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Galanter M, White WL, Hunter B. Narcotics Anonymous members in recovery from methamphetamine use disorder. Am J Addict 2023; 32:54-59. [PMID: 36428292 PMCID: PMC10099615 DOI: 10.1111/ajad.13362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Methamphetamine use disorder (MUD) is a major public health problem, but there are no evidence-based, best-practice, pharmacologic, or behavioral treatments for it. Narcotics Anonymous (NA) may provide an option for referral for such patients. METHODS Two waves of surveys were sent to a sample of NA members to evaluate demographic, drug use, and NA-related issues. Of 4445 responses received from US residents, 647 listed themselves as abstinent from their worst drug problem, methamphetamine. Twelve possible sources of support were scored by these latter respondents for how important each was for their own recovery. RESULTS Methamphetamine respondents were longstanding NA members, with their first NA meeting 30.2 years ago, 84.3% having served as sponsors for other members, and with little current craving (0.65 out of 10). Although now abstinent for an average of 13.4 years, at some point over the course of the membership, 47.4% had experienced a relapse, for an average of 16.7 months. In a factor analysis of resources scored, 29.6% of the variance fell under NA social and 29.2% spiritual; and 11.8% under outside professional support. DISCUSSION AND CONCLUSIONS NA served as a resource for supporting abstinence for some members with MUD. They scored social resources of NA support higher than both spiritual and outside institutional ones. SCIENTIFIC SIGNIFICANCE NA can serve as a community-based resource for MUD. Determining the nature of recovery that members with MUD have in NA can be useful for further research of socially grounded support for recovery in substance use disorders.
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Affiliation(s)
- Marc Galanter
- Department of Psychiatry, New York University School of Medicine, New York, New York, USA
| | - William L White
- Research Division, Chestnut Health Systems, Punta Gorda, Florida, USA
| | - Brooke Hunter
- Research Division, Chestnut Health Systems, Normal, Illinois, USA
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Noninvasive Vagus Nerve Stimulation in the Treatment of Methamphetamine Use Disorder: A Review Article. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2022. [DOI: 10.5812/ijpbs-123423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
: Methamphetamine (MA) use and the mortality it causes are increasing worldwide. The neurobiological mechanisms underlying the destructive effects of MA use are complex; however, there is much evidence that MA induces the dysfunction of monoaminergic transmission and causes oxidative stress, neuroinflammation, gliosis, and apoptosis. These toxic effects are associated with cardiotoxicity and neurotoxicity and with an imbalance in the autonomic nervous system, which altogether manifest themselves in clinical symptoms, such as neuropsychiatric disorders and cardiovascular diseases. There is no approved treatment for methamphetamine use disorder (MUD) despite all efforts made to date. The behavioral and pharmacological approaches currently used for the treatment of MUD are not completely effective. In this study, it is hypothesized that the stimulation of the vagus nerve and biological pathways underlying the processes of this stimulation might be effective as adjunctive therapy. Despite the potential effects of vagus nerve stimulation (VNS) to improve MUD, no study has yet examined the clinical potential effects of VNS in patients with the disorder. Therefore, further studies, including experimental and clinical trials, are needed to examine the effects of VNS on MUD.
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Jiang P, Sun J, Zhou X, Lu L, Li L, Huang X, Li J, Kendrick K, Gong Q. Functional connectivity abnormalities underlying mood disturbances in male abstinent methamphetamine abusers. Hum Brain Mapp 2021; 42:3366-3378. [PMID: 33939234 PMCID: PMC8249885 DOI: 10.1002/hbm.25439] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/09/2021] [Accepted: 03/26/2021] [Indexed: 02/05/2023] Open
Abstract
Anxiety and depression are the most common withdrawal symptoms of methamphetamine (METH) abuse, which further exacerbate relapse of METH abuse. To date, no effective pharmacotherapy exists for METH abuse and its withdrawal symptoms. Therefore, understanding the neuromechanism underlying METH abuse and its withdrawal symptoms is essential for developing clinical strategies and improving patient care. The aims of this study were to investigate brain network abnormalities in METH abusers (MAs) and their associations with affective symptoms. Forty-eight male abstinent MAs and 48 age-gender matched healthy controls were recruited and underwent resting state functional magnetic resonance imaging (fMRI). The severity of patient anxiety and depressive symptoms were measured by Hamilton anxiety and depression rating scales, which decreased across the duration of abstinence. Independent component analysis was used to investigate the brain network functional connectivity (FC) properties. Compared with healthy controls, MAs demonstrated hypo-intra-network FC in the cerebellar network and hyper-intra-network FC in the posterior salience network. A whole-brain regression analysis revealed that FC strength of clusters located in the right rostral anterior cingulate cortex (rACC) within the ventromedial network (VMN) was associated with affective symptoms in the patients. Importantly, the intra-network FC strength of the rACC in VMN mediated the association between abstinence duration and the severity level of affective symptoms. Our results demonstrate alterations in brain functional networks underlying METH abuse, and that the FC of rACC within VMN serve as a neural substrate in the association between abstinence length and affective symptom severity in the MAs.
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Affiliation(s)
- Ping Jiang
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional and Molecular Imaging Key Laboratory of Sichuan ProvinceChengduChina
| | - Jiayu Sun
- Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Xiaobo Zhou
- Department of PsychosomaticsAcademy of Medical Sciences & Sichuan Provincial People's HospitalChengduSichuanChina
| | - Lu Lu
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional and Molecular Imaging Key Laboratory of Sichuan ProvinceChengduChina
| | - Lei Li
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional and Molecular Imaging Key Laboratory of Sichuan ProvinceChengduChina
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional and Molecular Imaging Key Laboratory of Sichuan ProvinceChengduChina
| | - Jing Li
- Mental Health CenterWest China Hospital of Sichuan UniversityChengduChina
| | - Keith Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformationUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional and Molecular Imaging Key Laboratory of Sichuan ProvinceChengduChina
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Kondo A, Shimane T, Takahashi M, Takeshita Y, Kobayashi M, Takagishi Y, Omiya S, Takano Y, Yamaki M, Matsumoto T. Gender Differences in Triggers of Stimulant Use Based on the National Survey of Prisoners in Japan. Subst Use Misuse 2021; 56:54-60. [PMID: 33100112 DOI: 10.1080/10826084.2020.1833930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
There are a few studies on gender differences in terms of reasons and motives for methamphetamine use. Purpose/Objectives: To examine gender differences in triggers of methamphetamine use Methods: We provided a questionnaire survey to 699 inmates who were incarcerated because of violation of the Stimulants Control Act. Results: The results of DAST-20 (the severity of drug dependence) moderately correlated with the applicable numbers of the 37 situational triggers and 34 emotional triggers for stimulant use, respectively. Regarding gender differences, items including "when having sex" [46.3% (men) vs. 25.3% (women)], "when I have some money" (39.4% vs. 25.3%), and "after getting paid from work" (22.1% vs. 11.4%) were applicable in a significantly higher proportion in males (p < 0.001 and p = 0.008, respectively), whereas items including "worried about the body shape" (3.5% vs. 31.2%) and "after quarreling with someone" (11.7% vs. 29.1%) were applicable in a significantly higher proportion in females (p < 0.001 for both comparisons). Further, most trigger (emotions) items that exhibited gender differences were significantly higher in females. Many females answered that they had used drugs to relieve discomfort symptoms associated with menstrual periods. Conclusions/Importance: Thus, the awareness of important factors including learning how to deal with negative emotions (e.g. depression), repairing self-image, and recognizing physical and emotional changes associated with the menstrual cycle is helpful in providing proper care and treatment of drug addiction in females.
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Affiliation(s)
- Ayumi Kondo
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takuya Shimane
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | | | | | - Michiko Kobayashi
- Research Department, Research and Training Institute, Ministry of Justice, Chiba, Japan
| | - Yuriko Takagishi
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Psychology, Surugadai University, Saitama, Japan
| | - Soichiro Omiya
- Graduate School of Education, Joetsu University of Education, Niigata, Japan
| | | | - Mayuko Yamaki
- Training Institute for Correctional Personnel, Tokyo, Japan
| | - Toshihiko Matsumoto
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
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5
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Ru Q, Xiong Q, Zhou M, Chen L, Tian X, Xiao H, Li C, Li Y. Withdrawal from chronic treatment with methamphetamine induces anxiety and depression-like behavior in mice. Psychiatry Res 2019; 271:476-483. [PMID: 30544074 DOI: 10.1016/j.psychres.2018.11.072] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 08/20/2018] [Accepted: 11/30/2018] [Indexed: 01/25/2023]
Abstract
Methamphetamine (METH) is an illicit psychostimulant that is widely abused. After producing extreme pleasure, METH abuse leads to negative emotional states during withdrawal in clinical survey. However, the mood behavioral consequences of withdrawal from chronic METH exposure in animal experiments and related mechanisms have not been clarified yet. The aim of this study was to investigate the anxiety and depression-like phenotype in mice induced by withdrawal from chronic METH treatment and the potential molecular mechanism. We found that withdrawal from chronic METH treatment increased the immobility time during the forced swimming test and decreased central activities in open field test, indicating increased anxiety and depression-like behavior. Additional experiments showed that expression of brain-derived neurotrophic factor (BDNF), phosphorylated tropomyosin receptor kinase B (p-TrkB), phosphorylated extracellular signal-related kinase 1/2 (p-ERK1/2) and phosphorylated cAMP-response element binding protein (p-CREB) were decreased in the hippocampus and prefrontal cortex of mice in METH group and the level of mitogen activated protein kinase phosphatase-1 (MKP-1) was increased. Combined, our data show that withdrawal from chronic METH exposure induces anxiety and depression-like behavior associated with aberrant changes of proteins in BDNF-ERK-CREB pathway, providing new evidence for the involvement of BDNF pathway in the negative emotional states induced by withdrawal from METH.
