Special Needs Of Methamphetamine Addicts


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This is a presentation that I have done numerous times for the Southwestern Illinois Correctional Center (SWICC) in East Saint Louis, IL. SWICC is a drug treatment prison with 100 beds devoted to the treatment of methamphetamine dependence.

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  • Special Needs Of Methamphetamine Addicts

    1. 1. SPECIAL NEEDS OF METHAMPHETAMINE ADDICTS Presented by: J. Randall Webber, M.P.H. Southwestern Illinois Correctional Center June 19, 2007
    2. 5. Normal Functioning in the Reward Pathways <ul><li>Natural reinforcers related to survival (food, water, sex) cause a release of dopamine into the synapse </li></ul>
    3. 6. Dopamine Levels in the Shell of the Nucleus Accumbens (% of baseline)
    4. 7. Dopamine Levels in the Shell of the Nucleus Accumbens (% of baseline)
    5. 9. Dopamine Levels in the Shell of the Nucleus Accumbens (% of baseline)
    6. 10. Dopamine Levels in the Shell of the Nucleus Accumbens (% of baseline)
    7. 11. Dopamine Levels in the Shell of the Nucleus Accumbens (% of baseline)
    8. 12. PSYCHIATRIC RISKS ASSOCIATED WITH THE USE OF METHAMPETAMINE <ul><li>Acute depression (“the crash”) </li></ul><ul><li>Chronic depression/anhedonia </li></ul><ul><li>Acute stimulant psychosis </li></ul><ul><li>Persistent stimulant psychosis </li></ul><ul><li>Psychotic “flashbacks” </li></ul>
    9. 13. Differences Between Methamphetamine and Alcohol-Marijuana Abusers
    10. 14. ANHEDONIA= The inability to derive pleasure from previously pleasurable activities
    11. 15. AMPHETAMINE PSYCHOSIS: <ul><li>Onset of methamphetamine psychosis can be from 2-48 hours after the initial dose. </li></ul><ul><li>Onset appears as a result of acute intoxication. </li></ul><ul><li>While psychosis may appear during the withdrawal period, it is not a true withdrawal sign. </li></ul><ul><li>Generally associated with chronic, high dosage use. </li></ul><ul><li>More likely to occur in IV users and smokers. </li></ul>
    12. 16. AMPHETAMINE PSYCHOSIS: SYMPTOMS <ul><li>Suspiciousness </li></ul><ul><li>Irritability </li></ul><ul><li>Delusions of persecution and/or grandeur </li></ul><ul><li>Ideas of reference </li></ul><ul><li>Visual, auditory and/or tactile hallucinations (latter = formication) </li></ul><ul><li>Hyperactivity </li></ul>
    13. 17. AMPHETAMINE PSYCHOSIS: SYMPTOMS <ul><li>Agitation </li></ul><ul><li>Aggressiveness. </li></ul><ul><li>Depression, sometimes severe, may also be present. </li></ul><ul><li>Closely resembles paranoid schizophrenia. </li></ul>
    14. 18. AMPHETAMINE PSYCHOSIS <ul><li>Once an individual has suffered a CNS stimulant psychosis, s/he is more likely to experience the same outcome in the future. </li></ul><ul><li>Psychotic symptoms generally disappear as abstinence continues, and rarely persist beyond 24 hours after the cessation of drug use. </li></ul><ul><li>If psychotic signs persist beyond 24-48 hours, additional psychiatric consultation is advised . </li></ul>
    15. 19. COGNITIVE IMPAIRMENT: SUMMARY <ul><li>Actively using MA addicts demonstrate impairments in </li></ul><ul><ul><li>The ability to manipulate information </li></ul></ul><ul><ul><li>The ability to makes inferences </li></ul></ul><ul><ul><li>The ability to ignore irrelevant information </li></ul></ul><ul><ul><li>The ability to recall information </li></ul></ul>
    16. 20. Memory Difference between Stimulant and Comparison Groups
    17. 21. Differences between Stimulant and Comparison Groups on tests requiring perceptual speed
    18. 22. DRUG HUNGER <ul><li>Craving </li></ul><ul><li>Jonsing </li></ul><ul><li>Tweaking </li></ul>
    19. 23. DRUG HUNGER <ul><li>Acute-Immediately after “high” wears off </li></ul><ul><li>Baseline-Will begin after client has rested </li></ul><ul><li>Evoked-Produced by triggers/cues </li></ul>
    20. 24. Craving Needs to be Addressed Immediately Trigger Thought Craving Use
    21. 25. Can Unaddressed Craving Produces a “High”? <ul><li>Dopamine levels in the reward circuit are increased by thoughts of using. </li></ul><ul><li>If craving is not addressed soon enough, the client will “crash” if s/he does not use. </li></ul>
    22. 26. “Crashing from Craving” Positive Mood Negative Mood
    23. 27. Methamphetamine <ul><li>Methamphetamine and Sex </li></ul>
    24. 28. 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>
    25. 29. My Sexual Drive is Increased by the Use of:
    26. 30. My Sexual Pleasure is Enhanced by the Use of:
    27. 31. My Sexual Performance is Improved by the Use of: