“. . . Young people need to know that maybe for a minute you’ll be skinny and full of energy, but . . . here is my story for young people to consider. It takes everything I have to walk a flight of stairs. My lungs are destroyed. I have no control over my bladder — I pee my pants all the time. I cant take a bowel movement without a laxative”

Penny took meth for about four years.

THE METH ROLLER COASTER RIDE

The physical and psychological experiences from meth are often compared to a roller coaster ride. The euphoric intensity accompanied by a rush of exhilaration, energy, alertness, and a sense of invincibility are felt along the highest peaks of the ride. Meth produces an extreme sense of well-being that is usually associated with a sense of accomplishment, love, or some other highly rewarding external source of satisfaction and fulfillment. These effects are temporary and short-lived, yet the lows that follow are of matching intensity and duration, including extreme fatigue, disorientation, depression, and anhedonia (an inability to feel pleasure).

METH FOOLS THE BRAIN

The body produces natural stimulants that control the ups and downs of our biorhythms (the body’s natural cycles) such as sleep needs, mood, or hunger signals. For example, everyone has probably experienced epinephrine rushing through the body. Epinephrine is also known as adrenaline, and is produced by the adrenal glands to create the familiar flight-or-fight response the body experiences when confronted with a dangerous or threatening situation. During this response, the body speeds up all necessary bodily functions to protect us from a perceived harm or to help us to act quickly in an emergency. A thrilling roller coaster ride stimulates the release of epinephrine in the body, creating a rush of sensations.

Methamphetamine provokes the body into creating these types of stimulating body sensations. It does this by fooling the brain into increasing its release and supply of stimulating chemicals. In the case of epinephrine, the meth user is able to artificially stimulate the brain to re-create the energizing rush of feelings, like a racing heart and hyperalertness, that occur normally during a fight-or-flight situation.

Meth affects other of our body’s natural stimulants as well. Norepinephrine assists in the biorhythms of sleeping and waking. A common pattern for most people is to feel more energetic and more able to concentrate in the mornings and to feel more tired and mentally unfocused in the late afternoon. Meth allows temporary control over these natural rhythms by decreasing fatigue and increasing wakefulness.

Our body’s natural stimulants also decrease appetite and hunger. The reason for this may be related to the fight-or-flight response: As the body mobilizes to defend itself, all digestive and other nonessential processes get turned off while essential parts get turned on, namely the brain, blood, and heart, so that physical and mental awareness are increased.

Everyone is unique, both in personality and their personal biochemistry. Not everyone experiences pleasurable sensations from stimulants. Just like some people do not like roller coaster rides and find their effects unpleasant, some people do not like the effects from stimulants.

THE EFFECTS OF METH ON THE CENTRAL NERVOUS SYSTEM

Drugs do not contain highs; they trigger highs. The potential for feeling high exists naturally within the human nervous system, and countless options for getting high without taking drugs exist. Indeed, pleasure is a genuine physiological sensation. For example, the “runner’s high” is a natural physiological response caused by the release of endogenous chemicals, dopamines. Small children love to get dizzy and disoriented by spinning wildly in circles. Many people go skydiving, fall in love, paint, meditate … the list is endless.

Methamphetamine triggers a high via the central nervous system (CNS). The CNS controls the functions of the brain and the spinal cord. There are billions of nerve cells (neurons) within the CNS. A neuron is composed of a cell body; this contains the nucleus that is the director in charge of the neuron. To move a finger to scratch an itch from a bug bite, the neurons responsible for moving your finger need to communicate with each other. Dendrites and axons are fibers on neurons that act like messengers. The axons of one neuron and the dendrites of another neuron are very close but cannot quite touch. These spaces between neurons are called synapses, and because of this distance, the neurons cannot make contact with each other. A neuron releases chemical messengers, called neurotransmitters, from its axon to fill this gap and communicate with another neuron.

Neurotransmitters can be visualized as keys that unlock and open doors on neurons. These doors are called receptors and are located on the dendrites of a neuron. It is through this “key” and “lock” system that messages are conveyed throughout the CNS.

