Tuesday, November 29, 2011

Meth Really Isn't That Bad for You... Or is it?

Image from All Around The House


We all know that meth is a highly addictive, harmful stimulant drug that rots your teeth and makes you paranoid, stupid, unemployed, and homeless -- thereby ruining your life. So just say NO! to meth. Right, kids?

Methamphetamine (meth) and other stimulants are best known for their effects on the dopamine system, and hence for their propensity to be reinforcing and addictive. But meth actually increases the release and blocks the reuptake of all three monoamine neurotransmitters (norepinephrine and serotonin as well as dopamine). Meth addiction can cause alterations in brain function and cognitive performance, according to hundreds of published studies (reviewed in Barr et al., 2006; Baicy & London, 2007). The NIDA website lists a multitude of adverse effects from chronic heavy use:
Long-term methamphetamine abuse has many negative health consequences, including extreme weight loss, severe dental problems (“meth mouth”), anxiety, confusion, insomnia, mood disturbances, and violent behavior. Chronic methamphetamine abusers can also display a number of psychotic features, including paranoia, visual and auditory hallucinations, and delusions...
However, a new review article by Hart et al. (2011) concludes that prior studies have exaggerated the harmful effects of methamphetamine on brain structure and function, cognition, mental health, and dental health. In my view, one problem with this endeavor arises in the very first sentence of the abstract:
The prevailing view is that recreational methamphetamine use causes a broad range of severe cognitive deficits, despite the fact that concerns have been raised about interpretations drawn from the published literature. This article addresses an important gap in our knowledge by providing a critical review of findings from recent research investigating the impact of recreational methamphetamine use on human cognition.
Many people can use meth recreationally, in modest doses, without becoming dependent. In fact, the review begins by noting the performance enhancing effects of meth in high-functioning, healthy adults who are occasional users. These laboratory studies are conducted in a very controlled environment, using oral administration of pharmaceutical grade methamphetamine. No one disputes that acutely administered meth can have beneficial effects on cognitive performance (Barr et al., 2006):
Numerous studies have confirmed that MA abuse is associated with cognitive impairment. Unlike the acute effects of a single low dose of MA, which can improve cognitive processing speed, attention, concentration and psychomotor performance,77,78 long-term exposure to MA may result in profound neuropsychological deficits (see Nordahl et al2).
But how does acute meth affect the performance of meth abusers? Here, the authors cite their own work on the intranasal administration of 3 doses + placebo to 11 meth abusers (Hart et al., 2008). The same computerized battery of 5 cognitive tests was given to the participants during each session. The results in their entirety:
Figure 4 shows how methamphetamine altered performance over time on selected measures.1 As can be seen, methamphetamine improved performance on both of the selected tasks. On the DAT [divided attention task, for vigilance], all active methamphetamine doses decreased the mean hit latency and increased the maximum tracking speed (P<0.05). On the DSST [digit-symbol substitution task, for visuospatial processing], only the two intermediate doses (12 and 25mg) significantly improved performance. Relative to placebo, both doses increased the total number of trial attempts and correct responses (P<0.03). No other significant performance effects were noted.
There is no explanation of why these two tasks were "selected" instead of the other three. Nor is there any indication of how this performance compares to "normative data" or to participants who are not meth abusers. This is a bit ironic, because the most annoying critique within the review is the repeated failure to accept the performance of control subjects as valid. Sure, acute meth did speed up performance on "selected" measures of "selected" tasks, but was this generally better or worse than what's observed in those without a history of long-term meth abuse?

When evaluating whether meth really isn't that bad for you, my focus is on the chronic effects of meth in long-term abusers of the drug. I'll return to this critical issue in the next post.


Footnote

1 An intriguing aspect of the data is that a massive performance drop was seen from time 0 to time 15 min in the placebo condition. One could speculate that the participants knew by then that they weren't on meth. The "Good Drug Effects" and "Stimulated" self-report ratings peaked at 15 min post-snort, so there's a disappointment-related decrement on placebo.

Figure 4. Selected performance effects as a function of methamphetamine dose and time. Error bars represent one SEM. Overlapping error bars were omitted for clarity.


References

Baicy K, London ED. (2007). Corticolimbic dysregulation and chronic methamphetamine abuse. Addiction 102 Suppl 1:5-15.

Barr AM, Panenka WJ, MacEwan GW, Thornton AE, Lang DJ, Honer WG, Lecomte T. (2006). The need for speed: an update on methamphetamine addiction. J Psychiatry Neurosci. 31:301-13.

Hart, C., Gunderson, E., Perez, A., Kirkpatrick, M., Thurmond, A., Comer, S., & Foltin, R. (2008). Acute Physiological and Behavioral Effects of Intranasal Methamphetamine in Humans. Neuropsychopharmacology, 33 (8), 1847-1855 DOI: 10.1038/sj.npp.1301578

Hart, C., Marvin, C., Silver, R., & Smith, E. (2011). Is Cognitive Functioning Impaired in Methamphetamine Users? A Critical Review. Neuropsychopharmacology DOI: 10.1038/npp.2011.276

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15 Comments:

At November 29, 2011 9:04 AM, Anonymous London Counselling said...

