Learning Objectives

Practitioners who complete this training module will be able to…

1. Identify crystal meth by its various names and physical appearances, as well as

routes of administration

2. Identify factors that place people, especially gay men, at risk for using crystal meth

3. Understand the basic pharmacodynamics of crystal meth, and its effects on oral

and mental health

4. Identify typical presenting features of people who have an addiction to crystal meth

5. Understand the link between crystal meth use and changes in sexual behavior that

place a person at increased risk for acquiring/transmitting HIV and other STI’s, and

effects on overall health practices

6. Utilize methods to effectively engage and work with a person who is using crystal

meth

7. Locate community resources for persons at risk for or already using crystal meth

Routes of Administration Meth can be smoked, snorted, injected,

swallowed, or inserted anally through a

process sometimes referred to as “booty

bumping.”

While primarily affecting dopamine and

secondarily affecting serotonin and

norepinephrine neurotransmitters, meth

alters mood in different ways depending

on how it is taken.

The lure of meth is the sense of

increased focus, control, energy, and

decreased inhibitions that it brings.

Unlike other stimulants, meth is

made of dangerous synthetic

ingredients that the body cannot

metabolize.

Meth is powerfully addictive, and

people who use it frequently often

experience a rapid decline in

functioning.

Part of the reason meth is so

addictive has to do with its effects on

dopamine.

While a single dose of cocaine

releases approximately 400% more

dopamine than an orgasm and lasts 8-

20 minutes, a single dose of meth

releases 1500% more dopamine than

an orgasm and can last between 6-8

hours.

Straight to the brain.

1. Meth enters the brain cells from the

bloodstream.

2. It provides a storm of neurochecmical

activity causing the brain to release

chemical messengers, called

neurotransmitters (NTs), which stimulate

sections of the brain.

3. Meth affects the cerebral cortex and

causes one to experience a sense of

heightened energy and euphoria, as well

as a feeling of having elevated powers of

reasoning/thinking.

4. The drug also targets the limbic area, or

“pleasure center,” which regulates hunger,

flight, fight, and sex drive.

Cerebral Cortex

This area of the brain

is devoted to the

senses. It enables the

individual to see, hear,

smell, and touch. It

also facilitates speech

and the understanding

of words.

Limbic System

This system

influences instinctive

behavior similar to

animal responses that

relate to survival.

Brain Stem

This is the brain’s

lowest portion. It

controls basic

functions, such as

heart rate, breathing,

eating, and sleeping.

Body-Related

Stroke, seizures, tremors,

convulsions, headaches

Disturbances in heart

rhythm; increased heart rate

and respiration

Chest pain, cough,

respiratory failure

Numbness, decreased

appetite, and over long-term,

weight loss & malnourishment

Insomnia, hypersomnia,

fatigue

Dry mouth, burned lips, and

especially over long-term, worn

teeth and dental problems

Longer-term use can lead to

chemical burnout of pleasure

senses

Skin may feel tingly, which

can lead to vigorous scratching

and other associated skin

problems.

Dangerous rise in body

temperature or hyperthermia

Mood-Related

Depression, anxiety,

irritability, anger

Heightened alertness,

anxiety, or aggressiveness

Agitated, bizarre, and risky

behavior

Exhilaration and euphoria

Paranoia, hallucinations,

panic reactions

Possible psychosis and

paranoid thinking and behavior

(due to dopamine flooding)

Suicidal ideation

Physical and emotional

dependence

Source: NIDA InfoFacts

Other common features

of “Meth Mouth”

• Recurrent Acute

Necrotizing Ulcerative

Gingivitis (ANUG)

• Broken, atrophied, or

abscessed teeth

• Seriously bad breath

•Headaches, toothaches,

jaw and neck aches

(from tooth-grinding)

• High fever (from

infection)

• Nausea

• Difficulty eating

“Meth Mouth” and Acute Necrotizing Ulcerative Gingivitis (ANUG)The conditions of meth mouth are not always meth-related. “Meth mouth” symptoms could be caused by a combination

of factors in the individual, including prolonged stress, poor nutrition, poor oral hygiene, and consumption of large

amounts of sugar. Similarly, not all cases of ANUG appear with people who use meth. ANUG is characterized by

redness, swelling, and erosion of the gums, which causes the mouth to be very painful to the touch—even with a swab.

