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Methamphetamine
Terms modified by Methamphetamine Selected AbstractsMethamphetamine: Its History, Pharmacology, and TreatmentDRUG AND ALCOHOL REVIEW, Issue 4 2010Cameron N. McIntosh No abstract is available for this article. [source] The rise of methamphetamine in Southeast and East AsiaDRUG AND ALCOHOL REVIEW, Issue 3 2008REBECCA McKETIN Abstract Introduction and Aims. Southeast and East Asia has become a global hub for methamphetamine production and trafficking over the past decade. This paper describes the rise of methamphetamine supply and to what extent use of the drug is occurring in the region. Method and Design. The current review uses data collected through the Drug Abuse Information Network for Asia and the Pacific (DAINAP) and other available sources to analyse retrospectively methamphetamine trends within Southeast and East Asia. Results. Southeast and East Asia has experienced a methamphetamine epidemic in the past decade which began around 1997 and peaked in 2000,2001. While the situation has since stabilised in many countries, methamphetamine trafficking and use are still increasing in parts of the Mekong region and there is evidence of large-scale manufacture in Cambodia, Indonesia, Malaysia and the Philippines. Methamphetamine is typically smoked or ingested, but injection of the drug is apparent. Conclusion. While the peak of the methamphetamine epidemic has passed in parts of Southeast and East Asia, attention is needed to minimise the potential consequences of spreading methamphetamine production, trafficking and use in the Mekong region and in the peninsular and archipelago of Southeast Asia. [source] The prevalence of methamphetamine and amphetamine abuse in North America: a review of the indicators, 1992,2007DRUG AND ALCOHOL REVIEW, Issue 3 2008JANE CARLISLE MAXWELL PhD Senior Research Scientist Abstract Introduction. This paper reviews epidemiological information about methamphetamine production and use in North America. Methods. Information is drawn from a range of sources, including, but not limited to, historical accounts, peer-reviewed papers, population surveys and large national databases. Results. Methamphetamine and amphetamine use in North America is characterised by geographic variations, with different types of the drug, different routes of administration and different types of users at various times. Unlike some other drug use patterns in North America, the nature of methamphetamine use in Canada, Mexico and the United States has been linked closely in terms of production and supply of the drug. According to their national household surveys, the annual prevalence for ,speed' use in Canada was 0.8% in 2004, 0.3% for ,anfetaminas' and 0.1% for ,metanfetaminas' in Mexico in 2002, and 1.4% for ,stimulants' in the United States in 2006. Discussion. Although the data sources in the three North American countries are not consistent in methodology, terminology or frequency of reporting, all show similar trends. The type of stimulant most used has shifted from non-medical use of pharmaceutical amphetamine to use of powder methamphetamine and then to use of ,ice'. The indicators show the problem is greatest in the western parts of the countries and is moving eastward, but the decreased availability of pseudoephedrine may have a significant impact on the nature of the epidemic in the future. Nevertheless, use of methamphetamine poses a number of risks for users and specialised treatment resources for these various populations are needed. [source] Proximity to the US,Mexico border: a key to explaining geographic variation in US methamphetamine, cocaine and heroin purityADDICTION, Issue 10 2010James K. Cunningham ABSTRACT Aims Although illicit drug purity is a widely discussed health risk, research explaining its geographic variation within a country is rare. This study examines whether proximity to the US,Mexico border, the United States' primary drug import portal, is associated with geographic variation in US methamphetamine, heroin and cocaine purity. Design Distances (proximity) between the US,Mexico border and locations of methamphetamine, cocaine and heroin seizures/acquisitions (n = 239 070) recorded in STRIDE (System to Retrieve Information from Drug Evidence) were calculated for the period of 1990,2004. The association of drug purity with these distances and other variables, including time and seizure/acquisition size, was examined using hierarchical multivariate linear modeling (HMLM). Setting Coterminous United States. Findings Methamphetamine, cocaine and heroin purity generally decreased with distance from the US,Mexico border. Heroin purity, however, after initially declining with distance, turned upwards,a U-shaped association. During 2000,04, methamphetamine purity also had a U-shaped association with distance. For each of the three drugs, temporal changes in the purity of small acquisitions (<10 g) were typically more dynamic in areas closer to the US,Mexico border. Conclusions Geographic variance in methamphetamine, cocaine and heroin purity throughout the coterminous United States was associated with US,Mexico border proximity. The U-shaped associations between border-distance and purity for heroin and methamphetamine may be due to imports of those drugs via the eastern United States and southeast Canada, respectively. That said, areas closer to the US,Mexico border generally had relatively high illicit drug purity, as well as more dynamic change in the purity of small (,retail level') drug amounts. [source] Health outcomes associated with methamphetamine use among young people: a systematic reviewADDICTION, Issue 6 2010Brandon D. L. Marshall ABSTRACT Objectives Methamphetamine (MA) use among young people is of significant social, economic and public health concern to affected communities and policy makers. While responses have focused upon various perceived severe harms of MA use, effective public health interventions require a strong scientific evidence base. Methods We conducted a systematic review to identify scientific studies investigating health outcomes associated with MA use