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Affiliation(s)
- Qin Ru
- Wuhan Institutes of Biomedical Sciences, Jianghan University, Wuhan 430056, China.
| | - Qi Xiong
- Wuhan Institutes of Biomedical Sciences, Jianghan University, Wuhan 430056, China
| | - Mei Zhou
- Wuhan Institutes of Biomedical Sciences, Jianghan University, Wuhan 430056, China
| | - Lin Chen
- Wuhan Institutes of Biomedical Sciences, Jianghan University, Wuhan 430056, China
| | - Xiang Tian
- Wuhan Institutes of Biomedical Sciences, Jianghan University, Wuhan 430056, China
| | - Huqiao Xiao
- Wan Ji Psychiatric Hospital, Wuhan 430051, China
| | - Chaoying Li
- Wuhan Institutes of Biomedical Sciences, Jianghan University, Wuhan 430056, China
| | - Yi Li
- Wuhan Mental Health Center, Wuhan 430022, China.
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6
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Shabani S, Schmidt B, Ghimire B, Houlton SK, Hellmuth L, Mojica E, Phillips TJ. Depression-like symptoms of withdrawal in a genetic mouse model of binge methamphetamine intake. GENES BRAIN AND BEHAVIOR 2018; 18:e12533. [PMID: 30375183 DOI: 10.1111/gbb.12533] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/05/2018] [Accepted: 10/27/2018] [Indexed: 12/25/2022]
Abstract
Binge methamphetamine (MA) users have higher MA consumption, relapse rates and depression-like symptoms during early periods of withdrawal, compared with non-binge users. The impact of varying durations of MA abstinence on depression-like symptoms and on subsequent MA intake was examined in mice genetically prone to binge-level MA consumption. Binge-level MA intake was induced using a multiple-bottle choice procedure in which mice were offered one water drinking tube and three tubes containing increasing concentrations of MA in water, or four water tubes (control group). In two studies, depression-like symptoms were measured using a tail-suspension test and a subsequent forced-swim test, after forced abstinence of 6 and 30 hours from a 28-day course of chronic MA intake. An additional study measured the same depression-like symptoms, as well as MA intake, after prolonged abstinence of 1 and 2 weeks. MA high drinking mice and one of their progenitor strains DBA/2J escalated their MA intake with increasing MA concentration; however, MA high drinking mice consumed almost twice as much MA as DBA/2J mice. Depression-like symptoms were significantly higher early after MA access was withdrawn, compared to levels in drug-naïve controls, with more robust effects of MA withdrawal observed in MA high drinking than DBA/2J mice. When depression-like symptoms were examined after 1 or 2 weeks of forced abstinence in MA high drinking mice, depression-like symptoms dissipated, and subsequent MA intake was high. The MA high drinking genetic mouse model has strong face validity for human binge MA use and behavioral sequelae associated with abstinence.
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Affiliation(s)
- Shkelzen Shabani
- Grand Valley State University, Biomedical Sciences, Allendale, Michigan, USA.,Minot State University, Department of Biology, Minot, North Dakota, USA
| | - Bryan Schmidt
- Minot State University, Department of Biology, Minot, North Dakota, USA
| | - Bikalpa Ghimire
- Minot State University, Department of Biology, Minot, North Dakota, USA
| | - Sydney K Houlton
- Minot State University, Department of Biology, Minot, North Dakota, USA
| | - Laura Hellmuth
- Minot State University, Department of Biology, Minot, North Dakota, USA
| | - Erika Mojica
- Minot State University, Department of Biology, Minot, North Dakota, USA
| | - Tamara J Phillips
- Oregon Health and Science University, Department of Behavioral Neuroscience and Methamphetamine Abuse Research Center, Portland, Oregon, USA.,VA Portland Health Care System, Research Division, Portland, Oregon, USA
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Morais APD, Pita IR, Fontes‐Ribeiro CA, Pereira FC. The neurobiological mechanisms of physical exercise in methamphetamine addiction. CNS Neurosci Ther 2018; 24:85-97. [PMID: 29266758 PMCID: PMC6489779 DOI: 10.1111/cns.12788] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 11/28/2017] [Accepted: 11/30/2017] [Indexed: 12/15/2022] Open
Abstract
Methamphetamine (METH) is the primary drug within amphetamine-type stimulants which are the second most abused group of drugs worldwide. There is no pharmacological treatment addressed specifically to METH addiction, and behavioral therapy is shadowed by poor long-term recovery and relapse. Therefore, novel approaches to manage METH addiction are an urgent need. This review aims to describe the current state of physical exercise use on methamphetamine addiction management. The following searching terms in PubMed were used: ("physical exercise" OR "exercise") AND "methamphetamine." Relevant references from key publications and gray literature were also reviewed to identify additional citations for inclusion. Original investigation regarding physical exercise and methamphetamine addiction (clinical data) or neurobiological mechanisms of physical exercise in animal models of methamphetamine administration (preclinical data) was included. Overall, METH users demonstrated improvements, including better fitness and emotional measures, lower relapse rates, and sustained abstinence when compared to nonexercised individuals. The neurobiological mechanisms of physical exercise in METH users seem to reflect an interplay of several agents, including neurochemicals, oxidative stress, neurogenesis, gliogenesis, and blood-brain barrier as disclosed by preclinical data. Exercise-based interventions alone or as a conjoint therapy may be a useful tool for managing METH addiction.
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Affiliation(s)
- António Pedro Delgado Morais
- Institute of Pharmacology and Experimental Therapeutics/IBILIFaculty of MedicineUniversity of CoimbraCoimbraPortugal
| | - Inês Roque Pita
- Institute of Pharmacology and Experimental Therapeutics/IBILIFaculty of MedicineUniversity of CoimbraCoimbraPortugal
| | - Carlos Alberto Fontes‐Ribeiro
- Institute of Pharmacology and Experimental Therapeutics/IBILIFaculty of MedicineUniversity of CoimbraCoimbraPortugal
- CNC.IBILI—University of CoimbraCoimbraPortugal
| | - Frederico Costa Pereira
- Institute of Pharmacology and Experimental Therapeutics/IBILIFaculty of MedicineUniversity of CoimbraCoimbraPortugal
- CNC.IBILI—University of CoimbraCoimbraPortugal
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Hser YI, Huang D, Chou CP, Teruya C, Anglin MD. Longitudinal Patterns of Treatment Utilization and Outcomes among Methamphetamine Abusers: A Growth Curve Modeling Approach. JOURNAL OF DRUG ISSUES 2016. [DOI: 10.1177/002204260303300407] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study examined a sample of 205 amphetamine and methamphetamine (A/M) abusers in drug treatment programs across Los Angeles County. Data were collected during face-to-face interviews using a natural history interview instrument. We applied a series of growth curve models to investigate treatment effects on A/M use and criminal involvement during a 36-month period (24 months before and 12 months after the referent treatment admission). The modeling results showed strong concurrent treatment effects in reducing A/M use and criminal involvement (e.g., being in treatment was associated, on average, with a decrease of 4.65 to 5.14 days of A/M use per month and of 1.74 crimes per month). A longer length of cumulative time in treatment (either within single episodes or across multiple episodes) was associated with a lower level of A/M use during the initial month of the 36-month period and with a slower rate of decreased use in subsequent months. Cumulative treatment was not associated with trajectories of the criminal measures. The study findings provide some support for treatment effectiveness in decreasing A/M use among A/M abusers treated in community treatment programs. Longitudinal models allow opportunities to reveal the dynamic relationships between treatment and outcome.
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Manning V, Best D, Garfield JBB, Allsop S, Berends L, Lubman DI. Money well-spent: Further evidence of improved outcomes for methamphetamine users following treatment. Drug Alcohol Rev 2016; 36:E1-E3. [DOI: 10.1111/dar.12410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 02/08/2016] [Accepted: 02/16/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Victoria Manning
- Turning Point, Eastern Health and Monash University; Melbourne Australia
| | - David Best
- Sheffield Hallam University; Sheffield United Kingdom
| | | | - Steve Allsop
- National Drug Research Institute; Curtin University; Perth Australia
| | - Lynda Berends
- Centre for Health and Social Research; Australian Catholic University; Melbourne Australia
| | - Dan I. Lubman
- Turning Point, Eastern Health and Monash University; Melbourne Australia
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Rawson RA, Chudzynski J, Mooney L, Gonzales R, Ang A, Dickerson D, Penate J, Salem BA, Dolezal B, Cooper CB. Impact of an exercise intervention on methamphetamine use outcomes post-residential treatment care. Drug Alcohol Depend 2015; 156:21-28. [PMID: 26371404 PMCID: PMC4633370 DOI: 10.1016/j.drugalcdep.2015.08.029] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 07/31/2015] [Accepted: 08/17/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND We examined the efficacy of an 8-week exercise intervention on posttreatment methamphetamine (MA) use among MA-dependent individuals following residential treatment. METHODS 135 individuals newly enrolled in treatment were randomly assigned to a structured 8-week exercise intervention or health education control group. Approximately 1 week after completion of the intervention, participants were discharged to the community. Interview data and urine samples were collected at 1-, 3-, and 6-months post-residential care. Of the sample, 54.8% were classified as higher severity users (using MA more than 18 days in the month before admission) and 45.2% as lower severity users (using MA for up to 18 days in the month before admission). Group differences in MA use outcomes were examined over the 3 timepoints using mixed-multivariate modeling. RESULTS While fewer exercise participants returned to MA use compared to education participants at 1-, 3- and 6-months post-discharge, differences were not statistically significant. A significant interaction for self-reported MA use and MA urine drug test results by condition and MA severity was found: lower severity users in the exercise group reported using MA significantly fewer days at the three post-discharge timepoints than lower severity users in the education group. Lower severity users in the exercise group also had a lower percentage of positive urine results at the three timepoints than lower severity users in the education group. These relationships were not present in the comparison of the higher severity conditions. CONCLUSION Results support the value of exercise as a treatment component for individuals using MA 18 or fewer days/month.
