union.

The NHS offer services for drug and alcohol recovery, as do outside agencies, such as Addaction

Source: https://www.mirror.co.uk/news/uk-news/shocking-image-illustrates-how-drugs-18790997 July 2019

A USA TODAY NETWORK-Wisconsin project

Heroin entered their lives so easily.

For 10 addicts, the hard part is staying clean.

They got the pills from their doctors, then kept using them until they couldn’t stop. They switched to heroin because it was cheaper, because a friend said it was an easier, better way to get high.

They went to parties as teens, took pills, snorted powders. They got bored with the drugs they were doing and then found heroin, the drug they loved the most.

They had faced abuse, poverty, tragedy. Their pain was deep, and psychological, and the drug was an escape.

The stories of 10 recovering heroin addicts from Wisconsin are the stories of millions of Americans who have been hooked on opiates and either died, or lived with the consequences. They’ve lost friends. They’ve been arrested. They’ve lost touch with their family and friends, lost custody of their children.

COUNTY BY COUNTY: Deaths and ODs in Wisconsin.

“It wasn’t what they always told us it was going to be,” said Moriah Rogowski, a 22-year-old recovering addict, about her first time using heroin. She didn’t develop an addiction right away. But somewhere, more gradually than she expected, she lost control.

Like the other nine recovering heroin users profiled in this special report from USA TODAY NETWORK-Wisconsin, Rogowski has taken back control of her life. She’s clean. She lives in a different city, imagines a different future for herself.

Recovery from opiate addiction is hard, filled with setbacks. But these 10 people from across Wisconsin have taken the first steps toward a life after heroin. In photos, in words and in their own voices, these are their stories about how they started on heroin and fought to get off the drug.

‘That was the only way I liked to get high’

Moriah Rogowski, Green Bay

Moriah Rogowski liked the feeling of downers: Percocet, Vicodin, Oxycontin. She and her friends, the summer before high school, would go out to parties and crush pills and snort them.

She and her three siblings lived in a rural home near Mosinee, where she was homeschooled until eighth grade. In high school, she found her place among the stoners. One night she found herself in a drug house in Marshfield with 33-year-olds. She was 15.

That was the day she first tried heroin. She was afraid of needles, so she let someone else shoot the drug into a vein in her arm.

“That was the only way I liked to get high after that,” she said.

Rogowski is now 22. She’s been in and out of programs in Minnesota and Green Bay as she tried to get clean. But she’d come home and hang out with the same friends; each time they led her back to the drug.

She sought treatment at the methadone clinic in Wausau, where she saw others abusing the methadone and still using heroin. She fell into the same pattern.

She mixed heroin, crack, Xanax. There is a week of her life she can’t remember. She took her brother’s car and got an OWI. Her license was suspended.

Then, from somewhere, she found the will to change. She called her mom to come get her because she wanted to get clean. She began to use the methadone program correctly, taking classes and attending therapy sessions.

Rogowski has lived in Green Bay for two years. She hopes to complete her GED. And she’s trying to help others by working toward becoming a recovery coach.

— Laura Schulte, leschulte@gannett.com

A soldier’s widow masks her pain

Sarah Bear, Wausau

Sarah Bear didn’t want to feel anymore.

Her husband, Jordan, was killed in Afghanistan in 2012 during an attack at his base in the Kandahar province. More than a year later, just when she started being able to grieve her husband’s death, her oldest son’s dad died.

Bear’s addiction started in the summer of 2014 with pills — Vicodin, Oxycontin, Percocet. They dampened the pain of her losses. A friend had been prodding her to try heroin: It was cheaper, he said, and she wouldn’t have to use as much. She swore she would never touch it.

One day, Bear couldn’t get any pills. The withdrawals hit. She got sick; she couldn’t take care of her children. Eventually, she called the friend, and within a half hour was snorting heroin for the first time in her Antigo apartment.

Then, she felt nothing, just like she wanted.

“I completely, seriously fell in love with that drug,” she said. “There was nothing that compared to it, honestly. Sadly.”

She did heroin every day, either snorting or smoking it, and eventually injecting it.



Beginning in January 2015, Bear was in and out of jail, and on and off heroin. She tried methadone treatment but it didn’t stick.

In October 2016, Bear’s four children were taken from her. Two went to stay with her mom, and two with her grandmother.

Almost a year later, Bear, 33, found herself in North Central Health Care’s Lakeside Recovery in Wausau, a 21-day medically monitored substance abuse treatment program. She believes she hit rock bottom.

She started the program in mid-September and could feel the change within her as her Oct. 6 graduation approached. She’s determined to get better.

“I remember a time when my life was good, and I know that I can be back there,” she said. “I know that I can have that again.”

— Haley BeMiller, hbemiller@gannett.com

He laughed at the idea he could be saved

Nathan Scheer, Fond du Lac

Nathan Scheer felt the bottom drop out the day before Christmas Eve 2016. His wife and kids watched the cops haul him away.

His probation officer had heard he would test dirty and showed up at his home unannounced.

“On the way to jail I was higher than I’d been in years, but I remember my probation officer telling me she was going to save my life,” he said. “I laughed and told her you can’t save someone who doesn’t want to be saved.”

He first used prescription opiates after a car crash. One day he didn’t have enough money for hydrocodone pills. In their place, he was offered “dog food” —  a street name for heroin.

A decade-long fling with heroin followed, and it turned the 35-year-old factory worker from a regular, middle-class guy into a liar and a thief.


“I once explained to my wife that it (heroin) felt like what I imagine looking into the eyes of God would feel like,” Scheer said. “It’s the most religious experience you could ever imagine.”

But since the day the probation officer showed up a little more than a year ago, Scheer got clean through counseling, group support and a local church. He learned to feed his addictive personality through the gratification that comes with community service.

Today, Scheer and his 4-year-old son, Bentley, have gained recognition in Fond du Lac by cleaning up parks and playgrounds. Giving back is his metaphor for recovery. Father and son call it #cleanstreetforkids.

“I call it my beautiful disaster, because the way everything happened, I was so lucky. I had people who stuck by me while I waged war on myself.”

— Sharon Roznik, sroznik@gannett.com

‘They just kept prescribing pain meds’

Rebecca Palmieri, Wisconsin Rapids

Rebecca Palmieri’s house is quiet now. In August, a court commissioner ordered her to give up her five children. It was the second time in two years that she lost them.

She’s lost everything since she started using heroin. She’s been homeless. She has a record.

Palmieri, 39, had medical complications when she had her fifth child. That was in 2013.

“They just kept prescribing pain meds for five months after I had my son. They did corrective surgery, but, by then, I was hooked.”

She used pills for about two years. In January 2015, a friend came to her Wisconsin Rapids apartment with heroin. He told her to hold out her arm. In the empty bedroom, with her children in another part of the house, he injected her.

Using wasn’t an everyday thing, she said, until it was. She would look around her apartment to see what she could sell or return for money to buy the drug.

The courts put her kids into foster care. She was homeless for about six months. The kids went to live with her husband; they came back to her when he went to prison. She got clean and found a house. But the courts sent the kids back to her husband when he got out.

Palmieri said she has been clean since November 2016. She goes to the YMCA every day to work out; she attends addiction support group meetings. She wants to get her kids back.

“It’s probably the hardest thing I ever had to do,” she said, “to get clean and stay clean.”

— Karen Madden, kmadden@gannett.com

Sacred fire lights a path to recovery

Joey Powless, Oneida

Joey Powless stood by the sacred fire burning under a tepee in the center of Oneida. He busied himself by keeping the fire steady and clean, moving ash and coals out of the flames.

Powless, 36, a member of the Oneida Nation, called it the Grandpa Fire, and without it, he said, he would not have been able to stay clean for the past five years or so.

The sacred fire represents the spirit of native people, a connection to the past and present, a source of strength, a place to pray, a gateway to understanding.

“Without fire, we couldn’t live,” Powless said. “This is what we cooked our food with. This is what gave us life. Gave us heat. So without it we could never live. This is our very first teaching right here.”

His mother abandoned him and his family when he was a kid, and he responded at a young age with anger, he said. He started drinking and smoking pot at age 13. By the time he was in his early 20s, he added opioid medications and cocaine to the mix.



Powless was 28 when he first tried heroin at a party. He was deep into drug culture, and selling drugs to pay for his own drugs. “Cocaine really wasn’t doing nothing for me no more,” he said. Snorting heroin seemed like a natural thing to do.

It made him sick at first, but as that feeling eased, he felt the high. “That’s when the magic happens,” he said. He continued to chase that high. He graduated from snorting heroin to shooting it into his veins.

He was about 31 when he was jailed, and put into solitary confinement. It was there that he decided he didn’t want to be an addict anymore. “Because I have children,” he said. (Powless is the father of two teenagers.) “I didn’t want to be out of their lives no more.”

— Keith Uhlig, kuhlig@gannett.com

Arrests pile up after friend overdoses

Jennifer Solis, Stevens Point

Jennifer Solis was out of pills and already felt sick.

In the bathroom of her friend’s house in Stevens Point, she crushed up a little heroin and snorted it. It was the first time she had tried the drug.

Her friend, close by, was injecting it. They didn’t talk.

Solis, who was in her mid-20s at the time, looked down on people who used needles. She told herself she wouldn’t cross that line. She would.

Solis, now 34, was born in Colorado but moved to Wisconsin as a teenager. She was already using drugs with her friends — first marijuana, then cocaine — by the time she was 16.

“I think I was always looking for the next best thing,” she said. “I didn’t see myself as an addict back then.”

Solis became addicted to pain pills after she suffered a serious back injury as a result of domestic abuse, she said. After her friend introduced her to heroin, she used it every day.

