Crystal meth withdrawal – It’s not like heroin, but don’t expect it to be easy

Heroin, or opiate, withdrawal symptoms is the gold standard of addiction withdrawal. Imagine the worst flu of your life, multiply it by 1000, and then imagine knowing that taking a hit of this stuff will make it all better. Think sweats, fever, shaking, diarrhea, and vomiting. Think excruciating pain throughout as your pain sensors get turned back on after being blocked for way too long. Now you have an abstract idea of the hell and it’s no wonder why heroin withdrawal has become the one every other withdrawal is judged against.

Crystal meth withdrawal

Withdrawing from crystal meth use is nothing like opiate withdrawal and there’s no reason that the withdrawal symptoms should be. Opiates play a significant role in pain modulation and opioid receptors are present in peripheral systems in the body, which is the reason for the stomach aches, nausea, and diarrhea. Dopamine receptors just don’t play those roles in the body and brain, so withdrawal shouldn’t be expected to have the same effect.

But dopamine is still a very important neurotransmitter and quitting a drug  that has driven up dopamine release for a long time should be expected to leave behind some pain, and it does.

One of the important functions of dopamine is in signaling reward activity. When a dopamine spike happens in a specific area of the brain (called the NAc), it signifies that whatever is happening at that moment is “surprisingly” good. The parentheses are there to remind you that the brain doesn’t really get surprised, but the dopamine spike is like a reward signal detector, when it goes up, good things are happening.

Well guess what? During crystal meth withdrawal, when a crystal-meth user stops using meth, the levels of dopamine in the brain go down. To make matters worse, the long-term meth use has caused a decrease in the number of dopamine receptors available which means there’s not only less dopamine, but fewer receptors to activate. It’s not a surprise than that people who quit meth find themselves in a state of anhedonia, or an inability to feel pleasure. Once again, unlike the heroin withdrawal symptoms, anhedonia doesn’t make you throw up and sweat, but it’s a pretty horrible state to be in. Things that bring a smile to a normal person’s face just don’t work on most crystal-meth addicts who are new to recovery. As if that wasn’t bad enough, it can take as long as two years of staying clean for the dopamine function of an ex meth-addict to look anything like a normal person’s.

This anhedonia state can often lead to relapse in newly recovered addicts who are simply too depressed to go on living without a drug that they know can bring back a sense of normalcy to their life. The use of crystal-meth causes the sought-after spike in dopamine levels that helps relieve that anhedonic state.

When it comes to more physiological sort of withdrawal symptoms, the meth addict doesn’t have it that bad, I guess. After an extended period of sleep deprivation and appetite suppression that are some of the most predictable effect of meth, the average addict will do little more than sleep and eat for the first week, or even two, after quitting the drug. Many addicts experience substantial weight gain during this period as their metabolism slows and their caloric intake increases greatly. Like everything else, this too shall pass. With time, most addicts’ metabolism return to pre-use levels and their appetite catches up and returns to normal as well. Still, there’s no doubt that a little exercise can help many addicts in early recovery steer their bodies back on track.

There’s some research being talked about around the UCLA circles to see if detoxification from meth may help people do better in treatment for meth addiction by reducing the impact of their withdrawal. Detox before addiction treatment is an accepted fact in opiate and benzodiazepine addiction, but because of the supposedly “light” nature of crystal meth withdrawal, it’s been ignored. Hopefully by now, you realize that was a mistake.

Meth + Viagra = HIV and STDs?? Sex marathons and their danger

Co-authored by: Jamie Felzer

Sex marathons…what does that sound like to you?  Lots of sex, with multiple partners, for an extended period of time? Bingo! Come on down and collect a prize!!!

Why sex marathons can be dangerous

The combination of crystal meth and Viagra can leave users at a very high risk for contracting sexually transmitted infectionsSex marathons are where people have sex for a prolonged period of time, and often do so with multiple partners where they may seldom use protection.  Clearly this could cause some potential dangers.   All these dangers CAN be prevented (by using condoms, lubrication, and strict hygiene).  What makes these activities even more dangerous is the addition of crystal meth to help participants stay up for these long sex marathons and the prescription drug, Viagra to make sure they can perform sexually during these marathons. Put those two ingredients together and you have a powerfully volatile cocktail.