While recreational use of meth(pharmaceutical grade) may not be as horrible as is normally portrayed, a substance that is as potentially addictive (to some individuals)should not be messed around with. How is a person supposed to know if they are one of the potential addicts until they become addicted to it? Controlled usage of amphetamine can be useful for weight loss or even mood elevation for some, but for others amphetamine use can lead to the use of dangerous or adulterated street drugs. For this reason unprescribed and unmonitored use of amphetamines should continue to be discouraged.

 
At November 29, 2011 7:06 PM, Anonymous Leslie said...

How wonderful. Scientific research that "proves" that recreational hard drug use can be ok.

I'm kind of personally offended by this research in the same way that I was when I discovered that there's a nightclub in my neighborhood called "Addiction"

I love it when you rip this shit apart. You're awesome.

 
At December 15, 2011 2:14 PM, Anonymous Anonymous said...

So, meth doesn't mess up your teeth and destroy your skin? How about the before and after pictures of metheads?
http://www.youtube.com/watch?v=nT9sUA82KHc

 
At April 25, 2012 2:51 AM, Anonymous Anonymous said...

No it just proves, prior myths that single use of ma will not cannot permenantly SEVERLY harm your "brain cells" nerons. Doesnt make ot any less safe or more safe. And to be offended by research is hilarously close minded. Do you know what tylenol does to your liver?

 
At July 17, 2012 4:41 PM, Anonymous Anonymous said...

Tv said meth is the worst thing that's ever been created... A lot of hard drugs are okay as long as you're responsible with it. It's just a few dumbasses that gave the drug a bad name. I'd be fine with using meth, if I had kids I'd be fine with them doing it too, because I know I and they would be responsible enough to not abuse it. It's just the TV that tells you meth is worse than Nazism.

 
At April 23, 2013 6:18 PM, Anonymous sam iam said...

Meth is no more harmful to use than alcohol, cocaine, heroin, or any number of prescription drugs (one of which is given to millions of kids daily: amphetamines for ADHD).

In fact, meth is the least harmful of all of these.

As far as chronic use is concerned, meth is safer than all of the above drugs as well.

If you don't believe this, then you have been brainwashed by the very successful media campaigns which want to cast meth in a terrible light.

Don't get me wrong: many people cannot use this drug without significant problems coming their way. But no more so than any of the above illegal drugs, as well as some legal ones, namely alcohol (which kills ~75,000 people a year) or tobacco (which kills ~450,000 per year).

 
At June 01, 2013 9:43 PM, Anonymous Anonymous said...

look at the dosing amounts. 25mg?? anyone who does meth would laugh at that amount. typically a minimum "serving " smoked would be 50 mgs to lets say for a heavy user 500 mgs in one "bowl" to 1000 mgs for a heavy user. the problem is the significantly large doses taken and purity. i always thought they could eliminate the problem by legalizing meth but regulating it and diluting it down so much that its hard to do enough to cause the problems. a great cutting element i am knowledgeable about is N-ISOPROPYLBENZYLAMINE HYDROCHLORIDE. extremely difficult to tell from the real thing and definitely makes it psycologically difficult to "do to much.

personally i believe most people you see the horrible outcomes outcomes would not be much different if they had never touched drugs

 
At August 24, 2013 9:13 AM, Anonymous Anonymous said...

Isopropylbenzylamine is toxic. Much worse for you than inhaling meth.

I only found this blog as i was researching isopropylbenzylamine and this pop up on my google search.

 
At December 22, 2013 2:24 AM, Anonymous Anonymous said...

I have a 3 session (18months, 24 months and 9 months) history with meth. I do have a reasonably severe case of ADD. Grew up in Mid-TN where FDA approved pills were always a huge part of the illicit market. I remember taking 10mg Desosyn (d-methamphetamine HCL salt) at about age 16 and 1 pill at 10mg made me feel normal for the first time. 2 pills and you were praying to come down/sleep as you lie awake the second night. I tried to make this point with guys I had grown up beside. "Chop a gram into 100 lines and let's each do2." They claimed they had quality meth,(at the time making it), but in reality, I probably never bought a bag over 40-45% and that would be from kingpins/importers who ran other businesses like bank pres., successful medical pro, etc. I have had 6.5 yrs of peace between binges. As far as kids; I have 3 (21,18,15) and I can't imagine holding anything back if I found out someone had given them this shit. Addiction has been a battle since teens with only a few sober/straight years in between (Thanks God!), and I could not imagine the kids I poured my life into having the struggles I have given my age (48). Bear in mind tuition is paid to an Ivy League School (both older kids), fridge is full and bills are paid. I don't make it, and I don't sell it.
If you have done it for years occasionally with no ill effects from months of losing REM sleep then do what you will. I certainly can't throw moral rocks at you. Seriously think before you hand the first dose to a newbie. You don't know if you may have ruined a life. Just don't,..... please.
J

 
At February 20, 2014 11:13 AM, Anonymous Anonymous said...

You are an idiot

 
At February 22, 2014 11:35 AM, Blogger The Neurocritic said...