Most receptors are precisely attuned to accept only one type of neurotransmitter key. There are thousands of receptors in the body that will only open for particular neurotransmitters. The primary job of a neurotransmitter is to cross the synapse, find its receptor on the dendrites of the neighboring neuron, and unlock it. The dendrite then delivers the chemical message to the nucleus of its neuron. Message delivered!

Each neurotransmitter is responsible for a particular action. Some stimulate and some inhibit. Some neurotransmitters are responsible for movement. Others are needed for memory or for feeling emotions. Once the message has been delivered, the neurotransmitter is either destroyed or reabsorbed into the neuron that released it. This whole process is called neurotransmission.

THE NEUROTRANSMITTER DOPAMINE

“At a purely chemical level, every experience humans find enjoyable — whether listening to music, embracing a lover, or savoring chocolate — amounts to little more than an explosion of dopamine in the brain, as exhilarating and short-lived as a firecracker.”

Dopamine is the chemical in our body most fundamental to promoting the experience of pleasure. This neurotransmitter comes from the reward center of the brain (rewarding the person with high levels of positive, loving, pleasurable feelings). It is responsible for creating euphoria and uplifting emotions and mood. Dopamine helps control the limbic system, a part of the brain associated with basic needs and emotions, for example hunger, pain, pleasure, satisfaction, sex, and instinctive motivation. Dopamine is also responsible for many of the body’s activities, including motor coordination.

Eventually, this sense of well-being from dopamine wears off. The “key” — dopamine — that was “locked” in the receptors is released and sent back to the neuron that sent it in the first place. This neuron stores the dopamine for future use, a kind of recycling. Basically, this is how all receptors and neurotransmitters work in the body

THE METH HIGH: DOPAMINE

Methamphetamine’s powerful effects come from its impact on the brain’s reward, or pleasure, center. Meth does not directly release dopamine. It attaches itself to dopamine receptor sites and fools neurons into releasing large quantities of dopamine. This accounts for the intense rush a user experiences from meth.

In addition, meth prevents dopamine from being recycled. Instead, dopamine is active in the body for much longer, explaining the extra long duration of the meth high. The drug does this by blocking (inhibiting) the dopamine transporter involved in its reabsorption (reuptake) into the original neuron that sent it. Transporters are places on neurons that reabsorb the dopamine after it has completed its job. As a result, more dopamine becomes available to the brain. This extra dopamine, in turn, activates an even greater number of dopamine receptors. This increased release of dopamine is primarily responsible for the intensity and duration of meth-amphetamine’s effects.

In lab animal experiments conducted by Dr. Richard Rawson, director of UCLA’s Integrated Substance Abuse Program, sex caused dopamine levels to increase to 200 units and cocaine caused levels to rise to 350 units. With methamphetamine, dopamine levels jumped to about 1,250 units. Overall, this study showed that meth causes about 12 times as much feelings of pleasure as sex, food, and other activities, including the use of other illegal stimulant drugs. Rawson noted that all illegal drugs of abuse release dopamine, but that methamphetamine “produces the mother of all dopamine releases.”

NOREPINEPHRINE AND ANOREXIA

In a similar, though somewhat less substantial way, methamphetamine affects norepinephrine levels in the brain.

METHAMPHETAMINE VERSUS COCAINE

Meth and cocaine share similar stimulating effects because they provoke excessive dopamine to collect in the brain. However, meth stays in the body longer than cocaine. This results in a longer lasting high for meth, but means that meth has more time to damage neurons in the brain as well.

Many receptors for the neurotransmitter norepinephrine are found in a small section of the brain stem called the locus coeruleus, a part of the brain that integrates sensory messages from the eyes, ears, and other sense organs. Common reactions to norepinephrine release in the body are increased heart rate and body temperature. Amazingly, this part of the brain has only a few thousand nerve cells, but is connected to about a third of the entire brain. The persistent lack of appetite resulting from a meth high is probably due to the release of this neurotransmitter in the hypothalamus “satiety” section of the brain. This would communicate to the brain that it is satisfied and does not need any food to sustain it. Meth users are often described as looking emaciated and skeletal; this constant release of norepinephrine can lead to anorexia. As a result, some teens use meth to lose weight. This is more common with teenage girls.

