9781422282557

D R U G A D D I C T I O N A N D R E C O V E R Y

Stimulants:

Meth, Cocaine, and Amphetamines

John Perritano

S E R I E S C O N S U L TA N T SARA BECKER, Ph.D. Brown University School of Public Health/Warren Alpert Medical School

D R U G A D D I C T I O N A N D R E C O V E R Y

Stimulants:

Meth, Cocaine, and Amphetamines

D R U G A D D I C T I O N A N D R E C O V E R Y

Alcohol and Tobacco

Causes of Drug Use

Drug Use and Mental Health

Drug Use and the Family

Drug Use and the Law

Hallucinogens: Ecstasy, LSD, and Ketamine

Intervention and Recovery

Marijuana and Synthetics

Opioids: Heroin, OxyContin, and Painkillers

Over-the-Counter Drugs

Performance-Enhancing Drugs: Steroids, Hormones, and Supplements

Prescription Drugs

Stimulants: Meth, Cocaine, and Amphetamines

D R U G A D D I C T I O N A N D R E C O V E R Y

Stimulants:

Meth, Cocaine, and Amphetamines

John Perritano

S E R I E S C O N S U L TA N T SARA BECKER, Ph.D. Brown University School of Public Health Warren Alpert Medical School

MASON CREST

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Designer: Annemarie Redmond Copyeditor: Peter Jaskowiak Editorial Assistant: Andrea St. Aubin Series ISBN: 978-1-4222-3598-0 Hardback ISBN: 978-1-4222-3611-6 E-Book ISBN: 978-1-4222-8255-7

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TABLE OF CONTENTS

Series Introduction . . . . . . . . . . . . . . . . . . 7 Chapter One: What Are Stimulants? . . . . . . . . . . . . 11 Chapter Two: Methamphetamine . . . . . . . . . . . . . 21 Chapter Three: Cocaine and Crack . . . . . . . . . . . . 35 Chapter Four: Amphetamines and Other Stimulants . . . . . . 47 Further Reading . . . . . . . . . . . . . . . . . . 58 Educational Videos . . . . . . . . . . . . . . . . . 59 Series Glossary . . . . . . . . . . . . . . . . . . . 60 Index . . . . . . . . . . . . . . . . . . . . . . 61 About the Author . . . . . . . . . . . . . . . . . . 64 About the Advisor . . . . . . . . . . . . . . . . . . 64 Photo Credits . . . . . . . . . . . . . . . . . . . 64 Sidebars: This boxed material within the main text allows readers to build knowledge, gain insights, explore possibilities, and broaden their perspectives by weaving together additional information to provide realistic and holistic perspectives. Research Projects: Readers are pointed toward areas of further inquiry connected to each chapter. Suggestions are provided for projects that encourage deeper research and analysis. Text-Dependent Questions: These questions send the reader back to the text for more careful attention to the evidence presented there. Educational Videos: Readers can view videos by scanning our QR codes, providing them with additional educational content to supplement the text. Examples include news coverage, moments in history, speeches, iconic sports moments and much more! Series Glossary of Key Terms: This back-of-the-book glossary contains terminology used throughout the series. Words found here increase the reader’s ability to read and comprehend higher-level books and articles in this field. Words to Understand: These words with their easy-to-understand definitions will increase the reader’s understanding of the text, while building vocabulary skills.

Key Icons to Look for:

SERIES INTRODUCTION

Many adolescents in the United States will experiment with alcohol or other drugs by time they finish high school. According to a 2014 study funded by the National Institute on Drug Abuse, about 27 percent of 8th graders have tried alcohol, 20 percent have tried drugs, and 13 percent have tried cigarettes. By 12th grade, these rates more than double: 66 percent of 12th graders have tried alcohol, 50 percent have tried drugs, and 35 percent have tried cigarettes. Adolescents who use substances experience an increased risk of a wide range of negative consequences, including physical injury, family conflict, school truancy, legal problems, and sexually transmitted diseases. Higher rates of substance use are also associated with the leading causes of death in this age group: accidents, suicide, and violent crime. Relative to adults, adolescents who experiment with alcohol or other drugs progress more quickly to a full-blown substance use disorder and have more co-occurring mental health problems. The National Survey on Drug Use and Health (NSDUH) estimated that in 2015 about 1.3 million adolescents between the ages of 12 and 17 (5 percent of adolescents in the United States) met the medical criteria for a substance use disorder. Unfortunately, the vast majority of these IF YOU NEED HELP NOW . . . SAMHSA’s National Helpline provides referrals for mental-health or substance-use counseling. 1-800-662-HELP (4357) or https://findtreatment.samhsa.gov SAMHSA’s National Suicide Prevention Lifeline provides crisis counseling by phone or online, 24-hours-a-day and 7 days a week. 1-800-273-TALK (8255) or http://www.suicidepreventionlifeline.org

