Crystal Meth the Facts
Methamphetamine is a powerfully addictive stimulant that dramatically affects the central nervous system. The drug is made easily in clandestine laboratories with relatively inexpensive over-the-counter ingredients. These factors combine to make methamphetamine a drug with high potential for widespread abuse.
Methamphetamine is commonly known as “speed,” “meth,” and “chalk.” In its smoked form, it is often referred to as “ice,” “crystal,” “crank,” and “glass.” It is a white, odorless, bitter-tasting crystalline powder that easily dissolves in water or alcohol. The drug was developed early in this century from its parent drug, amphetamine, and was used originally in nasal decongestants and bronchial inhalers. Methamphetamine’s chemical structure is similar to that of amphetamine, but it has more pronounced effects on the central nervous system. Like amphetamine, it causes increased activity, decreased appetite, and a general sense of well-being. The effects of methamphetamine can last 6 to 8 hours. After the initial “rush,” there is typically a state of high agitation that in some individuals can lead to violent behavior.
Methamphetamine comes in many forms and can be smoked, snorted, orally ingested, or injected. The drug alters moods in different ways, depending on how it is taken.
Immediately after smoking the drug or injecting it intravenously, the user experiences an intense rush or “flash” that lasts only a few minutes and is described as extremely pleasurable. Snorting or oral ingestion produces euphoria – a high but not an intense rush. Snorting produces effects within 3 to 5 minutes, and oral ingestion produces effects within 15 to 20 minutes.
As with similar stimulants, methamphetamine most often is used in a “binge and crash” pattern. Because tolerance for methamphetamine occurs within minutes – meaning that the pleasurable effects disappear even before the drug concentration in the blood falls significantly – users try to maintain the high by binging on the drug.
In the 1980’s, “ice,” a smokable form of methamphetamine, came into use. Ice is a large, usually clear crystal of high purity that is smoked in a glass pipe like crack cocaine. The smoke is odorless, leaves a residue that can be resmoked, and produces effects that may continue for 12 hours or more.
STREET NAMES
Meth, Crank, Crystal, Crystal meth, Ice, Speed, C.R., Go, Go fast, Geek, Gack, Geet , Glass, Red rock, Tweak, Amp, Prope dope, P2P, Poor man’s coke, Pink glass, Chalk, Zip, Loker, Bulb baby, Bulber, Chore boy, Hitter, Gackers, Geeters, Tweakers, Rails, Train tracks, Railing down, Snorting fat rocks, Bangers, Slammers, Throwing darts, Hooking up, Freshies, Arrows.
EFFECTS
As a powerful stimulant, methamphetamine, even in small doses, can increase wakefulness and physical activity and decrease appetite. A brief, intense sensation, or rush, is reported by those who smoke or inject methamphetamine. Oral ingestion or snorting produces a long-lasting high instead of a rush, which reportedly can continue for as long as half a day. Both the rush and the high are believed to result from the release of very high levels of the neurotransmitter dopamine into areas of the brain that regulate feelings of pleasure.
Methamphetamine has toxic effects. High doses can elevate body temperature to dangerous, sometimes lethal, levels, as well as cause convulsions.
Long-term methamphetamine abuse results in many damaging effects, including addiction. In addition to being addicted to methamphetamine, chronic methamphetamine abusers exhibit symptoms that can include violent behavior, anxiety, confusion, and insomnia. They also can display a number of psychotic features, including paranoia, auditory hallucinations, mood disturbances, and delusions (for example, the sensation of insects creeping on the skin, which is called “formication”). The paranoia can result in homicidal as well as suicidal thoughts.
With chronic use, tolerance for methamphetamine can develop. In an effort to intensify the desired effects, users may take higher doses of the drug, take it more frequently, or change their method of drug intake. In some cases, abusers forego food and sleep while indulging in a form of binging known as a “run,” injecting as much as a gram of the drug every 2 to 3 hours over several days until the user runs out of the drug or is too disorganized to continue. Chronic abuse can lead to psychotic behavior, characterized by intense paranoia, visual and auditory hallucinations, and out-of-control rages that can be coupled with extremely violent behavior.
