As an addictions professional, you are no doubt painfully aware that use of methamphetamine, commonly known as meth, has skyrocketed over the past decade.  Millions of Americans have been seduced by this poisonous drug, lured by its promise to produce a cheap high.

National surveys indicate that some 12 million Americans have used meth, and a full four percent of eighth graders have tried it at least once. Obstetricians across the country are shocked by growing legions of infants born addicted to this highly toxic drug, as a result of their mothers' addictive use while pregnant  (Johnson, 2005).

Methamphetamine, a chemical cousin to amphetamine, was synthesized by a Japanese chemist in 1919. The drug was widely used during World War II to keep soldiers awake and focused during intensive combat missions. In America, meth was legally produced in the 1950s and became popular among homemakers, college students, athletes, truck drivers - and anyone else who was seeking an extra boost of energy. During the 1970s, the drug acquired the nickname "crank," as it was associated with motorcycle gangs in California and often smuggled in motorcycle crankcases.

Flash forward to the past decade, where methamphetamine use - once a West Coast phenomenon - has reached epidemic proportions throughout the country. Meth is now the second most widely used illicit substance, after marijuana, and meth users now account for a large proportion of the caseloads of alcohol/drug treatment programs in many parts of the country (Johnson, 2005; Braswell, 2006). (Ironically, as I write this article I'm looking out my office window, watching our gardener cut our grass. Recently, he shared with me that he lost his sister to meth addiction last year.)

Lure of meth and its deadly consequences

As Dirk Johnson vividly portrays in his book Meth: The Home-Cooked Menace, new users are rapidly seduced by the lure of this highly potent drug. Users report that the rush from cocaine pales in comparison to a meth-induced high. Initially, the drug produces stunning bursts of energy, heightened powers of concentration, a rush of euphoria, a heightened sense of self-esteem and an enhanced sex drive. The energy boost associated with meth ingestion presents a particular appeal to people working long hours at grueling jobs. As meth initially produces an abundance of dopamine, the sex drive is intensified. Frequently, sex becomes an obsession, often leading to patterns of abuse and heightened risk of HIV infection, as all precautions pertaining to safe sex are cast aside.

Unfortunately for the user, tolerance rapidly sets in, and the initial sensation of euphoria associated with "tweaking" gives way to a pervasive sense of desperation, as the addiction tightens its deadly grip. Habitual use leads to major changes in brain chemistry, as ingestion promotes the release of large amounts of the neuro-transmitters dopamine and serotonin in the limbic system, triggering the pleasure centers of the brain. Over time, however, the flood of mood-enhancing neuro-transmitters causes major interference with rational decision making processes, controlled by the prefrontal cortex. Habitual use obscures the user's ability to recognize and effectively respond to basic tasks essential to day-to-day living, and one's ability to "take care of business" becomes severely compromised.  At the same time, the brain loses its ability to produce dopamine and serotonin on its own, leading to deep depression when meth is not available, and a constant obsession with using the drug (Johnson, 2005; Gottlieb, 2006).

In short, both the physical and psychological consequences of meth addiction are devastating. Adverse effects on the various bodily systems include emaciation of the body stemming from chronic malnutrition; loss of teeth due to severe gum damage; and profound damage to the central nervous system. Even in young people, meth can cause blood pressure to soar so high that a user can suffer a stroke. Meth also can lead to serious respiratory problems, irregular heartbeat and extreme anorexia. Deadly convulsions associated with overuse are not uncommon. Psychiatrists claim that long-term meth users display symptoms that are virtually indistinguishable from paranoid schizophrenia, and severe depression typically accompanies withdrawal from the drug, stemming from alteration to the brain chemistry associated with chronic use. Cross-addiction frequently occurs among meth users, as they turn to alcohol and other sedatives to counter the feeling of constantly being wired and on the edge (Johnson, 2005).

One of the most dramatic illustrations of meth's devastating consequences is portrayed in the recently released documentary No More Sunsets (Suhr, 2006). This film vividly chronicles the struggles of 34-year-old Shawn Bridges as he lies in a hospital bed, slowly dying from congestive heart failure brought on by his addictive use of meth. Bridges suffered a heart attack at age 26, which his father attributes to his binging on meth. The former truck driver's heart is now enlarged two or three times its normal size, and physicians report that the bottom half of his heart is dead. In the words of Shawn's father, "He's got a 34-year-old body on the outside, with a 70-to 80-year-old man on the inside."