A collection of studies have been conducted with both hetero- and homosexual males involving the combination of these substances.  It was shown that those who generally used Meth were more likely to have sex, have sex with multiple partners and also more frequently not use protection. Particularly worrisome was the finding that homosexual men who used Meth and were HIV positive were the least likely to use condoms and were also the most depressed. members of this population often had 10 or more sex partners, thus quickly promoting the spread of STDs including HIV (if protection is not used).

Protection is VITAL in combating the spread of HIV

Taken together, these studies reveal that the consumption of Viagra is highly associated with insertive sexual behaviors.  This means that heterosexual men on Viagra more often partake in anal sex and homosexual men on Viagra more often partake in insertive sexual behaviors rather than receptive sexual behaviors. All insertive sexual behaviors have a high chance of causing the transmission of STDs because of the high amount of blood flow and low amount of protective tissues that reside in that area of the body.

Remember the ways of contracting HIV: Anal sex, vaginal sex, IVs and any other form of infectious blood mixing, and mother to child transmission.

Those who used a cocktail of Viagra, Meth and poppers (a form of Nitrates) increased the risk of contracting HIV, Syphilis and Hepatitis B over 100%!! While these drugs can sometimes be used without major complications, the concoction of them together creates a dangerous mix that puts everyone involved at a higher risk of contracting blood-borne diseases.  So, participate in sex marathons at your own risk but no matter what know your status and be sure to use protection!  Regardless of what the studies show, you can beat statistics by using caution during sex.

Citations:

Fisher, Dennis G; Reynolds, Grace L; Napper, Lucy E. Current Opinion in Infectious Diseases. Issue: Volume 23(1), February 2010, p 53–56.

Fisher, D. G., Malow, R., Rosenberg, R., Reynolds, G. L., Farrell, N., & Jaffe, A. (2006). Recreational Viagra use and sexual risk among drug abusing men. American Journal of Infectious Diseases, 2, 107-114.

Top ten list of things I’m grateful for – Recovery gifts in my life

Hi everyone,

The wife and I are taking our honeymoon trip for the next two weeks, which might slow down my writing a bit. Still, in appreciation of the life I live now, and in anticipation of the new year, I’ve compiled a list of things I’m grateful for right now:

Top ten list of gratitude

10 – Every night of rest that isn’t followed by obsessive thoughts about the money I owe, the money owed to me, and the endless drug runs I have to go on that day.

9 – The knowledge that every one of my friends is in my life because they appreciate who I am as a person, not for the money I have or the drugs that I’m holding.

8 – The talks I have with my parents – no longer weighed down by lies, half-truths, and manipulations – full of life, love, and appreciation of one another.

7 – Being there for my father as he struggles with cancer. Not looking to get anything but simply helping because I can.

6 – Getting close to finishing my Ph.D. and finally achieving the goal I set out for myself when I left jail, and with it my old life, behind.

5 – Helping others, who are struggling like I used to, to find the life they are looking for.

4 – Finding the love of my life and being present enough to know it.

3 – Understanding that life isn’t always easy, but that living properly and acting in a way that improves my life and that of others is the only way to get through it all.

2 – Being able to admit when I’m wrong and take in the guidance of others who love me.

1 – Spending most of my waking hours guilt free, appreciating what I have, and dreaming of where this wonderful journey is going to take me.

They’re not all monumental, but they’ve made my world what it is, and nearly all of them were missing from my crystal meth addled life.

As an exercise, you may want to try writing down your top ten list. It might be easy, or seem impossible, but when completed, it will bring clarity, that I guarantee.

How I cleaned up my act and dealt with my crystal meth addiction

I keep referring to the fact that I don’t believe in quick fixes for addiction.

My crystal meth addiction

Partially, this is due to research I’ve been exposed to that shows changes in the brain that are very long lasting. As I’d mentioned in an earlier post about crystal meth use, it can take as long as 2 years of staying clean for dopamine function in the brain to return to anything near normal levels, and though we don’t have any clear answers on this yet, the function that does return is most likely not the same as that which was lost.

But it’s also due to my own experience. I used a lot of meth for more than 4 years. It started out with $40 bags (a quarter gram) and eventually grew to almost daily 8-ball use (3.5 grams,), which I could only afford because I was selling pounds of the stuff. I’m sometimes surprised that my brain still functions at all, let alone at the levels it needs to for the things i’m doing now. Still, my memory has suffered and the jury on whether my ADD had worsened due to it or not is still out.

