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Effects of
D-Methamphetamine
Mexico Unit
December 1996
D-methamphetamine
became the predominant form of methamphetamine during the
late 1980s and is now widely associated with Mexican polydrug
trafficking organizations that clandestinely manufacture the
drug using the ephedrine or pseudoephedrine reduction method.
Like other types of methamphetamine, it is a potent central
nervous system stimulant with physical and psychological effects
very similar to cocaine and is known by a variety of street
names, including "speed," "crank," "ice,"
"meth," and "go-fast."
D-methamphetamine
appeals to drug abusers because it increases the body's metabolism
and produces euphoria, increases alertness, and gives the
abuser a sense of increased energy. High doses or chronic
use of d-methamphetamine, however, increases nervousness,
irritability, and paranoia. The extreme paranoia that d-methamphetamine
abusers can experience is often associated with a distorted
tendency toward violence. Adverse consequences of d-methamphetamine
abuse include the risk of stroke, heart failure, and prolonged
psychosis.
The
current availability and characteristics of d-methamphetamine
have expanded the abuser population to a point that far exceeds
any previous methamphetamine use. D-methamphetamine users
of the 1990s have several choices that their counterparts
in the 1960s, using dl-methamphetamine, did not have, leading
to an increase in the abuser population. In particular, being
able to smoke d-methamphetamine has allowed a population fearful
of needles and the association with Human Immunodeficiency
Virus (HIV) transmission to try the drug.
Because
d-methamphetamine use is spreading rapidly in the United States,
knowledge of the drug, coupled with the ability to recognize
the different patterns and stages of abuse, is becoming increasingly
important to medical personnel and law enforcement officers.
Methamphetamine abuse has three patterns: low intensity, binge,
and high intensity. Low-intensity abuse describes a user who
is not psychologically addicted to the drug and who administers
the drug by swallowing or snorting it. Binge and high-intensity
abusers are psychologically addicted and prefer to smoke or
inject d-methamphetamine to achieve a faster and stronger
high. The binge and high-intensity patterns of abuse differ
in the frequency in which the drug is abused. In addition,
while the binge pattern of abuse has seven stages within its
cycle-rush, high, binge, tweaking, crash, normal, and withdrawal-the
high-intensity abuse pattern usually does not include a state
of normalcy or withdrawal.
The
most dangerous stage of methamphetamine abuse for abusers,
medical personnel, and law enforcement officers is tweaking.
A d-methamphetamine abuser who is tweaking, known as a tweaker,
has probably not slept in 3-15 days and, consequently, will
be extremely irritable and paranoid. A tweaker does not need
provocation to behave or react violently, but confrontation
increases the chances of a violent reaction. If the tweaker
is using alcohol, his negative feelings and associated dangers
intensify.
There
are three types of methamphetamine: dextro-methamphetamine
(d-methamphetamine), dextro-levo methamphetamine (dl-methamphetamine),
and levo-methamphetamine (l-methamphetamine). A comparison
of the three methamphetamines appears in table 1.
D-methamphetamine
is the most potent and widely abused form of methamphetamine
in the United States today. During the 1980s, a new clandestine
methamphetamine manufacturing method using the precursor chemical
ephedrine/pseudoephedrine created d-methamphetamine. For the
abuser, d-methamphetamine not only is significantly more potent
than other forms of methamphetamine but also has fewer adverse
side effects. D-methamphetamine eventually became the predominant
form of methamphetamine illegally manufactured on the west
coast of the United States during the late 1980s and is now
widely associated with Mexican polydrug trafficking organizations.
The
other form of "clandestinely" manufactured methamphetamine
in the United States, dl-methamphetamine, is based on the
precursor chemical phenyl-2-propanol (P2P) and has been abused
since the 1960s. Compared to d-methamphetamine, dl-methamphetamine
is more difficult to manufacture, is two to three times less
potent, and produces side effects, such as shakes, tremors,
and stomach cramps. Although less potent, dl-methamphetamine
is still manufactured and distributed-primarily by outlaw
motorcycle gangs-throughout the United States. Because of
the increased demand for methamphetamine, individuals who
clandestinely manufactured methamphetamine in the 1960s and
1970s are reentering the trade to supplement the d-methamphetamine
supply with dl-methamphetamine.