Women and meth

Methamphetamine abuse is, in fact, an "equal opportunity addiction," and the drug presents a special appeal for women. In fact, close to half of all users entering treatment programs are female. In a culture obsessed with slender female body types bordering on anorexia, the drug is highly seductive to many teenage girls and women. Users find that they can fit into a size four dress after just a few month's use, and are thrilled to see men's heads turning in their direction. Unfortunately, female users often fall into abusive and controlling relationships with men who are also on meth, and serious patterns of domestic violence are the rule rather than the exception (Johnson, 2005).

Frequently, young women fail to practice birth control as they indulge in meth, and one of the saddest by-
produces of maternal addiction is the birth of meth-addicted babies as a consequence of in utero exposure during pregnancy. Consequences of prenatal drug exposure affecting these children can be devastating - meth-exposed infants typically experience severe physical withdrawal symptoms, the natural urge to suckle the mother's breast is stifled, and these infants are often severely underweight and undernourished. In my home state of Washington, an estimated 10,000 babies born in recent years have been exposed to meth and other drugs prenatally, and only a small proportion of these infants are receiving intensive treatment (Gottlieb, 2006).

Maternal addiction to methamphetamine and other drugs wields a heavy toll on family ties. In my own family, one of my stepdaughters was addicted to "speed" and alcohol from age 15 through her late 30s. Several years ago she lost custody of her two daughters as a consequence of her addiction. Fortunately, she chose to enter a court-referred residential treatment program as an alternative to incarceration, and she recently celebrated her sixth sobriety birthday! She has regained custody of her children, is working full-time at a local supermarket and has truly taken charge of her life. Her two daughters, I am pleased to report, are now doing extremely well. In fact, as of this writing they are visiting us in our new home in Washington.

Breaking free from meth

Due to the insidious nature of meth addiction, coupled with the fact that it may take up to two years for the addict's brain chemistry to normalize, many treatment authorities advocate a combination approach to treatment. Combination treatment often employs an initial residential phase, followed by intensive outpatient care, and regular participation in 12-step meetings or another recovery-focused support group. If you are counseling a client who is either struggling with meth-related issues, or witnessing a loved one caught up in the throes of this addiction, I cannot overemphasize the importance of urging them to immediately initiate treatment. In most parts of the country, skilled help is available for addicts who are ready to seek help, regardless of their ability to pay. Check with your local health department or the local chapter of the National Council on Alcoholism and Drug Dependence for assistance in linking up with appropriate treatment resources. 

In addition to professional treatment, encouraging the recovering addict to embrace a healthy lifestyle is vitally important in laying a solid foundation for lasting recovery. This is especially true in the case of methamphetamine addiction, due to the treacherous nature of this addiction, coupled with the protracted post-acute withdrawal period that occurs as the addict's brain chemistry and physiological systems slowly begin to heal.

Briefly stated, a wellness-oriented lifestyle bolsters the recovery process in a number of important areas:

• Exercise: Regular exercise is extremely helpful in recovery from meth addiction, as exercise strengthens both the body and the mind, while reducing risk of relapse (Newport, 2004; Gorski, 1989). In addition to providing an effective vehicle for releasing day-to-day stresses, exercise facilitates the body's production of endorphins, chemical messengers that stimulate the pleasure centers of the brain. Increased production of endorphins has a calming effect on the mind and body, and also is associated with increased energy and alertness.

Indeed, I firmly believe that motivating a recovering meth addict to engage in a regular program of vigorous exercise constitutes a critically important component of his or her overall recovery program. Exercise is a powerful antidepressant, and the increased production of endorphins associated with exercise can be extremely beneficial in helping former users relearn how to access the pleasure centers of their brains, without needing to rely on artificial chemical crutches. Brisk walking is my favorite recommended exercise regimen, as it is a readily accessible form of exercise that virtually anyone can engage in.