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Affiliation(s)
- Richard A. Rawson
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Joy Chudzynski
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Larissa Mooney
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Rachel Gonzales
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Alfonso Ang
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Daniel Dickerson
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Jose Penate
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Bilal A. Salem
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Brett Dolezal
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, 10833 Le Conte 37-131 CHS, University of California, Los Angeles, Los Angeles, CA, USA
| | - Christopher B. Cooper
- Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, 10833 Le Conte 37-131 CHS, University of California, Los Angeles, Los Angeles, CA, USA
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Quinn B, Stoové M, Dietze P. One-year changes in methamphetamine use, dependence and remission in a community-recruited cohort. JOURNAL OF SUBSTANCE USE 2015. [DOI: 10.3109/14659891.2015.1018972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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12
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Hellem TL, Sung YH, Shi XF, Pett MA, Latendresse G, Morgan J, Huber RS, Kuykendall D, Lundberg KJ, Renshaw PF. Creatine as a Novel Treatment for Depression in Females Using Methamphetamine: A Pilot Study. J Dual Diagn 2015; 11:189-202. [PMID: 26457568 PMCID: PMC4684979 DOI: 10.1080/15504263.2015.1100471] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Depression among methamphetamine users is more prevalent in females than males, but gender-specific treatment options for this comorbidity have not been described. Reduced brain phosphocreatine levels have been shown to be lower in female methamphetamine users compared to males, and, of relevance, studies have demonstrated an association between treatment-resistant depression and reduced brain phosphocreatine concentrations. The nutritional supplement creatine monohydrate has been reported to reduce symptoms of depression in female adolescents and adults taking antidepressants, as well as to increase brain phosphocreatine in healthy volunteers. Therefore, the purpose of this pilot study was to investigate creatine monohydrate as a treatment for depression in female methamphetamine users. METHODS Fourteen females with depression and comorbid methamphetamine dependence were enrolled in an 8-week open label trial of 5 g of daily creatine monohydrate and of these 14, 11 females completed the study. Depression was measured using the Hamilton Depression Rating Scale (HAMD) and brain phosphocreatine levels were measured using phosphorus magnetic resonance spectroscopy pre- and post-creatine treatment. Secondary outcome measures included anxiety symptoms, measured with the Beck Anxiety Inventory (BAI), as well as methamphetamine use, monitored by twice weekly urine drug screens and self-reported use. RESULTS The results of a linear mixed effects repeated measures model showed significantly reduced HAMD and BAI scores as early as week 2 when compared to baseline scores. This improvement was maintained through study completion. Brain phosphocreatine concentrations were higher at the second phosphorus magnetic resonance spectroscopy scan compared to the baseline scan; Mbaseline = 0.223 (SD = 0.013) vs. Mpost-treatment = 0.233 (SD = 0.009), t (9) = 2.905, p <.01, suggesting that creatine increased phosphocreatine levels. Also, a reduction in methamphetamine positive urine drug screens of greater than 50% was observed by week 6. Finally, creatine was well tolerated and adverse events that were related to gastrointestinal symptoms and muscle cramping were determined as possibly related to creatine. CONCLUSIONS The current study suggests that creatine treatment may be a promising therapeutic approach for females with depression and comorbid methamphetamine dependence. This study is registered on clinicaltrials.gov (NCT01514630).
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Affiliation(s)
- Tracy L Hellem
- a The Brain Institute, University of Utah , Salt Lake City , Utah , USA.,b The College of Nursing, University of Utah , Salt Lake City , Utah , USA
| | - Young-Hoon Sung
- a The Brain Institute, University of Utah , Salt Lake City , Utah , USA
| | - Xian-Feng Shi
- a The Brain Institute, University of Utah , Salt Lake City , Utah , USA.,c The Department of Psychiatry , University of Utah , Salt Lake City , Utah , USA
| | - Marjorie A Pett
- b The College of Nursing, University of Utah , Salt Lake City , Utah , USA
| | - Gwen Latendresse
- b The College of Nursing, University of Utah , Salt Lake City , Utah , USA
| | - Jubel Morgan
- a The Brain Institute, University of Utah , Salt Lake City , Utah , USA.,c The Department of Psychiatry , University of Utah , Salt Lake City , Utah , USA
| | - Rebekah S Huber
- a The Brain Institute, University of Utah , Salt Lake City , Utah , USA
| | | | - Kelly J Lundberg
- c The Department of Psychiatry , University of Utah , Salt Lake City , Utah , USA
| | - Perry F Renshaw
- a The Brain Institute, University of Utah , Salt Lake City , Utah , USA.,c The Department of Psychiatry , University of Utah , Salt Lake City , Utah , USA.,d VISN 19 MIRECC , Salt Lake City , Utah , USA
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13
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Brecht ML, Herbeck D. Time to relapse following treatment for methamphetamine use: a long-term perspective on patterns and predictors. Drug Alcohol Depend 2014; 139:18-25. [PMID: 24685563 PMCID: PMC4550209 DOI: 10.1016/j.drugalcdep.2014.02.702] [Citation(s) in RCA: 161] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 02/12/2014] [Accepted: 02/18/2014] [Indexed: 11/20/2022]
Abstract
INTRODUCTION This paper describes methamphetamine (MA) use patterns, specifically the duration of continuing abstinence ("time to relapse") for periods averaging 5 years post-discharge from treatment for MA use, and the relationship with selected user and treatment characteristics. METHODS A sample of 350 treatment admissions from a large county substance use disorder (SUD) treatment system was randomly selected (within gender, race/ethnicity, treatment modality strata). Retrospective self-report data are from natural history interviews (NHI) conducted approximately 3 years after treatment and a follow-up of 2-3 years later. Relapse is defined as any use of MA with time as the number of months of continuous MA abstinence after treatment discharge until relapse. This outcome was constructed from a monthly MA use timeline using NHI data. A Cox model was used to examine time to relapse and predictors. RESULTS Sixty-one percent of the sample relapsed to MA use within 1 year after treatment discharge and 14% during years 2-5. Significant protective factors predicting longer time to relapse included having experienced serious MA-related psychiatric/behavioral problems (hazard ratio [HR]=0.75, p=0.027), longer duration of the index treatment episode (HR=0.93, p=0.001), and participating in self-help or other treatment during the post-treatment abstinence period (HR=0.29, p<0.001); risk factors for shorter time to relapse included having a parent with alcohol and/or drug use problems (HR=1.35, p=0.020) and involvement in MA sales (HR=1.48, p=0.002). CONCLUSIONS Results contribute a long-term perspective on patterns of MA use following treatment and support a need for early post-treatment and long-term continuing care and relapse-prevention services.
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Affiliation(s)
- Mary-Lynn Brecht
- Integrated Substance Abuse Programs, Department of Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, 11075 Santa Monica Blvd., Suite 100, Los Angeles, CA 90025, United States; School of Nursing, University of California, Los Angeles, Factor 5-151, 700 Tiverton Ave., Los Angeles, CA 90095, United States.
| | - Diane Herbeck
- Integrated Substance Abuse Programs, Department of Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, 11075 Santa Monica Blvd., Suite 100, Los Angeles, CA 90025, United States
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Maxwell JC. A new survey of methamphetamine users in treatment: who they are, why they like "meth," and why they need additional services. Subst Use Misuse 2014; 49:639-44. [PMID: 24093526 DOI: 10.3109/10826084.2013.841244] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The quality and quantity of illicit methamphetamine has recently increased due to introduction of a new precursor, 1-phenyl-2-propanone (P2P). This paper updates the problems associated with methamphetamine use. Methamphetamine-using clients (N = 222) entering a Texas program participated in computer-assisted interviews in 2010 and 2011 about routes of administration, other drugs used, severity of dependence, mental and physical health, perceived risks and benefits of use, family history, and abuse and neglect experienced as children and adults. Special needs of this population include therapies for trauma, gender-focused counseling, safe housing, and prevention messages to discourage use of the drug.
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Affiliation(s)
- Jane Carlisle Maxwell
- Center for Social Work Research, University of Texas at Austin , Austin, Texas , USA
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Rawson RA, Rataemane S, Rataemane L, Ntlhe N, Fox RS, McCuller J, Brecht ML. Dissemination and implementation of cognitive behavioral therapy for stimulant dependence: a randomized trial comparison of 3 approaches. Subst Abus 2014; 34:108-17. [PMID: 23577903 DOI: 10.1080/08897077.2012.691445] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND This study evaluated the effectiveness of 3 approaches to transferring cognitive behavioral therapy (CBT) to addiction clinicians in the Republic of South Africa (RSA). METHODS Clinicians (N = 143) were assigned to 3 training conditions: ( 1 ) an in vivo (IV) approach in which clinicians received in-person training and coaching; ( 2 ) a distance learning (DL) approach providing training via videoconference and coaching through teleconferencing; and ( 3 ) a control condition (C) providing a manual and 2-hour orientation. RESULTS Frequency of use of CBT skills increased significantly with the IV and DL approaches compared with the C approach, and the IV approach facilitated greater use of CBT skills than the DL approach. During the active phase of the study, skill quality declined significantly for clinicians trained in the C condition, whereas those in the DL approach maintained skill quality and those in the IV approach improved skill quality. After coaching was discontinued, clinicians in the IV and DL approaches declined in skill quality. However, those in the IV approach maintained a higher level of skill quality compared with the other approaches. Cost of the IV condition was double that of the DL condition and 10 times greater than the C condition. CONCLUSIONS In vivo supervision and distance learning methods appear to be effective dissemination and implementation strategies, and distance learning has significant potential to be less costly.
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Affiliation(s)
- Richard A Rawson
- Integrated Substance Abuse Programs, University of California, Los Angeles, CA 90075-7535, USA.
