There's been a lot on the news and in the paper about a drug called methamphetamine making its way toward Baltimore. What can you tell us about it?
Given what we know about this drug, we can only hope that it does not gain a foothold in the Baltimore area. Methamphetamine is but one form of a class of drugs referred to as amphetamines or stimulants. Stimulants affect the central nervous system by acting on the brain's supply of chemical messengers and by changing the pattern with which nerves in the brain send off signals. They also affect the body's cardiovascular and temperature regulation systems (causing increases in heart rate and body temperature). Used under appropriate supervision, these medications do have legitimate uses, for example in treatment of attention deficit hyperactivity disorder (ADHD) or obesity.
Methamphetamine is one type of stimulant and is often referred to on the street as "crank." "Ice" refers to a crystallized, smokable chunk form of methamphetamine that produces a more intense reaction than cocaine or speed. It looks clear and crystal-like, not unlike frozen water. Ice is easy to make and very cheap. This combination of characteristics is what makes methamphetamine such a potential danger.
Misuse of these drugs occurs in part because they produce -- at least initially -- some positive effects. The user may experience a sense of exhilaration, heightened alertness, an increased ability to concentrate and a sense of well-being and of confidence and power. Pre-existing fatigue and depression are eliminated. Such effects are quite seductive and may lure a teen-ager into using the drug on a regular basis or in certain social situations.
Furthermore, because methamphetamines -- particularly the smokable form -- are so addictive and produce such an intense experience, individuals rarely use it one time. Some users will binge, that is, use it repeatedly in a relatively short time.
Over time, the body develops a tolerance to the drug and the user must use increasing amounts. As a result, addiction develops and individuals can experience severe withdrawal syndrome, as well as complications from long-term use. The withdrawal is quite powerful. Early on, the user experiences depression, agitation, anxiety and a high craving for the drug. A bit later, he or she will be extremely fatigued but unable to sleep. At this point, an individual may use other drugs, such as alcohol or other tranquilizers, in an attempt to sleep.
Accounts of methamphetamine often point to a link between use of this drug and violence or aggression. Most evidence does suggest that repeated use does lead to an increase in aggressive behaviors, but the actual dose and the social situation in which the drug is used also play a role. Whether occasional or one-time use of a small amount does so is much less clear. However, since ice is smoked, it is impossible to know beforehand how much drug actually gets to the brain.
Dr. Wilson is director of general pediatrics at Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.
Pub Date: 12/17/96