• Nutrition: Laying a solid nutritional foundation for one's recovery is critically important in breaking free from meth addiction. It is essential that the recovering addict learn the basics of sound nutrition and transition to a healthy diet, in order to restore normal body weight while repairing damage to the central nervous system and other bodily systems. Female users, who may have been lured down this deadly path with the promise of a trim figure, may require special counseling to help promote healthier expectations regarding their body image. (In my book The Wellness-Recovery Connection, I devote two full chapters to laying a strong nutritional foundation for recovery.)
• Oral Hygiene: Dental care is an important adjunct to addiction treatment, in attempting to halt and reverse severe damage to the gums and teeth that often accompanies chronic meth usage. This damage stems from the corrosive nature of the chemicals used in making meth, as well as from constant grinding of the teeth by wired addicts. Treatment programs need to establish linkages with free clinics and other community resources in an effort to avail their clients of effective dental care.
• Curbing Dangerous Substitute Addictions: As the newly recovering addict enters sobriety, dangerous "substitute addictions" often come to the fore. These can include nicotine addiction, excessive consumption of caffeine and sugar, and eating disorders (Newport, 2004). These addictive tendencies threaten to undermine the overall quality of recovery, and should be addressed as part and parcel of a truly comprehensive approach to treatment. Nicotine addiction is the leading preventable cause of death in America today, and the number one cause of death for people in recovery. Cigarette smoking among women in child-bearing years is of particular concern, as fetal exposure to nicotine in utero as a consequence of maternal smoking is associated with heightened risk of low weight births, stillbirths, birth defects and infant mortality (March of Dimes, 2006).
• Stress Management: Learning basic stress management skills, such as yoga, meditation and other mind-quieting techniques, also plays an important role in promoting successful recovery from meth addiction. It is critically important that everyone entering recovery learns how to effectively manage day-to-day stresses, without needing to turn to mind-altering drugs.
• Spiritual Grounding: Attaining a firm spiritual grounding in one's recovery is critically important in recovery from any addictive disorder. I believe this is especially true in recovery from meth addiction, where a secure anchoring in serenity and hopefulness is of paramount importance in successfully navigating the trying early phases of recovery. From a practical perspective, helping the recovering addict work through the process of making amends, while staking out a strong sense of central purpose in his or her life, constitutes a critically important component of the essential work to be accomplished throughout the early, middle and latter stages of recovery.
• Embracing a Wellness Lifestyle as a Positive Addiction: Perhaps most important of all, the process of transitioning to a healthy lifestyle can serve as a powerful "positive addiction," helping to fill the void that is created when one attempts to break free from methamphetamine and other toxic substances (Glasser, 1976; Newport, 2004). I firmly believe that encouraging the recovering addict to embrace a healthy lifestyle serves to strengthen his or her commitment to recovery, while concurrently bolstering one's self-esteem and overall enjoyment of life. In summary, I believe that a wellness-oriented lifestyle goes hand in hand with professional treatment in healing the damage associated with meth addiction, while promoting lasting recovery, improved health status outcomes and dramatically improved quality of life.

Until next time - To your health!

References

Braswell, Sterling R. (2006). American Meth: A History of the Methamphetamine Epidemic in America. Universe, Inc.

Glasser, William. Positive Addiction. New York: Harper Collins, 1976.

Gorski, Terrence T. Passages Through Recovery: An Action Plan for Preventing Relapse. Center City, MN: Hazelden, 1989.

Gottlieb, Paul. (2006). Meth and Motherhood: Parts 1 and 2. Peninsula Daily News, April 30 and May 1, 2006.

Johnson, Dirk. (2005). Meth: The Home-Cooked Menace. Center City, MN: Hazelden.

March of Dimes. (2006). Quick Reference: Smoking During Pregnancy. March of Dimes website www.marchofdimes.com. 

Newport, John. (2004). The Wellness-Recovery Connection: Charting Your Pathway to Optimal Health While Recovering from Alcoholism and Drug Addiction. Deerfield Beach, FL: Health Communications, Inc. 

Suhr, Jim. "Dying addict shares misery of meth with filmmaker in bid to save others." Associated Press, May 21, 2006. 

This article is published in Counselor,The Magazine for Addiction Professionals, October 2006, v.7, n.5, pp.46-50.

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