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Montoya JL, Umlauf A, Abramson I, Badiee J, Woods SP, Atkinson JH, Grant I, Moore DJ. Dynamic indices of methamphetamine dependence and HIV infection predict fluctuations in affective distress: a five-year longitudinal analysis. J Affect Disord 2013; 151:728-737. [PMID: 24012068 PMCID: PMC3845675 DOI: 10.1016/j.jad.2013.07.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Accepted: 07/31/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Methamphetamine (METH) use and human immunodeficiency virus (HIV) infection are highly comorbid, and both are associated with increased prevalence of affective distress. Delineating the trajectory of affective distress in the context of METH dependence and HIV infection is important given the implications for everyday functional impairment, adverse health behaviors, and increased risk for adverse health outcomes. METHODS We conducted a five-year longitudinal investigation involving 133 METH-dependent (74 HIV seropositive) and 163 non-METH-dependent (90 HIV seropositive) persons to examine both long-standing patterns and transient changes in affective distress. Mixed-effect regression models with random subject-specific slopes and intercepts evaluated the effect of METH dependence, HIV serostatus, and related variables on affective distress, as measured by the Profile of Mood States. RESULTS Transient changes in affective distress were found to be greater among those with a diagnosis of current MDD, briefer durations of abstinence from METH, and higher quantity of METH consumed. Weak associations were observed among static (time-independent predictors) covariates and long-standing patterns in affective distress. LIMITATIONS Study lacked data pertaining to the participants' involvement in METH treatment and relied on respondent-driven sampling. CONCLUSIONS Our longitudinal investigation of the trajectory of affective distress indicated that specific and dynamic indices of current METH use were associated with greater transient changes in mood. In the evaluation and treatment of affective distress, recency and quantity of current METH use are important to consider given their association with heightened affective distress and mood instability over time.
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Affiliation(s)
| | - Anya Umlauf
- University of California, San Diego, School of Medicine, Department of Psychiatry; La Jolla, CA
| | - Ian Abramson
- University of California, San Diego, Department of Mathematics; La Jolla, CA
| | - Jayraan Badiee
- University of California, San Diego, School of Medicine, Department of Psychiatry; La Jolla, CA
| | - Steven Paul Woods
- University of California, San Diego, School of Medicine, Department of Psychiatry; La Jolla, CA
| | - J. Hampton Atkinson
- University of California, San Diego, School of Medicine, Department of Psychiatry; La Jolla, CA,VA San Diego Healthcare System, San Diego, CA
| | - Igor Grant
- University of California, San Diego, School of Medicine, Department of Psychiatry; La Jolla, CA
| | - David J. Moore
- University of California, San Diego, School of Medicine, Department of Psychiatry; La Jolla, CA
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Silva CD, Neves AF, Dias AI, Freitas HJ, Mendes SM, Pita I, Viana SD, de Oliveira PA, Cunha RA, Fontes Ribeiro CA, Prediger RD, Pereira FC. A Single Neurotoxic Dose of Methamphetamine Induces a Long-Lasting Depressive-Like Behaviour in Mice. Neurotox Res 2013; 25:295-304. [DOI: 10.1007/s12640-013-9423-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 08/22/2013] [Accepted: 09/01/2013] [Indexed: 11/30/2022]
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McKenna S. “The Meth Factor”: Group Membership, Information Management, and the Navigation of Stigma. ACTA ACUST UNITED AC 2013. [DOI: 10.1177/009145091304000304] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Methamphetamine (or “meth”), a central nervous system stimulant, has been constructed as a dangerous drug with certain and extreme consequences. Incomplete and sometimes inaccurate portrayals, while aimed at preventing the initiation of use, stigmatize those who do use. Using data from in-depth, qualitative interviews with eight Northern Colorado women who are active meth users, this article explores how female meth users navigate this stigma through negotiation of group membership and management of information. The women in this study internalize and challenge the stigma: They identify as meth users and addicts yet view their own practices as distinguishing them from other users; and, they carefully control the extent to which they tell others of their use, even when contradictory to their sense of self and desirable relationships. These findings support the need for increased recognition and further examination of the role and enactment of agency among drug users and other oppressed groups.
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Li SX, Yan SY, Bao YP, Lian Z, Qu Z, Wu YP, Liu ZM. Depression and alterations in hypothalamic-pituitary-adrenal and hypothalamic-pituitary-thyroid axis function in male abstinent methamphetamine abusers. Hum Psychopharmacol 2013; 28:477-83. [PMID: 23913817 DOI: 10.1002/hup.2335] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 05/22/2013] [Indexed: 02/02/2023]
Abstract
The present study was to investigate depression and alterations in the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-thyroid (HPT) axis function in methamphetamine (METH) abusers after abstinence. Depression was assessed using the 13-item Beck Depression Inventory (BDI-13) scale; blood samples from in-patients who were METH abusers and age-matched and sex-matched healthy controls were collected. The demographic characteristics and history of METH abuse also was assessed. We found that serum levels of adrenocorticotropic hormone (ACTH) and thyroxine were increased; and serum levels of cortisol, triiodothyronine, and thyroid-stimulating hormone were decreased; and the BDI score was higher in METH abusers compared with control. In addition, there was no correlation between the BDI-13 score and any of hormones of HPA and HPT axis was found. Particularly, we found abnormally higher ACTH level and mismatched with lower cortisol level in abstinent METH abusers. These results indicate that METH abusers and that their HPA and HPT functions are all altered after abstinence. Chronically using METH may destroy the regulatory function of the HPA axis, especially the feedback regulation of cortisol to ACTH.
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Affiliation(s)
- Su-Xia Li
- National Institute on Drug Dependence, Peking University, Beijing, 100191, China
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20
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Kay-Lambkin FJ, Baker AL, Lee NM, Jenner L, Lewin TJ. The influence of depression on treatment for methamphetamine use. Med J Aust 2011; 195:S38-43. [PMID: 21806517 DOI: 10.5694/j.1326-5377.2011.tb03264.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Accepted: 04/18/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine whether the presence of comorbid depression influences response to psychological treatment for methamphetamine use. DESIGN Randomised controlled clinical trial. SETTING AND PARTICIPANTS Our study was conducted between 2001 and 2005 at two sites in Australia: the Hunter Region of New South Wales and the city of Brisbane, Queensland. The 214 participants, who were all using methamphetamine at least once a week in the month prior to the study, were self-referred or referred from health services or drug and alcohol clinical services. Participants were divided into two groups based on whether or not they had depressive symptoms at baseline. INTERVENTIONS The control group received only a self-help booklet; the two treatment groups received either two or four counselling sessions involving cognitive behaviour therapy and motivational interviewing techniques to manage methamphetamine use. MAIN OUTCOME MEASURES Changes in methamphetamine use and depression at 5 weeks and 6 months after baseline. RESULTS Over 70% of participants met criteria for depression at baseline, and depression was associated with significantly greater severity of methamphetamine use and related issues. Benzodiazepine use was significantly higher among depressed than non-depressed participants. Reductions in methamphetamine use between baseline and 5 weeks were independently predicted by comorbid depression, in favour of increased change among those with baseline depression. Depressed participants who received three or four counselling sessions showed a significant reduction in depression at 5 weeks. However, reductions in methamphetamine use and depression compared with baseline were no longer evident at 6 months. CONCLUSIONS Over the short term, comorbid depression did not negatively affect response to treatment, with some evidence of a dose-response treatment effect for reduction in depression. This was not maintained at 6 months, indicating that methamphetamine-focused treatment may not enable people with comorbid depression to make sustained improvement at the level of their counterparts without depression. TRIAL REGISTRATION NUMBER ACTRN12611000355976.
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Affiliation(s)
- Frances J Kay-Lambkin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.
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21
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Brecht ML, Greenwell L, von Mayrhauser C, Anglin MD. Two-Year Outcomes of Treatment for Methamphetamine Use. J Psychoactive Drugs 2011; Suppl 3:415-26. [PMID: 17357533 DOI: 10.1080/02791072.2006.10400605] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
While evaluation research supports the general effectiveness of substance abuse treatment, there is not a comprehensive literature on treatment effectiveness for methamphetamine (MA) use. The authors consider three outcome measures--MA use, criminal activity, and employment--compared across three periods: 24-months pretreatment, during treatment, and 24-months post-treatment. Data are from an intensive natural history interview conducted two to three years after treatment for 349 randomly selected admissions to treatment for MA abuse in a large publicly-funded county treatment system. Through this naturalistic design, data provide a system-wide perspective on effectiveness of treatment as usual. Results showed reduction in MA use and crime during and following treatment and increased employment following treatment over pretreatment levels. Regression analyses showed higher levels of education and more time in treatment related to more positive post-treatment outcomes for all three measures. Lower percentage of post-treatment months with MA use also was related to more pretreatment MA-related problems, lower pretreatment MA use, and residential (compared to outpatient) treatment modality. Lower post-treatment criminal activity was also related to gender (being female), lower pretreatment criminal activity, and residential modality. Higher percentage of post-treatment months with employment also was related to gender (being male), ethnicity (not African-American), and higher pretreatment employment.
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Affiliation(s)
- Mary-Lynn Brecht
- UCLA Integrated Substance Abuse Program, 1640 S. Sepulveda Blvd., Suite 200, Los Angeles, CA 90025, USA.