among young people aged 10,24 years. The International Classification of Diseases (ICD-10) was used to categorize outcomes and determine the level of evidence for each series of harms. Results We identified 47 eligible studies for review. Consistent associations were observed between MA use and several mental health outcomes, including depression, suicidal ideation and psychosis. Suicide and overdose appear to be significant sources of morbidity and mortality among young MA users. Evidence for a strong association between MA use and increased risk of human immunodeficiency virus (HIV) and other sexually transmitted infections is equivocal. Finally, we identified only weak evidence of an association between MA use and dental diseases among young people. Conclusions Available evidence indicates a consistent relationship between MA use and mental health outcomes (e.g. depression, psychosis) and an increased risk of mortality due to suicide and overdose. We found insufficient evidence of an association between MA use and other previously cited harms, including infectious diseases and dental outcomes. As such, future research of higher methodological quality is required to further investigate possible associations. Current interventions should focus attention upon MA-related health outcomes for which sound scientific evidence is available. [source] Genetic toxicity of methamphetamine in vitro and in human abusersENVIRONMENTAL AND MOLECULAR MUTAGENESIS, Issue 4 2003Jih-Heng Li Abstract Methamphetamine (METH) is a widely abused psychomotor stimulant. Although numerous studies have examined METH-induced neurotoxicity, its ability to produce genotoxic effects has not been evaluated. In this article, we report on the genotoxicity of METH in vitro and in human METH abusers. METH induced his+ revertants in Salmonella typhimurium strains TA98 and TA100, and increased the frequency of hprt mutants, micronuclei, and sister chromatid exchange (SCE) in cultured Chinese hamster ovary K1 (CHO-K1) cells. These METH-induced genotoxic effects were eliminated if METH exposure was conducted in the presence of rat liver S9, indicating that the genotoxicity was caused by METH, and not by metabolites of METH. In addition, reactive oxygen species (ROS) scavengers inhibited the METH-induced micronuclei in CHO-K1 cells. Further investigation with 76 human long-term METH abusers and 98 unexposed controls demonstrated that total METH exposure correlated with micronucleus and SCE frequencies in cultured lymphocytes. The results of this study indicate that METH is a genotoxic agent and that ROS may play a role in METH-induced genotoxicity. Environ. Mol. Mutagen. 42:233,242, 2003. © 2003 Wiley-Liss, Inc. [source] Why do we need an Addiction supplement focused on methamphetamine?ADDICTION, Issue 2007Richard A. Rawson ABSTRACT Methamphetamine is a substantial public health problem in many communities in the United States and in other parts of the world. In order to bring new knowledge about methamphetamine to policy makers, clinicians and researchers, this volume has compiled a set of articles containing new information about the drug and its effects. The articles contain information presented by researchers at two special methamphetamine meetings sponsored by the National Institute on Drug Abuse in 2005. [source] Approaches to the development of medications for the treatment of methamphetamine dependenceADDICTION, Issue 2007Frank J. Vocci ABSTRACT Background Methamphetamine abuse has become an increasing problem in both the United States and globally with concomitant increases in adverse medical, social and environmental sequelae. Behavioral therapies have been used with some success to treat methamphetamine abusers and dependent individuals, but are not universally efficacious. Methamphetamine has a rich pharmacology that theoretically provides many opportunities for potential pharmacotherapeutic intervention. Nevertheless, there are no approved medications with an indication for treating methamphetamine abusers or addicts at this time. Aim To describe briefly how methamphetamine functions and affects function in brain and report how basic researchers and clinicians are attempting to exploit and exploiting this knowledge to discover and develop effective pharmacotherapies. Results Scientifically based approaches to medications development by evaluating medications that limit brain exposure to methamphetamine; modulate methamphetamine effects at vesicular monoamine transporter-2 (VMAT-2); or affect dopaminergic, serotonergic, GABAergic, and/or glutamatergic brain pathways that participate in methamphetamine's reinforcing effects are presented. Conclusion The evidence supports the rationale that pharmacotherapies to decrease methamphetamine use, or reduce craving during abstinence may be developed from altering the pharmacokinetics and pharmacodynamics of methamphetamine or its effects on appetitive systems in the brain. [source] PRECLINICAL STUDY: Proteomic analysis of methamphetamine-induced reinforcement processes within the mesolimbic dopamine systemADDICTION BIOLOGY, Issue 3-4 2008Moon Hee Yang ABSTRACT Methamphetamine (MAP) is a commonly used, addictive drug, and a powerful stimulant that dramatically affects the central nervous system. In this study, we used the conditioned place preference (CPP) paradigm in order to study the reinforcing properties of MAP and the herewith associated changes in proteins within the mesolimbic dopamine system. A CPP was induced by MAP after three intermittent intraperitoneal injections (1 mg/kg) in rats and protein profiles in the nucleus accumbens, striatum, prefrontal cortex, cingulate cortex and hippocampus were compared with a saline-treated control group. In addition, a group of animals was run through extinction and protein profiles were compared with a non-extinguished group. Protein screening was conducted using two-dimensional electrophoresis analysis which identified 27 proteins in the group that showed MAP-induced CPP. Some of the proteins were confirmed by Western lot analysis. Identified proteins had functions related to the cytoskeleton, transport/endocytosis or