She called paramedics when a friend overdosed a few years ago, then watched as they used the counteracting drug naloxone to revive her. She was charged in that incident, and then arrests piled up quickly.

 

She joined Portage County’s drug court in May and stayed clean for her first three months. Then she relapsed by using heroin and methamphetamine. By October 2017, Solis had again been clean for three months.

Solis has five children but no contact with them. Her three oldest live with a relative and her two youngest were adopted as infants.

She wants to go back to school for interior design. But for now, Solis lives at the Salvation Army in Stevens Point, working to put her life back together.

— Chris Mueller, cmueller@gannett.com

‘I smoked pot with both my parents’

Kevin Williams, Wisconsin Rapids

Kevin Williams is 35 and lives in a Wisconsin Rapids assisted-care facility. His mother and father divorced when he was 8, and, he said, “I basically smoked pot with both my parents by the time I was 15.”
By the time Williams was an adult, he tried every drug he could.

Cocaine: “Why not? I was already stoned on weed.”

Meth: “I tell people I used meth once in my life for eight months.”

Opiates: A friend first gave him an oxycodone pill, “and I was like, ‘Why not?’ I crushed it up and snorted it. … It was like the absolute, most warmest hug I ever felt.”

He can’t remember when he first switched from prescription opiates to heroin. But shooting up the drug, he said, “was like stepping into the perfect temperature of bath water, and (the feeling) would go all the way up, and all the way down.”

Williams is disabled. He walks with a limp and his left arm hangs at his side.



“I went to prison a couple years back. I found out I had a brain tumor. They went in to take it out, and they cut a blood vessel … gave me a stroke.”

One day, two years ago, he ran out of money and got clean. He can’t explain why.

“These days … I feel better about my life than I ever have before. Which sounds pretty crazy, doesn’t it? I only got half a freakin’ body right now. … But I get by. I still joke and love and make it to the Dollar Tree. All my essentials are taken care of.”

— Keith Uhlig, kuhlig@gannett.com

Addiction becomes a legacy of abuse

Jodi Chamberlain, Stevens Point

Jodi Chamberlain couldn’t get pills. They cost too much.

She got heroin from a friend instead. She was alone in her bedroom the first time she snorted the drug.

She didn’t have to think or feel. She didn’t have to deal with anything. But, Chamberlain said, “when it ends, you just crave more.”

She used heroin again within a week.

Chamberlain was living in Stevens Point at the time. She was barely in her 20s, but was already a regular drug user — mostly pain pills, but also cocaine and other stimulants. Her addictions grew out of a turbulent childhood, which, she said, included incidents of sexual abuse by a relative.

“I was taught to lie and to not have feelings,” she said. “I’ve never felt feelings.”

Now 41, Chamberlain has been clean for about eight months. She moved back to Stevens Point late last year after living in Eau Claire. Sometimes she slept in a truck.

Chamberlain was arrested again and again. She was sentenced in May on felony drug charges, but instead of going to prison, a judge allowed her to participate in Portage County’s drug court. She’s never made it through treatment without going back to heroin. If she fails in drug court, she faces a prison sentence.

Chamberlain regrets how many people she hurt with her drug use, particularly her two children, who watched their mother struggle with addiction.

She wants to stay clean, but even she can’t say whether she will make it.

“I can’t make that promise to anyone, not even myself,” she said. “But I choose to have people in my life now who can help me when I am going through rough times.”

— Chris Mueller, cmueller@gannett.com

‘A very functional addict’ awaits prison

Kyle Keding, Wisconsin Rapids

Kyle Keding was 26 years old and had been a heavy user of drugs for years before he tried heroin.

He had been drinking and smoking marijuana for about half his life. He had been dependent on opiate painkillers such as Percodan and Oxycontin for about five years. The pills helped him get through long days as a welder and they helped him forget about the crap life handed him.

Keding was sexually molested when he was about 5 years old, first by a babysitter, then by a relative, he said. Those memories never left him, unless he was high. So he got high. A lot. For him, that was just part of life, in addition to work, being a parent and a husband.

 

“I was what you call ‘a very functional’ addict,” he said.

The heroin was a practical choice. Opiate painkiller manufacturers had changed the formula of their pills, making them more difficult to use to get high, and also created a huge opiate shortage.

“So I couldn’t find what I wanted. I called up my friend, and he was like, ‘Well, I’ve got some ‘ron (heroin). … (I was) kind of skeptical,” Keding said. “I had not done it before.”

He did not feel as if he had stepped over any kind of line. He had already liquefied prescription opiates and shot those up intravenously.

Shooting up, both synthetic opiates and heroin, gave him a stronger high. He chose the needle because his friend and dealer did not have enough pills to get Keding as high as he wanted.

“I can remember the words that came out of my mouth once I released the strap off my arm,” he said. “‘Oh, my God. This is amazing.’ And I knew right there, this is it. I was like, there was no turning back now. But there was.”

He used heroin for five years, until Dec. 2, 2014. That night he was with friends, getting high, and one of the people he was with died. He was charged with first-degree reckless homicide/deliver drugs. He accepted a plea deal on that charge on Dec. 1, 2017. He awaits sentencing in February and could face years in prison.

— Keith Uhlig, kuhlig@gannett.com

‘This is a lifelong battle’

Tommy Casper, Neenah

Tommy Casper said one of the main reasons he has stayed clean for more than seven months is because of his nephew Owen, who has only ever known him sober. Casper sees his sister Carly Fritsch, who overcame her own struggle with addiction, and Owen most days of the week after work. Casper plays on a recreational volleyball team with other recovering addicts and attends Narcotics Anonymous meeting three times a week.

Tommy Casper was alone in the basement of the two-story home where he grew up.

He sat on his bed and opened a small bag of heroin that had been on top of a dresser beside him. He hadn’t used the drug before, but at about $120 a bag, it was cheaper than the pills he used. He snorted it.

He found himself asking one thing as the feeling went away: “What do I need to do in order to feel that way again?” He used heroin again three hours later.

Casper was 21 years old and living in Muskego, a community of fewer than 25,000 people on the outskirts of Milwaukee. His mother had died about six months earlier and he struggled with the loss. His sporadic use of pain pills became an addiction.

“The first time I used (as a way) to cope — rather than using to have fun or go out — was at her funeral,” he said.

After he turned to heroin, Casper told himself he wouldn’t use a needle because “then I wasn’t as bad as other people.” He used a needle for the first time a year later.

After his mother died, Casper moved around — to a house in West Allis, then an apartment in Neenah. He began to steal to support his addiction, but got caught shoplifting at a Walmart in Fond du Lac. He was charged and went to treatment a few days later.

Casper hardly slept or ate for two weeks as he fought through the physical withdrawal from the drug.

 

Casper, now 29, has relapsed twice since going to treatment. He hasn’t used for about the last seven months and attends Narcotics Anonymous meetings three times a week. He has a full-time job at a call center in Appleton and hopes to use his story to help others.

“This is a lifelong battle that we’re going to be in,” he said.

— Chris Mueller, cmueller@gannett.com

About this project

Wisconsin has a heroin problem directly linked to its opioid epidemic. Every corner of the state has been affected, every taxpayer, every school district, every police department, every social service agency, every hospital.

But why do an estimated 6,600 Wisconsin residents regularly snort, inject or smoke heroin? And how do we get our state off this deadly drug?

A team of journalists from USA TODAY NETWORK-Wisconsin went to 10 people who know firsthand how heroin enters a person’s life, and how best to get away from its grip. Their stories are part of a project the news organization will continue in 2018 to investigate Wisconsin’s response to the opioid crisis and the most successful paths to recovery.

All photos and videos by Alexandra Wimley/USA TODAY NETWORK-Wisconsin

Send feedback to Robert Mentzer, project editor: rmentzer@gannett.com

How to get help

For people who want to get help with heroin addiction:

Emergency: In a life-threatening emergency, call 911.

United Way 2-1-1: If it’s not an emergency but you want information over the phone at any hour about local options, call 211.

Narcotics Anonymous: Local meetings can be found online at wisconsinna.org or by calling 1-866-590-2651.

Wisconsin Department of Health Services: Guide to treatment resources statewide, online at dhs.wisconsin.gov/opioids/.

Source: http://www.wisinfo.com/usat/heroin_addiction/?for-guid=7ba874c6-08dd-e611-b81c-90b11c341ce0#start

 

 

Millions of Americans are trapped in a cycle of drug abuse and addiction: In 2013, over 24 million reported that they had abused illicit drugs or prescription medication in just the past month. More than 1.7 million were admitted to treatment programs for substance abuse in 2012. The pursuit of a drug habit can cost these people everything – their friends and family, their home and livelihood. And nowhere is that impact more evident than in the faces of addicts themselves.

Here, the catastrophic health effects of drug abuse are plain to see, ranging from skin scabs to decayed and missing teeth. While meth is often seen as one of the most visibly destructive drugs, leading to facial wasting and open sores,various other illicit drugs, and even prescription medications can cause equally severe symptoms when continuously abused. The use of opioids like OxyContin or heroin can cause flushing and a rash of red bumps all over the skin, while cocaine abuse can result in a significant drop in appetite and dangerous malnutrition and weight loss. Ecstasy may cause grinding of teeth, and smoking cannabis releases carcinogens and other chemicals that can diminish skin collagen and produce an appearance of premature aging. Even alcohol abuse can lead to wrinkles, redness, and loss of skin elasticity.

Beyond the direct effects of substance abuse, perhaps its most damaging result is addiction itself. The compulsion of addiction makes drug use the most important purpose in an addict’s life, leading them to pursue it at any cost and treat anything else as secondary. Self-neglect becomes normal – an accepted cost of continuing to use drugs. And the consequences of addiction can remain etched in their very skin for years.