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22
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Depressive symptoms and patterns of drug use among street youth. J Adolesc Health 2011; 48:585-90. [PMID: 21575818 PMCID: PMC3096832 DOI: 10.1016/j.jadohealth.2010.09.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2010] [Revised: 09/20/2010] [Accepted: 09/21/2010] [Indexed: 11/22/2022]
Abstract
PURPOSE Rates of depression among street youth are poorly characterized, particularly as they pertain to concurrent drug use. We sought to assess associations between drug type and degree of depression in this population. METHODS Between October 2005 and November 2007, data were collected from a cohort of street-recruited youth aged 14-26 residing in Vancouver, Canada, for the At-Risk Youth Study. Active drug users were classified by predominant substance of use: daily marijuana use, weekly cocaine/crack use, weekly crystal methamphetamine use, or weekly heroin use. Adjusted mean number of depressive symptoms (measured by the Center for Epidemiological Studies Depression [CES-D] scale) was compared among the four groups using multiple linear regression. Logistic regression was also used to assess adjusted odds of CES-D score ≥ 22. RESULTS Among 447 youth, mean CES-D score was the highest among heroin users (adjusted mean: 22.7; standard deviation [SD]:1.2), followed by crystal methamphetamine users (adjusted mean: 21.8; SD: 1.1), then cocaine and/or crack users (adjusted mean: 19.1; SD: 1.0), and finally, marijuana users (adjusted mean: 18.3; SD: 1.1), resulting in a difference that was significant among groups (p < .001). When compared with daily marijuana users, odds of CES-D score ≥ 22 were higher among heroin users (adjusted odds ratio [AOR]: 2.64; 95% confidence interval [CI]: 1.39-4.99) and crystal methamphetamine users (AOR: 1.88; 95% CI: 1.04-3.42), but not among cocaine/crack users (AOR: 1.41; 95% CI: .79-2.52). CONCLUSION To our knowledge, this is the first report of drug use typologies and depression among street youth. Policymakers might heed the apparent vulnerability of heroin and crystal methamphetamine users to even greater degrees of depression than their peers.
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Oser CB, Leukefeld CG, Tindall MS, Garrity TF, Carlson RG, Falck R, Wang J, Booth BM. Rural drug users: factors associated with substance abuse treatment utilization. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2011; 55:567-86. [PMID: 20463206 PMCID: PMC2923294 DOI: 10.1177/0306624x10366012] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The purpose of this study is to use a modified version of Andersen's Behavioral Model of Health Services Use to identify the correlates of the number of substance abuse treatment episodes received by rural drug users. Data were collected from face-to-face interviews with 711 drug users in rural areas of Ohio, Arkansas, and Kentucky. Descriptive analyses examine rural drug users' substance use histories and retrospective substance abuse treatment service utilization patterns. A negative binomial regression model indicated that selected predisposing, historical health, and enabling factors were significantly associated with the utilization of substance abuse treatment among rural drug users. Despite high levels of recent and lifetime self-reported substance use among these rural drug users, treatment services were underutilized. Future studies are needed to examine the impact of the health care system and characteristics of the external environment associated with rural substance abuse treatment in order to increase utilization among drug users.
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Affiliation(s)
- Carrie B Oser
- Department of Sociology, Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY 40506, USA.
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Daniulaityte R, Falck R, Wang J, Carlson RG, Leukefeld CG, Booth BM. Predictors of depressive symptomatology among rural stimulant users. J Psychoactive Drugs 2010; 42:435-45. [PMID: 21305908 PMCID: PMC3320035 DOI: 10.1080/02791072.2010.10400706] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study examined sociodemographic and drug-related predictors of depressive symptoms among a rural, multistate sample of not-in-treatment stimulant drug users (n=710). Participants were recruited using respondent-driven sampling in Ohio, Arkansas, and Kentucky. The Patient Health Questionnaire (PHQ-9) was used to measure symptoms of depression. Moderate to severe depressive symptomatology was reported by 43.0% of the sample. Cumulative logistic regression analysis showed that daily and nondaily crack use as well as the daily use of cocaine HCl increased the odds of depressive symptoms. Methamphetamine use had no significant association with depression. The daily use of marijuana, the illicit use of tranquilizers, light/moderate cigarette smoking, and injection drug use also increased the risk of depressive symptoms. Living in Kentucky or Ohio (compared to Arkansas), having unstable living arrangements, and being White, female, and older were related to higher odds of depressive symptoms. These results suggest that a host of drug and nondrug factors need to be considered when addressing depressive symptoms in stimulant users.
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Affiliation(s)
- Raminta Daniulaityte
- Center for Interventions, Treatment, and Addiction Research, Department of Community Health, Boonshoft School of Medicine, Wright State University, Dayton, OH 45435, USA.
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Withdrawal from chronic exposure to amphetamine, but not nicotine, leads to an immediate and enduring deficit in motivated behavior without affecting social interaction in rats. Behav Pharmacol 2010; 21:359-68. [PMID: 20571366 DOI: 10.1097/fbp.0b013e32833c7cc8] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Psychostimulant withdrawal leads to depressive symptoms, such as anhedonia and social dysfunction. We determined the effects of withdrawal from chronic exposure to nicotine (9 mg/kg/day salt, 28 days) or amphetamine (10 mg/kg/day salt, 7 days) on the motivated response for a sucrose reward and on social interaction in rats. Both nicotine and amphetamine exposure increased the motivated response for sucrose. However, only spontaneous amphetamine withdrawal led to an immediate and persistent decrease in motivated behavior, which was not correlated with body weight loss. Social interaction was not affected during withdrawal from either drug. These results indicate that withdrawal from chronic amphetamine exposure leads to an immediate and enduring anhedonic state.
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KAY-LAMBKIN FRANCESJ, BAKER AMANDAL, MCKETIN REBECCA, LEE NICOLE. Stepping through treatment: Reflections on an adaptive treatment strategy among methamphetamine users with depression. Drug Alcohol Rev 2010; 29:475-82. [DOI: 10.1111/j.1465-3362.2010.00203.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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HIDES LEANNE, SAMET SHARON, LUBMAN DANI. Cognitive behaviour therapy (CBT) for the treatment of co-occurring depression and substance use: Current evidence and directions for future research. Drug Alcohol Rev 2010; 29:508-17. [DOI: 10.1111/j.1465-3362.2010.00207.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Iudicello JE, Woods SP, Vigil O, Scott JC, Cherner M, Heaton RK, Atkinson JH, Grant I. Longer term improvement in neurocognitive functioning and affective distress among methamphetamine users who achieve stable abstinence. J Clin Exp Neuropsychol 2010; 32:704-18. [PMID: 20198527 PMCID: PMC2911490 DOI: 10.1080/13803390903512637] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Chronic use of methamphetamine (MA) is associated with neuropsychological dysfunction and affective distress. Some normalization of function has been reported after abstinence, but little in the way of data is available on the possible added benefits of long-term sobriety. To address this, we performed detailed neuropsychological and affective evaluations in 83 MA-dependent individuals at a baseline visit and following an average one-year interval period. Among the 83 MA-dependent participants, 25 remained abstinent, and 58 used MA at least once during the interval period. A total of 38 non-MA-addicted, demographically matched healthy comparison (i.e., HC) participants were also examined. At baseline, both MA-dependent participants who were able to maintain abstinence and those who were not performed significantly worse than the healthy comparison subjects on global neuropsychological functioning and were significantly more distressed. At the one-year follow-up, both the long-term abstainers and healthy comparison groups showed comparable global neuropsychological performance and affective distress levels, whereas the MA-dependent group who continued to use MA were worse than the comparison participants in terms of global neuropsychological functioning and affective distress. An interaction was observed between neuropsychological impairment at baseline, MA abstinence, and cognitive improvement, with abstinent MA-dependent participants who were neuropsychologically impaired at baseline demonstrating significantly and disproportionately greater improvement in processing speed and slightly greater improvement in motor abilities than the other participants. These results suggest partial recovery of neuropsychological functioning and improvement in affective distress upon sustained abstinence from MA that may extend beyond a year or more.
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Affiliation(s)
- Jennifer E Iudicello
- Department of Psychiatry, HIV Neurobehavioral Research Center, University of California, San Diego, School of Medicine, La Jolla, CA 92103, USA.
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Feasibility and acceptability of a phase II randomized pharmacologic intervention for methamphetamine dependence in high-risk men who have sex with men. AIDS 2010; 24:991-1000. [PMID: 20397286 DOI: 10.1097/qad.0b013e328336e98b] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine whether actively using, methamphetamine (meth)-dependent men who have sex with men (msm) could be enrolled and retained in a pharmacologic intervention trial, and the degree to which participants would adhere to study procedures, including medication adherence. study design: phase ii randomized, double-blind trial of bupropion vs. placebo. METHODS Thirty meth-dependent, sexually active MSM were randomized to receive daily bupropion XL 300 mg or placebo for 12 weeks. Participants received weekly substance use counseling, provided weekly urine specimens, and completed monthly audio-computer assisted self-interview (ACASI) behavioral risk assessments. Adherence was measured by medication event monitoring systems (MEMS) caps (the number of distinct MEMS cap openings divided by the number of expected doses) and self-report. RESULTS Ninety percent completed the trial: 89% of monthly ACASIs were completed, 81% of study visits were attended, and 81% of urine samples were collected. Adherence by MEMS cap was 60% and by self-report was 81% and did not differ significantly by treatment assignment. The median number of positive urine samples was 5.5 out of a possible 11 (50%). Participants in both arms reported similar declines in the median number of sex partners (P = 0.52). No serious adverse events occurred and there were no significant differences in adverse events by treatment assignment (P = 0.11). CONCLUSIONS It is feasible to enroll and retain actively using, meth-dependent MSM in a pharmacologic intervention. Bupropion was well tolerated. Study participation and retention rates were high, however, study drug medication adherence was only moderate. Findings support a larger trial with improved adherence support to evaluate the efficacy of bupropion and other pharmacologic interventions for meth dependence in this population.