SHORT-TERM EFFECTS

Even small amounts of methamphetamine can cause such physical effects as insomnia, loss of appetite, increased physical activity, racing heart, increased sexual libido, increased rate of breathing, tremors, elevated blood pressure and body temperature, dilation of pupils (meth users might wear sunglasses due to a sensitivity to light, whether indoors or outside), convulsions, nausea, vomiting, stomach cramps, and diarrhea.

Psychological effects include euphoria, alertness, obsession with details, anxiety, irritability, rage, aggressiveness, depression, paranoia, hallucinations, psychosis, and anhedonia. Remember, these psychological and physical effects can last anywhere from six to 14 hours or more, depending on the route of exposure, dose, and purity of the meth used.

Teens report feeling uninhibited, in control, confident, and energetic after taking meth. Yet the high that meth brings is temporary. When meth users come down from their high, the negative effects are so intense that this experience is called crashing. The paradox of meth is that the sought-after euphoric effects of the meth high quickly turn into their opposite. Users need more and more meth to achieve and maintain the same high they felt when they first used meth. Research indicates that this can happen after using meth only one or two times. Eventually, users need meth just to feel any type of pleasure whatsoever. Some meth users try to alleviate the negative effects of crashing by taking other drugs such as cocaine or heroin. This vicious cycle of chasing after a meth high to feel normal and to escape meth’s crushing aftereffects is what makes meth an extremely addictive drug compared to any other stimulants.

TOLERANCE

Tolerance can be defined as the need for increasing doses of a drug over time to maintain the same effect achieved at previous lower doses. The body becomes tolerant to the effects of meth within minutes. Remember, after smoking or injecting meth, the user experiences an intense explosion of dopamine, experienced as a euphoric high. Meth users try to maintain that high by using ever-increasing quantities of meth, or by switching to a faster-acting way of using, such as moving from snorting to injecting. Some abusers go on a binge known as a “meth run,” injecting a gram (1,000 mg) of meth every two to three hours until the user runs out of the drug or is too intoxicated to continue. This can last for several days or even weeks. To compare, a medicinal dose of legal methamphetamine, Desoxyn, is about five to 15 milligrams (mg) per day. This means a user on a meth run is taking approximately 800 times the therapeutic dose of meth each day. (Approximate illegal dose of 1,000 mg times every three hours [eight times a day] divided by an average of 10 mg, the therapeutic dose of meth.)

There are two ways to understand how a person can develop tolerance to meth. First, methamphetamine depletes the neurotransmitter norepinephrine from the body. As the brain’s supply of norepinephrine dwindles, the user needs more and more meth to maintain a consistent high. This tolerance can happen after only one or two doses of meth. Secondly, ketosis causes tolerance. Ketosis is a by-product of not eating for long periods of time. Not only does this produce very bad breath, but when a person stops eating, it changes the body’s metabolism, causing the urine to become more acidic. As we learned in site, the more acidic the urine, the more methamphetamine is excreted in the urine. This causes the user to need more and more meth to achieve the same high.

BINGING, TWEAKING, AND CRANK BUGS

Many meth users go on “binge and crash” runs for three to five days and then crash, sleeping for one or two days. During these binges, users often become agitated and feel “wired.” Their behavior becomes unpredictable. They may be friendly and calm one moment, then angry and terrified the next, prone to out-of-control rages, delusions, paranoia, and violence. This phase of the meth high is called tweaking. Tweakers become hyperactive, obsessed with details, and intensely focused, and feel compelled to repeat meaningless tasks, such as taking apart and reassembling clocks, stereos, and other types of machinery. The release of high amounts of the body’s fight-or-flight chemicals, epinephrine (adrenaline) and norepinephrine, is thought to cause this tweaking effect in a meth user.

Tweakers may also have a strong sensation of bugs crawling beneath their skin, a disorder known medically as formication but more often referred to as “crank bugs.” Meth users can pick obsessively at these invisible “bugs,” creating unsightly oozing sores and scabs on their faces and bodies.

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