When I got clean, it took me more than 2 years of no substance use whatsoever to get to the point where I felt I was “back to normal.” There were certainly stages of improvement along the way, but I literally had to learn how to live without drugs. It wasn’t easy.

Filling up the necessary recovery time

As you’ll find out continuously throught this blog, my road wasn’t without it’s share of bumps either. I got kicked out of my first rehab for using after about 3 months of staying clean and though my second try was successful, it was far from easy and the struggles taught me a lot about myself and what I am capable of.

I’ve included, and will keep writing, a series of posts about rechanneling addictive personality tendencies into more constructive activities that can help in getting through the tough periods of readjustment. I can say that for me, it was this rechanneling that made it possible to get through my days.

Be it my schooling, working out, or my newfound passion for gardening (on my tiny patio), finding new ways to occupy my restless mind have proven indispenseble for my new, improved life. While I might not have been preparing for it, there’s been a quiet in my mind I didn’t even know before…

Read the upcoming posts for ideas on what you can do to rechannel your energy into things that will improve, not destroy, your life…

Alcohol, benzos, and opiates – Withdrawal that might kill you

Along with teaching and telling stories, part of my goal here at All About Addiction is to get important information out to those who can benefit from it.

Most drug users who quit drug use “cold turkey” have to go through withdrawal of some sort. Withdrawal is never comfortable, but sometimes it can actually be dangerous. The list below outlines some drugs that should NEVER be quit suddenly without medical supervision. This is the reason why some rehab treatment is preceded by a medical detox period lasting anywhere from 2 days to a week or more.

Which withdrawals can actually kill?

  1. Alcohol – Yes, after long term use, withdrawal from alcohol can kill. Alcohol withdrawal syndrome can take on mild, moderate, or severe forms. If while withdrawing from alcohol a person develops a fever, extreme nausea, diarrhea, or DT (delirium tremens), they need to be rushed to see a doctor as soon as possible. In fact, alcohol withdrawal after heavy, chronic use is best managed under the care of a doctor or a professional medical detox unit. By using medications that relieve withdrawal symptoms, these professionals can essentially eliminate any of these risks.
  2. Benzodiazepines – Benzos were introduced as a replacement to barbiturates that were causing common overdose cases, many of which resulted in death. Nevertheless, withdrawal from extended use of benzodiaepines can kill. Whether Xanax (alprazolam), Ativan (lorazepam), Valium (diazepam) or other variations, long term use of Benzodiazepines requires medical supervision to be completed successfully with minimal side-effects and risk to the patient. Normally, the withdrawal process is managed by slowly reducing the dose and transferring the patient from a slow acting, to a long acting, form of the drug. Still, full resolution of benzodiazepine withdrawal syndrome can take up to 6 months (or even longer).
  3. Opiates – Many people are surprised to learn that in most cases, withdrawal from many opiates is not deadly. Still there are some very important exceptions. Methadone, a long-acting opiate often prescribed as a replacement for heroin can cause death during withdrawal if it’s consumed in high enough doses for a long enough period. The debate of whether the state should be prescribing something like this should be saved for a later date. It is one of the better ways of getting people off of heroin, though obviously, all it does is replace dependence on one substance with another, more manageable one. Also, some of the recently popular methods of rapid-detox from heroin addiction can themselves cause death, and many other negative side-effects. Overall, I would recommend checking in with a physician and conducting opiate withdrawal in a controlled setting. Withdrawal under Suboxone or Subutex can be far less horrific.

Much of the danger in withdrawal from all of these drugs has to do with the body’s response to the extreme changes in the chemical processes going on in the brain and the rest of the body. Alcohol, Benzos, and Opiates interference with the GABA system, the body’s most common downregulator.

Withdrawal from these drugs is like trying to turn the heat up in a cold house with a broken thermostat and an out of control heater – It won’t always lead to disaster, but it’s a bad idea.

The withdrawal danger summary

That’s pretty much it. “Cold Turkey” withdrawal from cocaine, marijuana, crystal meth, ecstasy, GHB (never mix GHB with alcohol though!!!), and many other recreationally used drugs will not lead to death in the vast majority of cases. While it may make you uncomfortable, and you may feel moody, constipated, dehydrated, hungry or nauseous, and a whole slew of other symptoms, the chances of someone actually dying from withdrawal are very small.