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When pro- and anti-drug information sit side-by-side online, it can be hard for kids to separate fact from fiction.

adolescents did not receive treatment. Less than 10 percent of those with a diagnosis received specialty care, leaving 1.2 million adolescents with an unmet need for treatment. The NSDUH asked the 1.2 million adolescents with untreated substance use disorders why they didn’t receive specialty care. Over 95 percent said that they didn’t think they needed it. The other 5 percent reported challenges finding quality treatment that was covered by their insurance. Very few treatment providers and agencies offer substance use treatment designed to meet the specific needs of adolescents. Meanwhile, numerous insurance plans have “opted out” of providing coverage for addiction treatment, while others have placed restrictions on what is covered. Stigma about substance use is another serious problem. We don’t call a person with an eating disorder a “food abuser,” but we use terms like “drug abuser” to describe individuals with substance use disorders. Even treatment providers often unintentionally use judgmental words, such as describing urine screen results as either “clean” or “dirty.” Underlying this language is the idea that a substance use disorder is some kind of moral failing or character flaw, and that people with these disorders deserve blame or punishment for their struggles.

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And punish we do. A 2010 report by CASA Columbia found that in the United States, 65 percent of the 2.3 million people in prisons and jails met medical criteria for a substance use disorder, while another 20 percent had histories of substance use disorders, committed their crimes while under the influence of alcohol or drugs, or committed a substance-related crime. Many of these inmates spend decades in prison, but only 11 percent of them receive any treatment during their incarceration. Our society invests significantly more money in punishing individuals with substance use disorders than we do in treating them. At a basic level, the ways our society approaches drugs and alcohol— declaring a “war on drugs,” for example, or telling kids to “Just Say No!”— reflect a misunderstanding about the nature of addiction. The reality is that addiction is a disease that affects all types of people—parents and children, rich and poor, young and old. Substance use disorders stem from a complex interplay of genes, biology, and the environment, much like most physical and mental illnesses. The way we talk about recovery, using phrases like “kick the habit” or “breaking free,” also misses the mark. Substance use disorders are chronic, insidious, and debilitating illnesses. Fortunately, there are a number of effective treatments for substance use disorders. For many patients, however, the road is long and hard. Individuals recovering from substance use disorders can experience horrible withdrawal symptoms, and many will continue to struggle with cravings for alcohol or drugs. It can be a daily struggle to cope with these cravings and stay abstinent. A popular saying at Alcoholics Anonymous (AA) meetings is “one day at a time,” because every day of recovery should be respected and celebrated. There are a lot of incorrect stereotypes about individuals with substance use disorders, and there is a lot of false information about the substances, too. If you do an Internet search on the term “marijuana,” for instance, two top hits are a web page by the National Institute on Drug Abuse and a page operated by Weedmaps, a medical and recreational

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marijuana dispensary. One of these pages publishes scientific information and one publishes pro-marijuana articles. Both pages have a high-quality, professional appearance. If you had never heard of either organization, it would be hard to know which to trust. It can be really difficult for the average person, much less the average teenager, to navigate these waters. The topics covered in this series were specifically selected to be relevant to teenagers. About half of the volumes cover the types of drugs that they are most likely to hear about or to come in contact with. The other half cover important issues related to alcohol and other drug use (which we refer to as “drug use” in the titles for simplicity). These books cover topics such as the causes of drug use, the influence of drug use on the family, drug use and the legal system, drug use and mental health, and treatment options. Many teens will either have personal experience with these issues or will know someone who does. This series was written to help young people get the facts about common drugs, substance use disorders, substance-related problems, and recovery. Accurate information can help adolescents to make better decisions. Students who are educated can help each other to better understand the risks and consequences of drug use. Facts also go a long way to reducing the stigma associated with substance use. We tend to fear or avoid things that we don’t understand. Knowing the facts can make it easier to support each other. For students who know someone struggling with a substance use disorder, these books can also help them know what to expect. If they are worried about someone, or even about themselves, these books can help to provide some answers and a place to start.