FYI - that most recent comment was directed at sam iam.

 
At May 05, 2014 7:06 PM, Anonymous Anonymous said...

I'm familiar with Carl Hart's work and while what he's saying is certainly valid, it's also misrepresented a lot and he's not without his own larger social agenda. His basic point is that Crystal Meth, not unlike Crack in the 80's or Marijuana in the 30's, or any other drug at any other time, is not necessarily as addictive as media and social services organizations, et al make it out to be. That there are such things as casual meth users. And at least initial studies show that casual meth use doesn't necessarily have the type of extreme health issues short term that media would make you believe. In addition, there's simply not enough long-term studies to really make a determination on whether or not casual meth use will create the level of long term negative effects that chronic use would. In fact, it's possible casual use of the drug might have very minimal effects. In essence, there isn't really proof to say otherwise. And I don't doubt any of that. But the truth is crystal meth is a highly addictive drug. Whether or not it is or isn't more addictive than crack or heroin or alcohol is really besides the point. Chronic addiction to crystal meth gives you a much higher than likely chance of developing negative short-term and long-term health issues. And just as some people can't control drinking...or sex...or gambling...there are going to be people who simply abuse the drug and the results for those people can be catastrophic. The reason I think public health announcements have a tendency to lean towards the "Reefer Madness" version of things "USE IT ONCE AND YOUR DEAD" is because they believe - rightly or wrongly - that there's a very short windwo (i.e. 30-second PSA) to get through to people, especially young people, and feel this is the most effective way of stopping people from trying the drug. It's no different than the scare tactics presidential campaigns use; or the NRA uses; or Pacifica radio uses. This may or may not be the right approach, but it's how it's currently done. And I think this is really Carl Hart's agenda. That the public is being misled and that a more thoughtful and thorough conversation needs to be had about the use and effects of hard drugs and that public policy should be based on that (and therefore by extension socioeconomic issues will be addressed as well) and not be influenced by misinformation and scare tactics. It's a fair enough point and one I do not disagree with at all. HOWEVER - even if only 35% of people who ever tried meth got addicted and suffered severe health consequences...is that a risk you want to take. If every time you got on a plane, or drove your car, or ate ice cream you had a 35% chance of it destroying your life...would you take that plane? Would you drive that car? Would you eat that ice cream? I don't doubt the validity of the study, but it is anything but an endorsement to start trying meth.

 
At May 06, 2014 4:22 PM, Blogger The Neurocritic said...

You made a number of good points, thanks for your comment. The percentage of casual meth users who do get addicted is probably lower than 35%, but that's not meant to be taken as an endorsement.

 
At May 31, 2014 8:56 AM, Anonymous Anonymous said...

Being a "casual" user back in college days (89-92) I can say honestly I never had any issues other than sleep deprivation. No heebie jeebie stuff you hear about with todays product. I watched an acquaintance and her son spiral around the drain with a meth addiction back in 2004 & one night out of boredom I tried a couple lines & it took less than an hr to notice a HUGE difference in what I used to call Cyrstal M & what they call meth today. Ugly ugly difference...my brain felt like it was numb, couldn't stop ruminating about silly stuff, and spaced out. Not a good high period.
Well about 4 months later, in a discussion with a court reporter friend, she informed me that a "cooker" currently on trial confessed to cooking his batch without removing the packaging, meaning aluminum foil, plastic, everything was thrown in.
I wouldn't touch any of the street grade meth that's available today with a 10 ft. straw. But if Walter White ever resurfaces all bets may be off. :-P

 
At November 24, 2014 9:46 AM, Anonymous Anonymous said...

The response 2 comments ago was solid. Best, most logical analysis and understanding of the situation with consideration for the facts, and secret agendas from those laying claims about meths health consequences.

The key concept of "misinterpretation" that the commenter introduced was also excellent! At the end of the day, even if methamphetamine is not as harmful as it is portrayed, regardless of which aspect the focus is upon, i.e. long-term vs short-term, the overwhelming majority of general recordings and understandings, thus far, cannot negate that severe health consequences from meth use are a strong possibility. Therefore, meth is STILL a very addictive substance due to its interaction with the the pleasure/reward dopamine receptors and that fact that the spiked increase in dopamine is actually double, if not more, than cocaine's high!!!

Habit forming and addictive written all over it. Never endorse this drug to anyone even if society exaggerates its negativity.

I also agree with your analysis of the scare tactic; logical maneuver for them. And would I try meth if I knew statistically 35% got addicted with severe health consequences ? Absolutely yes lol.

I understand the point you attempt to make at the end, but using analogies to "Car" and "plane" rides is literally comparing apples and oranges lol. Would an individual eat an ice cream with "35% chance of destroying life" ? Hell no, because its just an ice cream.

Meth doesn't "destroy life", it delivers a pleasurable, sought after high, and has an addictive potential that could result in health consequences; those set of aforementioned variables are not the same as the variables in a dangerous car or plane ride, or an ice cream that destroys your life LOL

Other than that 1-dimensional perspective, the comment was solid. Perhaps you were just lazy on that last element and figured you didn't need to over explain; but eh guess we will find out lol

 

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