Drug addiction – Methamphetamine
Introduction
Addictive drugs are chemical substances that alter the function of the nervous system, leading to a detrimental biopsychosocial disorder and severe withdrawal symptoms when resisting the stimuli from drugs. Long-term consumption of those chemicals can lead to physical and psychological dependence as well as increased drug sensitization, which can exacerbate the addiction.
Methamphetamine
Methamphetamine is a potent central nervous system stimulant that is primarily a drug for enhancing performance or for recreation. A less renowned function of it is a second-line treatment for ADHD (attention deficit hyperactivity disorder) as well as obesity. Further research has also suggested its effects as a potential traumatic brain injury treatment. The name refers to the racemic free base – a mixture of equal proportions of levomethamphetamine and dextromethamphetamine in their pure amine forms. However, its chloride salt form, more commonly known as crystal meth, is more famous.
History
Amphetamine, a precedent discovery of methamphetamine, was first synthesized in 1887 by a Chemist called Lazăr Edeleanu. Not long after that, from ephedrine, chemist Nagai Nagayoshi was able to produce methamphetamine. In the early 1930s, commercialized under the name Benzedrine, its uses were treatment for ADHD or a bronchodilator for asthma. During World War II, this drug was used to overcome fatigue and enhance alertness among soldiers. Its misuse began in the 1960s as a recreational drug.
Social issue
It is estimated by the United Nations Office on Drugs and Crime (UNODC) that Methamphetamine is one of the most prevalent drugs, with more than 36 millions users in 2020. Southeast Asia experienced the sharpest elevation in total number of drug users, with most of them being teenagers and young people. Areas with high numbers of drug users often reported alarmingly increased crime rates.
Mechanism of action
Methamphetamine increases the release of dopamine, which is a neurotransmitter affiliated with pleasure, reward and motor functions, by stimulating the presynaptic neurons as well as inhibiting its reuptake. Meth also blocks the absorption of other hormones like norepinephrine, and serotonin as a result of the inhibition of monoamine transporters (DAT, NET, and SERT), which increase the level of neurotransmitter in the synaptic gap. This elevation in the concentration of neurotransmitter enhances the synaptic activity, thus resulting in heightened alertness, euphoria, and increased energy. Chronic usage of meth led to an accumulation of neurotoxin, particularly in dopamine neurons; consequently, it contributes to long-term cognitive deficits and emotional disturbances.
Health consequences
Physical
It is a sympathomimetic drug that causes vasoconstriction and tachycardia; abnormal extra heart beats and irregular heart rhythms may also result from its usage, which can be lethal. The effects can also include loss of appetite, hyperactivity, dilated pupils, flushed skin, excessive sweating, increased movement, dry mouth and teeth grinding, altering the appearance significantly, thus creating the typical looks of drug users – the Meth mouth. This condition includes the abnormal loss of teeth and dry mouth, primarily due to bruxism, combination of detrimental chemicals and also poor oral hygiene. Another life-threatening consequence of using Meth is the risk of having sexually-transmitted diseases, such as HIV. Sharing needles while injecting the drugs and having prolonged sexual intercourse between users are traced back as the prime causes.
Psychological
Psychological effects typically associated with euphoria, dysphoria, changes in libido, alertness, apprehension and concentration, decreased sense of fatigue, insomnia. The impacts also include anxiety, depression, amphetamine psychosis, suicide, and violent behaviors. Methamphetamine is a direct neurotoxin to dopaminergic neurons in humans through processes like excitotoxicity, oxidative stress, metabolic compromise, UPS dysfunction, protein nitration, endoplasmic reticulum stress and p53 expression. Usage of Meth is also linked with elevated risk of Parkinson’s disease.
Dependence and withdrawal
Tolerance of users increase rapidly with regular recreational use, thus requiring more dosage each time to obtain the same effects. In dependent users of Meth, the severeness of withdrawal symptoms positively correlates with level of drug tolerance. When chronic consumption of Methamphetamine is discontinued abruptly, anxiety, drug craving, dysphoric mood, fatigue, increased appetite, increased movement can occur to users.
Treatment
Cognitive-behavioral therapy (CBT) can help patients to alter unhealthy thoughts and behaviors that contribute to their drug abuse. Research suggests that CBT will be effective in treating stimulant addiction when combined with contingency management. CM includes principles of positive reinforcement by providing tangible rewards when a target is achieved and withholding the rewards when the aim is not met.
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