exocytosis (e.g. profilin-2 and syntaxin-binding protein), and signal transduction, among others. [source] Role of peroxynitrite in methamphetamine-induced dopaminergic neurotoxicity and sensitization in miceADDICTION BIOLOGY, Issue 3 2000Syed F. Ali Methamphetamine (METH)-induced dopaminergic neurotoxicity is thought to be associated with the generation of reactive oxygen species (ROS) and reactive nitrogen species (RNS). Recently, we have reported that copper/zinc(CuZn)-superoxide dismutase transgenic mice are resistant to METH-induced neurotoxicity. In the present study, we examined the role of the neuronal nitric oxide synthase (nNOS), susceptibility of nNOS knockout (KO) mice and sensitization to psychostimulants after neurotoxic doses of METH. Male SwissWebster mice were treated with or without 7-nitroindazole (7-NI) along with METH (5 mg/kg,ip,q 3h × 3) and were sacrificed 72 h after the last METH injection. Dopamine (DA) and dopamine transporter (DAT) binding sites were determined in striatum from saline and METH-treated animals. 7-NI completely protected against the depletion of DA, and DAT in striatum. In follow-up experiments nNOS KO mice along with appropriate control (C57BL/6N, SV129 and B6JSV129) mice were treated with METH (5 mg/kg,ip, q 3h × 3) and were sacrificed 72 h after dosing. This schedule of METH administrations resulted in only 10,20% decrease in tissue content of DA and no apparent change in the number of DAT binding sites in nNOS KO mice. However, this regime of METH resulted in a significant decrease in the content of DA as well as DAT binding sites in the wild-type animals. Pre-exposure to single or multiple doses of METH resulted in a marked locomotion sensitization in response to METH. However, the nNOS KO mice show no sensitization in response to METH after single or multiple injections of METH. Therefore, these studies strongly suggest the role of peroxynitrite, nNOS and DA system in METH-induced neurotoxicity and behavioral sensitization. [source] Effect of an Electronic Control Device Exposure on a Methamphetamine-intoxicated Animal ModelACADEMIC EMERGENCY MEDICINE, Issue 4 2010Donald M. Dawes MD Abstract Objectives:, Because of the prevalence of methamphetamine abuse worldwide, it is not uncommon for subjects in law enforcement encounters to be methamphetamine-intoxicated. Methamphetamine has been present in arrest-related death cases in which an electronic control device (ECD) was used. The primary purpose of this study was to determine the cardiac effects of an ECD in a methamphetamine intoxication model. Methods:, Sixteen anesthetized Dorset sheep (26,78 kg) received 0.0 mg/kg (control animals, n = 4), 0.5 mg/kg (n = 4), 1.0 mg/kg (n = 4), or 1.5 mg/kg (n = 4) of methamphetamine hydrochloride as a slow intravenous (IV) bolus during continuous cardiac monitoring. The animals received the following exposures in sequence from a TASER X26 ECD beginning at 30 minutes after the administration of the drug: 1) 5-second continuous exposure, 2) 15-second intermittent exposure, 3) 30-second intermittent exposure, and 4) 40-second intermittent exposure. Darts were inserted at the sternal notch and the cardiac apex, to a depth of 9 mm. Cardiac motion was determined by thoracotomy (smaller animals, , 32 kg) or echocardiography (larger animals, > 68 kg). Data were analyzed using descriptive statistics and chi-square tests. Results:, Animals given methamphetamine demonstrated signs of methamphetamine toxicity with tachycardia, hypertension, and atrial and ventricular ectopy in the 30-minute period immediately after administration of the drug. Smaller animals (n = 8, , 32 kg, mean = 29.4 kg) had supraventricular dysrhythmias immediately after the ECD exposures. Larger animals (n = 8, > 68 kg, mean = 72.4) had only sinus tachycardia after the exposures. One of the smaller animals had frequent episodes of ventricular ectopy after two exposures, including runs of delayed onset, nonsustained six- to eight-beat unifocal and multifocal ventricular tachycardia that spontaneously resolved. This animal had significant ectopy prior to the exposures as well. Thoracotomy performed on three smaller animals demonstrated cardiac capture during ECD exposure consistent with previous animal studies. In the larger animals, none of the methamphetamine-intoxicated animals demonstrated cardiac capture. Two control sheep showed evidence of capture similar to the smaller animals. No ventricular fibrillation occurred after the exposure in any animal. Conclusions:, In smaller animals (32 kg or less), ECD exposure exacerbated atrial and ventricular irritability induced by methamphetamine intoxication, but this effect was not seen in larger, adult-sized animals. There were no episodes of ventricular fibrillation after exposure associated with ECD exposure in methamphetamine-intoxicated sheep. ACADEMIC EMERGENCY MEDICINE 2010; 17:436,443 © 2010 by the Society for Academic Emergency Medicine [source] Illegal Route Estimation of the Seized Illicit Drug, Methamphetamine, by the Comparison of Striation Marks on Plastic Packaging FilmsJOURNAL OF FORENSIC SCIENCES, Issue 6 2009Ritsuko Sugita Ph.D. Abstract:, In Japan, the most common illicit drug is methamphetamine. It is possible to trace the origin of this drug by analyzing its organic and inorganic impurities and/or byproducts using several methods, such as GC, GC/MS, and inductively coupled plasma-mass spectrometry (ICP-MS). As reported here, one other method includes comparison of the striation lines of polymer sheet layers from packaging using a polarized light method. Other alternative methods include analyzing the heat sealer pattern, layer thickness surface characteristics, and/or components of polymer sheet layers using infrared spectroscopy. Several of these alternative methods were used to analyze the origins of 29 packages confiscated from three regions over a 1000 km distance in Japan. Results indicated that packages seized from different regions had some polymer sheet layers which contained striation lines and heat sealer patterns that were similar. [source] Methamphetamine-induced neurotoxicity and microglial activation are not mediated by fractalkine receptor signalingJOURNAL OF NEUROCHEMISTRY, Issue 2 2008David M. Thomas Abstract Methamphetamine (METH) damages dopamine (DA) nerve endings by a process that has been linked to microglial activation but the signaling pathways that mediate this response have not yet been delineated. Cardona et al. [Nat. Neurosci. 