D-methamphetamine
is clandestinely manufactured using the ephedrine or pseudoephedrine
reduction method. This simple manufacturing method has been
used to produce quantities of up to 200 pounds at a time,
which are eventually sold to an increasingly demanding abuser
population.
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Figure 1. |
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D-methamphetamine
increases the heart rate, blood pressure, body temperature,
and rate of breathing and dilates the pupils. In the United
States, the drug is used legally in the medical treatment
of narcolepsy, a rare sleeping disorder. Tolerance to the
drug develops quickly, and strict medical supervision is required.
Adverse physical consequences of d-methamphetamine abuse include
the risk of stroke and heart failure.
D-methamphetamine
appeals to drug abusers because it increases the body's metabolism
and produces euphoria, increases alertness, and gives the
abuser a sense of increased energy. D-methamphetamine can
enable a shy person to become a "social butterfly"
and a tired person to become energized. A d-methamphetamine
high has two distinct advantages over dl-methamphetamine:
it does not need to be injected to achieve the same high,
and it causes fewer adverse side effects. The increase in
metabolism that d-methamphetamine causes, however, can also
lead to dramatic mood swings, ranging from hyperactive behavior
to severe depression.
High
doses or chronic use of d-methamphetamine increases nervousness,
irritability, and paranoia. Ronald K. Siegel, in his book
Whispers: The Voice of Paranoia, details seemingly
bizarre scenarios in which methamphetamine abusers believe
they are being followed by the police, the Federal Bureau
of Investigation, the Central Intelligence Agency, and even
the Mafia. However, these scenarios are not unusual when dealing
with methamphetamine abusers.
For
example, a police lieutenant described an encounter he had
with a methamphetamine abuser who called his office from a
cellular telephone. The drug abuser was driving on Interstate
5 and sounded quite rational when he said he wanted to file
a complaint about a narcotic enforcement officer, who was
following him everywhere he went. Slowly, the drug abuser's
voice began to sound panicky, and he begged the police lieutenant
to tell his officer to get off the car roof. The police lieutenant
could hear the driver swerving on the road and slamming on
his brakes, trying to shake the imaginary officer from the
car roof.
Adverse
psychological consequences of d-methamphetamine abuse can
include a prolonged psychosis. This psychosis, called "amphetamine
delusional disorder" or "amphetamine psychosis,"1
adds to the extreme paranoia both visual and auditory hallucinations
and often ends in hysteria. For example, a young woman entered
an emergency room and demanded that her brain be returned
to her. Immediately, the hospital staff physically restrained
and sedated her, but before the sedation took effect, the
young woman thrashed back and forth on the gurney. In her
psychotic state, she screamed, "Give me my brain back!
I'm dying! I don't want to die without my brain!"
The
extreme paranoia that d-methamphetamine abusers can experience
is often associated with a distorted tendency toward violence.
A vivid example of amphetamine psychosis and the distorted
tendency toward violence can be seen in the excerpts taken
from a USA Today article and presented in the accompanying
box.
Although
d-methamphetamine is not physically addictive, it is psychologically
addictive. A person physically addicted to a drug, such as
heroin, can die during withdrawal from the drug because body
tissue is dependent on the drug to function. However, a person
psychologically addicted to a drug, such as d-methamphetamine,
will not die from lack of the drug but will experience severe
depression and suicidal tendencies during withdrawal. As a
result, treating d-methamphetamine abusers is difficult because
abusers often simply take more d-methamphetamine to end the
severe depression.
The advent
of d-methamphetamine has expanded the methamphetamine abuser
population to an all-time high. While dl-methamphetamine historically
appealed to blue collar, white males, d-methamphetamine has
attracted not only these users but also college students,
young professionals, minorities, and especially women. According
to the Drug Abuse Warning Network (DAWN), males still account
for approximately 70 percent of all methamphetamine users
in the U.S. metropolitan areas, but about 30 percent of methamphetamine
users are now listed as women. Although a 1994 Drug Enforcement
Administration statistical analysis of methamphetamine users
by age in U.S. metropolitan areas placed the majority of the
users between the ages of 20 and 39, up to one quarter of
all abusers are under 20 or over 39 (figure 2, page 5).
