Dr. Pohl discusses what women should know about methamphetamine and shares why it is such a problem.
Let’s talk a few minutes about methamphetamine. Methamphetamine is actually speed. People can think back to the 60s and 70s when people were being speed freaks. It got very unpopular because people got very skinny, very scrawny, didn’t sleep, were undernourished, and it was happening out in the West Coast and what replaced it–cocaine.
Well, methamphetamine is back, and it’s a big problem in our culture. It’s a very compelling drug. I mean, this is a drug that stimulates the brain reward center. The main chemical that it works on is dopamine. So dopamine is the chemical that makes us feel good. It’s a chemical that’s secreted when we have a good laugh. It’s a chemical that’s secreted inside our normal brain function when we eat our first bite of a hot fudge sundae, when we are having sex, and having an orgasm, when we are skiing off a mountain. If you are a runner, when you get a runner’s high.
We find this drug. We bring it in from the outside, and it reproduces not a hot fudge sundae but a hot fudge sundae! So we now end up with this flood of dopamine inside our central nervous system. Dopamine is the chemical, the natural produced chemical in the brain that drives us to do things to keep us alive. We now find an external source to get that.
What happens is that drug becomes first, takes what’s called survival salience, over eating, over sleeping, over relationships, over morality. “I need that drug.” It’s a very powerful stimulus, and we end up seeing horrible behavioral abnormalities.
It’s associated with aggressive behavior because it hits that fight or flight center as well. So people are paranoid because their fear is way out of control. People are angry and can be aggressive and violent, and usually that’s associated with this drug. It’s a horrible drug.
Withdrawal isn’t as dramatic perhaps as alcohol withdrawal or opioid withdrawal, but it’s definitely significant. People feel very bad when they stop. Their dopamine supplies usually are very depleted, so they are feeling what’s called anhedonia. They feel bad. They feel flat. They feel tired. They feel irritable, and that often will drive them to do the drug again, and it’s a cycle that takes a long time to end.
We are talking about a brain at 30 days off methamphetamine looking positively abnormal. It is an interesting phenomenon. In treatment, we see people who feel pretty good at 30 days, but if you look at their brain PET scan or their functional MRI scan, their dopamine receptor system is depleted 80 percent.
At 14 months, so that’s another year later, they are really coming back into the way they were if they never used methamphetamine before. So this is a drug that takes a long time to get better from.
The treatment that’s effective for methamphetamine dependence is really no different than the treatment for alcohol dependence or for opioid dependence. You have to separate from the drug, and you have to be separated for a while. That’s not enough. Simply separating from the drug is not enough because the drug has depleted your dopamine receptor system, and it depends how long you have used, but if you have used this drug for a period of time, you need to sort of rehabilitate. You need to learn how to live without the drug.
Chances are you are going to be driven to do that drug from time-to-time. You need to develop some systems that are going to help you say no when the drug is either offered or when you have a bad day or when you are tired or when you want to feel that dopamine surge. You also have to learn how to re-establish your dopamine system with exercise and meditative practice and communication skills with other people.
About Dr. Mel Pohl, M.D.:
Dr. Mel Pohl, M.D., is a Board Certified Family Practitioner. He is the Vice President of Medical Affairs and the Medical Director at the Las Vegas Recovery Center (LVRC), the only private, freestanding, medically managed inpatient detoxification and addiction treatment facility in Las Vegas, Nevada.