Complications of Meth Abuse
Methamphetamine – or simply, meth – is a central nervous system stimulant drug that can lead to severe social, occupational, legal and health consequences. Aside from a spectrum of potential physical health concerns, meth users frequently experience co-occurring mental health issues.
- A co-occurring mental health disorder can complicate a user’s ability to get help and stay sober if they are not getting integrated treatment, i.e., dual diagnosis interventions that aim to address both conditions simultaneously.
- Users may feel they are blocking troublesome psychiatric symptoms by using meth (i.e., self-medicating) and this erroneous thought process makes it difficult to stop using the drug.
The 2010 National Survey on Drug Use and Health indicates people with co-occurring disorders experience greater unemployment rates, arrests, emergency room visits and residential instability.
It is important to understand how meth impacts a person’s mental health and to know the type of treatment options that are available to fully address these issues.
- Having an addiction to meth and also suffering from a mental health problem like depression or bipolar disorder is called a dual diagnosis.
- According to the Substance Abuse and Mental Health Services Administration (SAMHSA), people with co-occurring disorders are more difficult to treat due to treatment adherence problems.
- SAMHSA also reports that people with co-occurring disorders are more likely to have poorer tre
atment outcomes than p
- eople with either disorder alone.
Meth and the Brain
The biochemical actions of meth in the brain serve to increase the activity of dopamine—a neurotransmitter that is instrumental in an individual’s motivation, pleasure and various motor functions. The increase in dopamine helps to impart feelings of reward or pleasure, which can be incredibly reinforcing. The pleasurable effects and euphoric sensations of a drug high can strongly motivate persistent drug use behavior in order to repeat the experience.
Long-term meth use may lead to impairments in memory, learning, psychomotor abilities and informational processing.
- According to the National Institute on Drug Abuse (NIDA), chronic meth users show structural and functional alterations in areas of their brains associated with emotion and memory; this may underlie their vulnerability to experiencing emotional and cognitive problems.
- Long-term use can lead to dopamine transport reduction within the nervous system—an alteration that would help explain some of the motor and cognitive impairments associated with meth use.
- It is estimated that adults with a serious mental illness (e.g., major depressive disorder, bipolar disorder, schizophrenia, etc.) are more than eight times more likely to have a co-occurring illicit drug dependencethan those without mental illness.
Some research shows that cognitive deficits and anhedonia (reduced ability to perceive pleasure) can last for months following discontinuation of meth use.
- Biological, psychological and social stressors also increase the vulnerability to addiction.
Addiction and mental health disorders frequently co-occur across a range of age groups, including a younger demographic; between 2001 and 2004, 9.9 percent of adolescents ages 13 to 18 had co-occurring mental health and illicit drug use disorders.
- 45.8 percent had a co-occurring mood disorder (e.g., depression).
- 47.2 percent had a co-occurring anxiety disorder (e.g., panic disorder).
- 70.3 percent had a co-occurring impulse control disorder (e.g., kleptomania).
Meth and Depression
Depression is perhaps the most common co-occurring mental health disorder seen amongst meth users.
- Epidemiological data indicate that approximately 40 percent of adults using amphetamines have a lifetime history of depression.
- Intravenous meth users reported more depressive symptoms compared to users who smoked or snorted meth.
- With chronic meth use, dopamine levels and activity can become severely depleted in the brain, resulting in a condition called anhedonia or an impaired ability to experience pleasure.
Some of the features of depression – such as isolation and lack of motivation – make participation in some recovery and treatment activities nearly impossible if left untreated.
- Meth addiction and co-occurring depression can increase your vulnerability to self-harming behaviors and suicidal thoughts.
- Studies show the antidepressant bupropion can reduce cue-induced cravings and may be useful in managing depressive effects of meth use.
- Combining effective medications with motivational interviewing and cognitive-behavioral therapy can increase the chances of successful recovery from both disorders.
Meth and Psychosis
Schizophrenia is perhaps one of the most recognizable mental health disorders with psychosis as a defining feature. Meth-induced psychosis can easily be misdiagnosed as schizophrenia, as the outward signs of both can be very difficult to distinguish.
Meth use can exacerbate psychotic symptoms in someone diagnosed with schizophrenia but chronic use can also lead to meth-induced psychosis. Both schizophrenia and meth-induced psychosis are associated with higher criminal justice referrals and lengthy treatment.
- Up to 46 percent of people using meth on a regular basis report meth-induced psychosis.
- Clinical evidence suggests “meth runs or binges” are likely to end in symptoms resembling psychosis.
- According to some research, there is an underlying genetic vulnerability that may link schizophrenia and meth-induced psychosis. Seven genes have been identified in association with meth-induced psychosis. Six of these genes are linked to susceptibility.
- Schizophrenic patients have a high vulnerability to developing psychosis-type symptoms with low exposure to amphetamines, like cocaine. Similarly, users with amphetamine-induced psychosis have a high vulnerability to develop a primary psychosis-like syndrome.
- Meth-induced psychosis can be characterized by both negative and positive syndromes.
- Negative psychotic features includes speech poverty, psychomotor retardation and a flat affect (emotional blunting).
- Positive psychotic features include some of the more commonly seen signs and symptoms such as persecutory delusions, auditory and visual hallucinations and incoherent speech.
- Typically, symptoms of meth-induced psychosis can completely resolve with abstinence from meth.
Meth and Anxiety or Anxiety Disorders
Anxiety is another common symptom among meth users; it occurs during both active use and withdrawal. According to a 2010 study in the American Journal of Addiction:
- More than 75 percent of meth users reported symptoms of anxiety.
- 40 percent of meth users seeking treatment reported a history of anxiety disorders.
- 25 percent of meth addicts still met criteria for a current anxiety disorder up to three years following outpatient drug treatment.
- The two most common anxiety disorders seen were Generalized Anxiety Disorder followed by Social Anxiety Disorder.
Meth users with a dually-diagnosed anxiety disorder had significantly greater odds of being hospitalizedthan meth users without an anxiety disorder. Further, the odds of having attempted suicide once or more during their lifetime was three times higher in those with a dual diagnosis of meth dependence and anxiety compared to those with meth dependence alone.
Attention-Deficit Hyperactivity Disorder, or ADHD, is broken into three subtypes: hyperactive, inattentive and combined.
- Adolescents and adults diagnosed with ADHD may be at an increased risk of meth use and abuse because of their increased likelihood of previous exposure to stimulant medications.
- Stimulant drugs – such as Adderall, Ritalin, and Vyvanse – are often prescribed to treat symptoms of ADHD.
Some treated individuals may progress from therapeutic use of these prescription drugs to abuse of them, thereby providing an incentive to one day switch to use of an illegal drug with similar effects.
- In 2008, 2.8 million adults were prescribed a stimulant to treat symptoms of ADHD.
- Meth can work in a similar way to prescription stimulants in relieving symptoms of ADHD.
- Patients presenting to treatment for meth addiction may complain of these symptoms resurfacing.
- Some research indicates that meth users with childhood ADHD behaviors were more likely to experience meth-induced psychosis.
- Other research examining lifetime diagnoses of ADHD, show that ADHD is significantly more prevalent in meth users at 21 percent compared to 6 percent of non-meth users.
In addition to treating depression and reducing cravings, the antidepressant Wellbutrin has been shown to be effective at treating symptoms of ADHD.
- This could be a significant pharmacological resource in treating ADHD and meth use.
- A non-stimulant medication to treat ADHD, combined with behavioral treatment and 12-Step support groups may be the best course of treating co-occurring meth addiction and ADHD.
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