Click here for an animated infographic

Source: https://www.rehabs.com/explore/faces-of-addiction/

Waiheke Island lawyer and meth researcher Chloe Barker is thrilled to see Jacinda Ardern, who acted on her findings, become Prime Minister.

For her Master’s thesis, Barker carried out heart-breaking research on the impacts on children of growing up in methamphetamine laboratories in New Zealand.

She found that through contact with contaminated environments, children sometimes had levels of meth in their hair, blood and urine that were higher that that of addicts.

Although the impacts on children are devastating, the laws are “toothless” and often fail to protect them, Barker said.

After her research findings were published in a police magazine in 2012, Jacinda Ardern contacted her and suggested meeting over coffee.

“She was amazingly passionate and obviously really cared about the issue,” Barker said.

A Labour list MP at the time, Ardern arranged for broader publication of Barker’s research, helping to raise awareness of the issue.

Ardern cited Barker’s research in parliament to support law changes to make it a crime for people to manufacture meth when a child is present.

However, the Sentencing (Protection of Children from Criminal Offending) Amendment Bill never made it into law.

Police can prosecute meth manufacturers under general child abuse laws, but the rates of conviction are low, because it is hard to prove children have been intentionally harmed by P [methamphetamine] manufacture, Barker said.

Ardern campaigned for a protocol to be introduced assigning responsibilities to the police and Child, Youth and Family (CYF) when children are found in P labs. New protocols have since been developed.

“I was really impressed that she had a million things on her plate, but she cared enough to be proactive and make practical changes that have assisted the police.

“I’m absolutely stoked about Jacinda becoming the Prime Minister.

“I think she’s going to give a voice to a lot of people who don’t have a voice currently,” Barker said.

Examining police files, Barker found that from 2006 to 2010, 191 children were living in the presence of methamphetamine laboratories that were shut down by police.

In 2002, children were living in 34 percent of the houses where laboratories were discovered.

The dangers of growing up in P laboratories include exposure to toxic chemicals, risks of explosions and fires, and a higher likelihood of having weapons in the house.

Children in meth laboratories also face higher risks of physical, sexual and emotional abuse, she said. 

“Given everybody can clearly see the dangers to children, there should be a specific law that says if you cook meth in the presence of a child, you’re committing a crime,” Barker said.

The 39-year-old has returned to her full time job as a commercial lawyer after completing her Master of Forensic Science degree at the University of Auckland.

Barker said Ardern won’t provide a “magic answer” for all life’s ills, but she is hopeful children might yet get the legal protection from meth exposure that they deserve.

“There is obviously a problem with P on Waiheke and I’m sure there are lots of communities around New Zealand that are exactly the same,” she said. 

Source: https://www.stuff.co.nz/national/politics/98147222/meth-researcher-thrilled-with-new-prime-minister October 2017

Research on children living in homes used as methamphetamine labs confirms police concerns over the risks. Ellen Brook reports.

The worrying trend of young children living in meth labs and being exposed to toxic chemicals has been highlighted in a research project with support from the Police National Clan Lab Response team in Auckland.

Auckland lawyer Chloe Barker, who analysed Police and ESR (Environmental Science and Research) data related to children and clandestine (clan) labs as part of a master’s degree thesis last year, has raised the red flag on the risks for young children. Her conclusions not only back up anecdotal evidence from police officers, but go on to say that existing child abuse laws are inadequate for prosecuting offenders.

Ms Barker’s research, based on Police data from 2006 to 2010, showed that dozens of children, with an average age of six years, were exposed to clan lab activity each year. On average, children were living or present in 25 per cent of New Zealand meth labs, rising to 34 per cent in 2010.

Latest figures show that of the 94 clan labs located in 2012, children were in 27 of them; 45 children were identified and 25 were present at the time police found the labs.

Other findings included:

  1. About a quarter of the labs where children were present were either “A” or “B” grade, ie, “up and bubbling” or ready to use.
  2. Weapons were found in about 36 per cent of the labs in which children were present.
  3. There was a higher proportion of gang affiliation for labs in which children were present than in total meth labs (51% compared with 43%).
  4. Fires and explosions occurred in 16 labs between 2006 and 2010, two of which had children present.
  5. The percentage of labs in which children were living or present and in which one or more referrals were made to Child, Youth and Family increased from about 5 per cent in 2006 to 93 per cent in 2010.

A more detailed audit of police files from 2008-2009 gave an even more disturbing picture of the dangers children were exposed to.

  1. In 21 per cent of labs there was evidence that children were present during the manufacturing process.
  2. In 45 of 53 labs reviewed there was evidence of chemicals within reach of children.
  3. In 36 of 53 labs, chemicals were stored in food or drink containers. In one case, a child’s school drink bottle, complete with a name and school room number, was found to contain highly acidic chemicals.

Source: https://www.policeassn.org.nz/newsroom/publications/featured-articles/meth-kids March 2013 

Once you drop, you can’t stop – sometimes for up to 15 hours. Images revealing how LSD interacts with receptors in the brain could explain why a trip lasts so long, while another study involving a similar receptor unpicks how the drug makes these experiences feel meaningful.

LSD acts on with a number of different receptors in the brain, including ones for the chemicals serotonin and dopamine, but it’s not known exactly which receptors are responsible for its various effects. Daniel Wacker and his colleagues at the University of North Carolina, Chapel Hill, used crystallography to look at the structure of LSD when it binds to a receptor in the brain that normally detects serotonin. They discovered that part of this serotonin 2B receptor acts as a lid, closing around the LSD molecule and trapping it.

This could explain the extended trips the drug produces. “It takes LSD very long to get into the receptor, and once it’s stuck it doesn’t go away,” says Wacker.

However, there is conflicting evidence. Other studies have shown that LSD hangs around in the blood for a long time. “No prolonged action at the receptor is needed to explain the duration of action,” says Matthias Liechti at the University of Basel, Switzerland.

But if Wacker is right, the fact that LSD seems to get stuck inside the receptor might mean it can have effects at very low doses. In recent years, there have been reports of some people taking LSD in amounts too small to cause hallucinations, in an attempt to boost creativity or general well-being.

There’s little hard evidence about whether this microdosing works, but Wacker says psychoactive effects at low doses are plausible. “Our study suggests even very low amounts of LSD may be enough to cause psychoactive effects.” Scientific interest in LSD’s clinical use has revived in recent years – notably to relieve severe psychiatric conditions such as PTSD and anxiety. There are also signs that LSD has helpful non-psychoactive effects on other ailments, such as cluster headaches.

Suppressing bliss

A second study finds evidence that LSD affect the brain by binding to serotonin receptors, and hints at possible ways to harness some of its effects therapeutically. Katrin Preller and her colleagues at the University of Zurich, Switzerland, gave 22 volunteers 100 micrograms of LSD each to determine the role of the serotonin 2A receptor, which is similar to the one studied by Wacker’s team.

In some of the tests, subjects were also given ketanserin, a drug that blocks the serotonin 2A receptor. In those tests, the trippy effects of LSD – including hallucinations, feeling separate from the body, and feelings of bliss – were completely blocked, showing that this receptor must be responsible for them.

The researchers also played songs to the participants. Some of the songs were ones the volunteers had chosen as meaningful beforehand, while others were not. While on LSD, they rated what had been non-meaningful songs as highly meaningful – an effect that, once again, ketanserin blocked.

Preller thinks these findings suggest that the serotonin 2A receptor is important for how we decide which things are relevant to us. “This is something that’s incredibly important for our everyday life,” she says. “We do it constantly, for example if you see a familiar face.”

Some psychiatric conditions, such as schizophrenia and phobias, are associated with paying too much attention to unimportant stimuli. Preller speculates that LSD might help people refocus their attention in a different direction.

“If you have a depressed patient ruminating about negative thoughts, LSD might facilitate a process where you attribute meaning to other things,” says Preller.

Alternatively, people with these conditions might benefit from drugs that reduce the action of the serotonin 2A receptor, like ketanserin.

Source: Journal reference: Current Biology, DOI: 10.1016/j.cub.2016.12.030 Journal reference: Cell, DOI: 10.1016/j.cell.2016.12.033

Fentanyl is a painkiller that is 50 times stronger than heroin. It has already killed thousands, including Prince. Chris McGreal reveals why so many are playing Russian roulette with this lethal drug Natasha Butler had never heard of fentanyl until a doctor told her that a single pill had pushed her eldest son to the brink of death – and he wasn’t coming back. “The doctor said fentanyl is 100 times more potent than morphine and 50 times more potent than heroin. I know morphine is really, really powerful. I’m trying to understand. All that in one pill? How did Jerome get that pill?” she asked, her voice dropping to a whisper as the tears came. “Jerome was on a respirator and he was pretty much unresponsive. The doctor told me all his organs had shut down. His brain was swelling, putting pressure on to the spine. They said if he makes it he’ll be a vegetable.”

Painkiller addiction claims more lives in the US than guns, cutting across class, race and region

The last picture of Jerome shows him propped immobile in a hospital bed, eyes closed, sustained only by a clutch of tubes and wires. Natasha took the near impossible decision to let him die.  “I had to remove him from life support. That’s the hardest thing to ever do. I had him at 15 so we grew together. He was 28 when he died,” she said. “I had to let him die but after that I needed some answers. What is fentanyl and how did he get it?” That was a question asked across Sacramento after Jerome and 52 other people in and around California’s capital overdosed on the extremely powerful synthetic opioid, usually only used by hospitals to treat patients in the later stages of cancer, over a few days in late March and early April 2016. Twelve died.