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Marquez C, Mitchell SJ, Hare CB, John M, Klausner JD. Methamphetamine use, sexual activity, patient-provider communication, and medication adherence among HIV-infected patients in care, San Francisco 2004-2006. AIDS Care 2009; 21:575-82. [PMID: 19444665 DOI: 10.1080/09540120802385579] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
While numerous studies examine methamphetamine use and associated risky sexual behaviors in HIV-uninfected individuals, few studies have surveyed HIV-infected individuals in the health care setting. To assess the frequency and trends of methamphetamine use, sexual activity, injection drug use, patient-provider communication, and medication adherence among HIV-infected persons in care, we administered a one-page anonymous survey in 2004 and 2006. The survey was conducted at the two University of California, San Francisco outpatient HIV clinics: at Moffitt Hospital (Moffitt), serving primarily privately insured patients, and at San Francisco General Hospital (SFGH), a county hospital serving primarily patients who are uninsured or publicly insured. In 2006, 39% of men who have sex with men (MSM), 33% of heterosexual men, and 11% of women reported methamphetamine use in the prior 12 months. Methamphetamine use was significantly associated with an increased number of sex partners among MSM and heterosexual men, and poor anti-retroviral medication adherence. Among MSM, methamphetamine use was more common at the SFGH clinic. Between 2004 and 2006, reported methamphetamine use in the last 12 months decreased among MSM at Moffitt (38 to 20%, p<0.01), but increased at SFGH (40 to 50%, p<0.05). Among methamphetamine users we found a high frequency of injection of methamphetamine, which increased at SFGH from 38 to 55%, p<0.05. Patient-provider communication regarding methamphetamine use has increased from 2004 to 2006 but no significant change has been found for providers asking patients about sexual activity. Overall, we found methamphetamine use to be common among HIV-infected patients in care, and associated with an increased number of sex partners, a high frequency of injection drug use, and poor adherence to anti-retroviral medications. These findings support the need for improved screening and clinic-based interventions to reduce and treat methamphetamine abuse and associated high risk sexual behaviors.
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Affiliation(s)
- Carina Marquez
- Internal Medicine, University of California-San Francisco, CA, USA.
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Sutcliffe CG, German D, Sirirojn B, Latkin C, Aramrattana A, Sherman SG, Celentano D. Patterns of methamphetamine use and symptoms of depression among young adults in northern Thailand. Drug Alcohol Depend 2009; 101:146-51. [PMID: 19153017 PMCID: PMC2692876 DOI: 10.1016/j.drugalcdep.2008.11.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2008] [Revised: 10/29/2008] [Accepted: 11/27/2008] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Depression often co-occurs with amphetamine type stimulant use and can negatively impact drug treatment outcomes. Understanding the temporal relationship between depressive symptoms and methamphetamine use can further inform both treatment and mental health options. METHODS Methamphetamine users aged 18-25 years were enrolled in a 12-month randomized behavioral trial in Thailand. Questionnaires were administered every 3 months and included information on substance use and depressive symptoms. Pattern of methamphetamine use during follow-up was characterized into four groups: early cessation, late cessation, relapse and persistent use. Multinomial logistic regression was used to determine the impact of baseline depressive symptoms (CES-D score and % > or =22) on patterns of methamphetamine use during follow-up. Linear and logistic regression was used to determine the impact of patterns of methamphetamine use on depressive symptoms at the end of the trial. RESULTS No association was found between baseline depressive symptoms and subsequent patterns of methamphetamine use. A significant relationship was found between patterns of methamphetamine use and ensuing depressive symptoms, with those achieving cessation experiencing lower levels of depressive symptoms. DISCUSSION Many symptoms of depression may resolve with cessation or reduction in methamphetamine use. Clinical and community-based efforts that facilitate drug users' attempts to stop using drugs should be supported as they may contribute to positive cessation outcomes and help to improve overall mental health.
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Affiliation(s)
- Catherine G. Sutcliffe
- Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, United States
| | - Danielle German
- Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, United States
| | - Bangorn Sirirojn
- Research Institute for Health Sciences, Chiang Mai University, 110 Intravaroros Road, Amphur Muang, Chiang Mai, Thailand 50202
| | - Carl Latkin
- Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, United States
| | - Apinun Aramrattana
- Research Institute for Health Sciences, Chiang Mai University, 110 Intravaroros Road, Amphur Muang, Chiang Mai, Thailand 50202
| | - Susan G. Sherman
- Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, United States
| | - David Celentano
- Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205, United States
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Dobkin C, Nicosia N. The War on Drugs: Methamphetamine, Public Health, and Crime. THE AMERICAN ECONOMIC REVIEW 2009; 99:324-349. [PMID: 20543969 PMCID: PMC2883188 DOI: 10.1257/aer.99.1.324] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
In mid-1995, a government effort to reduce the supply of methamphetamine precursors successfully disrupted the methamphetamine market and interrupted a trajectory of increasing usage. The price of methamphetamine tripled and purity declined from 90 percent to 20 percent. Simultaneously, amphetaminerelated hospital and treatment admissions dropped 50 percent and 35 percent, respectively. Methamphetamine use among arrestees declined 55 percent. Although felony methamphetamine arrests fell 50 percent, there is no evidence of substantial reductions in property or violent crime. The impact was largely temporary. The price returned to its original level within four months; purity, hospital admissions, treatment admissions, and arrests approached preintervention levels within eighteen months. (JEL I12, K42).
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Affiliation(s)
- Carlos Dobkin
- Dobkin: Department of Economics, University of California, 1156 High St., Santa Cruz, CA 95064 ( ); Nicosia: RAND, 1776 Main St., M5W, PO Box 2138, Santa Monica, CA 90407-2138 ( )
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Methamphetamine induces long-term alterations in reactivity to environmental stimuli: correlation with dopaminergic and serotonergic toxicity. Neurotox Res 2009; 15:232-45. [PMID: 19384596 DOI: 10.1007/s12640-009-9024-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2008] [Revised: 10/08/2008] [Accepted: 10/08/2008] [Indexed: 10/20/2022]
Abstract
Methamphetamine (METH) abuse is known to induce persistent cognitive and behavioral abnormalities, in association with alterations in serotonin (5-HT) and dopamine (DA) systems, yet the neurobiological mechanisms underpinning this link are elusive. Thus, in the present study we analyzed the long-term impact of an acute toxic regimen of METH (4 mg/kg, subcutaneous x 4 injections, 2 h apart) on the reactivity of adult male rats to environmental stimuli, and correlated it to toxicity on 5-HT and DA innervations. Two separate groups of METH-injected rats were compared to their saline-treated controls on object exploration and startle paradigms, at either 1 or 3 weeks after METH administration, respectively. Twenty-four hours after behavioral testing, animals were sacrificed, and the neurotoxic effects of the METH schedule on DA and 5-HT terminals were measured through immunochemical quantification of their transporters (DAT and 5-HTT). At both 1 and 3 weeks after treatment, METH-injected rats exhibited a significant decline in the number of exploratory approaches to unfamiliar objects, which was significantly correlated with a parallel reduction in DAT immunoreactivity (IR) in the nucleus accumbens (NAc) core. Furthermore, METH-treated rats displayed a significant enhancement in startle magnitude after 3 (but not 1) weeks, which was inversely correlated with a decrement in 5-HTT IR in the Cg3 infralimbic area of prefrontal cortex. Our results suggest that METH induces long-term changes in object exploration and startle responsiveness, which may be respectively underpinned by reductions in DAergic and 5-HTergic brain terminals.
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Anglin MD, Urada D, Brecht ML, Hawken A, Rawson R, Longshore D. Criminal justice itreatment admissions for methamphetamine use in California: a focus on Proposition 36. J Psychoactive Drugs 2008; Suppl 4:367-81. [PMID: 18284103 DOI: 10.1080/02791072.2007.10399898] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Methamphetamine (MA) use is considered as one of the nation's most pressing drug problems. In California, MA use has outstripped all other drugs in epidemiological extent, law enforcement activities, and treatment services demand. An opportunity for further study of MA use and its treatment emerged from a change in offender sentencing options introduced by California's Substance Abuse and Crime Prevention Act of 2000 (SACPA). Results indicate that statewide admissions for MA rose from 8.4% in FY 1992/1993 to 34.6% in FY 2004/2005, a four-fold increase over the 13 years. From the year before SACPA implementation to the year after, the percentage of treatment admissions due to MA use increased from 18.8% to 25.6%, an increase largely due to the fact that SACPA admissions were over 50% MA users. With the exception of alcohol, MA users entering treatment through SACPA had higher completion rates (about one third) from community based treatment than users of other primary drugs. This result held true for demographic and other subgroups of MA users. Multivariate regression results illuminate the relative importance of the variables examined. Implication of the findings for policy, intervention services, and research are discussed.
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Affiliation(s)
- M Douglas Anglin
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, UCLA, Los Angeles, CA 90025, USA.
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Marinelli-Casey P, Gonzales R, Hillhouse M, Ang A, Zweben J, Cohen J, Hora PF, Rawson RA. Drug court treatment for methamphetamine dependence: Treatment response and posttreatment outcomes. J Subst Abuse Treat 2008; 34:242-8. [PMID: 17596903 DOI: 10.1016/j.jsat.2007.04.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2006] [Revised: 03/07/2007] [Accepted: 04/05/2007] [Indexed: 11/21/2022]
Abstract
Relatively little is known about the impact of drug court treatment programs for methamphetamine (MA) dependence. This article examines treatment performance among a subsample of 287 MA-dependent adults who participated in the Methamphetamine Treatment Project from 1999 to 2001. To gain a preliminary indication of MA users' response to drug court intervention, we compared a group of 57 MA-dependent participants treated in outpatient treatment within the context of a drug court to a group of comparable MA-dependent individuals treated in outpatient treatment but not supervised by a drug court (n = 230). Analyses reveal that drug court participation was associated with better rates of engagement, retention, completion, and abstinence, compared to outpatient treatment without drug court supervision. Six- and 12-month outcome analyses indicated that participants who were enrolled in drug court intervention used MA significantly less frequently. These findings suggest that drug court supervision coupled with treatment may improve the outcomes of MA-dependent offenders beyond that seen from treatment alone.
