Methamphetamine Resources

ADDITIONAL RESOURCES

Methamphetamine Abuse and Dependence: An Update / Richard A. Rawson, PhD, Rachel Gonzales, MPH, and Walter Ling, MD
The problems associated with methamphetamine (MA) abuse and dependence in the United States (U.S.) have significantly expanded in the 2000s, as witnessed by the growing presence of MA-abusing populations within the treatment, medical, and legal systems. This paper provides an update on the current MA problem. The primary goals of the authors are to help clinicians improve their programs and services by providing them with the necessary information needed to increase their clinical knowledge and skills so that they can effectively treat individuals who abuse or are dependent on MA.

The NSDUH Report:: National Survey on Drug Use and Health 2002-04
NSDUH Report Sept. 16, 2005 SAMHSA Office of Applied Studies (powerpoint)

Emerging research on methamphetamine / Jane Carlisle Maxwell
Purpose of review: To describe and review the literature published on methamphetamine in 2003–2004, with a particular focus on patterns of use, its effects on the user and society, and progress being made towards effective treatment strategies.
Recent findings: The methamphetamine epidemic continues to grow, dominating drug use trends in many parts of the world, and signifying an increasing need for effective treatment. In addition to the already-documented physical effects of the drug, preliminary evidence suggests methamphetamine dependence may cause long-term neuronal damage. Recently abstinent users have been found to do poorly on neurocognitive tests of attention and motor skills, both factors that can adversely affect treatment outcomes. Methamphetamine use is also implicated in aggression and violence and there are increasing presentations to emergency rooms. It also affects the developing fetus, as well as children and adults who are exposed to toxic chemicals at laboratory sites. Outpatient programs, such as the Matrix Model, show improved in-treatment performance. Case management was found to be an effective intervention. Agonist-type pharmacotherapy in combination with quality behavioral therapy should produce benefit and a reduction in risks caused by stimulant abuse.
Summary: The increasing evidence that methamphetamine has adverse effects on the human brain indicates the pressing need for effective prevention and treatment approaches. There is a need to take these findings, particularly those that involve cognitive deficits, into consideration in current treatment programs and when developing new treatments.

A multi-site comparison of psychosocial approaches for the treatment of methamphetamine dependence / Richard A. Rawson, et al
ABSTRACT
Aims The Center for Substance Abuse Treatment (CSAT) Methamphetamine Treatment Project (MTP) is the largest randomized clinical trial of treatments for methamphetamine (MA) dependence to date. The objective of the study was to compare the Matrix Model, a manualized treatment method, with treatmentas usual (TAU) in eight community out-patient settings in the Western United States.
Design Over an 18-month period between 1999 and 2001, 978 treatment seeking, MA-dependent people were randomly assigned to receive either TAU at each site or a manualized 16-week treatment (Matrix Model).
Setting The study was conducted as an eight-site out-patient trial, with six sites located in California and one each in Montana and Hawaii.
Findings In the overall sample, and in the majority of sites, those who were assigned to Matrix treatment attended more clinical sessions, stayed in treatment longer, provided more MA-free urine samples during the treatment period and had longer periods of MA abstinence than those assigned to receive TAU. Measures of drug use and functioning collected at treatment discharge and 6 months post-admission indicate significant improvement by participants in all sites and conditions when compared to baseline levels, but the superiority of the Matrix approach did not persist at these two timepoints.
Conclusions Study results demonstrate a significant initial step in documenting the efficacy of the Matrix approach. Although the superiority of the Matrix approach over TAU was not maintained at the post-treatment timepoints, the in-treatment benefit is an important demonstration of empirical support for this psychosocial treatment approach.

The Meth Epidemic in America: Two Surveys of U.S. Counties: The Criminal Effect of Meth on Communities, The Impact of Meth on Children / National Association of Counties (July 5, 2005)

The nature, time course and severity of methamphetamine withdrawal / Catherine McGregor, et al
Aims:
To characterize the natural history of methamphetamine withdrawal during the first 3 weeks of abstinence.
Design: Cross-sectional study with comparison group.
Setting: A substance use treatment facility in Chiang Mai Province, Thailand.
Participants: The sample comprised 21 in-patients undergoing treatment for methamphetamine dependence. Nine age- and sex-matched non-dependent individuals provided comparison data.
Measurements: Instruments including: the Amphetamine Withdrawal Questionnaire, a modified version of the Cocaine Selective Severity Assessment, Clinical Global Impression scale and the St Mary’s Hospital Sleep Questionnaire were completed daily for the first 3 weeks of abstinence.
Findings: Methamphetamine withdrawal severity declined from a high initial peak within 24 hours of the last use of amphetamines reducing to near control levels by the end of the first week of abstinence (the acute phase). The acute phase of amphetamine withdrawal was characterized by increased sleeping and eating, a cluster of depression-related symptoms and less severely, anxiety and craving-related symptoms. Following the acute withdrawal phase most withdrawal symptoms remained stable and at low levels for the remaining 2 weeks of abstinence.
Conclusions: This study has provided evidence of a methamphetamine withdrawal syndrome that can be categorized into two phases, the acute phase lasting 7–10 days during which overall symptom severity declined in a linear pattern from a high initial peak, and a subacute phase lasting at least a further 2 weeks.

Will the Methamphetamine Problem Go Away? / Richard A. Rawson, PhD; M. Douglas Anglin, PhD; Walter Ling, MD
ABSTRACT. Methamphetamine use has clearly reached epidemic proportions in large parts of the western and midwestern US. Because of the regional specificity of methamphetamine use, there is speculation that itmay be a temporary problem and not a long-term public health problem. Unfortunately there are a number of factors that suggest that significant methamphetamine problems may persist or even expand. For this reason, it is important that federal law enforcement, prevention, research and treatment agencies prepare strategies to address the likelihood of this persisting problem. This article reviews the issues concerning the future of the methamphetamine problem in the US and provides some recommendations for setting priorities to address the problem.

Two New Surveys of U.S. Counties: “The Effect of Meth Abuse on Hospital Emergency Rooms” / “The Challenges of Treating Meth Abuse” National Association of Counties (January, 2006)