Ask Paul at the RSIC: Using stimulants to combat opioid abuse is dangerous
March 25, 2019
RENO, Nev. — The opioid epidemic has received much needed attention in recent months due to the number of nationwide overdoses.
The Centers for Disease Control (CDC) reports opioids were involved in nearly 48,000 overdose deaths in 2017 which amounts to more than 2/3 of all overdose deaths. While opioids are at a crisis level, we also need to be diligent in our recognition of other substance use and trends in our community and the country.
When working with patients, I begin treatment with a complete biopsychosocial evaluation. This evaluation allows me to notice trends, and I've seen a rise in the use of stimulants, specifically methamphetamine. I researched national trends and found the CDC shows the most commonly reported drugs used in Nevada's primary drug treatment admissions are stimulants, including methamphetamine.
In California, over one third of voluntary admissions were for stimulants, including methamphetamine, even surpassing marijuana which was 25 percent. Another chilling statistic from the CDC shows Nevada's amphetamine death rate is the highest in the nation. Actually the death rate from amphetamines will pass the state's prescription opioid death rate if current trends continue.
What can we do? The first thing we can do is educate people and make them aware that amphetamine use, abuse and dependence can be deadly.
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Stimulant use, including methamphetamines, tends to get ignored until a person is acting erratic and becomes a danger to himself or others.
What can we do? The first thing we can do is educate people and make them aware that amphetamine use, abuse and dependence can be deadly. We can also offer options to prevent them from ever starting to use or help them stop using if they have already started.
Let's start with defining methamphetamine. What is it? What does it do? Why does it make people act crazy, and why is it so addictive? The addictive part of using methamphetamine is from the powerful rush of feel-good chemicals released in the brain when a person uses the drug. This feeling can cause a person to get hooked right from the start.
Amphetamines prescribed by a doctor for ADHD and narcolepsy are one type of stimulant. Methamphetamine is a more powerful stimulant, like a stimulant on monster steroids. It's made of toxic chemicals such as acetone that's used in paint thinner and nail polish remover, and toluene that's used in brake fluid. Many methamphetamine ingredients are toxic chemicals that could even be harmful if taken alone.
When people take methamphetamine they feel euphoric and aroused, have reduced fatigue, and feel confident and full of energy. This is such a good feeling that it takes over the person's life, and it's all the person can think about.
This intense high is so strong it can keep the person using continually for days. As you can imagine, if you've been up for a few days, how would you feel? Remember, what comes up must come down. The withdrawal symptoms are opposite of the feelings people experience when they are high.
These withdrawal symptoms include severe depression, low mood, anxiety, psychosis, irritability, fatigue and disturbed sleep as well as increased cravings for more of the drug, and thought impairment. Unfortunately, some of the cognitive impairment (brain damage) from methamphetamine use can be permanent.
Even small amounts of meth can result in increased wakefulness and the physical/emotional/mental strain that comes with exhaustion. Also, the person can experience decreased appetite, rapid heartbeat and breathing, increased blood pressure and body temperature as part of the withdrawal.
Another effect of methamphetamine use is the decrease in saliva production. This means acids and sugar, especially from energy or soft drinks, build up on the persons teeth, leading to decay which results in losing teeth or tooth damage. Methamphetamine use can also make a person look dramatically older in a short amount of time.
Since meth can affect judgement, lessen inhibitions, and create intense cravings, people under its influence can be more likely to engage in risky behaviors such as unsafe sex. Stimulant drug abuse at times leads to promiscuity which can expose the person to sexually transmitted diseases.
People who have HIV/AIDS and use methamphetamine have more injury to nerve cells and mental health problems than people with HIV/AIDS who don't use the drug. Some other negative consequences include itching and skin sores from scratching, anxiety, confusion, sleep problems, violent behavior, paranoia (extreme or unreasonable distrust in others) and hallucinations (hearing or seeing people or images that seem real but are not).
Also, there are emotion and memory problems associated with using methamphetamine and these problems may be permanent. One of the most concerning aspects of using substances that are bought on the street is the person does not know what they are taking.
At this time, there is no FDA approved medication for the treatment of methamphetamine or stimulant use disorder. The most effective treatments for methamphetamine addiction are behavioral therapies, like cognitive-behavioral therapy, which helps patients recognize, avoid, and cope with the situations in which they are most likely to use drugs.
People who are challenged with stimulant dependency can receive this type of therapy from a qualified substance use professional.
On a personal note, I have witnessed wonderful healing and transformation of people who are dependent on stimulants. There is hope and help available if you or a loved one are struggling with addiction. Please reach out and call your substance use specialist to begin your new life!
"Ask Paul" is a health column by Paul Snyder, MA, LADC-S, a Substance Use Counselor at the Reno-Sparks Tribal Health Center. It originally published in the January edition of The Camp News, the RSIC's monthly newsletter. If you know of anyone who wants to stop or slow down using substances, call Snyder at 775-329-5162, ext. 1962, or call the 24 hour Crisis Hotline at 775-784-8090 if needed.