These
changes and increases in the abuser population can be attributed
to the evolution in the methamphetamine trade from dl- to
d-methamphetamine, in the available methods of abuse, and
in the means of distribution.
The
dl-methamphetamine users of the 1960s and 1970s had to inject
the drug to get the desired rush or feeling of exhilaration.
During this period, dl-methamphetamine was usually produced
and distributed by outlaw motorcycle gangs and their associates.
By
contrast, d-methamphetamine users of the 1990s may swallow,
snort, inject, or smoke the more powerful drug, with new users
preferring the first two methods and hard-core users favoring
the last two. Being able to smoke d-methamphetamine has allowed
a population fearful of needles and possible HIV transmission
to try the drug.
Moreover,
current d-methamphetamine users do not have to associate with
outlaw motorcycle gang members to purchase the drug. Distributors
now come from a variety of classes and lifestyles. Also, abusers
have the choice to smoke or inject d-methamphetamine for the
euphoric high. Swallowing or snorting d-methamphetamine is
generally a gateway to smoking or injecting the drug.
D-methamphetamine
has become attractive to adolescents and college students
because the drug is perceived to enhance them both mentally
and physically. D-methamphetamine can make an overachiever
in academics or sports become even better, at least initially.
Some teenage boys and young men believe that d-methamphetamine
can transform them from being a good soccer or football player
to superstar status because the d-methamphetamine will help
them run faster and improve their concentration.
Some
young men also believe that d-methamphetamine will turn them
into sexual superstars, making it one of several drugs of
choice in the club or "rave" scene. D-methamphetamine
abusers report that having sex while abusing d-methamphetamine
is extraordinary. Because of increased sexual stamina, d-methamphetamine
abusers also tend to have more than one sexual partner. In
addition, because the drug induces feelings of invincibility,
methamphetamine abusers often ignore the consequences of unprotected
sex and contract sexually transmitted diseases, including
HIV. D-methamphetamine abusers, moreover, frequently acknowledge
having bizarre sexual practices, the most notable being the
incorporation of pain.
Figure
2. Methamphetamine Abuser Population
In
addition, an often desired side effect of d-methamphetamine
is that the drug diminishes the body's desire for food. Dr.
Harold Crossley of the University of Maryland School of Dentistry
explains that d-methamphetamine imitates epinephrine (adrenaline),
a drug found naturally within the body. Adrenaline places
the person in a "fight-or-flight" mode, an immediate,
heightened state of alertness necessary for swift action and
decision making during a crisis. Dr. Crossley notes that during
an automobile accident, for instance, people often experience
the fight-or-flight phenomenon, resulting from a surge of
adrenaline. During and immediately after this surge, they
do not usually have the urge to eat. Because d-methamphetamine
imitates the effects of adrenaline, it also produces the side
effect of appetite suppression, which is very attractive to
adolescent girls and young women who often want to be as thin
as the models and actresses they see on television, in the
movies, and in magazines.
Unfortunately,
the old adage that "speed kills" seems to have been
forgotten. Medical professionals treating drug abusers maintain
that heroin addicts can frequently live long lives, whereas
methamphetamine abusers often do not. When the dl-methamphetamine
injectors (speed freaks) of the 1960s overdosed, they experienced
shakes, tremors, and stomach cramps, and then heart attacks
or strokes. These side effects painted an unattractive picture
in the minds of potential abusers.
In
stark contrast, current d-methamphetamine abusers who overdose
do not have any warning signs that they have taken a fatal
dose. Without these signs, death can be unexpected and very
sudden. When an abuser has taken a lethal dose of d-methamphetamine,
the heart rate will rapidly increase and the abuser will collapse
and suffer a fatal heart attack or stroke. The only overt
sign that a d-methamphetamine abuser has taken a fatal dose
of the drug is an abnormally high temperature (104°F or above)
or the symptoms of a heart attack or stroke. When law enforcement
officers apprehend an abuser with a dangerously high temperature,
medical attention is immediately required.
Once
under medical supervision, a person suspected of d-methamphetamine
intoxication should be kept in a quiet room to minimize sensory
stimulation, as well as be given drugs to control agitation,
blood pressure, and seizures. The patient should also be monitored
for body hydration and temperature.
