Pleasure Drain

By Mary Vance

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Like all amphetamines, meth produces an initial rush, a euphoric effect followed by an unpleasant crash that leaves the user profoundly depressed and craving the drug. Meth is chemically similar to dopamine, the neurotransmitter responsible for movement, memory, attention, and feelings of enjoyment and well-being. When a person uses meth, either by shooting, snorting, or smoking, the drug crosses the blood-brain barrier, where it fits into dopamine receptors and stimulates neurons to release very high levels of dopamine. Although cocaine, alcohol, nicotine, and other drugs cause dopamine release, meth releases levels about ten times higher and simultaneously blocks dopamine reuptake, prolonging the high. The drug has a twelve-hour half-life, compared with cocaine’s hour.

Over time, meth destroys dopamine receptors, making it impossible to feel pleasure. A meth user’s desire to get high is extremely intense, surpassing the urge associated with other drugs, so recovery is challenging. A source who works in an outpatient drug treatment program in Fremont comments, “Former users may not leave their lifestyles behind, and once they’ve cleaned up, they have nowhere to go. Returning to the same environment plays a big role with repeat offenders.”

In Alameda County, meth use has been climbing steadily, up from 18 percent of drug abusers in recovery in 2002 to 21 percent in 2005. Nationally, meth lab seizures have rocketed up 577 percent since 1995. Recovery rates hover around 50-60 percent, both nationally and locally, but relapse rates are astounding: over 90 percent, according to national statistics. “I think the problem is tremendous in Alameda County,” notes the source, who did not want to be identified. “Most of the cases I get now are meth users. A few years ago, crack was the epidemic, but now we’ve finally realized how big meth is. I have clients aged sixteen all the way up to sixty.”

Meth induces the release of high levels of adrenaline, which causes anxiety, wakefulness (some users report staying up for days or even weeks at a time on binges), and intensely focused attention. It ups the ante on blood pressure and body temperature, so the user risks heart attacks and strokes. While users say the drug makes them feel confident and attractive, meth literally destroys the body’s tissues. It also suppresses appetite, making it an attractive but deadly diet aid.

Research suggests that some damage incurred from chronic meth use may be permanent, and while it is possible for receptors in the brain to heal, the process is not well understood. Users may suffer impaired motor function, psychosis, and death. “Some clients go into psychosis and need to be hospitalized,” says the source.

Brain scans show that after a year of sobriety, some damaged dopamine receptors have regenerated, but those in recovery still showed severe cognitive impairment in memory, judgment, and motor coordination, similar to Parkinson’s Disease. Some users also experience lead poisoning from the chemicals used to cook meth. Says the source, “Most often, I’ll see nervous tics or facial twitches that seem to stay with them. Some have paranoia that stays.”

And then there’s “meth mouth,” characterized by yellowing, broken, rotting teeth. Meth causes salivary glands in the mouth to dry up, allowing acids to eat away at enamel, accelerating tooth decay. Users also obsessively grind their teeth.

Treatment programs can last up to eighteen months or longer, but few prevention programs remain in Alameda County. “It’s hard because there’s no money,” says the source. “We used to have a program for students where we’d go into schools and talk, but state budgets have cut funding in all areas. That affects outreach, and prevention programs aren’t bringing money in.”