Less than a month later, this mysterious drug – largely unheard of by most Americans – killed the musician Prince and burst on to the national consciousness. Fentanyl, it turned out, was the latest and most disturbing twist in the epidemic of opioid addiction that has crept across the United States over the past two decades, claiming close to 200,000 lives. But Prince, like almost all fentanyl’s victims, probably never even knew he was taking the drug.

“The number of people overdosing is staggering,” said Lieutenant Tracy Morris, commander of special investigations who manages the narcotics task force in Orange County, which has seen a flood of the drug across the Mexican border. “It is truly scary. They don’t even know what they’re taking.” The epidemic of addiction to prescription opioid painkillers, a largely American crisis, sprung from the power of big pharmaceutical companies to influence medical policy. Two decades ago, a small family-owned drug manufacturer, Purdue Pharma, unleashed the most powerful prescription painkiller yet sold over the pharmacist’s counter. Even though it was several times stronger than anything else on the market, and bore a close relation to heroin, Purdue claimed that OxyContin was not addictive and was safe to treat even relatively minor pain. That turned out not to be true.

It spawned an epidemic that in the US claims more lives than guns, cutting across class, race and geographic lines as it ravages communities from white rural Appalachia and Mormon Utah to black and Latino neighbourhoods of southern California. The prescription of OxyContin and other painkillers with the same active drug, oxycodone, became so widespread that entire families were hooked. Labourers who wrenched a back at work, teenagers with a sports injury, just about anyone who said they were in pain

was put on oxycodone. The famous names who ended up as addicts show how indiscriminate the drug’s reach was; everyone from politician John McCain’s wife Cindy to Eminem became addicted.

Clinics staffed by unscrupulous doctors, known as “pill mills”, sprung up churning out prescriptions for cash payments. They made millions of dollars a year. By the time the epidemic finally started to get public and political attention, more than two million Americans were addicted to opioid painkillers. Those who finally managed to shake off the drug often did so only at the cost of jobs, relationships and homes.

After the government finally began to curb painkiller prescriptions, making it more difficult for addicts to find the pills and forcing up black market prices, Mexican drug cartels stepped in to flood the US with the real thing – heroin – in quantities not seen since the 1970s. But, as profitable as the resurgence of heroin is to the cartels, it is labour intensive and time-consuming to grow and harvest poppies. Then there are the risks of smuggling bulky quantities of the drug into the US.

The ingredients for fentanyl, on the other hand, are openly available in China and easily imported ready for manufacture. The drug was originally concocted in Belgium in 1960, developed as an anaesthetic. It is so much more powerful than heroin that only small quantities are needed to reach the same high. That has meant easy profits for the cartels. The Drug Enforcement Administration (DEA) has said that 1kg of heroin earns a return of around $50,000. A kilo of fentanyl brings in $1m.

At first the cartels laced the fentanyl into heroin to increase the potency of low-quality supplies. But prescription opioid painkillers command a premium because they are trusted and have become increasingly difficult to find on the black market. So cartels moved into pressing counterfeit tablets.  But making pills with a drug like fentanyl is a fairly exact science. A few grammes too much can kill. “It’s very lethal in very small doses,” said Morris. “Even as little as 0.25mg can be fatal. One of our labs had a dime next to 0.25mg and you could barely see it. It’s about the size of the head of a pin. Potentially that could kill you.”

The authorities liken buying black market pills to playing Russian roulette. “These pills sold on the street, nobody knows what’s in them and nobody knows how strong they are,” said Barbara Carreno of the DEA.

After Prince died, investigators found pills labelled as prescription hydrocodone, but made of fentanyl, in his home, suggesting he bought them on the black market. The police concluded he died from a fatal mix of the opioid and benzodiazepine pills, a particularly dangerous combination. It is likely Prince did not even know he was taking fentanyl.  Others knowingly take the risk. In his long battle with addiction, Michael Jackson, used a prescription patch releasing fentanyl into his skin among the arsenal of drugs he was fed by compliant doctors. Although it was two non-opioids that killed him, adding fentanyl into the mix was hazardous.

Jerome Butler, a former driver for Budweiser beer who was training to be a security guard, thought he was taking a prescription pill called Norco. His mother’s voice breaks as she recounts what she knows of her son’s last hours. Natasha said she was aware he used cannabis, but had no idea he was hooked on opioid painkillers. She said her son at one time had a legitimate prescription and may have become addicted that way. She has since discovered he was paying a doctor, well known for freely prescribing opioids, to provide pills.  “I didn’t even know,” she said. “You find stuff out after. It’s killing me because they’re saying, ‘Well, yeah, Jerome was taking them pills all the time.’ And I’m like, ‘He was doing what?’”

Jerome may have had a prescription, but like many addicts he will have needed more and more. The pill that killed him was stamped M367, a marking used on Norco pills made of an opioid, hydrocodone. It was a fake with a high dosage of fentanyl.   This is fentanyl. The first time you take it you’re not coming back. You’re gone

“If Jerome had known it was fentanyl he would never have took that,” said Natasha. “This ain’t like crack or a recreational drug that people been doing for so many years and survived it but at 60 or 70 die from a drug overdose because their heart can’t take it no more. This is fentanyl. The first time you take it you’re not coming back. You’re gone.”

That wasn’t strictly true of the batch that hit Sacramento. It claimed 11 other lives. The youngest victim was 18-year-old George Berry from El Dorado Hills, a mostly white upscale neighbourhood. The eldest was 59. But others survived. Some were saved by quick reactions; doctors were able to hit them with an antidote before lasting damage was done. Others swallowed only enough fentanyl to leave them seriously ill but short of death.

It was a matter of luck. When investigators sent counterfeit pills seized after the Sacramento poisonings for testing at the University of California, they found a wide disparity in the amount of fentanyl each contained. Some pills had as little as 0.6mg. Others were stuffed with 6.9mg of the drug, which would almost certainly be fatal. The DEA thinks the difference was probably the result of failing to mix the ingredients properly with other powders, which resulted in the fentanyl being distributed unevenly within a single batch of counterfeit pills.

That probably explains the unpredictable mass overdosing popping up in cities across the US. In August, 174 people overdosed on heroin in six days in Cincinnati, which has one of the fastest-growing economies in the Midwest. Investigators suspect fentanyl because the victims needed several doses of an antidote, Naloxone, where one or two will usually suffice with heroin. The same month, 26 people overdosed on fentanyl-laced heroin in a four-hour period in Huntington, a mostly white city in one of the poorest areas of West Virginia. In September seven people died from fentanyl or heroin overdoses in a single day in Cuyahoga County, Ohio.

The US authorities don’t know for sure how many people fentanyl kills because of the frequency with which it is mixed with heroin, which is then registered as the cause of death. The DEA reported 700 fatalities from fentanyl in 2014 but said it is an underestimate, and rising. In 2012, the agency’s laboratory carried out 644 tests confirming the presence of fentanyl in drug seizures. By 2015, the number of positive tests escalated to 13,002.

The police did not have to look far for the source of the drug that killed Jerome. He and his girlfriend were staying at the house of her aunt, Mildred Dossman, while they waited for their own place to live. Jerome was smoking cannabis and drinking beer with Dossman’s son, William. Shortly before 1am, William went to his mother’s bedroom and came back with the fake Norco pill. Jerome took it and said he was going to bed.  Jerome’s girlfriend was in jail after being arrested for an unpaid traffic fine and so he was alone with their 18 month-old daughter, Success, lying next to him.

“The doctors explained to me that within a matter of minutes he went into cardiac arrest,” said his mother. “Then as he lay there that’s when time progressed for the organs to be poisoned by fentanyl. He was dying with his daughter next to him.” Natasha said other people in the house heard her son in distress, complaining his heart was hurting. But they did nothing because they were afraid that calling an ambulance would also bring the police.

It was not until 10 hours later that the Dossmans finally sought help from a neighbour who knew Jerome. He tried CPR and then called the medics. The police came, too, and in time Mildred Dossman, 50, was charged with distributing fentanyl and black market opioid painkillers. She was the local dealer.

The DEA is tightlipped about the investigation into the Sacramento deaths as its agents work on persuading Dossman to lead them to her suppliers. But it is likely she was getting the pills from Mexican cartels using ingredients from labs in China where production of fentanyl’s ingredients is legal.  Carreno said some Mexican cartels have long relationships with legitimate Chinese firms which for years supplied precursor chemicals to make meth amphetamine.

Packages of fentanyl are often moved between multiple freight handlers so their origins are hard to trace. Larger shipments are smuggled in shipping containers. Last year, six Chinese customs officials fell ill, one of them into a coma, after seizing 72kg of various types of fentanyl from a container destined for Mexico. American police officers have faced similar dangers. In June, the DEA put out a video warning law enforcement officers across the US that fentanyl was different to anything they have previously encountered and they should refrain from carting seizures back to the office.   “A very small amount ingested, or absorbed through the skin, can kill you,” it said.   A New Jersey detective appears in the video after accidentally inhaling “just a little bit of fentanyl puffed into the air” during an arrest: “It felt like my body was shutting down… I thought that was it. I thought I was dying.”

Along with the Mexican connection, a home-grown manufacturing industry has sprung up in the US. Weeks after Jerome died, agents arrested a married couple pressing fentanyl tablets in their San Francisco flat.

Candelaria Vazquez and Kia Zolfaghari made the drug to look like oxycodone pills. They sold them across the country via the darknet using Bitcoin for payment – on one occasion Zolfaghari cashed in $230,000. The couple shipped the drugs through the local post office. Customers traced by the DEA thought they were buying real painkiller pills. The couple ran the pill press in their kitchen. According to a DEA warrant, a dealer said Zolfaghari made large numbers of tablets: “He could press 100 out fast as fuck.”

