beth rutkowski, m.p.h.finnertyucla pacific southwest addiction technology transfer center

1. Beth Rutkowski, M.P.H. finnerty@ucla.edu Pacific Southwest Addiction Technology Transfer Center UCLA Integrated Substance Abuse Programs

2. Consequences to the Brain

6. PET Scan of Long-Term Impact of Methamphetamine on the Brain

7. Decreased dopamine transporter binding in METH users resembles that in Parkinson�s Disease If DAT is decreased in young METH users (almost to that observed in Parkinson�s Disease), and DAT decreases with age, may we see an increase in the number of Parkinsonian patients over time? If DAT is decreased in young METH users (almost to that observed in Parkinson�s Disease), and DAT decreases with age, may we see an increase in the number of Parkinsonian patients over time?

9. Cognitive and Memory Effects

10. Differences between Stimulant and Comparison Groups on tests requiring perceptual speed

11. Memory Difference between Stimulant and Comparison Groups

12. Longitudinal Memory Performance

16. How much does the brain heal?

17. PET Scan of Long-Term Meth Brain Damage

19. Partial Recovery of Brain Metabolism in Methamphetamine (METH) Abuserafter Protracted Abstinence

20. Acute and Long-Term Effects of the Methamphetamine Abuse A Quick Review:

21. MethamphetamineAcute Physical Effects Increases Heart rate Blood pressure Pupil size Respiration Sensory acuity Energy

22. MethamphetamineAcute Psychological Effects Increases Confidence Alertness Mood Sex drive Energy Talkativeness Decreases Boredom Loneliness Timidity

23. Long-Term Effects of Methamphetamine

24. MethamphetamineChronic Physical Effects Tremor Weakness Dry mouth Weight loss Cough Sinus infection

25. MethamphetamineChronic Psychological Effects Confusion Concentration Hallucinations Fatigue Memory loss Insomnia

26. Local Infections

28. Faces of Methamphetamine Images courtesy Multnomah County Sheriff�s Office

29. Meth Mouth Rotting of teeth around the gums Process may involve lack of saliva production or qualities of methamphetamine or its constituents Smoking/snorting problems Bruxism; Rampant caries

30. Infective Endocarditis (i.e., staphylococcus aurcus) Frequent among IDUs 8-16% of hospital admissions for IDUs Organism colonizes skin, also includes drug, adulterants, packaging, fluids Occurs mostly to right side of heart Most common symptom is chest pain, cough, fever, chills, arthralgia Antibiotic treatment or surgery Infective Endocarditis (i.e., staphylococcus aurcus) Frequent among IDUs 8-16% of hospital admissions for IDUs Organism colonizes skin, also includes drug, adulterants, packaging, fluids Occurs mostly to right side of heart Most common symptom is chest pain, cough, fever, chills, arthralgia Antibiotic treatment or surgery

31. MATRIX MODEL TREATMENT

32. STAGES OF RECOVERY - STIMULANTS

37. Successful Outpatient Treatment Predictors Durations over 90 days (with continuing care for another 9 months). Techniques and clinic practices that improve treatment retention are critical. Treatment should include 3-5 clinic visits per week for at least 90 days.

38. Successful Outpatient Treatment Predictors Employ evidence-based practices [i.e., CBT, CM, Community Reinforcement Approach, Motivational Interviewing, Matrix Model]. Family involvement and 12-step programs appear to improve outcome. Urine testing (at least weekly is recommended)

39. Special treatment consideration should be made for the following groups of individuals: Female MA users (higher rates of depression; very high rates of previous and present sexual and physical abuse; responsibilities for children). Injection MA users (very high rates of psychiatric symptoms; severe withdrawal syndromes; high rates of hepatitis). MA users who take MA daily or in very high doses.

40. Special treatment consideration should be made for the following groups of individuals: Homeless, chronically mentally ill and/or individuals with high levels of psychiatric symptoms at admission. Individuals under the age of 21. Gay men (at very high risk for HIV and hepatitis).