9 (2006), 917] recently identified the microglial-specific fractalkine receptor (CX3CR1) as an important mediator of MPTP-induced neurodegeneration of DA neurons. Because the CNS damage caused by METH and MPTP is highly selective for the DA neuronal system in mouse models of neurotoxicity, we hypothesized that the CX3CR1 plays a role in METH-induced neurotoxicity and microglial activation. Mice in which the CX3CR1 gene has been deleted and replaced with a cDNA encoding enhanced green fluorescent protein (eGFP) were treated with METH and examined for striatal neurotoxicity. METH depleted DA, caused microglial activation, and increased body temperature in CX3CR1 knockout mice to the same extent and over the same time course seen in wild-type controls. The effects of METH in CX3CR1 knockout mice were not gender-dependent and did not extend beyond the striatum. Striatal microglia expressing eGFP constitutively show morphological changes after METH that are characteristic of activation. This response was restricted to the striatum and contrasted sharply with unresponsive eGFP-microglia in surrounding brain areas that are not damaged by METH. We conclude from these studies that CX3CR1 signaling does not modulate METH neurotoxicity or microglial activation. Furthermore, it appears that striatal-resident microglia respond to METH with an activation cascade and then return to a surveying state without undergoing apoptosis or migration. [source] Involvement of 5-HT3 receptors in the development and expression of methamphetamine-induced behavioral sensitization: 5-HT3A receptor channel and binding studyJOURNAL OF NEUROCHEMISTRY, Issue 3 2006Ji-Hoon Yoo Abstract Methamphetamine (MAP) is one of the most commonly abused drugs in Asia, and previous studies suggest that serotonin 3 receptors (5-HT3) are involved in MAP-induced locomotion and reward. However, little is known about the role of 5-HT3 receptors in MAP-induced behavioral sensitization. Here, we measured the effects of MDL 72222, a 5-HT3 antagonist, and SR 57227 A, a 5-HT3 agonist, on the development and expression of MAP-induced behavioral sensitization, and alternations of 5-HT3 receptor binding labeled with the 5-HT3 -selective antagonist, [3H]GR65630, in mice. In addition, we investigated the effects of MAP on 5-HT3A receptor channel activity in Xenopus laevis oocytes expressing 5-HT3A receptors. We found that MDL 72222 attenuated both the development and expression of behavioral sensitization to MAP (1.0 mg/kg, i.p.), and that this attenuating effect of MDL 72222 was reversed by pre-treatment with SR 57227 A. In oocytes expressing 5-HT3A receptor, MAP exhibited a dual modulation of 5-HT3A receptor channel activity, i.e. pre-treatment with a low dose of MAP (0.1 µm) enhanced 5-HT-induced inward peak current (I5-HT) but a high dose of MAP (100 µm) inhibited I5-HT. The acute administration of MDL 72222 with MAP decreased [3H]GR65630 binding versus MAP alone in the mouse striatum. Our results suggest that MDL 72222 attenuates MAP-induced behavioral sensitization via 5-HT3 receptors in the caudate putamen, and that 5-HT3 receptor antagonists like MDL 72222 have potential as novel anti-psychotic agents for the treatment of MAP dependence and psychosis. [source] Implication of Rho-associated kinase in the elevation of extracellular dopamine levels and its related behaviors induced by methamphetamine in ratsJOURNAL OF NEUROCHEMISTRY, Issue 2 2003Minoru Narita Abstract A growing body of evidence suggests that several protein kinases are involved in the expression of pharmacological actions induced by a psychostimulant methamphetamine. The present study was designed to investigate the role of the Rho/Rho-associated kinase (ROCK)-dependent pathway in the expression of the increase in extracellular levels of dopamine in the nucleus accumbens and its related behaviors induced by methamphetamine in rats. Methamphetamine (1 mg/kg, subcutaneously) produced a substantial increase in extracellular levels of dopamine in the nucleus accumbens, with a progressive augmentation of dopamine-related behaviors including rearing and sniffing. Methamphetamine also induced the decrease in levels of its major metabolites, 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanilic acid (HVA). Both the increase in extracellular levels of dopamine and the induction of dopamine-related behaviors by methamphetamine were significantly suppressed by pretreatment with an intranucleus accumbens injection of a selective ROCK inhibitor Y-27632. In contrast, Y-27632 had no effect on the decrease in levels of DOPAC and HVA induced by methamphetamine. Under these conditions, there were no changes in protein levels of membrane-bound RhoA in the nucleus accumbens following methamphetamine treatment. It is of interest to note that the microinjection of Y-27632 into the nucleus accumbens failed to suppress the increases in extracellular levels of dopamine, DOPAC, and HVA in the nucleus accumbens induced by subcutaneous injection of a prototype of µ-opioid receptor agonist morphine (10 mg/kg). Furthermore, perfusion of a selective blocker of voltage-dependent Na+ channels, tetrodotoxin (TTx) into the rat nucleus accumbens did not affect the increase in extracellular levels of dopamine in the rat nucleus accumbens by methamphetamine, whereas the morphine-induced dopamine elevation was eliminated by this application of TTx. The extracellular level of dopamine in the nucleus accumbens was also increased by perfusion of a selective dopamine re-uptake inhibitor 1-[2-[bis(4-fluorophenyl)methoxy]-4-(3-phenylpropyl)piperazine (GBR-12909) in the nucleus accumbens. This effect was not affected by pretreatment with intranucleus accumbens injection of Y-27632. These findings provide first evidence that Rho/ROCK pathway in the nucleus accumbens may contribute