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36
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Das-Douglas M, Colfax G, Moss AR, Bangsberg DR, Hahn JA. Tripling of methamphetamine/amphetamine use among homeless and marginally housed persons, 1996-2003. J Urban Health 2008; 85:239-49. [PMID: 18163214 PMCID: PMC2430118 DOI: 10.1007/s11524-007-9249-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2007] [Accepted: 11/29/2007] [Indexed: 11/26/2022]
Abstract
Methamphetamine/amphetamine (MA)-related morbidity and mortality has been increasing in the United States. MA use is associated with high-risk sexual behavior and syringe-sharing practices. Homeless and marginalized housed persons (H/M) have high rates of substance use and mental health disorders. Little is known about trends of MA use among the H/M. The objective of this study was to quantify increases in MA use among H/M in San Francisco and to determine which demographic and behavioral subgroups have experienced the greatest increases in MA use. We conducted serial cross-sectional population-based studies in three waves: 1996-1997, 1999-2000, and 2003 and studied 2,348 H/M recruited at shelters and lunch lines. The main outcome was self-reported current (30-day) MA use. We found a tripling of current MA use among H/M persons from 1996 to 2003, with a sevenfold increase in smoked MA use. MA use doubled to tripled in most demographic and behavioral subgroups, whereas it quadrupled in those under age 35, and there was a fivefold increase among HIV-infected persons. The increase in MA use among H/M places a vulnerable population at additional increased risk for HIV infection and MA-use related morbidity and mortality. Among HIV-infected H/M, the increase in MA use has important public health implications for the development and secondary transmission of drug-resistant HIV caused by synergistic neurocognitive decline, poor adherence to HIV medications, and increased sexual risk behavior. Clinicians caring for H/M persons should inquire about MA use, refer interested MA users to MA dependence treatment programs and provide targeted HIV sexual risk reduction counseling. For HIV-infected H/M MA users, clinicians should closely monitor adherence to HIV or other chronic medications, to avoid unnecessary morbidity and mortality. Further research is needed to elucidate the most effective prevention and treatment for MA use and dependence among the H/M.
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Affiliation(s)
- Moupali Das-Douglas
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, CA 94143, USA.
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Galloway GP, Singleton EG, Anglin MD, Rawson RA, Patricia MC, Joseph B, Richard B, Alison Hamilton B, Cynthia B, Darrell C, Judith C, Florentina C, Alice D, Melissa D, Yvonne F, Freese TE, Cheryl G, Galloway GP, Vikas G, James H, Kathryn H, Alice H, Iguchi MY, Lord RH, McCann MJ, Sam M, Pat M, Jeanne O, Susan P, Chris R, Norman R, Janice S, Stalcup PA, Stamper ES, Janice S, Sarah Turcotte M, Denna V, Ahndrea W, Kathryn W, Joan Z. How Long Does Craving Predict Use of Methamphetamine? Assessment of Use One to Seven Weeks after the Assessment of Craving. SUBSTANCE ABUSE: RESEARCH AND TREATMENT 2008. [DOI: 10.4137/sart.s775] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aims This study lays the foundation for a clinical prediction model based on methamphetamine craving intensity and its ability to predict the presence or absence of within-treatment methamphetamine use. Design We used a random effects logistic approach for estimating repeated-measures, generalized linear mixed models (GLMM) using craving as the sole predictor of methamphetamine. A multivariate GLMM included craving, length of treatment, treatment assignment, and methamphetamine use the previous week as covariates to control for potential confounds. We performed receiver operating characteristic (ROC) analyses to evaluate predictive accuracy. We investigated further whether methamphetamine craving predicted subsequent use more accurately at intervals more proximal to versus those more distal to assessment, examining one-week periods ending one to seven weeks after assessment of craving. Setting The study was part of the Center for Substance Abuse Treatment (CSAT) Methamphetamine Treatment Project (MTP). Subjects Analyses were based on data from 691 methamphetamine dependent outpatients enrolled in the MTP. Measurements Craving was assessed by self-report on a 0–100 scale. Self-reported methamphetamine use was toxicologically verified. Craving and drug use were assessed weekly for 8 weeks. Findings In the univariate analysis craving predicted methamphetamine use in the week immediately following the craving report (p < 0.0001), with subject-specific use increasing 0.38% for each one-point increase in craving on a 0–100 scale. In the multivariate analysis the probability of use decreased by 2.45% for each week in treatment increased by 33.11% for previous methamphetamine use, and the probability of methamphetamine use still increased with craving, rising 0.28% for each one-point increase in craving score (all p < 0.0001). Predictive accuracy was strongest at the one-week time-lag and declined in magnitude the more distal the assessment period. Conclusions Craving is a predictor of within-treatment methamphetamine use. Intensity of craving is appropriate for use as a surrogate marker in methamphetamine dependence.
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Affiliation(s)
- Gantt P. Galloway
- Addiction Pharmacology Research Laboratory, St. Lukes Hospital, 7th floor, 3555 Cesar Chavez Street, San Francisco, CA 94110
| | - Edward G. Singleton
- The MayaTech Corporation, 1100 Wayne Avenue, Suite 900, Silver Spring, MD 20910
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Costenbader EC, Zule WA, Coomes CM. The impact of illicit drug use and harmful drinking on quality of life among injection drug users at high risk for hepatitis C infection. Drug Alcohol Depend 2007; 89:251-8. [PMID: 17320314 PMCID: PMC1974852 DOI: 10.1016/j.drugalcdep.2007.01.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2006] [Revised: 01/10/2007] [Accepted: 01/15/2007] [Indexed: 02/02/2023]
Abstract
BACKGROUND Heavy alcohol use, hepatitis C and illicit drug use each have been shown to have negative impacts on health-related quality of life (HRQL). To date, considerations of HRQL have not played a prominent role in the design and measurement of intervention strategies for out-of-treatment at-risk populations. METHODS Data were collected from out-of-treatment IDUs recruited through street outreach in North Carolina. Multiple linear regression analyses were used to examine the independent effects of HCV status, harmful drinking (AUDIT), and illicit drug use on HRQL (SF-36). RESULTS Fifty-one percent of 619 study participants tested HCV-positive; 57% met criteria for harmful or hazardous drinking and 63% reported daily use of hard drugs. HRQL scores for this population were significantly lower than those of the general population. Multiple linear regression analyses demonstrated that harmful levels of alcohol consumption and use of methamphetamine in the past month had the strongest associations with reduced HRQL. CONCLUSIONS Given the high rates of HCV in most IDU communities, new harm reduction approaches are needed for these populations which focus beyond prevention to the functioning and well being of those already infected. In particular, reducing heavy alcohol use in addition to slowing HCV progression shows promise for improving HRQL.
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Affiliation(s)
- Elizabeth C Costenbader
- Substance Abuse Treatment, Evaluations and Interventions (SATEI), RTI International, Research Triangle Park, NC 27709, USA.
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39
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Baker A, Dawe S. Amphetamine use and co-occurring psychological problems: Review of the literature and implications for treatment. AUSTRALIAN PSYCHOLOGIST 2007. [DOI: 10.1080/00050060500094654] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- A Baker
- Centre for Mental Health Studies, University of Newcastle , Newcastle, New South Wales
| | - S Dawe
- School of Applied Psychology, Griffith University , Brisbane, Queensland, Australia
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Luchansky B, Krupski A, Stark K. Treatment response by primary drug of abuse: does methamphetamine make a difference? J Subst Abuse Treat 2006; 32:89-96. [PMID: 17175402 DOI: 10.1016/j.jsat.2006.06.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2005] [Revised: 06/01/2006] [Accepted: 06/05/2006] [Indexed: 11/20/2022]
Abstract
The purposes of this study were to examine the outcomes of a sample of patients receiving publicly funded substance abuse treatment in Washington State and to compare the outcomes of those using methamphetamine (MA) with patients using other drugs of abuse. All data for this study came from administrative systems in Washington State, and the outcomes included completion of and readmission to treatment, employment, and various forms of criminal justice involvement. Treatment records were linked to outcome data using both deterministic and probabilistic matching techniques. Patients were tracked for 1 year following their discharge, and analyses were performed separately on a study population of adults and a study population of youth. For both adults and youth, the results showed that across outcomes, there were few differences between MA users and users of other hard drugs, whereas there were consistent differences between MA users and users of alcohol and marijuana. Alcohol and marijuana users tended to have more positive outcomes than the other groups. Future research should focus on more detailed analyses of the type of treatment received by patients, particularly for MA users.
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41
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Robinson L, Rempel H. Methamphetamine Use and HIV Symptom Self-Management. J Assoc Nurses AIDS Care 2006; 17:7-14. [PMID: 16979510 DOI: 10.1016/j.jana.2006.07.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2005] [Indexed: 11/24/2022]
Abstract
This study describes HIV-related symptoms in a methamphetamine-using sample of 20 men living in southern California. Data were obtained in 2004 and 2005 using a cross-sectional design. Participants were administered the Revised Sign and Symptom Check-List for Persons With HIV Disease and the Addiction Severity Index and were engaged in a semistructured interview. Participants reported using methamphetamine to treat HIV-related depression, fatigue, and neuropathic pain. HIV-related diarrhea seemed to diminish with methamphetamine use, although this was not a motivation for use. These results, although preliminary, suggest that further study of the interplay between methamphetamine use and HIV symptom management is warranted.
