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Breaking Bad Here? Not Yet?

January 17, 2014  |  Falmouth Enterprise

By Dr. Michael Bihari

Earlier this week the television program Breaking Bad received a Golden Globe Award for the best television drama series. The program, which recently ended, focused on a high school chemistry teacher who manufactured and distributed methamphetamine, popularly known as crystal meth.

Interestingly, in the past week I read a report about drug abuse in different regions of the country and a front page article in the Cape Cod Times about crystal meth use in Provincetown. 

Methamphetamine Abuse

Methamphetamine is a powerful, highly addictive stimulant that affects the central nervous system. Commonly known as meth, chalk, ice, and crystal, it takes the form of a white, odorless, bitter-tasting crystalline powder that easily dissolves in water or alcohol.

Meth comes in several forms and can be smoked, inhaled (snorted), injected, or taken by mouth. Smoking is the most common way of ingesting the drug.

Smoking or injecting meth puts the drug very quickly into the bloodstream and brain, which causes an immediate, intense “rush” and intensifies the drug’s potential for addiction. The rush lasts only a few minutes and is described as extremely pleasurable. Snorting produces euphoria—a high, but not an intense rush.

Meth is most often abused in a “binge and crash” pattern. Because the pleasurable effects of meth disappear even before the concentration of the drug in the blood falls significantly, users try to maintain the high by taking more of the drug. Some abusers indulge in a form of binging known as a “run,” foregoing food and sleep while continuing to use meth for up to several days.

Making Meth

Most of the meth abused in the U.S. is manufactured in “superlabs” here or most often in Mexico. The drug can easily made in small clandestine laboratories (as depicted in Breaking Bad), with relatively inexpensive over-the-counter medications such as pseudoephedrine, a common ingredient in cold medications.

To curb production of methamphetamine, Congress passed the Combat Methamphetamine Epidemic Act in 2005, that requires pharmacies to keep logs of purchases of products containing pseudoephedrine and limits the amount of those products you can purchase per day. Locally, these products are kept behind the counter with prescription medications.

Unfortunately, meth labs have adapted to these restrictions by “smurfing”: obtaining pseudoephedrine from multiple sources, below the legal thresholds, using multiple false identifications.

Effects of Meth Abuse

Meth is a powerful stimulant and even in small doses can increase alertness and physical activity and decrease appetite. The drug can also cause several cardiovascular problems, including rapid heart rate, irregular heartbeat, and increased blood pressure. An overdose of meth can cause elevated body temperature and convulsions and if not treated immediately, can result in death.

Chronic meth abusers may have difficulty feeling any pleasure other than that provided by the drug, fueling further abuse. Chronic abuser may cause significant anxiety, confusion, insomnia, mood disturbances, and violent behavior. Other serious symptoms include paranoia, hallucinations (hearing and seeing things), and delusions, such as the sensation of insects crawling under the skin. Psychotic symptoms can sometimes last for months or years after a person has quit abusing meth.

Long-term users of meth also suffer physical effects, including weight loss, severe tooth decay and tooth loss (“meth mouth”), and skin sores. The dental problems may be caused by a combination of poor nutrition and dental hygiene as well as dry mouth and teeth grinding caused by the drug. Skin sores are the result of picking and scratching the skin to get rid of insects imagined to be crawling under it.

Meth Use Around the Country

In a 2011 document, The National Drug Threat Assessment, the U.S. Department of Justice reported on the greatest drug threat by region as reported by state and local agencies. West of the Mississippi River, depending on specific region, the threat of meth abuse ranged from 50 percent to 79 percent. These same areas have the lowest threat of prescription pill and heroin use at less than 10 percent.

Interestingly, those numbers are reversed in the New England with a meth threat of less than 2 percent and one of the nation’s highest threat of prescription pill abuse at 26 percent and heroin at 36 percent. 

Hopefully methamphetamine will not increase locally; we have enough of a problem here dealing with prescription pill abuse and the resurgence of heroin.

Recommended Resources

National Drug Threat Assessment: A fascinating and disturbing document about drug use in the U.S.

MedlinePlus Methamphetamine: Access to in-depth information about meth

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