If you have any more specific questions regarding your case though, don’t shy from asking me!

Crystal meth and cocaine, Agassi and Gasquet- The reality of drug use in our society.

AgassiAfter Andre Agassi’s recent confessions in a tell-tale book about his use of crystal meth during his playing days, Richard Gasquet, who recently made it to the Wimbledon semifinals has just tested positive for cocaine.

He says he was contaminated with the drug when he kissed a woman who was using it.  Right. Unless the woman was covered in an inch thick layer of coke, or unless Gasquet drank about a pint of her heavily intoxicated saliva, we all know that’s a lie. I’m pretty sure the committee now deliberating will come to the same conclusion.

Drug use in our society

The bottom line is that drugs are everywhere, including our star athletes, night-club hopping starlets, and big-time business executives. And in case you haven’t figured this out, they’re not going away. The best we can do is to keep researching the problem so that we can:

  1. Educate the public (educational and dissemination research).
  2. Identify risky users earlier (assessment and genetics research).
  3. Figure out the most effective ways to get them into treatment (intervention research).
  4. Discover the best methods to treat them (clinical and pharmacological research).
  5. Repeat the cycle.

That’s it! That’s all we’ve got. Recreational drug use will most likely continue forever, and I for one think that’s the wrong problem for us to be focusing on.

Interdiction – Our current solution to drug use

Limiting the drug supply, which is a big part of how our government currently deals with the problem, drives up the price of street drugs. This in turn reduces their purity (dealers have to make money) and gets in the way of recreational drug use. So far so good. But guess what?

Addicts don’t care about the cost of drugs.

Trust me, I used to sell them and use. I used to know a lot of other people who did too. Addicts are not making rational decisions based on economic realities. They’ll sell their stuff, lie cheat and steal their way to more drugs. Their brains are no longer depending on rational thinking when it comes to their drug use. That’s pretty much the definition of addiction.

Decriminalization – Our next step

I’m going to write a post soon about the notion of decriminalization. Decriminalization is different from legalization. Making drugs legal is like sanctioning their use – making citizens think the drugs are okay. For the most part, they’re not. But decriminalization would take addicts out of our prisons and give them the treatment they need. I think it’s time we faced the music and dealt with drug use problems at their core, with the people most often negatively affected by them.

Reduce HIV Transmission – Shooting up, clean needles, and addiction treatment

Co-authored by: Jamie Felzer

We’ve talked often on this  site about many of the negative things that often come along with heavy drug use. We’ve not yet talked about any of the factors that make injection drug use even worse. Users inject cocaine, crystal meth, and heroin, or any combination of these.

Shooting up and disease

In addition to all of the other, addiction-relevant, factors we’ve talked about on here, injection drug use brings about the worry of blood borne pathogens, especially HIV and Hepatitis C.  While it may not always be easy to find clean needles or worry about cleaning a needle between uses there are steps that can be taken to reduce the risk of transmission.

1. Get Tested!!  HIV/AIDS testing is available all over the world, often for free.   Having another STD or illness can easily kill someone with AIDS. Know your status!

President Obama just finalized a plan to revoke the 22 year travel ban on those living with HIV/AIDS.  This will significantly reduce the stigma of HIV/AIDS and should bring about more testing centers and education.  See this video to hear Obama.

2. While it may not always be easy, take great care to try to check the needle for visible signs of blood before injecting. If you think the needle may have been used before, clean it with bleach or another disinfectant.

3. Utilize the free clinics around your town that give out free, clean needles.  They are there to help you!!  Use these addiction support centers for clean needles and other equipment (like the bleach I mentioned earlier).

4. Talk about it! Regardless of where you may live, the group of people you hang out, studies have shown that talking about this subject matter increases awareness and can decrease chance of infections.  Being informed is your most important tool. For more info check out AIDS Global Information or AIDS Action.

5. Get help! Treatment options are widely available and they serve as a very effective method for reducing risky behaviors.  We can offer you placement help if you’re in southern California, but even if not SAMHSA has a relatively good addiction treatment locator – Check it out.

Citation:

CAPS Fact Sheet: What are IDU HIV Prevention Needs?