Although
d-methamphetamine toxicity can be medically treated if diagnosed
in time, d-methamphetamine abusers typically have a short
life span. They have high rates of death resulting from suicide,
motor vehicle accidents, and murder. Medical complications
such as overdoses and malnutrition claim many d-methamphetamine
abusers within an average of 10 years of drug use.
According
to Dr. S. Alex Stalcup, Medical Director of the New Leaf Treatment
Center in Concord, California, who is involved in the treatment
of methamphetamine addicts, methamphetamine abuse has three
patterns: low intensity, binge, and high intensity. Low-intensity
abuse describes a user who is not psychologically addicted
to the drug but uses d-methamphetamine on a casual basis by
swallowing2 or snorting it. Binge and high-intensity abusers
are psychologically addicted and prefer to smoke or inject
d-methamphetamine to achieve a faster and stronger high. Binge
abusers use methamphetamine more than low-intensity abusers
but less than high-intensity abusers.
Low-intensity
abusers swallow or snort d-methamphetamine, using it the same
way many people use caffeine or nicotine. Low-intensity abusers
want the extra stimulation the d-methamphetamine provides
so that they can stay awake long enough to finish a task or
a job, or they want the appetite suppressant effect to lose
weight. These people frequently hold jobs, raise families,
and otherwise function normally. They may include people such
as truck drivers trying to reach their destination, workers
trying to stay awake until the end of their normal shift or
an overtime shift, and housewives trying to keep a clean house
as well as be a "perfect mother and wife."
Even
though a law enforcement officer is not likely to encounter
low-intensity abusers, these individuals are one step away
from becoming binge abusers. They already know the stimulating
effect that d-methamphetamine provides them by swallowing
or snorting the drug, but they have not experienced the euphoric
rush associated with smoking or injecting it and have not
encountered clearly defined stages of abuse. However, according
to Dr. Stalcup, simply switching to smoking or injecting d-methamphetamine
offers the abusers a quick transition to a binge pattern of
abuse.
Binge
abusers smoke or inject d-methamphetamine and experience euphoric
rushes that are psychologically addictive. Figure 3 shows
the cycle of a binge abuser: rush, high, binge,3
tweaking, crash, normal, and withdrawl.
Figure
3. Binge Pattern of Abuse Cycle.
Rush.
The
rush is the initial response the abuser feels when smoking
or injecting d-methamphetamine and is the aspect of the drug
that low-intensity abusers do not experience when snorting
or swallowing the drug. During the rush, the abuser's heartbeat
races and metabolism, blood pressure, and pulse soar. Meanwhile,
the abuser can experience feelings "equivalent to ten
orgasms." Unlike the rush associated with crack cocaine,
which lasts for approximately 2-5 minutes, the d-methamphetamine
rush can continue for 5-30 minutes.
The reason for the d-methamphetamine rush is that the drug,
when smoked or injected, triggers the adrenal gland to release
a hormone called epinephrine (adrenaline), which puts the
body in a battle mode, fight or flight. In addition, the physical
sensation that the rush gives the abuser most likely results
from the explosive release of dopamine4
in the pleasure center of the brain.
High.
The
rush is followed by the high, sometimes called the shoulder.
During the high, the abuser often feels aggressively smarter
and becomes argumentative, often interrupting other people
and finishing their sentences. The high can last 4-16 hours.
Binge.
The
binge is the continuation of the high. The abuser maintains
the high by smoking or injecting more d-methamphetamine. Each
time the abuser smokes or injects more of the drug, a smaller
euphoric rush than the initial rush is experienced until,
finally, there is no rush and no high. During the binge, the
abuser becomes hyperactive both mentally and physically. The
binge can last 3-15 days.
Tweaking.
Tweaking
occurs at the end of the binge when nothing the abuser does
will take away the feeling of emptiness and "dysphoria,"5
including taking more d-methamphetamine. Tweaking is very
uncomfortable, and the abuser often takes a depressant to
ease the bad feelings. The most popular depressant is alcohol,
with heroin a close second.