The pair made so much money that agents searching their flat found luxury watches worth $70,000, more than $44,000 in cash and hundreds of “customer order slips” which included names, amounts and tracking numbers. The flat was stuffed with designer goods. The seizure warrant described Vazquez’s shoe collection as “stacked virtually from floor to ceiling”. Some still had the $1,000 price tags on them. Zolfaghari was arrested carrying a 9mm semi-automatic gun and about 500 pills he was preparing to post. The dealers made so much money that their flat was stuffed with luxury goods and cash.

Even as Americans are getting their heads around fentanyl, it is being eclipsed. In September, the DEA issued a warning about the rise of a fentanyl variant that is 100 times more powerful – carfentanil, a drug used to tranquilise elephants.

“Carfentanil is surfacing in more and more communities,” said the DEA’s acting administrator, Chuck Rosenberg. “We see it on the streets, often disguised as heroin. It is crazy dangerous.”

The drug has already been linked to 19 deaths in Michigan. Investigators say that with its use spreading, it is almost certainly claiming other lives. Dealers are also getting it from China, where carfentanil is not a controlled drug and can be sold to anyone.

Natasha Butler is still trying to understand the drug that killed her son. She wants to know why it is that it took Jerome’s death for her to even hear of it. She accuses the authorities of failing to warn people of the danger, and politicians of shirking their responsibilities.   A bill working its way through California’s legislature stiffening sentences for fentanyl dealing died in the face of opposition from the state’s governor, Jerry Brown, because it would put pressure on the already badly crowded prisons.

“I’m so dumbfounded. How does that happen?” says Natasha. Her tears come frequently as she sits at a tiny black table barely big enough to seat three people. She talks about Jerome and the tragedy for his three children, including Success, who she is now raising.

But some of the tears are to mourn the devastating impact on her own life. “Look where I’m at. I was in Louisiana. I had a house. I had a job. I had a car. I had a life. I worked every day. I was a manager for a major company. I came here, I became homeless. I had to move into this apartment to help out my granddaughter,” she said. “You see me. This is what my kitchen table is. My son is dead. He had three kids and those two mothers of those kids are depending on me to be strong. I want answers and help. I say, you got the little fish. Where did they get it from? How did they get it here? You are my government. You are supposed to protect us.”

Source:  https://www.theguardian.com/global/2016/dec/11/pills-that-kill-why-are-thousands-dying-from-fentanyl-abuse–

There’s a new drug in town.

It’s called Shatter and it looks like dark-amber toffee. It’s THC, the chemical that causes the high in marijuana, extracted from the plant and has highly addictive qualities, said Stratford police Insp. Sam Theocharis.

It’s been around for a while but it’s new to Stratford, Theocharis said.  Police have started to see the drug a bit more frequently and wanted to get the message out to the public.

“When you look at it, it just looks like goo but it’s a new form of marijuana drug,” he said.

Shatter is clear, smooth and solid. It can consist of more than 80% THC, according to the High Times website.

Police seized some Tuesday along with methamphetamine, cocaine, marijuana and prescription drugs after an investigation by the Street Crime Unit.  Two men in their 40s were arrested and face several charges including possession for the purpose of trafficking. The drugs seized are valued at more than $1,500. Cell phones, scales and baggies were also seized, police said.

Shatter sells for about $100 a gram on the streets. It’s dangerous and often leads to overdose, police said.  Whether it will overshadow crystal meth and oxycodone in popularity has yet to be seen.

“I can’t predict but anything that gives you a better high is going to be sought after,” Theocharis said.

Source: http://www.stratfordbeaconherald.com/

 

President Obama this week told an audience in Jamaica that U.S. efforts against illegal drugs were “counterproductive” because they relied too much on incarceration—particularly for “young people who did not engage in violence.”

In what the president termed “an experiment … to legalize marijuana” in Colorado and Washington state, he said he believed they must “show that they are not suddenly a magnet for additional crime, that they have a strong enough public health infrastructure to push against the potential of increased addiction.”

In regard to Jamaica and the entire Caribbean and Central American region, he said, “a lot of folks think … if we just legalize marijuana, then it’ll reduce the money flowing into the transnational drug trade, there are more revenues and jobs created.”

To some of us, Jamaica hardly seems an auspicious location for encouraging “experimentation” with drugs, in particular because of the challenges already faced by their deficient institutions of public health and criminal justice. The U.S. Department of State 2015 International Narcotics Control Strategy Report(INCSR) states:

Jamaica remains the largest Caribbean supplier of marijuana to the United States and local Caribbean islands. Although cocaine and synthetic drugs are not produced locally, Jamaica is a transit point for drugs trafficked from South America to North America and other international markets. In 2014, drug production and trafficking were enabled and accompanied by organized crime, domestic and international gang activity, and police and government corruption. Illicit drugs are also a means of exchange for illegally-trafficked firearms entering the country, exacerbating Jamaica’s security situation.

Drugs flow from and through Jamaica by maritime conveyance, air freight, human couriers, and to a limited degree by private aircraft. Marijuana and cocaine are trafficked from and through Jamaica into the United States, Canada, the United Kingdom, Belgium, Germany, the Netherlands, and other Caribbean nations. Jamaica is emerging as a transit point for cocaine leaving Central America and destined for the United States, and some drug trafficking organizations exchange Jamaican marijuana for cocaine. . . .

The conviction rate for murder was approximately five percent, and the courts continued to be plagued with a culture of trial postponements and delay. This lack of efficacy within the criminal courts contributed to impunity for many of the worst criminal offenders and gangs, an abnormally high rate of violent crimes, lack of cooperation by witnesses and potential jurors, frustration among police officers and the public, a significant social cost and drain on the economy, and a disincentive for tourism and international investment.

This does not seem like a place where “legal” marijuana would contribute to “reduced money flow” to the transnational drug trade, or “create jobs.”  The president apparently thinks Jamaica should consider allowing more drugs, based on a faulty understanding of what is actually happening in Jamaica and in the U.S.

His charge of high incarceration rates for non-violent offenders is not factual. For instance, data show that only a fraction of one percent of state prison inmates are low-level marijuana possession offenders, while arrests for marijuana and cocaine/heroin possession and use were no more than 7 percent of all arrests,nationwide, in 2013.

Though critics of drug laws claim that hundreds or even thousands of prisoners are low-level non-violent offenders unjustly sentenced, the reality was shown recently by the President’s inability to find more than a handful of incarcerated drug offenders who would be eligible for commutation of their sentence because they fit the mythological portrait of excessive or unjust drug sentences.

Further, since 2007, the US is currently experiencing a surge in daily marijuana use, an epidemic of heroin overdose deaths (with minorities hardest hit), while the southwest border is flooded with heroin and methamphetamine flow, as shown by skyrocketing border seizures.

Importantly, Colorado, following marijuana “legalization,” has become a black-market magnet, and is currently supplying marijuana, including ultra-high-potency “shatter” to the rest of the U.S., leading to law suits by adjacent states. Legalization has not reduced criminal activity nor the threat of financial corruption.

As for Central America, Obama’s policies have shown stunning neglect. Actual aid for counter-drug activities, and for resources for interdicting smugglers have all diminished, while the countries of Central America have become battlegrounds for Mexican cartels, with meth precursors piling up at the docks, the cocaine transiting Venezuela to Honduras is surging, and violence is at an all-time high, with families fleeing north in unprecedented numbers. The Caribbean/Central American region has become deeply threatened, as noted by the State Department report above—torn apart by drug crime.

In this context the president encourages governments in the region to make drugs more acceptable and more accessible in their communities, and with even greater legal impunity?

Moreover, these developments have been accompanied by a steady drumbeat of medical science reports increasingly showing the serious dangers of marijuana use, especially for youth.   Yet President Obama speaks in a manner increasingly disconnected from the domestic and international reality of the drug problem.

Source:  David W. Murray and John P. Walters  WEEKLY STANDARD  April 11, 2015

I K Lyoo, S Yoon, T S Kim, S M Lim, Y Choi, J E Kim, J Hwang, H S Jeong, H B Cho, Y A Chung and P F Renshaw

Abstract

Adolescence is a period of heightened vulnerability both to addictive behaviors and drug-induced brain damage. Yet, only limited information exists on the brain mechanisms underlying these adolescent-specific characteristics. Moreover, distinctions in brain correlates between predisposition to drug use and effects of drugs in adolescents are unclear.

Using cortical thickness and diffusion tensor image analyses, we found greater and more widespread gray and white matter alterations, particularly affecting the frontostriatal system, in adolescent methamphetamine (MA) users compared with adult users.

Among adolescent-specific gray matter alterations related to MA use, smaller cortical thickness in the orbitofrontal cortex was associated with family history of drug use. Our findings highlight that the adolescent brain, which undergoes active myelination and maturation, is more vulnerable to MA-related alterations than the adult brain.

Furthermore, MA-use-related executive dysfunction was greater in adolescent MA users than in adult users. These findings may provide explanation for the severe behavioral complications and relapses that are common in adolescent-onset drug addiction. Additionally, these results may provide insights into distinguishing the neural mechanisms that underlie the predisposition to drug addiction from effects of drugs in adolescents.

Source:  Molecular Psychiatry , (10 February 2015) | doi:10.1038/mp.2014.191

It’s not often that Sherwood, Oregon – a small, quiet suburb located southwest of Portland – makes the front page news – especially for stories related to drugs.  But it did the first weekend of February 2014, when two teenage girls ended up in the hospital after using a dangerous and relatively new designer drug.  The drug – officially known as 25i-NBOMe – is most commonly referred to as simply “25I” or “N-Bomb”.  “Smiles” is another nickname for N-Bomb and other closely related substances.