to the increase in extracellular levels of dopamine in the nucleus accumbens evoked by a single subcutaneous injection of methamphetamine. In contrast, this pathway is not essential for the increased level of dopamine in this region induced by morphine, providing further evidence for the different mechanisms of dopamine release by methamphetamine and morphine in rats. [source] The protective effect of melatonin on methamphetamine-induced calpain-dependent death pathway in human neuroblastoma SH-SY5Y cultured cellsJOURNAL OF PINEAL RESEARCH, Issue 2 2010Wilasinee Suwanjang Abstract:, Methamphetamine (METH) is a potent psychostimulant drug that may cause neuronal cell degeneration. The underlying mechanisms of METH-induced neuronal toxicity remains poorly understood. In this study, we investigated an important role of calpain-dependent cascades in methamphetamine-induced toxicity in human dopaminergic neuroblastoma SH-SY5Y cultured cell lines. In addition, the protective effect of melatonin against METH-induced calpain-dependent death pathway was also investigated. The results of this study show that METH significantly decreased cell viability and tyrosine hydroxylase phosphorylation in SH-SY5Y cultured cells. Melatonin reversed the toxic effect of METH by inducing cell viability. In addition, melatonin was able to restore the reduction in mitochondrial function and phosphorylation of tyrosine hydroxylase in SH-SY5Y treated cells. An induction of calpain expression and activity but a reduction of calpain inhibitor (calpastatin) protein levels were observed in SH-SY5Y cells treated with METH but these effects were diminished by melatonin. These results implicated calpain-dependent death pathways in the processes of METH-induced toxicity and also indicated that melatonin has the capacity to reverse this toxic effect in SH-SY5Y cultured cells. [source] Analysis of methamphetamine and its metabolites in hairBIOMEDICAL CHROMATOGRAPHY, Issue 2-3 2003Nariaki Takayama Abstract Methamphetamine (MA) is a sympathomimetic amine whose abuse has become a serious problem in Japan, Korea, Taiwan and other Southeast Asian countries. The use of hair for the determination of MA use has become more commonplace. The maximum period in which MA and its main metabolites (amphetamine and p -hydroxymethamphetamine) can be detected in urine is about 10 days after its use. However, proof of MA use is possible in hair even several years after its use if the part of the hair that grew in the period of its use is available. In addition, segmental analysis of hair is capable of clarifying the history of MA abuse. This paper reviews the clean-up, extraction, analytical method and distribution of MA and its metabolites in hair from reports published in the last 20 years. Copyright © 2003 John Wiley & Sons, Ltd. [source] A novel pharmacological concept in an animal model of psychosis,ACTA PSYCHIATRICA SCANDINAVICA, Issue 2001R. R. Dawirs Objective:,We have analysed pharmacologically induced perturbation of functional and structural neurogenesis in the prefrontal cortex (PFC) and hippocampus. Method:,Juvenile gerbils received a single dose of methamphetamine (METH, 50 mg/kg, i.p.). In adults the following parameters were quantitatively investigated: prefrontal dopaminergic and GABAergic innervation densities (immunocytochemistry), morphogenesis of pyramidal cells (Golgi), dentate granule cell proliferation (BrdU-labelling), working memory and behavioural inhibition (delayed response, open-field). Results:,A single challenge of METH continuously suppresses granule cell proliferation in adult gerbils and initiates rewiring of neuronal networks in the PFC which run concurrently with the development of severe deficits in PFC-related behaviours. Conclusion:,It appears that a continuous remodelling of neuronal circuits is an inherent property of the brain, the biological significance of which seems to be to ascertain adaptive interaction between brain and environment. Learning more about drug-induced neuronal reorganization might be basic for understanding the genesis of psychotic conditions in the brain. This presentation is based both on own research and on a review of the literature. [source] A cost-effectiveness analysis of modafinil therapy for psychostimulant dependenceDRUG AND ALCOHOL REVIEW, Issue 3 2010JAMES SHEARER Abstract Introduction and Aims. To examine the cost-effectiveness of modafinil (200 mg daily) plus counselling compared with placebo for the treatment of psychostimulant dependence. Design and Methods. Cost and outcome data were collected alongside two randomised controlled trials of modafinil 200 mg daily over 10 weeks for methamphetamine (n = 74) and cocaine dependence (n = 8), respectively. Incremental cost-effectiveness ratios representing the additional costs to achieve a given outcome were calculated for both the change in the number of stimulant-free days and quality-adjusted life years 12 weeks post-treatment. Results. The incremental cost-effectiveness ratio indicated that it would cost an additional $AUD79 to achieve an extra stimulant-free day with modafinil compared with placebo. This result was not statistically significant, but appeared to be a robust estimate after sensitivity analysis. Counselling, whether received within program or from other services, improved the cost-effectiveness of modafinil relative to placebo. Discussion and Conclusions. Strategies to improve the uptake of counselling are recommended as cost-effective.