Methamphetamine and Sexuality

4,506 views
4,215 views

Published on

This is a reposting of my slides from the "Methamphetamine and Sexuality Presentation I did at the Southern Illinois Methamphetamine Conference in April of 2009. The original contained slides that were not part of the presentation.

0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
4,506
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
36
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Slide 10 Environmental stimuli (external triggers) or emotional conditions (internal triggers) will often cause the recovering addict to think of using drugs and/or alcohol. For example, the patient runs into his old source of drugs at the market. Or, the patient gets into a fight with her husband, and immediately thinks of having a drink. Historically, she has always had a drink after fighting with her spouse. A single thought of drinking or using will typically pass through one’s mind in 30 to 90 seconds, allowing one to continue thinking about AODs. AOD use is often the beginning of the relapse process. This inflames the neurochemistry of the addiction and moves the brain into the craving stage. At this craving stage, it is very difficult, if not impossible, to stop the slide into drug or alcohol use. To the actively using addict/alcoholic or the substance abuser in early recover, the Trigger - Thought - Craving - Use sequence feels as if it happens simultaneously. You feel triggered, and you immediately want to use. Knowing this process can be very helpful to the recovering addict/alcoholic. The successful key in dealing with the process is to avoid it getting started. It is extremely important to stop the thought when it first begins and to prevent it from building into an overpowering craving. It is vitally important to do this as soon as you recognize the thoughts occurring. This can be accomplished by using a number of Thought Stopping techniques.
  • Slide 10 Environmental stimuli (external triggers) or emotional conditions (internal triggers) will often cause the recovering addict to think of using drugs and/or alcohol. For example, the patient runs into his old source of drugs at the market. Or, the patient gets into a fight with her husband, and immediately thinks of having a drink. Historically, she has always had a drink after fighting with her spouse. A single thought of drinking or using will typically pass through one’s mind in 30 to 90 seconds, allowing one to continue thinking about AODs. AOD use is often the beginning of the relapse process. This inflames the neurochemistry of the addiction and moves the brain into the craving stage. At this craving stage, it is very difficult, if not impossible, to stop the slide into drug or alcohol use. To the actively using addict/alcoholic or the substance abuser in early recover, the Trigger - Thought - Craving - Use sequence feels as if it happens simultaneously. You feel triggered, and you immediately want to use. Knowing this process can be very helpful to the recovering addict/alcoholic. The successful key in dealing with the process is to avoid it getting started. It is extremely important to stop the thought when it first begins and to prevent it from building into an overpowering craving. It is vitally important to do this as soon as you recognize the thoughts occurring. This can be accomplished by using a number of Thought Stopping techniques.
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Recovery from Methamphetamine Addiction Lighthouse Institute
  • Methamphetamine and Sexuality