Fortunately for the Oregon teens, an off-duty deputy sheriff spotted them on the roadside as one of the girls was having a seizure.  He stopped and called an ambulance, only to have the other girl soon start seizing as well.  These girls survived, but several other teens experimenting with the deadly LSD-like drug haven’t been as lucky.  It’s been estimated that at least 19 deaths in the past couple of years are linked to the drug, including:

* June 2012 – The death of North Dakota teen Christian Bjerk, who was found lying dead on the ground after a fatal reaction to 25I [1].

 

* June 2012 – The death of 17-year-old Elijah Stai, who stopped breathing and ended up on life support after ingesting 25I mixed with chocolate.  The Minnesota teen died 3 days later, when his parents made the gut-wrenching decision to take him off life support [1].

* October 2012 – The death of a 21-year-old Arkansas male, who reportedly used N-Bomb intranasally.

* January 2013 – The death of Noah Carrasco, an 18-year-old Scottsdale, Arizona high school student.  He quickly lost consciousness after taking the deadly drug via nose drops that he thought contained LSD [2].

* April 2013 – The death of an 18-year-old student attending Arizona State University, believed to be caused by the designer drug N-Bomb [3].

* June 2013 – The death of 17-year-old Henry Kwan of Sydney, Australia, who threw himself out of a window and fell to his death after taking N-Bomb [4]

* September 2013 – The death of a 17-year-old high school student in Pennsylvania.  An overdose of the drug caused him to stop breathing, reportedly resulting in his death [5].

* February 2014 – The death of Jake Harris, a 21-year-old U.K. lifeguard and father-to-be.  Harris reportedly stabbed himself in the neck multiple times with broken glass after taking the drug [6]

 

Needless to say, the drug has the authorities – as well as many parents – very concerned.  One of the biggest problems is that the drug is often sold as LSD.  Although it’s similar to LSD in many ways, its effects can be significantly more dangerous.

 

Legal Issues Unfortunately, designer drugs often slip through the cracks in terms of drug enforcement, making them legal until deemed otherwise by the authorities.  With regards to N-Bomb, which had previously been legal, the fatalities linked to its use resulted in the Drug Enforcement Administration classifying it as a Schedule I controlled substance in October 2013.  The authorities have not been lenient with those individuals who either sold or supplied the drug to those who have suffered or died from its effects.

In the case of the two girls from Oregon, an adolescent boy was taken into custody for allegedly supplying them with the drug.  A total of 15 individuals have been charged in connection to the deaths of Elijah Stai and Christian Bjerk, a law-enforcement endeavor that’s been aptly dubbed “Operation Stolen Youth”.  Adam Budge, the 18 year-old friend who gave the drug to Stai, is facing murder charges for his death.  Charles Carlton, a 29-year-old man from Katy, Texas, pleaded guilty to numerous charges related to the two teens’ deaths, including possession with intent to distribute.  He had sold the deadly drugs via his online business, Motion Resources [7].

Potent Hallucinogen

N-Bomb is a hallucinogenic designer drug that is often likened to LSD, although some say that it’s up to 25 times more potent.  Designer drugs are synthetically produced by altering the chemical structure of existing drugs, like cocaine or marijuana.  They are meant to be used recreationally, and mimic the effects of the other drugs.  N-Bomb is actually derived from phenethylamine, commonly known as mescaline.  Mescaline is a natural substance found in the peyote cactus.  Mescaline’s use as a recreational drug became illegal in the U.S. in 1970, due to its psychedelic properties.

N-Bomb and other hallucinogens are known for causing powerfully altered perceptions, including brightly colored and widely distorted visual images.  Some users of the drug have described its effects as “Nirvana” and “ecstasy”, reporting “trips” very similar to those experienced with LSD.  As is typically the case with psychedelics, the unpredictable effects of N-Bomb have varied widely from one individual to the next.

Pleasurable effects of N-Bomb may include:

* Euphoria

* Bright moving colors and other vivid visual hallucinations

* Spiritual “awakening”

* A sense of profoundness

* Positive mood

* Enhanced awareness

* Enhanced creativity

* Loving feelings

* Sexual sensations and enhanced desire

Side effects of N-Bomb may include:

* Psychosis

* Altered state of consciousness

* Agitation

* Erratic behavior

* Chills, flushing

* Severe double vision

* Teeth grinding, jaw clenching

* Dilated pupils

* Depressed mood

* Confusion

* Nausea

* Intense negative emotions

* Paranoia

* Intense anxiety

* Muscle spasms and contractions

* Insomnia

* Impaired communication

* Vasoconstriction

* Swelling of feet, hands, face

* Kidney damage / failure

* Seizures

* Heart failure

* Coma

* Asphyxiation

How N-Bomb Is Used

N-Bomb or 25I is often sold on strips of blotter paper, which is one of the reasons users often erroneously assume it’s LSD.  The strip of paper is placed under the tongue, which allows the drug to enter the bloodstream sublingually. N-Bomb is also available as a powder.  Users can snort the powder like cocaine, smoke it, or mix it with a liquid and inject it like heroin.   Some users combine it with water in a nasal spray bottle to administer via the nose.  Vaporizing and then inhaling the drug is another method of administration used by some, but it makes controlling the dose very precarious.

When the drug is taken orally or sublingually, the effects generally last between 6 and 10 hours.  Those who inhale or snort the drug will generally experience its effects for a shorter period, ranging from 4 to 6 hours.  This can vary though, depending on the amount used.  When the substance is vaporized and then inhaled, the effects may kick in much more quickly but not last as long.

Dosing N-Bomb

A typical dose of N-Bomb is somewhere between 600 and 1200 micrograms.  Because the doses are so tiny (1 gram is the equivalent of 1,000,000 micrograms), it’s often very difficult to measure a dose accurately.  This is why users have a high risk of accidentally overdosing on the drug [8].

Multiple Concerns Arise About N-Bomb

Like so many designer drugs – particularly newer ones – N-Bomb isn’t fully understood.  It’s been on the street for less than 5 years, and it was discovered in a lab just 11 years ago.  So the full and long-term effects are not yet known.  What little information we do have is primarily from those who have had a bad reaction to the drug or died from it. Also, like other designer drugs and street drugs in general, there’s no way of knowing exactly what you’re getting.  It’s not at all uncommon for these substances to have other substances added in – making them even more dangerous than ever for users who don’t know what they’re getting.   Dealers often sell them under false names, like LSD.  After all, it’s a hallucinogenic drug with similar effects used in a similar manner.  No big deal…to them.

Information For Parents

If you’re the parent of a teen, it’s important to be aware of drugs in general, but especially designer drugs like N-Bomb.  First, these drugs are more readily available than you might realize.  Since new designer drugs are being created and coming available practically daily, they

slip through the cracks legally (at least for a while) so they’re much easier for teens to obtain.  Many are sold online or by friends or acquaintances.

Second, they’re appealing to many teens because they’re “exciting” and “cool”. They may rationalize that since it’s not a “real” drug, like cocaine or methamphetamine, it’s safe (or at least safer) to try.  And of course, their peers will often try to convince them that these drugs are harmless fun.  On top of that, teens tend to be reckless.  They tend to still perceive themselves as invincible, and often don’t consider the potential long-term consequences of their behavior.  Even when the risks are presented, teens often ignore them – much the same way they roll their eyes when reminded ad nauseam that drinking and driving is very dangerous or that wearing seatbelts saves lives.

Still, it’s vital to talk to your teen about N-Bomb and other designer drugs.  Strive to maintain good communication with him or her, and make sure your teen knows (both by your words AND your actions) that you genuinely care and that your door is always open, so to speak. If you do think your teen is using N-Bomb or any other drugs – including illegitimate prescription drugs, designer drugs, and regular street drugs – have a conversation as soon as possible.  Don’t ignore it.  Don’t minimize it.  Don’t assume that experimenting with drugs is just a normal part of adolescence.  Take it very seriously.  Consider setting up an appointment for an evaluation with an addiction specialist to determine if drug rehab is necessary.  Your teen may resent you, but a dead teen will never have the opportunity to appreciate how much you really do care.

Source:  addictiontreatmentmagazine.com  21st April 2014

Resources:

[1] http://www.houstonpress.com/2013-03-14/news/motion-research-charles-carlton/

[2] http://www.usatoday.com/story/news/nation/2013/05/04/n-bomb-drug-stirs-fear/2135407/

[3] http://www.azcentral.com/news/arizona/articles/20130503phoenix-area-n-bomb-drug-stirs-fear.html

[4] http://www.theaustralian.com.au/news/features/high-alert-why-synthetic-drugs-are-so-hard-to-police/story-e6frg8h6-1226673596866

[5] http://www.abc27.com/story/23605144/deadly-drug-n-bomb-claims-teens-life

[6] http://www.dailymail.co.uk/news/article-2552893/Lifeguard-stabbed-neck-taking-former-legal-high-N-bomb-hallucinating-tried-stop-effect-drug.html

[7] http://www.chron.com/neighborhood/katy/crime-courts/article/Katy-man-pleads-guilty-in-multi-state-drug-ring-5305077.php

[8] healthandwelfare.idaho.gov

Youngsters exposed to methamphetamine before birth had increased cognitive problems at age 7.5 years, highlighting the need for early intervention to improve academic outcomes and reduce the potential for negative behaviors. The researchers studied 151 children exposed to methamphetamine before birth and 147 who were not exposed to the drug. They found the children with prenatal methamphetamine exposure were 2.8 times more likely to have cognitive problem scores than children who were not exposed to the drug.

In the only long-term, National Institutes of Health-funded study of prenatal methamphetamine exposure and child outcome, researchers found youngsters exposed to the potent illegal drug before birth had increased cognitive problems at age 7.5 years, highlighting the need for early intervention to improve academic outcomes and reduce the potential for negative behaviors, according to the study published online by The Journal of Paediatrics.