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Affiliation(s)
- Linda Robinson
- Hahn School of Nursing and Health Sciene, University of San Diego, USA
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42
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Mitchell SJ, Morris SR, Kent CK, Stansell J, Klausner JD. Methamphetamine use and sexual activity among HIV-infected patients in care--San Francisco, 2004. AIDS Patient Care STDS 2006; 20:502-10. [PMID: 16839249 DOI: 10.1089/apc.2006.20.502] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Samuel J Mitchell
- STD Prevention and Control Services, San Francisco Department of Public Health, San Francisco, California, USA
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43
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Colfax G, Shoptaw S. The methamphetamine epidemic: implications for HIV prevention and treatment. Curr HIV/AIDS Rep 2006; 2:194-9. [PMID: 16343378 DOI: 10.1007/s11904-005-0016-4] [Citation(s) in RCA: 144] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Methamphetamine and related amphetamine compounds are among the most commonly used illicit drugs, with over 35 million users worldwide. In the United States, admissions for methamphetamine treatment have increased dramatically over the past 10 years. Methamphetamine use is prevalent among persons with HIV infection and persons at risk for HIV, particularly among men who have sex with men. In addition to being associated with increased sexual risk behavior, methamphetamine causes significant medical morbidity, including neurologic deficits, cardiovascular compromise, dental decay, and skin infections, all of which may be worsened in the presence of HIV/AIDS. Methamphetamine use may also result in decreased medication adherence, particularly during "binging" episodes. Behavioral counseling remains the standard of treatment for methamphetamine dependence, although the effectiveness of most counseling interventions has not been rigorously tested. Pharmacologic and structural interventions may prove valuable additional interventions to reduce methamphetamine use.
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Affiliation(s)
- Grant Colfax
- San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 710, San Francisco, CA 94102, USA.
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44
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Volkow ND, Li TK. Drugs and alcohol: treating and preventing abuse, addiction and their medical consequences. Pharmacol Ther 2006; 108:3-17. [PMID: 16098597 DOI: 10.1016/j.pharmthera.2005.06.021] [Citation(s) in RCA: 128] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2005] [Accepted: 06/06/2005] [Indexed: 01/12/2023]
Abstract
Recent advances in the fields of genetics, molecular biology, behavioral neuropharmacology, and brain imaging have dramatically changed our understanding of the addictive process and why relapse occurs even in the face of catastrophic consequences. Addiction is now recognized as a chronic brain disease that involves complex interactions between repeated exposure to drugs, biological (i.e., genetic and developmental), and environmental (i.e., drug availability, social, and economic variables) factors. Its treatment, therefore, requires, in general, not only a long-term intervention but also a multipronged approach that addresses the psychiatric, medical, legal, and social consequences of addiction. Also, because addiction usually starts in adolescence or early adulthood and is frequently comorbid with mental illness, we need to expand our treatment interventions in this age group both for substance abuse and psychiatric disorders.
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Affiliation(s)
- Nora D Volkow
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892, USA.
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45
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Rawson RA, Gonzales R, Obert JL, McCann MJ, Brethen P. Methamphetamine use among treatment-seeking adolescents in Southern California: Participant characteristics and treatment response. J Subst Abuse Treat 2005; 29:67-74. [PMID: 16135335 DOI: 10.1016/j.jsat.2005.04.001] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2004] [Revised: 04/22/2005] [Accepted: 04/25/2005] [Indexed: 11/29/2022]
Abstract
This study examined participant characteristics and treatment response among substance-abusing adolescents who received outpatient treatment (N=305, 70.2% adolescent male, 55.3% White, 33.1% Latino, average age of 16 years). Chart reviews were performed on existing intake and discharge assessments between 1999 and 2003 from two Matrix Institute on Addictions treatment clinics. Analyses comparing methamphetamine (meth)-using (n=90) and non-meth-using (n=215) adolescents revealed that adolescent females and older youth were more likely to use meth. Meth users reported greater psychosocial dysfunction and higher rates of substance use at treatment discharge compared with non-meth users. Suicidal ideation and substance use during treatment were predictors of early treatment dropout among the total sample. Meth-using adolescents may need enhanced treatment programming, because they appear to present for treatment with higher levels of dysfunction. Implications are discussed in terms of developing strategies that minimize drug use and maximize treatment response among substance-abusing adolescents.
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Affiliation(s)
- Richard A Rawson
- UCLA Integrated Substance Abuse Programs, Los Angeles, CA 90095, USA.
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46
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McGregor C, Srisurapanont M, Jittiwutikarn J, Laobhripatr S, Wongtan T, White JM. The nature, time course and severity of methamphetamine withdrawal. Addiction 2005; 100:1320-9. [PMID: 16128721 DOI: 10.1111/j.1360-0443.2005.01160.x] [Citation(s) in RCA: 229] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
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.
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Affiliation(s)
- Catherine McGregor
- Department of Clinical and Experimental Pharmacology, University of Adelaide, Australia
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47
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Hser YI, Evans E, Huang YC. Treatment outcomes among women and men methamphetamine abusers in California. J Subst Abuse Treat 2005; 28:77-85. [PMID: 15723735 DOI: 10.1016/j.jsat.2004.10.009] [Citation(s) in RCA: 115] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2004] [Revised: 08/08/2004] [Accepted: 10/28/2004] [Indexed: 11/26/2022]
Abstract
This prospective longitudinal study examined treatment outcomes among 1,073 methamphetamine-abusing patients (567 women, 506 men) from 32 community-based outpatient and residential programs in 13 California counties. Data were collected at intake and at 3 months and 9 months after admission. With one exception, improvements from baseline to follow-up were observed in all areas measured by the Addiction Severity Index for both women and men in either modality. Compared to men, women demonstrated greater improvement in family relationships and medical problems, and similar improvement in all other areas, despite the fact that more women were unemployed, had childcare responsibilities, were living with someone who also used alcohol or drugs, had been physically or sexually abused, and reported more psychiatric symptoms. Implications for service improvement are discussed.
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Affiliation(s)
- Yih-Ing Hser
- UCLA Integrated Substance Abuse Programs, Neuropsychiatric Institute, University of California-Los Angeles, Los Angeles, CA 90025, USA.
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48
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Sexton RL, Carlson RG, Siegal HA, Falck RS, Leukefeld C, Booth B. Barriers and Pathways to Diffusion of Methamphetamine Use Among African Americans in the Rural South. J Ethn Subst Abuse 2005; 4:77-103. [PMID: 16870573 DOI: 10.1300/j233v04n01_06] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There are no studies of African Americans methamphetamine use in the South where it is widespread among whites. We describe factors that inhibit or facilitate the diffusion of methamphetamine use among African Americans based on qualitative interviews with 86 drug users in rural Arkansas and Kentucky. Results suggest low prevalence of methamphetamine use among African Americans, and interviewees cited several barriers to its diffusion which were linked to the drug's ingredients, psychoactive and physiological effects, difficulty in accessing distribution networks, and established African-American preference for cocaine. Fourteen African Americans reported methamphetamine use and discussed pathways to it. Possible increases in African- American methamphetamine use merits further investigation.
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Affiliation(s)
- Rocky L Sexton
- Center for Interventions, Treatment and Addiction Research, Department of Community Health, Wright State University School of Medicine, Dayton, OH 45435, USA.
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Abstract
Methamphetamine (MA) abuse is increasing to epidemic proportions, both nationally and globally. Chronic MA use has been linked to significant impairments in different arenas of neuropsychological function. To better understand this issue, a computerized literature search (PubMed, 1964-2004) was used to collect research studies examining the neurobiological and neuropsychiatric consequences of chronic MA use. Availability of MA has markedly increased in the United States due to recent technological improvements in both mass production and clandestine synthesis, leading to significant public health, legal, and environmental problems. MA intoxication has been associated with significant psychiatric and medical comorbidity. Research in animal models and human subjects reveals complicated mechanisms of neurotoxicity by which chronic MA use affects catecholamine neurotransmission. This pathology may underlie the characteristic cognitive deficits that plague chronic MA users, who experience impairments in memory and learning, psychomotor speed, and information processing. These impairments have the potential to compromise, in turn, the ability of MA abusers to engage in, and benefit from, psychosocially based chemical-dependency treatment. Development of pharmacological interventions to improve these cognitive impairments in this population may significantly improve the degree to which they may be able to participate in treatment. Atypical antipsychotics may have some promise in this regard.
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Affiliation(s)
- Charles W Meredith
- Department of Psychiatry and Behavioral Sciences, University of Washington, and VA Puget Sound Health Care System (S-116 ATC), 1160 S. Columbian Way, Seattle, WA 98108, USA.
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50
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Peck JA, Reback CJ, Yang X, Rotheram-Fuller E, Shoptaw S. Sustained reductions in drug use and depression symptoms from treatment for drug abuse in methamphetamine-dependent gay and bisexual men. J Urban Health 2005; 82:i100-8. [PMID: 15738315 PMCID: PMC3456165 DOI: 10.1093/jurban/jti029] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Methamphetamine abusers often complain of feelings of depression that can complicate accurately diagnosing these individuals during treatments for methamphetamine abuse. This article presents an examination of temporal associations between documented methamphetamine use and reported ratings of depression among 162 gay and bisexual male methamphetamine abusers who participated in a 16-week randomized clinical trial of four behavioral therapies for methamphetamine abuse. Methamphetamine use was measured using thrice-weekly urine samples analyzed for drug metabolite. Self-reported depressive symptoms were collected weekly using the Beck Depression Inventory (BDI). At treatment entry, 73.2% of participants rated their depressive symptoms as mild or higher in severity (BDI>or=10), with 28.5% reporting BDI scores in the moderate to severe range (BDI>or=19). All participants reported significant decreases in depressive symptoms from baseline through the end of treatment, regardless of treatment condition, HIV status, or mood disorder diagnosis. A mixed regression model showed methamphetamine use for up to 5 days prior to the BDI score strongly predicted depressive symptoms (F1, 968=18.6, P<.0001), while BDI scores had no significant association with subsequent methamphetamine use. Findings show that behavioral methamphetamine abuse treatment yields reductions in methamphetamine use and concomitant depressive symptom ratings that are sustained to 1 year after treatment entry.
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Affiliation(s)
- James A Peck
- UCLA Integrated Substance Abuse Programs, 11075 Santa Monica Boulevard, Suite 200, Los Angeles, CA 90025, USA.
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