Often, people who have ANUG neglect their oral hygiene; have compromised immune systems because of malnutrition,

stress, or chronic diseases like HIV.

Why does meth use cause ANUG?Meth use causes ANUG for the following reasons:

While high and during a crash, people who use meth neglect their basic hygiene.

While high, people who use meth have a suppressed appetite, but their bodies still need energy, which

results in craving candy and sugary drinks.

During highs, people who use meth do not sleep, which weakens their immune system.

Meth causes excessive sweating and diarrhea which leads to dehydration. People who use meth will most

likely turn to soda or sugary drinks to re-hydrate.

Meth causes dry mouth because of excessive sweating and dehydration. Dry mouth increases the amount of

bacteria in a person’s mouth, which produces acid. The increased acid leads to quicker tooth decay.

Because people who use meth can experience extreme alertness and excitement while high, they often grind

their teeth and clench their jaws.

When people who use meth smoke the meth, the chemicals in meth are vaporized and heated. This irritates

the mouth and cause sores, which can become infected if left untreated.

When people who use meth snort meth, the chemicals drain down the back of the throat, which leads to

corrosion.

Meth also causes the constriction of blood vessels, which over time, completely kills the blood vessels to the

gums. Info from Martin S. Spiller, DMD (2000)

Another category also exists for

people who use meth only on

occasion and who do not

experience the problems

associated with greater-intensity

use.

Although not representative of all people who use meth, the following are some

typical characteristics:

More common in individuals who identify as males between the ages of

19 and 40.

People who use meth regularly or who are currently “high” may present

with a lot of “nervous energy”—jittery, anxious, and talkative with wide-

open eyes (despite their sensitivity to light).

Characteristics of people who are clinically addicted to meth and have been

using for a longer period of time include the following:

Weight loss, skin lesions, tooth decay

Loss of bone strength, liver damage, seizures and convulsions,

pneumonia, heart disease, strokes, aneurisms, Parkinson’s disease, and

ulceration of the cornea (from smoking methamphetamine).

Remember: Not all people who use meth present with these

characteristics, and it may not be possible to tell whether someone uses it

occasionally. However, knowing this information may be relevant to care

management considerations.

• The use of meth for sexual reasons has been found to be more common among men

who are HIV positive.

• Men who use crystal meth have been found to be three times more likely to have

unprotected receptive anal sex than men who do not use crystal meth.

Further information & resources… Treatment & referral resources…

Comprehensive resources for gay men on physical, sexual

spiritual health and substance use:

http://www.lifelube.org

Resources for professionals in addictions and recovery fields:

http://www.ATTCnetwork.org

Diffusion of Effective Behavioral Interventions (DEBI):

http://www.effectiveinterventions.org

Center on Halsted - State of Illinois AIDS/HIV & STD

Hotline: 1-800-243-2437 (1-800-AID-AIDS); Online Referral

Database: www.centeronhalsted.org/hot/admin/survey.cfm

Howard Brown Health Center - Crystal Clear:

773-388-1600

www.howardbrown.org/hb_services.asp?id=41

AIDS Foundation of Chicago: Crystal Meth & HIV/AIDS

http://www.aidschicago.org/prevention/meth.php

Test Positive Aware Network (TPAN):

http://www.tpan.org

Haymarket Center: 1-866-945-5786

www.hcenter.org

Lake Shore Hospital: 1-800-888-0560

www.chicagolakeshorehospital.com

ONDCP, DOJ & HHS collaboration on meth resources:

www.methresources.gov

Resources on prevention, intervention, treatment & recovery:

www.drugfree.org/

Crystal Meth Anonymous: CMA Meeting Directory

http://www.crystalmeth.org/find-a-cma-meeting.html

CMA Chicago:

www.crystalmethchicago.org

Self-test developed by Narcotics Anonymous:

http://www.friendsofchoices.org/TTT_meth.htm

CAGE and CAGE-AID assessment tools:

http://pubs.niaaa.nih.gov/publications/inscage.htm

http://www.associatedneurologists.com/cage.html

Substance Abuse Treatment Facility Locator Sponsored by

the Substance Abuse and Mental Health Services

Administration (SAMHSA):

http://findtreatment.samhsa.gov/

This will only take a minute and your

participation is important. Please click the link

below or cut and paste into your web-browser

to access the post-test. Thank you!

http://www.surveymonkey.com/s/XBR7X3X