[Shearer J, Shanahan M, Darke S, Rodgers C, van Beek I, McKetin R, Mattick RP. A cost-effectiveness analysis of modafinil therapy for psychostimulant dependence. Drug Alcohol Rev 2010] [source] The rise of methamphetamine in Southeast and East AsiaDRUG AND ALCOHOL REVIEW, Issue 3 2008REBECCA McKETIN Abstract Introduction and Aims. Southeast and East Asia has become a global hub for methamphetamine production and trafficking over the past decade. This paper describes the rise of methamphetamine supply and to what extent use of the drug is occurring in the region. Method and Design. The current review uses data collected through the Drug Abuse Information Network for Asia and the Pacific (DAINAP) and other available sources to analyse retrospectively methamphetamine trends within Southeast and East Asia. Results. Southeast and East Asia has experienced a methamphetamine epidemic in the past decade which began around 1997 and peaked in 2000,2001. While the situation has since stabilised in many countries, methamphetamine trafficking and use are still increasing in parts of the Mekong region and there is evidence of large-scale manufacture in Cambodia, Indonesia, Malaysia and the Philippines. Methamphetamine is typically smoked or ingested, but injection of the drug is apparent. Conclusion. While the peak of the methamphetamine epidemic has passed in parts of Southeast and East Asia, attention is needed to minimise the potential consequences of spreading methamphetamine production, trafficking and use in the Mekong region and in the peninsular and archipelago of Southeast Asia. [source] The prevalence of methamphetamine and amphetamine abuse in North America: a review of the indicators, 1992,2007DRUG AND ALCOHOL REVIEW, Issue 3 2008JANE CARLISLE MAXWELL PhD Senior Research Scientist Abstract Introduction. This paper reviews epidemiological information about methamphetamine production and use in North America. Methods. Information is drawn from a range of sources, including, but not limited to, historical accounts, peer-reviewed papers, population surveys and large national databases. Results. Methamphetamine and amphetamine use in North America is characterised by geographic variations, with different types of the drug, different routes of administration and different types of users at various times. Unlike some other drug use patterns in North America, the nature of methamphetamine use in Canada, Mexico and the United States has been linked closely in terms of production and supply of the drug. According to their national household surveys, the annual prevalence for ,speed' use in Canada was 0.8% in 2004, 0.3% for ,anfetaminas' and 0.1% for ,metanfetaminas' in Mexico in 2002, and 1.4% for ,stimulants' in the United States in 2006. Discussion. Although the data sources in the three North American countries are not consistent in methodology, terminology or frequency of reporting, all show similar trends. The type of stimulant most used has shifted from non-medical use of pharmaceutical amphetamine to use of powder methamphetamine and then to use of ,ice'. The indicators show the problem is greatest in the western parts of the countries and is moving eastward, but the decreased availability of pseudoephedrine may have a significant impact on the nature of the epidemic in the future. Nevertheless, use of methamphetamine poses a number of risks for users and specialised treatment resources for these various populations are needed. [source] Technology and innovation in the psychosocial treatment of methamphetamine use, risk and dependenceDRUG AND ALCOHOL REVIEW, Issue 3 2008FRANCES J. KAY-LAMBKIN Abstract Issues. The dramatic increase in methamphetamine use has led to the urgent need for high-quality, effective treatments and management strategies for methamphetamine use problems to be developed and disseminated. Although some evidence exists for the use of psychological, pharmacological and other approaches to treatment for problematic methamphetamine use, other evidence suggests that many methamphetamine users do not access these treatment options due to a range of individual and service-level barriers. Approach. A review of available research literature was undertaken to identify treatment strategies for methamphetamine users, which overcome the problems associated with treatment access for this important target group and involve technological and other innovative approaches. Key Findings. Several approaches to addressing problematic methamphetamine use have been suggested, including assertive engagement strategies, flexibility in the provision of treatment and retention strategies and use of a multi-focused intervention package, such as stepped care, perhaps including new technologies as alternatives or supplements to face-to-face-delivered treatments. No research currently exists to examine the possible benefit of these strategies for people with methamphetamine use problems. Implications. The use of stepped-care intervention packages has the potential to address many of the current challenges faced by both clinicians and clients in treating methamphetamine use problems. Conclusions. Although promising, these approaches require further attention and research effort, particularly among the specific group of methamphetamine users. [source] Methamphetamine use among Australian workers and its implications for preventionDRUG AND ALCOHOL REVIEW, Issue 3 2008Professor ANN M. ROCHE Director Abstract Introduction and Aims. Little attention has been directed to the use of methamphetamine among Australian workers. To address this, a study was conducted that examined drug consumption patterns of the Australian work-force. Design and Method. A secondary analysis of the 2004 National Drug Strategy Household Survey (NDSHS) data was undertaken that focused on methamphetamine use among those in paid employment. Results. Methamphetamine use in the past 12 months was reported by 4.0% of workers compared to 2.2% of respondents not in the paid work-force. A larger proportion of male (4.8%) than female workers (3.0%) used methamphetamine. The highest prevalence occurred among 18,29-year-old workers (11.2%; males: 12.6%; females: 9.4%), and among workers in hospitality (9.5%), construction (5.4%) and transport (5.4%) industries and among tradespeople (6.5%). Significantly more methamphetamine users reported absenteeism compared to users of other illicit drugs and non-drug users. Among respondents reporting methamphetamine use, 13.4% reported absenteeism due to illicit drug use, while 56.8% reported absenteeism due to any illness or injury. Significantly more methamphetamine users (32.9%) reported going to work under the influence than users of other illicit drugs. Compared to users of other illicit drugs, methamphetamine users were also significantly more likely to