Methamphetamine prepared for consumption
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Methamphetamine overdose deaths increased significantly from 2011-2018 based on a recent study in JAMA Psychology. While excessive deaths were seen across all ethnic and ethnic groups, non-Hispanic American Indians and Alaskan indigenous communities showed the highest overall mortality rates.
Over the course of the study, methamphetamine deaths increased more than 4fold among non-Hispanic American Indians and Alaska natives. While mortality rates increased among both men and women, the increase was more pronounced among men, the data revealed. Study results also revealed that non-Hispanic Blacks had the fastest increases in overarching mortality rates in 2011-2018. This indicates a worrying trend in a group that previously had very low rates of methamphetamine overdose deaths.
Prolonged periods of reduced access to education, combined with high levels of poverty and discrimination associated with the delivery of health care services are among the reasons that are thought to be causing health differences in the two groups. seo. The sharp increase in mortality reported by the study authors demonstrates the importance of treatments that address cultural and gender differences.
“While much attention has been focused on the opioid crisis, the methamphetamine crisis has been quietly, but actively, gaining momentum – especially among American Indians and Alaska Natives, who are affected by a number of health conditions. giving an unfair effect, ”Nora D. Volkow, MD, director of NIDA and senior author of the study, said in a press release. “The American Indian and Alaska American populations have structural disadvantages but they have cultural strengths that can be used to prevent methamphetamine use and promote health outcomes for those living with addiction.”
With recent national data showing that the majority of methamphetamine users are between the ages of 25 and 54, the researchers decided to focus on the group. this age. When they looked at data from this population as a whole, they found an increase in overweight deaths. Specifically, methamphetamine-related deaths rose from 1.8 to 10.1 per 100,000 men, and from 0.8 to 4.5 per 100,000 women. This represents an increase of more than fivefold from 2011 to 2018.
Long-term use of methamphetamine, which leads to structural and molecular changes in the brain, is associated with a number of serious health risks including seizures, psychosis, memory loss, along with the frequency of relapses. high coverage and risk of death from overeating. In addition, the risk for hypertension, increased risk for heart attack, arrhythmias, strokes, and Parkinson’s disease was well explained. And, unlike opioids, medications are not currently approved by the FDA for the treatment of methamphetamine use disorder or excessive relapse.
That said, there are specific behavioral therapies such as epilepsy management therapy that have been proven to promote the reduction of methamphetamine abuse-related harm. This includes giving visible rewards such as vouchers for food, film passes or even cash prizes to reinforce positive behaviors such as abstinence. This has been helpful for patients in methadone programs and psychosocial counseling.
“What stands out about methamphetamine is how addictive the agent is,” says Dr. Scott Krakower, a child and adolescent psychologist with Zucker Hillside Hospital. “Overcoming long and heavy can be a major risk of relapse.”
“In the last few years, more and more patients have been abusing this agent. The opioid crisis itself will not distract us – if anything, it has helped providers recognize how slavery has affected our population, ”offered Krakower . He also explained that treatment “may involve individual and group therapeutic approaches such as behavioral therapy (CBT) and motivational interviews to encourage abstinence. ”
“Identifying populations with a higher level of methamphetamine overdose is a crucial step toward preventing the methamphetamine crisis,” said Beth Han, MD, PhD, MPH, lead author of the study . “By focusing on the specific needs of individuals and developing culturally designed interventions, we can begin to move away from one-size-fits-all approaches and towards more appropriate specific interventions. ”
In the Indian health care system, there is a combination of shared decisions (between patient and health care provider) and a holistic approach to the well-being of established traditions among some Indian and Alaskan American organizations. Traditional techniques such as speaking circles (members of a group give an uninterrupted speech) and rituals such as smudging (burning herbal products to clear or purify a mist bath) have been introduced into many health practices. of tribal communities.
Perhaps one way to prevent drug use among young people is to embrace these traditions since they offer a cultural opportunity to encourage resilience. A focus on culturally appropriate and community-based prevention could engage teenagers and families with progressive intervention strategies that clarify provider and community education as well as efforts to prevent -this crowd.
In addition, a recent clinical trial published in the New England Journal of Medicine reported therapeutic benefits (reduction of methamphetamine use and drug cravings) with the combination of naltrexone with bupropion in patients with exercise disorders. methamphetamine over a period of 12 weeks. Naltrexone is an opioid receptor antagonist used to treat opioid use disorder (OUD), while bupropion is a stimulant-like antidepressant that works through the norepinephrine and dopamine systems and may reduce anxiety or rest associated with methamphetamine removal which is the basis for continued use. .
The pressure the response of both drugs was better than placebo (13.6% vs. 2.5%), but it was still very low. That said, the number one treatment required (NNT) was very encouraging at 9, making it similar to the therapeutic benefit achieved for treating mental health disorders, such as antidepressant medications that have been prescribed to treat depression and naltrexone to treat alcohol use disorder. (NNT is a measure of medical intervention utility, accounting for the number of patients who required medical treatment to benefit one person).
And while the design of the trial (series parallel comparison design with weighted responses) may be confusing, it does ensure that there is a clear way to evaluate the effectiveness of the dual-drug approach. Future experiments to reproduce the results in a more naturalistic design or to continue with this experiment would certainly be useful to determine whether this therapeutic approach (using naltrexone and bupropion) is ion. -made as an ongoing pharmacologic approach.
“Long-term methamphetamine abuse has been shown to cause diffuse changes to the brain, which can contribute to serious health effects beyond addiction itself,” said Madhukar H. Trivedi, MD, Side Medical Center South Texas University, Dallas, in a press release, led the lawsuit. “The good news is that some of the structural and neurochemical brain changes are reversed in people who recover, reaffirming the importance of new and more effective treatment strategies. to celebrate. ”
“It’s a great moment to find this combination of medicines [naltrexone and bupropion] be helpful for methamphetamine use disorders, ”said Krakower.