    1. 1. WELCOME TO METHAMPHETAMINE AND HIGH RISK SEXUAL BEHAVIOR J. Randall Webber, M.P.H. JRW Behavioral Health Training & Consultation www.randallwebber.com
    2. 2. What is this? <ul><li>Rapid pulse </li></ul><ul><li>Increased breathing rate </li></ul><ul><li>Flushing </li></ul><ul><li>Dilated pupils </li></ul><ul><li>Increased libido (sex drive) </li></ul><ul><li>Stimulation of the brain’s “reward circuit” </li></ul><ul><li>Exhilaration </li></ul>
    3. 3. What is this? <ul><li>Rapid pulse </li></ul><ul><li>Increased breathing rate </li></ul><ul><li>Flushing </li></ul><ul><li>Dilated pupils </li></ul><ul><li>Increased libido </li></ul><ul><li>Stimulation of the brain’s “reward circuit” </li></ul><ul><li>Exhilaration </li></ul><ul><li>(THIS IS WHERE PARTICIPANTS GIVE A DIFFERENT ANSWER) </li></ul>
    4. 4.
    5. 5. Meth use simulates a state of being “in love”
    6. 6. Human Brain: Location of the “Reward Pathway”
    7. 7. Meth use simulates a state of being “in love” <ul><li>Reward pathway is not very smart: If feels good, it must be important </li></ul><ul><li>Reward pathway is infantile: I want it! I want it! I WANT IT NOW! </li></ul>
    8. 8. Normal Functioning in the Reward Pathway <ul><li>Natural reinforcers related to survival (food, water, sex) cause an increase of the neurotransmitter dopamine within the reward pathway </li></ul>
    9. 9. Dopamine Levels in the Shell of the Nucleus Accumbens (% of baseline)
    10. 10. Dopamine Levels in the Shell of the Nucleus Accumbens (% of baseline)
    11. 11. Psychoactive substances (Drugs) also cause an increase of dopamine <ul><li>Psychoactive substances (drugs) also cause an increase of dopamine </li></ul>
    12. 12. Dopamine Levels in the Shell of the Nucleus Accumbens (% of baseline)
    13. 13. Dopamine Levels in the Shell of the Nucleus Accumbens (% of baseline)
    14. 14. Dopamine Levels in the Shell of the Nucleus Accumbens (% of baseline)
    15. 15. Dopamine Levels in the Shell of the Nucleus Accumbens (% of baseline)
    16. 16. Dopamine Levels in the Shell of the Nucleus Accumbens (% of baseline)
    17. 17. Dopamine Levels in the Shell of the Nucleus Accumbens (% of baseline)
    18. 18. Dopamine Levels in the Shell of the Nucleus Accumbens (% of baseline)
    19. 19. My sexual drive is increased by the use of … (Rawson et al., 2002)
    20. 20. My sexual pleasure is enhanced by the use of … (Rawson et al., 2002)
    21. 21. My sexual performance is improved by the use of … (Rawson et al., 2002)
    22. 22. Meth-Sex Patterns of Behavior <ul><li>Increased libido </li></ul><ul><ul><li>Both genders </li></ul></ul><ul><ul><li>Men more than women </li></ul></ul><ul><ul><li>Among women, MUCH more than cocaine </li></ul></ul><ul><li>Impulsivity </li></ul><ul><li>Impaired decision making </li></ul>
    23. 23. Meth-Sex Patterns of Behavior <ul><li>Risk-taking </li></ul><ul><li>Wider range of sexual practices </li></ul><ul><ul><li> receptive anal sex in heterosexual women </li></ul></ul><ul><ul><li>Paraphilias </li></ul></ul><ul><ul><ul><li>Sexual urges, fantasies or behaviors with non-human objects </li></ul></ul></ul><ul><ul><ul><li>Sexual behaviors involving humiliation or suffering of oneself or another person </li></ul></ul></ul><ul><ul><ul><li>Adult sexual behavior that involves children, adolescents or non-consenting adults </li></ul></ul></ul>
    24. 24. Meth-Sex Patterns of Behavior <ul><li>Wider range of sexual practice s </li></ul><ul><ul><li>Paraphilias </li></ul></ul><ul><ul><ul><li>Exhibitionism </li></ul></ul></ul><ul><ul><ul><li>Fetishism </li></ul></ul></ul><ul><ul><ul><li>Frotteurism </li></ul></ul></ul><ul><ul><ul><li>Pedophilia </li></ul></ul></ul><ul><ul><ul><li>Hebophilia </li></ul></ul></ul><ul><ul><ul><li>Masochism </li></ul></ul></ul><ul><ul><ul><li>Sadism </li></ul></ul></ul><ul><ul><ul><li>Transvestitism </li></ul></ul></ul><ul><ul><ul><li>Voyeurism </li></ul></ul></ul>
    25. 25. Meth Addicted Women’s Treatment Issues <ul><li>Reasons for initial use </li></ul><ul><ul><li>Boyfriend introduction </li></ul></ul><ul><ul><li>Reduce fatigue and perform duties of employee, mother, homemaker, wife </li></ul></ul><ul><ul><li>Weight loss </li></ul></ul><ul><ul><li>Cope with abuse (current and historical) </li></ul></ul><ul><ul><li>Enhance sexual activities </li></ul></ul>
    26. 26. Treatment Issues with Meth-dependent Women <ul><li>Concerns about inability to perform responsibilities </li></ul><ul><li>Concerns about weight gain </li></ul><ul><li>Emergence of abuse issues </li></ul><ul><li>Anhedonia/depression </li></ul>