drive a car, operate heavy machinery or abuse someone while under the influence. Discussion and Conclusions. The specific details of the profile of workers using methamphetamine and the impact it has on work performance allows for the development of targeted interventions and tailored prevention strategies previously not possible. [source] Surge in treatment admissions related to methamphetamine use in Cape Town, South Africa: implications for public healthDRUG AND ALCOHOL REVIEW, Issue 2 2008ANDREAS PLÜDDEMANN Abstract Introduction and Aims. In the past decade, methamphetamine has become increasingly a drug of concern globally. The purpose of this study is to describe the changing trends in treatment admissions for methamphetamine abuse in Cape Town, South Africa and to highlight the implications of these changes for policy, practice and research. Design and Methods. Data were collected on admissions for drug abuse treatment through a regular monitoring system involving drug treatment centres and programmes in Cape Town every 6 months as part of the South African Community Epidemiology Network on Drug Use (SACENDU). A one-page form was completed by treatment centre personnel to obtain demographic data, the patients' primary and secondary substances of abuse, the mode, frequency and age of first use of substance and information on prior treatment. Results. The results indicate that between 2004 and 2006 a dramatic increase in treatment admissions for methamphetamine abuse occurred, a large proportion of the methamphetamine patients are adolescents and that the drug is almost exclusively smoked. Discussion and Conclusions. The rapid increase in admissions for methamphetamine abuse is of great concern, particularly as the drug has a number of serious, often chronic, side effects and that a large proportion of the patients are adolescents. The implications for public health are discussed. [source] MDMA, methamphetamine and their combination: possible lessons for party drug users from recent preclinical researchDRUG AND ALCOHOL REVIEW, Issue 1 2007KELLY J. CLEMENS Abstract The substituted amphetamines 3,4-methylenedioxymethamphetamine (MDMA, ,Ecstasy') and methamphetamine (METH, ,ice', ,speed') are increasingly popular drugs amongst party-drug users. Studies with humans have investigated the acute and possible long-term adverse effects of these drugs, yet outcomes of such studies are often ambiguous due to a variety of confounding factors. Studies employing animal models have value in determining the acute and long-term effects of MDMA and METH on brain and behaviour. Self-administration studies show that intravenous METH is a particularly potent reinforcer in rats and other species. In contrast, MDMA appears to have powerful effects in enhancing social behaviour in laboratory animals. Brief exposure to MDMA or METH may produce long-term reductions in dopamine, serotonin and noradrenaline in the brain and alterations in the density of various receptor and transporter proteins. However it is still unclear, particularly in the case of MDMA, whether this reflects a ,neurotoxic' effect of the drug. Lasting alterations in social behaviour, anxiety, depressive symptoms and memory have been demonstrated in laboratory rats given MDMA or METH and this matches long-term changes reported in some human studies. Recent laboratory studies suggest that MDMA/METH combinations may produce greater adverse neurochemical and behavioural effects than either drug alone. This is of some concern given recent evidence that party drug users may be frequently exposed to this combination of drugs. [source] Changes in the initiation of heroin use after a reduction in heroin supplyDRUG AND ALCOHOL REVIEW, Issue 4 2006CAROLYN DAY Abstract Increasing heroin use in Australia over the past 30 years has been associated with a decline in the age of initiation to heroin use. The 2001 Australian heroin shortage was used to assess the effects of a reduction in heroin supply on age of initiation into heroin injecting. Data collected from regular injecting drug users (IDU) over the period 1996,2004 as part of the Australian Illicit Drug Reporting System were examined for changes in self-reported age of first heroin use after the onset of the heroin shortage. Estimates were also made of the number of young people who may not have commenced injecting heroin during the heroin shortage. The proportion of IDU interviewed in the IDRS who were aged ,24 years decreased from 46% in 1996 to 12% in 2004, with the most marked drop in 2001, the year in which there was an abrupt and marked reduction in heroin availability. Of those who reported first injecting between 1993 and 2000, similar proportions reported heroin and amphetamine as the first drug injected. After 2000, methamphetamine was the drug most often reported as being the first injected. Estimates suggested that between 2745 and 10 560 young people may not have begun to inject heroin in 2001 as a result of reduced heroin supply. If around one in four of these young users had progressed to regular or dependent heroin use, then there may have been a reduction of between 700 and 2500 dependent heroin users. There was an increase in amphetamine injecting but it is unclear to what extent any reduction in heroin injecting has been offset by increased amphetamine injecting. Reduced heroin availability probably resulted in a reduction in the number of new heroin injectors in Australia. Efforts need to be made to reduce the chances that young people who have initiated methamphetamine injecting do not move to heroin injecting when the heroin supply returns. [source] Impact of the heroin ,drought' on patterns of drug use and drug-related harmsDRUG AND ALCOHOL REVIEW, Issue 2 2004Dr MARIE C. LONGO Senior Research Officer Abstract Since late 2000, anecdotal reports from drug users and health professionals have suggested that there was a reduction in the supply of heroin in Adelaide in the first half of 2001, referred to as a heroin ,drought'. The aim of this paper was to critically review evidence for this, using data obtained from 100 injecting drug users surveyed for the 2001 Illicit Drug