Although there are no physical manifestations of a withdrawal syndrome when methamphetamine use is stopped, there are several symptoms that occur when a chronic user stops taking the drug. These include depression, anxiety, fatigue, paranoia, aggression, and an intense craving for the drug.
Methamphetamine abuse has three patterns, low intensity, binge and high intensity. Low intersity abuse describes a user whi is not psychologiacally addicted to the drug but uses it on a casual basis by swallowing or snorting it. Binge and high intensity abusers are psychologically addicted and prefer to smoke or inject it to achieve a faster and stronger high. Binge users use it more that low intensity abusers but less that high intensity abusers.
Tweaking occurs at the end of the binge when nothing the abuser does will take away the feeling of emptiness and dysphoria, including taking more methamphetamine. Tweaking is very uncomfortable, and the abuser often takes a depressant to ease the bad feelings. The most popular depressant is alcohol, with heroin a close second. Tweaking is the most dangerous stage of the methamphetamine abuse cycle to law enforcement officers and other individuals near the abuser. If the abuser is using alcohol to ease the discomfort, the threat to law enforcement officers intensifies. During this stage, law enforcement officers must clearly identify the underlying dangers of the situation and avoid the assumption that the tweaker is just a cocky drunk.
To a binge abuser, the crash means an incredible amount of sleep. The body’s epinephrine has been depleted, and the body uses the crash to replenish its supply. Even the meanest, most violent abuser becomes almost lifeless during the crash and poses a threat to no one. The crash can last 1-3 days
Often 30-90 days must pass after the last drug use before the abuser realizes that he is in withdrawal. First, without really noticing, the individual becomes depressed and loses the ability to experience pleasure. The individual becomes lethargic; he has no energy. Then the craving for more methamphetamine hits, and the abuser often becomes suicidal. If the abuser, however, takes more methamphetamine at any point during the withdrawal, the unpleasant feelings will end.
The high-intensity abusers are the addicts, often called speed freaks. Their whole existence focuses on preventing the crash, and they seek that elusive, perfect rush–the rush they had when they first started smoking or injecting methamphetamine. With high-intensity abuser, each successive rush becomes less euphoric, and it takes more methamphetamine to achieve it. Each high is not quite as high as the one before. During each subsequent binge, the abuser needs more methamphetamine, more often, to get a high that is not as good as the high he wants or remembers. Tweaking for the high-intensity abuser is still the most dangerous time to confront him because tweakers are extremely unpredictable and short-tempered. The crash is often spoken of in terms of “I never sleep,” or “I sleep with one eye open.” In an attempt to appear normal, perhaps because of an appointment with a doctor, lawyer, or court official, high-intensity abusers will make themselves take short naps; otherwise, they see no need to come down from the high.