    27. 27. What if…….. <ul><li>Sex is highly pleasurable </li></ul><ul><li>Meth use is highly pleasurable </li></ul><ul><li>Sex + meth = ? </li></ul>
    28. 28. Synergistic Addiction <ul><li>The combination of methamphetamine dependence and sexual compulsivity can produce an addiction that is greater than the sum of the two (1 + 1  2) </li></ul>
    29. 29. Meth-Sex Triggering Meth Sex Craving Use
    30. 30. Meth-Sex Triggering Sex Meth Craving Use
    31. 31. Characteristics of Adolescents with Methamphetamine Problems* Information from the CSAT Cross-Site Adolescent Data Set * My thanks to my colleagues at Lighthouse Institute for this information
    32. 32. Characteristics of Adolescents with Methamphetamine Problems <ul><li>Data from GAIN </li></ul><ul><li>“Most need treatment for methamphetamine” = 234 </li></ul><ul><li>Met DSM-IV-TR diagnostic criteria for other AOD abuse/dependency = 4500 </li></ul>
    33. 33.
    34. 34. Percent of Adolescents With Lifetime Victimization
    35. 35. High Severity Victimization* <ul><li>Early age of onset </li></ul><ul><li>Long duration of abuse </li></ul><ul><li>Multiple perpetrators </li></ul><ul><li>Perpetrators were family members or other trusted individual </li></ul><ul><li>Invasive abuse </li></ul><ul><li>Physical violence or threat of violence </li></ul><ul><li>Victim not believed or was blamed </li></ul>* These characteristics were identified by Bill White
    36. 36. Percent of Adolescents With Lifetime Victimization Vs. High Severity Victimization
    37. 37. Percent of Adolescents With Victimization in Past Year
    38. 38. Percent of Adolescents Having Unprotected Sex in Past 90 Days
    39. 39. Methamphetamine Use in the Gay Community
    40. 40. Men who have sex with men are not always gay Today the focus is on gay men
    41. 43. HIV Prevalence in Intensive Outpatient Clinics among MSM by Substance of Choice
    42. 44. Common Names for Methamphetamine in the Gay Community <ul><li>Christine </li></ul><ul><li>Chrissy </li></ul><ul><li>Tina </li></ul><ul><li>Common Names for Methamphetamine in the General Community </li></ul><ul><li>Meth, crystal, chalk, crank, ice/glass (smokable methamphetamine) </li></ul>
    43. 45. Recent studies have shown that MSM who use meth are: <ul><li>Less likely to use condoms, or to use them properly. </li></ul><ul><li>More likely to engage in unprotected receptive anal sex. </li></ul><ul><li>More likely to have multiple sex partners. </li></ul><ul><li>More likely to have anonymous sex partners. </li></ul><ul><li>More likely to be infected with HIV and other STDs </li></ul>
    44. 46. Sexuality/HIV risk <ul><li>Compared to non-methamphetamine users, methamphetamine users: </li></ul><ul><ul><li>Have more sexual partners </li></ul></ul><ul><ul><li>(Among heterosexuals) have increased incidence of anal intercourse </li></ul></ul><ul><ul><li>Less likely to use condoms </li></ul></ul><ul><ul><li>More likely to engage in prostitution or sexual bartering </li></ul></ul><ul><ul><li>Have sex with a known i.v. drug user </li></ul></ul><ul><ul><li>Have a sexually-transmitted disease </li></ul></ul>
    45. 47. Meth-Sex Patterns of Behavior <ul><li>Marathon Sex Binges </li></ul><ul><li>Use of Viagra, Cialis, Levatra </li></ul><ul><ul><li>Potential risks: </li></ul></ul><ul><ul><ul><li>Use with butyl or amyl nitrate can lead to  BP </li></ul></ul></ul><ul><ul><ul><li>Use with certain other medications can lead to  BP (a normal effect of methamphetamine) </li></ul></ul></ul><ul><ul><ul><li>Aggravation of heart problems </li></ul></ul></ul><ul><ul><ul><li>Decreased vision or loss of vision </li></ul></ul></ul><ul><ul><ul><li>Priapism (Erection  4 hours) </li></ul></ul></ul>
    46. 48. Methamphetamine Interaction with HIV
    47. 49. Meth Has Been Found to: <ul><li>Suppress immune system responses to HIV or other infections. </li></ul><ul><li>Cause dangerous interactions with HIV medications. </li></ul><ul><li>Increase HIV viral activity. </li></ul><ul><li>Accelerate HIV-related dementia and other health problems. </li></ul>
    48. 50. Neurological Damage Associated with Meth and HIV <ul><li>HIV can cause neurological impairment leading to cognitive dysfunction </li></ul><ul><li>Chronic methamphetamine use may lead to neurological impairment </li></ul><ul><li>The combination of meth use by an HIV + individual may produce a synergistic effect (1 + 1  2) </li></ul><ul><li>Source: Jernigan, Gamst, Archibald, Fennema-Notestine, et. al. (2005). Effects of Methamphetamine Dependence and HIV Infection on Cerebral Morphology. American Journal of Psychiatry, 162: 1461-1472 </li></ul>

    ×