Piercing the Darkness
Project HOPE, a street medicine team, has worked to provide medical/mental health/addiction needs of those experiencing homelessness for over a decade. We work hard to bridge those we encounter to primary care providers, mental health professionals, addiction treatment facilities, etc. Over the last decade we have noticed that demographics in the homeless population have changed. The age range we were seeing was between mid forties to upper fifties. In contrast, we now see a huge increase in those aging out of foster care at eighteen, with the upper age range being the mid thirties.
We’ve also noted that the abuse of substances have switched; in the past it’s been marajuana, alcohol, and heroin. Today’s substance of most prevalence is methamphetamine, with co-occurring marajuana, alcohol, and/or heroin use. Our teams round bi-weekly in search of our unsheltered friends who are in need of acute medical, mental health, and substance abuse treatment for addiction recovery. We frequently encounter homeless individuals who are in various stages of methamphetamine use. Our attempts to reach them have us in search for answers on why methamphetamine has become an increasing problem, the effects it has on the body and brain, and how we can reach those in the throes of methamphetamine addiction. In our search we felt it important to share so that readers would begin to understand the complexity of methamphetamine abuse. We are hopeful that this information will serve to educate everyone on the ill effects of methamphetamine abuse and deter all from attempting to try it.
Drug facts:
Methamphetamine (meth) is a powerful highly addictive stimulant that affects the central nervous system. People can take meth by smoking, swallowing, snorting, or injecting it.
Meth is highly addictive because it increases the amount of dopamine (reward chemical) in the brain. The drug’s ability to rapidly release high levels of dopamine in reward areas of the brain strongly reinforces drug taking behavior, making the user want to repeat the experience over and over. (NIDA) (NIH.GOV)
Various stages of methamphetamine use:
Rush- is the initial response the user feels when smoking or injecting methamphetamine. During the rush, the user’s heartbeat races and metabolism, blood pressure and pulse soar, this can last for 5-30 minutes. The rush triggers the adrenal gland to release a hormone called epinephrine (adrenaline), which puts the body in a battle mode, fight or flight. In addition, the physical sensation that the rush gives the abuser most likely results from the explosive release of dopamine in the pleasure center of the brain.
High- also known as the shoulder comes after the rush; in this state the user feels confident, talkative or argumentative; this state can last from 4-16 hours.
Binge- The user is using the drug over and over to continue experiencing the rush, which ultimately disappears along with the high. This state can last for 3-15 days, leaving the user hyperactive both mentally and physically.
Tweaking- Comes at the end of the binge, the user cannot experience the rush or high in this stage even with more meth use. Tweaking is uncomfortable, and users often seek a depressant-most commonly alcohol or heroin to ease the discomfort. This is the most dangerous stage of use because of the discomfort, hyperactivity, irritability, and the disinhibition from alcohol.
Crash- Is exactly as it implies, the user’s epinephrine has been depleted and massive amounts of sleep are needed to replenish it. This can last 1-3 days.
Normal- The user returns to a somewhat normal state until they start the cycle of use again.
Withdrawal- There are no immediate withdrawal symptoms for the meth user. Withdrawal is experienced usually slowly over time with abstinence. Within 30-90 days the user will experience depression and lose the ability to experience pleasure. Users will frequently become suicidal. (narconon.org)
Because meth increases release of large amounts of dopamine (pleasure chemical) in the brain it is the primary reason for relapse. This also accounts for why one in four people who use meth one time are immediately addicted. With repeated meth use, the user no longer experiences pleasure from release of reward chemicals from the brain normally. Our observations are consistent with the stages of use and accounts for our team feeling as though we are unable to reach users. In addition to dispensing medical and mental health care we work hard to educate and plant the seed of recovery. We have numerous, and repetitive conversations with individuals using meth, who appear to be present in those conversations. As of late we will have another homeless individual interject with “You know they cannot hear you right?” At first I did not put much stock into those types of comments until I went on a deeper dive of what methamphetamine does to the brain. In addition to its negative effects on neurotransmitters in the brain below are the negative effects on the body and other areas of the brain.
Skin: Many meth users look to suffer from acne and meth induced hallucinations, which cause users to pick at their skin thinking that bugs are beneath the surface. This often leads to many skin infections.
Teeth: Meth causes the user to have a decrease in saliva production which contributes to tooth decay, tooth loss, and gum disease.
Heart, lungs, kidneys, liver, and brain: Those who use regularly and long term put excess strain on their organs leading to a variety of health consequences, and permanent damage.
Hepatitis, HIV, and AIDS: Meth increases sexual libido and lowers a users inhibitions placing them at risk for these diseases as well as STD’s. There is a high risk of these diseases in those who inject the drug, who are also sharing needles.
Seizures: Meth users tend to suffer long lasting convulsions. Seizures caused by meth are dangerous and can lead to sudden death.
Malnutrition: Meth is a powerful stimulant and appetite suppressant, which accounts for massive and sudden weight loss in the user. The user will go for long periods of time without food over meth use.
Psychosis: Meth users have a higher predisposition for Parkinson’s disease, memory issues, and dementia. Long term meth users may experience schizophrenia-like psychosis throughout their use, and meth induced psychosis which for some is irreversible, even after abstinence. (addictions.com)
I believe that methamphetamine abuse robs the user of their individual life. It keeps the user from experiencing the vast array of feelings and emotions that come with the ups and downs of life. It robs them of the ability to experience pleasure normally. I realize that meth abuse can often be the result of various forms of trauma, or untreated mental illness.
The work of recovery is incredibly difficult for the meth user, not only because they have potentially destroyed the pathway for dopamine release, but they have a very difficult time coping with feelings and emotions outside of those which produce happiness. The meth user seems to have lost hope in ever experiencing happiness and pleasure. This places the meth user at an incredible risk for relapse and death. It can be overwhelming for those close to the user who bear witness to all the consequences of meth use. It can feel like our words and actions to help the user are not making any impact, which often leads to estranged relationships. While the statistics for successful recovery with meth addiction are low, there is always room for hope. Without hope, piercing the darkness would never be possible.