The researchers studied 151 children exposed to methamphetamine before birth and 147 who were not exposed to the drug. They found the children with prenatal methamphetamine exposure were 2.8 times more likely to have cognitive problem scores than children who were not exposed to the drug in a test often used for measuring cognitive skills, the Connors’ Parents Rating Scale.

“These problems include learning slower than their classmates, having difficulty organizing their work and completing tasks and struggling to stay focused on their work,” said Lynne M. Smith, MD, a lead researcher at the Los Angeles Biomedical Research Institute (LA BioMed) and corresponding author of the study. “All of these difficulties can lead to educational deficits for these children and potentially negative behavior as they find they cannot keep up with their classmates.”

Methamphetamine use among women of reproductive age is a continuing concern, with 5% of pregnant women aged 15-44 reporting current illicit drug use. Methamphetamine usage during pregnancy can cause a restriction of nutrients and oxygen to the developing fetus, as well as potential long-term problems because the drug can cross the placenta and enter the fetus’s bloodstream.

Previous research in Sweden found evidence of lower IQ scores, decreased school performance and aggressive behavior among children with prenatal methamphetamine exposure. The study tracked the children through age 15, but it didn’t compare them to children who had no prenatal methamphetamine exposure.

Researchers at LA BioMed and in Iowa, Oklahoma and Hawaii — all places where methamphetamine usage is prevalent — have been tracking children who were not exposed to the drug and children with prenatal methamphetamine exposure since 2002, as part of the Infant Development, Environment and Lifestyle (IDEAL) Study. This study, which is the only prospective, longitudinal National Institutes of Health study of prenatal methamphetamine exposure and child outcome, was conducted under the auspices of Principal Investigator Barry M. Lester, PhD, at Women & Infants Hospital of Rhode Island.

“By identifying deficits early in the child’s life, we can intervene sooner and help them overcome these deficits to help them have greater success in school and in life,” said Dr. Smith. “Through the IDEAL Study, we are able to track these children and better understand the long-term effects of prenatal methamphetamine exposure.”

Source: Effects of Prenatal Methamphetamine Exposure on Behavioral and Cognitive Findings at 7.5 Years of Age.  The Journal of Pediatrics,    March  2014 

Purdue Pharma L.P. will present a poster describing the changes in abuse of OxyContin® and immediate-release oxycodone in rural Kentucky following the August 2010 introduction of reformulated OxyContin. This data is composed of follow-up interviews with a cohort of individuals in Kentucky who self-identified as original OxyContin abusers and will be presented at the College on Problems of Drug Dependence (CPDD) 75th Annual Meeting June 15 to 20 in San Diego.

Details of the scheduled poster presentation follows:

* Monday, June17, 8:00-10:00 a.m. PDT,  Poster No. 73

* “Abuse of OxyContin and immediate-release (IR) oxycodone in a rural Kentucky county following introduction of reformulated OxyContin – results from 6-month follow-up interviews” A. DeVeaugh-Geiss, C. Leukefeld, J. Havens, H. Kale, P. Coplan, H. Chilcoat

Study participants (individuals that reported abuse of original OxyContin prior to the reformulation) were initially interviewed about their drug use before and after the introduction of reformulated OxyContin, followed by six-month follow-up interviews.

Among the 164 participants who completed the 6-month follow-up interviews, 76 percent selected original OxyContin as their preferred drug prior to the reformulation.  In contrast, 66 percent of this population selected immediate-release oxycodone as their preferred drug after the reformulation; only one participant selected reformulated OxyContin as his or her preferred drug.

In follow-up interviews, 23 percent of participants reported attempting to manipulate the reformulated OxyContin for purposes of abuse.

From the initial interviews following the reformulation to the 6-month follow-up, the overall prevalence of original OxyContin abuse declined from 60 percent to 11 percent, and the overall frequency of abuse among those who abused declined from 11.3 days per month to 3.3 days per month.

During the same time period, prevalence of reformulated OxyContin abuse declined from 33 percent to 18 percent, while frequency among those who abused remained stable at 5.9 days per month vs. 5.7 days per month.

A decline in the prevalence of immediate-release oxycodone abuse, from 96 percent to 85 percent, also was observed during this time, while the frequency of abuse remained relatively constant.

Some abuse of OxyContin continued, and further research is necessary to determine whether similar effects are observed in other populations that abuse or misuse OxyContin.

The research was funded by Purdue Pharma L.P.

Source:  www.new.gnom.es   San Diego 17th June 2013

Drug traffickers in the central city of Da Nang have switched their focus on methamphetamine and heroin from opium and marijuana over the last two years, a senior police officer told a press conference on drug prevention on Friday.

Lieutenant colonel Nguyen Xuan Cuong, Deputy Head of Counter Narcotics Office under the city’s Public Security Department, said the number of traffickers caught with methamphetamine in 2012 was seven times more than the amount in 2011.

Cuong added the city’s narcotics police force last year arrested a total of 128 drug offenders with 921.4 grams of methamphetamine, 54 grams of heroin and 133.6 grams of marijuana extracts.

A report at the conference shows there are an estimated 1,500 addicts and drug users at rehabilitation centers across the city.

Source: www.tuoitrenews.vn   16th June 2013

 

Not many of us are chemists. Yet by removing one oxygen atom average people here in Missouri regularly are turning common decongestants like Sudafed and Claritin-D into the illicit drug methamphetamine. Nationwide those explosive mom and pop meth labs were estimated by a Rand study to cost taxpayers more than $23 billion a year in health care costs, child endangerment and clean-up. But as St. Louis Public Radio’s Maria Altman reports a local pharmaceutical company may have the answer.

In a non-descript office building in suburban St. Louis a little company was busy developing big technology; a binding agent to make a tamper-resistant drug. They weren’t yet sure exactly what drug Westport Pharmaceuticals they would tackle. Paul Hemings is the General Manager and Vice President of the Highland Pharmaceuticals subsidiary. He says looking back, it was staring them in the face.

“It started with our patent attorney who also has a chemistry background and lives out in Pacific where this meth problem is huge and one day she just mentioned ‘have you thought about this?” That is how to prevent pseudoephedrine, a common ingredient in nasal decongestants, from being turned into methamphetamine. Zephrex-D was the result.

How It Works

Hemings points out the pills’ waxy white coating. He says the new drug works just as well as other pseudoephedrine products, but meth cooks can’t extract the key ingredient. That means they can’t make meth. “We can end meth labs in the U.S. starting right here in our backyard where the problem is the biggest,” Hemings said. Last year alone law enforcement seized more than 1,800 clandestine labs in Missouri, the most of any state in the country. Detective Sgt. Jason Grellner is with the Franklin County Narcotics Enforcement Unit and is considered the expert on Missouri’s meth lab epidemic.Grellner says he was skeptical of Zephrex-D after years of being told by large pharmaceutical companies that a tamper-resistant drug couldn’t be made.

Now he says he’s a believer. “I’ve seen the testing by independent laboratories; I’ve personally tested the product in a one-pot meth lab setting; and I know of other testing that has been done,” he said. “They have manufactured a product that is meth lab resistant.”

Requiring A Prescription?

Grellner doesn’t expect “big pharma,” as he calls it, to change their pseudoephedrine products, at least not yet. He says for now the best way to keep the pills that still can be converted into meth away from criminals is to require prescriptions. “They have manufactured a product that is meth lab resistant.” – Detective Sgt. Jason Grellner

That faces strong opposition, including from the St. Louis Chapter of the Asthma and Allergy Foundation. “We do know that meth is a terrible problem in Missouri, we just disagree on how to take care of this,” said Joy Krieger, the foundation’s executive director and a registered nurse. Krieger says they support a proposed law to further limit the amount of pseudoephedrine people can buy each month, but she says getting a prescription is an expensive hassle. “Pseudoephedrine is safe for those purchasing it for proper reasons, so penalizing

residents and citizens who have done nothing wrong we think is not a fair way to look for a solution,” she said.

The Legal Perspective

State Representative Jeff Roorda has sponsored legislation for the state-wide prescription law every year since 2005. The Democrat from Jefferson County, the heart of Missouri’s meth country, says with Zephrex-D, there is a good alternative available for cold and allergy sufferers, so there can be no more excuses. “Now we have a pseudoephedrine that’s incapable of being converted into methamphetamine, I mean arguments against this just hold absolutely no water anymore,” Roorda said. The impact of Zephrex-D remains to be seen.

Westport Pharmaceuticals officials say they’re open to selling their binding technology to other drug-makers. Right now Zephrex-D is only available in Missouri and the Metro East. Officials say they plan a national roll-out this summer.


Source: http://www.news.stlpublicradio.org 13th March

 

 

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”

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

 

 


 

TORONTO, Nov. 2 — Methamphetamine can be detected in the hair of newborns whose mothers used the drug during pregnancy, researchers here have found.