Tweaking
is the most dangerous stage of the d-methamphetamine abuse
cycle to law enforcement officers and other individuals near
the abuser. If the abuser is using alcohol to ease the discomfort,
the threat to law enforcement officers intensifies. During
this stage, law enforcement officers must clearly identify
the underlying dangers of the situation and avoid the assumption
that the tweaker is just a cocky drunk. A more thorough description
of the tweaker, the dangers associated with this stage of
abuse, and options for law enforcement can be found on page
9.
Crash.
To
a binge abuser, the crash means an incredible amount of sleep.
The body's epinephrine has been depleted, and the body uses
the crash to replenish its supply. Dr. Stalcup describes the
crash as "complete." He states that during the crash,
he would not hesitate to bring his own son into the room with
the meanest, most violent abuser because the abuser becomes
almost lifeless during the crash and poses a threat to no
one. The crash can last 1-3 days.
Normal.
After
the crash, the abuser returns to normal-a state that is slightly
deteriorated from the "normal" state before he used
d-methamphetamine. This stage ordinarily lasts between 2 and
14 days. However, as the frequency of bingeing increases,
the duration of the normal stage decreases.
Withdrawal.
No
acute, immediate symptoms of physical distress are evident
with d-methamphetamine withdrawal, a stage that the abuser
may slowly enter. Often 30-90 days must pass after the last
drug use before the abuser realizes that he is in withdrawal.
First, without really noticing, the individual becomes depressed
and loses the ability to experience pleasure. The individual
becomes lethargic; he has no energy. Then the craving for
more d-methamphetamine hits, and the abuser often becomes
suicidal. If the abuser, however, takes more d-methamphetamine
at any point during the withdrawal, the unpleasant feelings
will end. Consequently, the success rate for d-methamphetamine
rehabilitation is very low. Ninety-three percent of those
in treatment return to abuse d-methamphetamine, according
to Dr. Stalcup.
The
high-intensity abusers are the addicts, often called "speed
freaks." Their whole existence focuses on preventing
the crash, and they seek that elusive, perfect rush-the rush
they had when they first started smoking or injecting d-methamphetamine.
With
the high-intensity abuser, each successive rush becomes less
euphoric, and it takes more d-methamphetamine to achieve it.
Each high is not quite as high as the one before (figure 4).
During each subsequent binge, the abuser needs more d-methamphetamine,
more often, to get a high that is not as good as the high
he wants or remembers.
Figure 4. High Intensity Pattern of Abuse Cycle The
High Intensity abuse pattern does not usually include a state
of normalcy or withdrawl as seen in the binge pattern of abuse
Tweaking
for the high-intensity abuser is still the most dangerous
time to confront him because tweakers are extremely unpredictable
and short-tempered. The crash is often spoken of in terms
of "I never sleep," or "I sleep with one eye
open." In an attempt to appear normal, perhaps because
of an appointment with a doctor, lawyer, or court official,
high-intensity abusers will make themselves take short naps;
otherwise, they see no need to come down from the high. Table
2 (page 10) summarizes some observable symptoms pertinent
to a high-intensity abuser.
A d-methamphetamine
abuser is most dangerous when tweaking. The fact that a law
enforcement officer is confronting the tweaker makes him more
dangerous, not just to the officer on the scene but also to
anyone nearby. When tweaking, the abuser has probably not
slept in 3-15 days and consequently will be extremely irritable.
The tweaker craves more d-methamphetamine, but no dosage will
help re-create the euphoric high. The result is a strong feeling
of uncontrollable frustration that makes the tweaker unpredictable
and dangerous.
If
the law enforcement officer on the scene is unfamiliar with
the physical signs of a tweaker, the abuser can appear normal.
In fact, Dr. Stalcup suggests that, unlike a person intoxicated
on alcohol with glassy eyes, slurred speech, and difficulty
even standing up, a tweaker appears "super-exaggerated
normal." The tweaker's eyes are clear, his speech concise,
and his movements brisk. With a closer look at the tweaker,
law enforcement officers will notice that his eyes are moving
about ten times faster than normal and may roll. He is talking
in a quick, often steady voice with a slight quiver to it,6
and his movements are quick and jerky. The individual's movements
are often exaggerated because he is overstimulated, and his
thinking is scattered and subject to paranoid delusions.