Reporting System (IDRS). This project is carried out annually in all Australian jurisdictions, and collects up-to-date information on the markets for heroin, methamphetamine, cocaine and cannabis. This paper also investigates the possible implications of this ,drought' on patterns of drug use and drug-related harms. The 2001 IDRS found consistent reports by users of an increase in the price of heroin, together with decreases in purity and availability. These factors resulted in a decrease in the frequency of self-reported heroin use among those surveyed in 2001, and a concomitant increase in the use of other drugs, in particular methamphetamine and morphine. The heroin ,drought' appears to have had a substantial impact on several indices of drug-related harm. There was a marked decrease in the number of opioid-related fatalities, and hospital data also showed reductions in heroin-related presentations. Treatment service data showed an increase in the number of admissions related to amphetamines. There is a need for health promotion and education on the adverse effects of methamphetamine use, and the development of improved treatment protocols for methamphetamine abuse and dependence. [source] Proximity to the US,Mexico border: a key to explaining geographic variation in US methamphetamine, cocaine and heroin purityADDICTION, Issue 10 2010James K. Cunningham ABSTRACT Aims Although illicit drug purity is a widely discussed health risk, research explaining its geographic variation within a country is rare. This study examines whether proximity to the US,Mexico border, the United States' primary drug import portal, is associated with geographic variation in US methamphetamine, heroin and cocaine purity. Design Distances (proximity) between the US,Mexico border and locations of methamphetamine, cocaine and heroin seizures/acquisitions (n = 239 070) recorded in STRIDE (System to Retrieve Information from Drug Evidence) were calculated for the period of 1990,2004. The association of drug purity with these distances and other variables, including time and seizure/acquisition size, was examined using hierarchical multivariate linear modeling (HMLM). Setting Coterminous United States. Findings Methamphetamine, cocaine and heroin purity generally decreased with distance from the US,Mexico border. Heroin purity, however, after initially declining with distance, turned upwards,a U-shaped association. During 2000,04, methamphetamine purity also had a U-shaped association with distance. For each of the three drugs, temporal changes in the purity of small acquisitions (<10 g) were typically more dynamic in areas closer to the US,Mexico border. Conclusions Geographic variance in methamphetamine, cocaine and heroin purity throughout the coterminous United States was associated with US,Mexico border proximity. The U-shaped associations between border-distance and purity for heroin and methamphetamine may be due to imports of those drugs via the eastern United States and southeast Canada, respectively. That said, areas closer to the US,Mexico border generally had relatively high illicit drug purity, as well as more dynamic change in the purity of small (,retail level') drug amounts. [source] Withdrawal symptoms in abstinent methamphetamine-dependent subjectsADDICTION, Issue 10 2010Todd Zorick ABSTRACT Aims Withdrawal symptoms have been linked to a propensity for relapse to drug abuse. Inasmuch as this association applies to methamphetamine (MA) abuse, an understanding of the course of MA withdrawal symptoms may help to direct treatment for MA dependence. Previous studies of symptoms manifested during abstinence from MA have been limited in size and scope. We asked (i) whether debilitating psychological and/or physical symptoms appear during the first several weeks of MA abstinence, (ii) how craving for MA evolves and (iii) whether psychiatric symptoms (e.g. depression, psychosis) persist beyond a month of abstinence. Design A study of MA-dependent participants, who initiated and maintained abstinence from the drug for up to 5 weeks, compared to a matched healthy comparison group. Setting In-patient research hospital ward (MA-dependent subjects) and out-patient (comparison subjects). Participants Fifty-six MA-dependent and eighty-nine comparison subjects. Measurements Rater-assessed MA withdrawal questionnaire and self-report assessment of craving (MA-dependent subjects) and self-report assessment of psychiatric symptoms (both groups). Findings At study entry, MA-dependent subjects exhibited a wide range in severity of depressive symptoms, with the average score at a mild,moderate level of severity. Symptoms of psychosis were also prevalent. While depressive and psychotic symptoms largely resolved within a week of abstinence, craving did not decrease significantly from the time of initiating abstinence until the second week, and then continued at a reduced level to the fifth week. Conclusions Depressive and psychotic symptoms accompany acute withdrawal from methamphetamine but resolve within 1 week. Craving is also present and lasts at least 5 weeks. [source] Mephentermine dependence without psychosis: a Brazilian case reportADDICTION, Issue 6 2010Henrique Faria De Sousa ABSTRACT Background Substance abuse is a serious health concern. This report presents the case of a 22-year-old Brazilian man with a history of mephentermine use who fulfils all the criteria for chemical dependence listed by ICD-10. Mephentermine is a sympathomimetic agent derived from methamphetamine which, in Brazil, is restricted to veterinary use. Case description The subject used the substance at a high dose (120 mg) to improve his physical performance while working out at a gym. His symptoms included anorexia and insomnia. After days of intense activity, he felt fatigue and soreness. A physical examination revealed scars on both forearms from the injections and a psychological examination revealed moderate speech and motor agitation. Conclusions Cases such as this may be common among the general public. They should have some bearing upon medical practice and public health policies involving drugs. [source] | |||||||||||||||||||