Action Points

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

Canadian scientists also confirm previous research showing possible link between cannabis dependence and schizophrenia

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  

TORONTO, Nov. 2 — Methamphetamine can be detected in the hair of newborns whose mothers used the drug during pregnancy, researchers here have found.
Action Points

  • 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

People who abused methamphetamine or other amphetamine-like stimulants were more likely to develop Parkinson’s disease than those who did not, in a new study from the Centre for Addiction and Mental Health (CAMH).
The researchers examined almost 300,000 hospital records from California covering 16 years. Patients admitted to hospital for methamphetamine or amphetamine-use disorders had a 76 per cent higher risk of developing Parkinson’s disease compared to those with no diagnosis. Globally, methamphetamine and similar stimulants are the second most commonly used class of illicit drugs.
“This study provides evidence of this association for the first time, even though it has been suspected for 30 years,” said lead researcher Dr. Russell Callaghan, a scientist with CAMH. Parkinson’s disease is caused by a deficiency in the brain’s ability to produce a chemical called dopamine. Because animal studies have shown that methamphetamine damages dopamine-producing areas in the brain, scientists have worried that the same might happen in humans.
It has been a challenge to establish this link, because Parkinson’s disease develops in middle and old age, and it is necessary to track a large number of people with methamphetamine addiction over a long time span. The CAMH team took an innovative approach by examining hospital records from California – a state in which methamphetamine use is prevalent – from 1990 up to 2005. In total, 40,472 people, at least 30 years of age, had been hospitalized due to a methamphetamine- or amphetamine-use disorder during this period.
These patients were compared to two groups: 207,831 people admitted for appendicitis with no diagnosis of any type of addiction, and 35,335 diagnosed with cocaine use disorders. A diagnosis of Parkinson’s disease was identified from hospital records or death certificates. Only the methamphetamine group had an increased risk of developing Parkinson’s disease.
While the appendicitis group served as a comparison to the general population, the cocaine group was selected for two reasons. Because cocaine is another type of stimulant that affects dopamine, this group could be used to determine whether the risk was specific to methamphetamine stimulants. Cocaine users also served as a control group to account for the health effects or lifestyle factors associated with dependence on an illicit drug.
“It is important for the public to know that our findings do not apply to patients who take amphetamines for medical purposes, such as attention deficit hyperactivity disorder (ADHD), since these patients use much lower doses of amphetamines than those taken by patients in our study,” said Dr. Stephen Kish, a CAMH scientist and co-author.
To put the study findings into numbers, if 10,000 people with methamphetamine dependence were followed over 10 years, 21 would develop Parkinson’s, compared with 12 people out of 10,000 from the general population. “It is also possible that our findings may underestimate the risk because in California, methamphetamine users may have had less access to health-care insurance and consequently to medical care,” said Dr. Callaghan.
The current project is significant because it is one of the few studies examining the long-term association between methamphetamine use and the development of a major brain disorder. “Given that methamphetamine and other amphetamine stimulants are the second most widely used illicit drugs in the world, the current study will help us anticipate the full long-term medical consequences of such problematic drug use,” said Dr. Callaghan.
Media Contact: Michael Torres, Media Relations, CAMH; 416-595-6015

Source: www.camh.net 26th July 2011

Background

Methamphetamine (METH), an abused illicit drug, disrupts many cellular processes, including energy metabolism, spermatogenesis, and maintenance of oxidative status. However, many components of the molecular underpinnings of METH toxicity have yet to be established. Network analyses of integrated proteomic, transcriptomic and metabolomic data are particularly well suited for identifying cellular responses to toxins, such as METH, which might otherwise be obscured by the numerous and dynamic changes that are induced.

Methodology/Results

We used network analyses of proteomic and transcriptomic data to evaluate pathways in Drosophila melanogaster that are affected by acute METH toxicity. METH exposure caused changes in the expression of genes involved with energy metabolism, suggesting a Warburg-like effect (aerobic glycolysis), which is normally associated with cancerous cells. Therefore, we tested the hypothesis that carbohydrate metabolism plays an important role in METH toxicity. In agreement with our hypothesis, we observed that increased dietary sugars partially alleviated the toxic effects of METH. Our systems analysis also showed that METH impacted genes and proteins known to be associated with muscular homeostasis/contraction, maintenance of oxidative status, oxidative phosphorylation, spermatogenesis, iron and calcium homeostasis. Our results also provide numerous candidate genes for the METH-induced dysfunction of spermatogenesis, which have not been previously characterized at the molecular level.

Conclusion

Our results support our overall hypothesis that METH causes a toxic syndrome that is characterized by the altered carbohydrate metabolism, dysregulation of calcium and iron homeostasis, increased oxidative stress, and disruption of mitochondrial functions.

Source: . PLoS ONE 6(4): e18215. doi:10.1371/journal.pone.0018215. (2011)
Sun L, Li H-M, Seufferheld MJ, Walters KR Jr, Margam VM, et al. Sun L, Li H-M, Seufferheld MJ, Walters KR Jr, Margam VM, et al.

A new study suggests that the brain damage suffered by children whose mothers used metamphetamine during pregnancy may be even worse than the effects that alcohol has on a fetus.

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

The State Government figures show that out of 4619 drivers pulled over, one in 73 tested positive to either cannabis or methamphetamines. This compared to an average of one in 250 drivers testing positive for alcohol. The results surprised police.

The results come just two days after research by the National Drug and Alcohol Research Centre showed 57 per cent of clubbers admitted driving under the influence of alcohol and 52 per cent under the influence of cannabis. The VicRoads-commissioned study reported that just under half of those surveyed admitted driving soon after taking other drugs.

43% said they had taken ecstasy and 42 % speed.

Source: Minister for Police & Emergency Services. Victoria. Australia. April 15 2005

The number of people admitted into hospital because of GHB poisoning has quadrupled in the period 2004-2009. In total, 1200 persons were admitted in the ER’s of hospitals who had swallowed the party drug (23 persons per week). This was reported by the Consumer and Safety Foundation last Sunday.
Almost sixty percent of the treatments took place in the weekend. It mainly concerns males (69 percent). Something more than half of the victims was in the age of 20 to 29 years, one in five in the age of 30 to 39 (22 percent) and fourteen percent between 15 and 19.

Many of the patients not only used GHB, but also alcohol (34%) or other drugs like XTC (10%), cocaine (7%) or speed (1%). Almost all victims at the ER’s suffer from GHB poisoning, 40 percent need to be admitted into hospital, half of which even at the IC department.

Going ‘out’ because of GHB is regarded as something normal. The Consumer and Safety Foundation wants there to be more education and information on GHB. According to the foundation the party drug now has a too positive image: “It’s cheap, simply to get, people break loose and become jolly and do not suffer a hangover. That image has to change for reality. GHB is addictive and can even be life threatening. And the long term damage to health is not yet known.”

(Source: http://www.veiligheid.nl/csi/veilighe id.nsf/wwwVwContent/M_7CC86ED715F24DE9C125778500330C70) Aug 2010

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

There were 897 deaths involving heroin or morphine in 2008, an 8 per cent rise compared with 2007 and the highest number since 2001. The number of deaths involving methadone rose throughout 2004 to 2008, to 378 in the latest year, an increase of 16 per cent compared with 2007 (and 73 per cent higher than in 2004). There were 235 deaths involving cocaine in 2008, continuing the long-term upward trend.

 

There were 99 deaths involving amphetamines in 2008, with nearly half of these being accounted for by deaths mentioning ecstasy. Cannabis was mentioned in 19 deaths in 2008, while the number of deaths mentioning GHB rose to 20 in 2008 from 9 in 2007. The number of deaths that mentioned benzodiazepines rose to 230 in 2008, an increase of 11.

 

Source: Office for National Statistics  26 August 2009

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

DALLAS — June 3, 2008 — Young adults who abuse amphetamines may be at greater risk of suffering a heart attack, UT Southwestern Medical Center researchers have found.In the study, available online in the journal Drug and Alcohol Dependence, researchers examined data from more than 3 million people between 18 and 44 years old hospitalized from 2000 through 2003 in Texas and found a relationship between a diagnosis of amphetamine abuse and heart attack.

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.

Source: www.utsouthwestern.edu June 3rd 2008

 

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.

Source: Associated Press reported Aug. 28. 2004

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.

Source: National Institute of Drug Abuse(NIDA), NIH Publication. March 2001.

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.

Source: DEA Media Advisory. Sept 2002.

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.

Source: Author NoraVolkow and Linda Chang, U.S. Department of Energy’s Brookhaven National Laboratory. Dec 2001.

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.

Source: London, E., et at (2004) Mood Disturbances and Regional Cerebral Metabolic Abnormalities in Recently Abstinent Methamphetamine Abusers. Archives of General Psychiatry, 61W: 73-84.

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.”

Source: Momstell News online Aug. 2005

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.”

Source: American Journal of Psychiatry, August 2005
Methamphetamine is currently the number-one drug problem in many parts of the United States, according to a report issued today by the National Association of Counties (NACo). The drug, which stimulates the central nervous system, modifies the behavior of users and after lengthy use can change the way the brain functions. Psychological effects can include anger, panic, paranoia, hallucinations, repetitive behavior, confusion, jerky or flailing movements, irritability, insomnia, aggression, incessant talking, convulsions, aggressive acts, and suicide. “Now add a child to this mixture,” the NACo report suggests, and there is a risk of child abuse and neglect, a fact that’s being reflected in increasing numbers of children grossly neglected by addicted parents or exposed to the harmful effects of small-scale in-home labs that produce the drug. A survey of counties in 13 states showed marked increases in methamphetamine-caused out-of-home placements of children over the past three years, with many of the children removed from their homes already sick and in need of intensive medical and social services. County officials also reported that it is much harder to reunify meth-related families, with recidivism so great with meth users that reunification often does not last. “Children who are the victims of the methamphetamine epidemic are presenting many challenges to social service workers, foster parents, counselors, and adoption workers,” the report concludes. Copies of the NACo methamphetamine survey are available at jratner@naco.org.
Source: Center for Health & Healthcare in Schools, www.healthinschools.org. July 5 2005

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.”

Source: Los Angeles Times Dec. 28 2005

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.

Source Great Falls Tribune, March 13, 2006.

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.

Source: www. Medical News Today Aug.17th 2006

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

Source:BMJ 2006;332:825-828 (8 April), doi:10.1136/bmj.38743.539398.3A (published 24 February 2006)

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.

Source:Sunday Times(Australia) Oct 2003

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)

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