The
tweaker does not need provocation to react violently; however,
confrontation increases the chance for a violent reaction.
Law enforcement officers should consider the potential for
violence when determining that a suspect is tweaking.7
For example, case histories indicate that tweakers react negatively
to the sight of a police uniform.
Confrontation
between the tweaker and law enforcement often results in a
verbal or physical assault on the officer.
Besides
confrontation, Dr. Stalcup states that nobody knows for certain
what will trigger a tweaker to be irrational and violent.
A tweaker exists in his own world, seeing and hearing things
that no one else can perceive. His hallucinations are so vivid
that they seem real. What law enforcement officers say and
do enter into the abuser's altered reality, and if his paranoia
is triggered, law enforcement appears to be a threat to the
tweaker's life.
Dr.
Stalcup states that it is during tweaking that hostage situations
can easily occur. If the abuser feels cornered, with no means
of escape, the tweaker is likely to take a hostage, often
an associate, a relative, or a police officer. In extreme
cases, the tweaker may physically assault the hostage.
If
the tweaker has chosen to ease his discomfort with alcohol,
he becomes a "disinhibited tweaker," making reasoning
with the him or even identifying him as a tweaker more difficult.
Physical signs of a tweaker become blurred to an observer
when the tweaker is using alcohol. Motor and speech functions,
for example, become impaired, but not to the degree of a person
using only alcohol. The rapid eye movement and the quick speech
of a tweaker might actually slow to an apparently normal speed.
However, a tweaker using alcohol can be identified in two
ways:
If
a strong smell of alcohol is present, but no signs of drunkenness
exist, law enforcement officers and medical personnel should
err on the side of caution and approach the person as a tweaker
using alcohol rather than assume the person is harmless. Because
tweakers using alcohol are ordinarily not concerned with the
consequences of their actions, a situation can quickly lead
to violence. Additional guidance appears in "Safety Tips
for Approaching a Tweaker" (page 12).
When
asked how law enforcement officers should approach a tweaker
using alcohol, Dr. Stalcup explains the policy employed at
his outpatient clinic, where staff members encounter tweakers
daily. In addition to trying to take the tweaker to a darkened
room with as little stimulus as possible, staff members immediately
call for law enforcement assistance. Talking to a tweaker
using alcohol is not effective in subduing him because a tweaker
does not care about the consequences of his actions. Once
police assistance arrives, the tweaker is usually restrained
physically and sedated, for both the abuser's protection and
for those treating him. For law enforcement officers, this
step ordinarily means requesting backup and medical assistance.
To restrain a tweaker without sedation could cause him to
have seizures that could lead to death.
Figure
5. Examples of Crank Bugs. This
individual almost dies from his "Crank Bugs." He
gouged at his skin until the bugs became infected, and then
the infection began to poison his body. The abuser has generations
of scars on his body and had used d-methamphetamine as recently
as the day before these pictures were taken. Although the
abuser shows signs of d-methamphetamine abuse through the
appearance of crank bugs, he does not exhibit other effects
noted in table two. This individual is not gaunt; he had no
central pallor or body odor. He did sweat, and his teeth appeared
normal.(Photos of the individual are property of the NDIC)
Law
enforcement officers are most likely to encounter tweakers
at the emergency room and during domestic disputes, as well
as possibly during traffic stops for erratic driving episodes
or motor vehicle accidents. Tweakers often will go to the
hospital in hopes of obtaining treatment to ease their extreme
discomfort or will even call the emergency number for assistance.
However, when confronted with medical personnel's routine
questions, tweakers frequently become violent, and medical
staffs often require police assistance.
Regarding
domestic disputes, cities across the United States report
increased percentages of domestic violence incidents associated
with d-methamphetamine use. Domestic disputes, ordinarily
regarded as dangerous situations for law enforcement, become
intensified when a tweaker is involved because of that individual's
unpredictability.
Many
motor vehicle violations and accidents may also involve tweakers.
Paranoid and hallucinating, tweakers may decide to travel
in their automobiles. Their delusional state makes moving
shapes and shadows appear threatening, and they are very likely
to increase their speed and exhibit erratic driving patterns
as they attempt to evade the images. An additional threat
to society and themselves may stem from tweakers' tendency
to arm themselves for their personal safety. Interviews with
d-methamphetamine abusers have confirmed that these individuals
often maintain weapons in their automobiles, as well as in
their residences.