—Sara J. Becker, Ph.D., Assistant Professor (Research), Center for Alcohol and Addictions Studies, Brown University School of Public Health, Assistant Professor (Research), Department of Psychiatry and Human Behavior, Brown University Medical School

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WORDS TO UNDERSTAND

euphoria: feelings of extreme happiness. neurotransmitter: a chemical that carries messages between nerve cells and between nerve cells and muscles. panic attacks: sudden, overwhelming feelings of fear or anxiety that prevent a person from functioning. paranoia: unreasonable suspicion of other people. synthesize: to produce a new substance through various chemical processes. tolerance: the state of needing more of a particular drug in order to achieve the same effect.

CHAPTER ONE

WHAT ARE STIMULANTS?

Samantha (“Sam”) lived in a suburban dream world of manicured lawns, soccer games, and visits to the mall. Even the name of her town, Walnut Creek, conjured images of lazy Sundays and barbecues. The family had two boats and a large-screen TV to go along with their four-bedroom house. But Sam was not having any of that. She didn’t want anything to do with her sister, her parents, or their middle-class life. As she later told the San Francisco Chronicle , she didn’t fit in. Sam took her first drink when she was 16. It was a beer, and she liked it. She smoked pot, too, and she liked that even more. She dabbled in cocaine, and a few weeks later snorted methamphetamine, also known as crystal meth. Sam remembers it clearly. She was at a friend’s house with four girls. Each put a bit of meth up their nose. Then they put a bit more. Sam was hooked. Someone mentioned meth was called “tweak,” and Sam began “tweaking” every day. The drug made her happy. Sam had struggled with depression in the

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12 STIMULANTS: METH, COCAINE, AND AMPHETAMINES

Heavy users like Sam will get their drugs wherever they can.

past, and meth held her feelings of depression at bay. She had also struggled with her weight, and drugs helped her to lose weight quickly. She became more sociable. Life was good—or so it seemed. Reality soon set in, however. And when that happened, Sam’s life spiraled out of control. Sam changed. Her appearance became more ragged. Her weight dropped from 145 to 100 pounds and she started losing her hair. Her school work suffered and she often showed up late for class. She started fighting with family and friends. Her parents tried grounding her, but she just snuck out her bedroom window and continued to use drugs. Sam’s drug use put a strain on her family—her mother was already exhausted by muscular dystrophy, and her dad started to drink heavily. At one point, the meth supply ran low, so Sam used amphetamines and smoked pot instead. A few months later, the meth was back, and Sam was back using it.

13 CHAPTER ONE: WHAT ARE STIMULANTS?

That month she smoked meth every day, and things went from bad to worse. Sam stole from her parents, using their money to buy drugs. When her father confronted her, she ran away. That night she stayed at a friend’s house and smoked pipe after pipe until morning. When she came back, her dad sat her down and asked her if she wanted to get help. Sam thought about it—about the effects on her body, her family, her friends, and her schoolwork—and finally agreed.

HOW STIMULANTS WORK

Sam’s drug use involved various types of stimulants. Stimulants are drugs that speed up activity in the brain and spinal cord; this causes the heart to beat faster and blood pressure to increase. People taking stimulants often feel more alert and energetic. Stimulants can be smoked, inhaled, or swallowed. The most commonly misused stimulants are meth, amphetamines, cocaine, and medications used to treat attention-deficit hyperactivity disorder (ADHD), a condition in which children have difficulty controlling their behavior. Some stimulants, such as caffeine, have been a part of foods and beverages for thousands of years. Starting in the 19th century, stimulants were created in laboratories to treat ailments such asthma, obesity, neurological disorders, and many other illnesses. Today, they are one of the most misused drug categories. The United Nations Office on Drugs and Crime estimates that 24.7 million people across the globe misuse 500 metric tons (551 tons) of stimulants a year. Once inside the body, stimulants affect the brain by enhancing the effects of several key neurotransmitters . Neurotransmitters are chemicals that allow billions of brain cells, called neurons, to communicate with each other. Stimulants especially enhance the effect of two neurotransmitters— dopamine and norepinephrine. Stimulants increase production of dopamine,

14 STIMULANTS: METH, COCAINE, AND AMPHETAMINES

the “feel good” neurotransmitter. It can make you feel wonderful when your body produces it. But too much dopamine can cause a person to become nervous or hallucinate. That’s because the chemical affects how a person moves and thinks. Norepinephrine works like adrenaline, which the body releases when a person gets excited, fearful, or angry. Norepinephrine narrows the body’s blood vessels and increases blood pressure and sugar levels. It gives a person more energy.

Caffeine is a hugely popular stimulant drug. It’s obviously much safer than a lot of the other stimulants discussed here, but it’s still a drug.