A methamphetamine abuser is most dangerous when tweaking. The fact that a law enforcement officer is confronting the tweaker makes him more dangerous, not just to the officer on the scene but also to anyone nearby. When tweaking, the abuser has probably not slept in 3-15 days and consequently will be extremely irritable. The tweaker craves more methamphetamine, but no dosage will help re-create the euphoric high. The result is a strong feeling of uncontrollable frustration that makes the tweaker unpredictable and dangerous. If the law enforcement officer on the scene is unfamiliar with the physical signs of a tweaker, the abuser can appear normal. In fact, unlike a person intoxicated on alcohol with glassy eyes, slurred speech, and difficulty even standing up, a tweaker appears super-exaggerated normal. The tweaker’s eyes are clear, his speech concise, and his movements brisk. With a closer look at the tweaker, law enforcement officers will notice that his eyes are moving about ten times faster than normal and may roll. He is talking in a quick, often steady voice with a slight quiver to it, and his movements are quick and jerky. The individual’s movements are often exaggerated because he is overstimulated, and his thinking is scattered and subject to paranoid delusions. The tweaker does not need provocation to react violently; however, confrontation increases the chance for a violent reaction. Law enforcement officers should consider the potential for violence when determining that a suspect is tweaking. For example, case histories indicate that tweakers react negatively to the sight of a police uniform. Confrontation between the tweaker and law enforcement often results in a verbal or physical assault on the officer. Besides confrontation, nobody knows for certain what will trigger a tweaker to be irrational and violent. A tweaker exists in his own world, seeing and hearing things that no one else can perceive. His hallucinations are so vivid that they seem real. What law enforcement officers say and do enter into the abuser’s altered reality, and if his paranoia is triggered, law enforcement appears to be a threat to the tweaker’s life. It is during tweaking that hostage situations can easily occur. If the abuser feels cornered, with no means of escape, the tweaker is likely to take a hostage, often an associate, a relative, or a police officer. In extreme cases, the tweaker may physically assault the hostage. If the tweaker has chosen to ease his discomfort with alcohol, he becomes a disinhibited tweaker, making reasoning with him or even identifying him as a tweaker more difficult. Physical signs of a tweaker become blurred to an observer when the tweaker is using alcohol. Motor and speech functions, for example, become impaired, but not to the degree of a person using only alcohol. The rapid eye movement and the quick speech of a tweaker might actually slow to an apparently normal speed. However, a tweaker using alcohol can be identified in two ways: 1. First, individuals who can get close enough to see the tweaker’s eyes should look for a horizontal-gaze nystagmus. This phenomenon occurs when the methamphetamine abuser, who is also using alcohol, looks out of the corner of his eyes, and the eyes jerk back and forth. 2. Second, if communication lines are open with the tweaker, ask the tweaker if he is using methamphetamine and then inquire if he is also drinking alcohol. If a strong smell of alcohol is present, but no signs of drunkenness exist, one should err on the side of caution and approach the person as a tweaker using alcohol rather than assume the person is harmless. Because tweakers using alcohol are ordinarily not concerned with the consequences of their actions, a situation can quickly lead to violence.
Cities across the United States report increased percentages of domestic violence incidents associated with methamphetamine use. Domestic disputes, ordinarily regarded as dangerous situations for law enforcement, become intensified when a tweaker is involved because of that individual’s unpredictability. Many motor vehicle violations and accidents may also involve tweakers. Paranoid and hallucinating, tweakers may decide to travel in their automobiles. Their delusional state makes moving shapes and shadows appear threatening, and they are very likely to increase their speed and exhibit erratic driving patterns as they attempt to evade the images. An additional threat to society and themselves may stem from tweaker’s tendency to arm themselves for their personal safety. Interviews with methamphetamine abusers have confirmed that these individuals often maintain weapons in their automobiles, as well as in their residences.of that individual’s unpredictability. Tweakers may also be present at raves or parties. In addition, to support their habit, tweakers often participate in spur-of-the-moment crimes, such as purse snatching, strong-arm robberies, assaults with a weapon, burglaries, and thefts of motor vehicles. Methamphetamine is readily available and is spreading rapidly across the United States. Unlike the abusers in the 1960s and 1970s, today’s methamphetamine abusers cross ethnic and gender boundaries. Methamphetamine is psychologically addictive during the binge and high-intensity patterns of abuse, with users becoming paranoid and unpredictable.
TREATMENT
At this time the most effective treatments for methamphetamine addiction are cognitive behavioral interventions. This approach is designed to help modify the patient’s thinking, expectancies, and behaviors and to increase skills in coping with various life stressors. There are some established protocols that emergency room physicians use to treat individuals who have had a methamphetamine overdose. Because hyperthermia and convulsions are common and often fatal complications of such overdoses, emergency room treatment focuses on the immediate physical symptoms. Overdose patients are cooled off in ice baths, and anticonvulsant drugs may be administered also.