Tweakers
may also be present at "raves" or parties. In addition,
to support their habit, tweakers often participate in spur-of-the-moment
crimes, such as purse snatchings, strong-arm robberies, assaults
with a weapon, burglaries, and thefts of motor vehicles.
D-methamphetamine
is readily available and is spreading rapidly across the United
States. Unlike the abusers in the 1960s and 1970s, today's
d-methamphetamine abusers cross ethnic and gender boundaries.
While d-methamphetamine is not physically addictive, it is
psychologically addictive during the binge and high-intensity
patterns of abuse, with users becoming paranoid and unpredictable.
Consequently, health officials and law enforcement personnel
encountering such individuals -particularly those in the tweaking
stage of d-methamphetamine abuse-will increasingly face situations
in which abusers are likely to become violent. Knowledge about
d-methamphetamine, along with the ability to recognize the
different patterns and stages of abuse can help minimize the
escalation of potentially violent situations.
Table 1. Effects of Methamphetamine
Abuse * L-methamphetamine, found in over-the-counter
cold medicines, such as Vicks InhalersŪ, is the least active
methamphetamine and is rarely abused. It affects the cardiovascular
system more than the central nervous system and causes shakes,
tremors, and stomach cramps long before the exhilarating effects
of the drug become apparent.
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| Weight loss |
D-methamphetamine literally eats
away at the body fat and muscles. High-intensity abusers
often lose 50-100 pounds. |
| Central pallor |
D-methamphetamine raises the blood
pressure and increases the pulse; this, in turn,
constricts the blood vessels at the skin's surface. The
result: the center of the face becomes very pale. |
| Sweating |
Body temperature increases if the
abuser takes enough d-methamphetamine. The abuser begins
to sweat, most frequently on the upper lip and brows. |
| Body odor |
The abuser loses interest in
personal hygiene. Also, d-methamphetamine is not a clean
drug. Its chemicals, much like alcohol, are present in
the abuser's perspiration and emit a putrid smell
resembling glue and mayonnaise. |
| Bad teeth |
The abuser's teeth turn first gray
and then black. Research is being conducted on whether
the degradation of the teeth is from the drug use or poor
hygiene resulting from the drug use. (Abusers often grind
their teeth continually.) |
| Scars/open sores on exposed skin |
The scars indicate that the abuser
has experienced formication or "crank bugs."
Formication is an advanced form of
d-methamphetamine-induced hallucination during which the
abuser sees bugs on his skin. The individual scratches at
the "bugs," trying to remove them, but instead
the abuser gouges the skin, leaving scars. Open sores
indicate recent d-methamphetamine use (figure 5, page
11). |
Figure
4. High-Intensity Pattern of Abuse Cycle. The high-intensity
abuse pattern does not usually include a state of normalcy
or withdrawal as seen in the binge pattern of abuse.
1 The physical and psychological
effects of methamphetamine and amphetamine are very similar.
In fact, the effects methamphetamine and amphetamine induce
are so similar that they can be differentiated from one another
only by laboratory analysis of the drug.
2
To swallow d-methamphetamine, the abuser simply places d-methamphetamine
powder into an empty capsule and swallows it or places the
d-methamphetamine powder in a beverage and drinks it.
3
The binge is a stage within the binge pattern of abuse.
4
Dopamine is a neurotransmitter that gives a person pleasure
and makes him feel euphoric, giddy, or high.
5
Dysphoria is the opposite of euphoria.
6
When asked whether a tweaker can maintain eye contact, Dr.
Stalcup said, "Yes, a tweaker can look you straight in
your eyes and lie to you. His voice will sound steady, but
a trained professional can identify a slight quiver in the
voice that indicates the person is tweaking and potentially
dangerous."
7
Although d-methamphetamine abusers downplay their tendency
toward violence, they admit to hiding weapons, just in case
they feel they need them. The weapons are not limited to guns.
Axes, hammers, and knives are all worthy of having on hand
should the d-methamphetamine abuser feel threatened.
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