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Arteriosclerosis, Thrombosis, and... Sep 2019While the opioid epidemic has garnered significant attention, the use of methamphetamines is growing worldwide independent of wealth or region. Following overdose and... (Review)
Review
While the opioid epidemic has garnered significant attention, the use of methamphetamines is growing worldwide independent of wealth or region. Following overdose and accidents, the leading cause of death in methamphetamine users is cardiovascular disease, because of significant effects of methamphetamine on vasoconstriction, pulmonary hypertension, atherosclerotic plaque formation, cardiac arrhythmias, and cardiomyopathy. In this review, we examine the current literature on methamphetamine-induced changes in cardiovascular health, discuss the potential mechanisms regulating these varied effects, and highlight our deficiencies in understanding how to treat methamphetamine-associated cardiovascular dysfunction.
Topics: Arrhythmias, Cardiac; Atherosclerosis; Cardiomyopathies; Cardiovascular Diseases; Humans; Hypertension, Pulmonary; Methamphetamine; Vasoconstriction
PubMed: 31433698
DOI: 10.1161/ATVBAHA.119.312461 -
Drug and Alcohol Dependence Oct 2014Despite initial reports of a decline in use in the early 2000s, methamphetamine remains a significant public health concern with known neurotoxic and neurocognitive... (Review)
Review
BACKGROUND
Despite initial reports of a decline in use in the early 2000s, methamphetamine remains a significant public health concern with known neurotoxic and neurocognitive effects to the user. The goal of this review is to update the literature on methamphetamine use and addiction since its assent to peak popularity in 1990s.
METHODS
We first review recent epidemiological reports with a focus on methamphetamine accessibility, changes in use and disorder prevalence rates over time, and accurate estimates of the associated burden of care to the individual and society. Second, we review methamphetamine pharmacology literature with emphasis on the structural and functional neurotoxic effects associated with repeated use of the drug. Third, we briefly outline the findings on methamphetamine-related neurocognitive deficits as assessed via behavioral and neuroimaging paradigms. Lastly, we review the clinical presentation of methamphetamine addiction and the evidence supporting the available psychosocial and pharmacological treatments within the context of an addiction biology framework.
CONCLUSION
Taken together, this review provides a broad-based update of the available literature covering methamphetamine research over the past two decades and concludes with recommendations for future research.
Topics: Amphetamine-Related Disorders; Central Nervous System Stimulants; Cognition; Cost of Illness; Humans; Methamphetamine; Prevalence
PubMed: 25176528
DOI: 10.1016/j.drugalcdep.2014.08.003 -
International Journal of Molecular... May 2021Pseudoephedrine (PSE) is a drug with a long history of medical use; it is helpful in treating symptoms of the common cold and flu, sinusitis, asthma, and bronchitis. Due... (Review)
Review
Pseudoephedrine (PSE) is a drug with a long history of medical use; it is helpful in treating symptoms of the common cold and flu, sinusitis, asthma, and bronchitis. Due to its central nervous system (CNS) stimulant properties and structural similarity to amphetamine, it is also used for non-medical purposes. The substance is taken as an appetite reducer, an agent which eliminates drowsiness and fatigue, to improve concentration and as a doping agent. Due to its easier availability, it is sometimes used as a substitute for amphetamine or methamphetamine. Pseudoephedrine is also a substrate (precursor) used in the production of these drugs. Time will tell whether legal restrictions on the sale of this drug will reduce the scale of the problem associated with its misuse.
Topics: Bronchodilator Agents; Humans; Methamphetamine; Pseudoephedrine; Risk Assessment; Substance-Related Disorders
PubMed: 34067981
DOI: 10.3390/ijms22105146 -
CNS Drugs Dec 2014Psychotic symptoms and syndromes are frequently experienced among individuals who use methamphetamine, with recent estimates of up to approximately 40 % of users... (Review)
Review
Psychotic symptoms and syndromes are frequently experienced among individuals who use methamphetamine, with recent estimates of up to approximately 40 % of users affected. Although transient in a large proportion of users, acute symptoms can include agitation, violence, and delusions, and may require management in an inpatient psychiatric or other crisis intervention setting. In a subset of individuals, psychosis can recur and persist and may be difficult to distinguish from a primary psychotic disorder such as schizophrenia. Differential diagnosis of primary vs. substance-induced psychotic disorders among methamphetamine users is challenging; nevertheless, with careful assessment of the temporal relationship of symptoms to methamphetamine use, aided by state-of-the art psychodiagnostic assessment instruments and use of objective indicators of recent substance use (i.e., urine toxicology assays), coupled with collateral clinical data gathered from the family or others close to the individual, diagnostic accuracy can be optimized and the individual can be appropriately matched to a plan of treatment. The pharmacological treatment of acute methamphetamine-induced psychosis may include the use of antipsychotic medications as well as benzodiazepines, although symptoms may resolve without pharmacological treatment if the user is able to achieve a period of abstinence from methamphetamine. Importantly, psychosocial treatment for methamphetamine dependence has a strong evidence base and is the optimal first-line treatment approach to reducing rates of psychosis among individuals who use methamphetamines. Prevention of methamphetamine relapse is the most direct means of preventing recurrence of psychotic symptoms and syndromes. Long-term management of individuals presenting with recurrent and persistent psychosis, even in the absence of methamphetamine use, may include both behavioral treatment to prevent resumption of methamphetamine use and pharmacological treatment targeting psychotic symptoms. In addition, treatment of co-occurring psychiatric disorders including depression and anxiety is important as a means of preventing relapse to methamphetamine use, which is often triggered by associated symptoms.
Topics: Central Nervous System Stimulants; Humans; Methamphetamine; Psychoses, Substance-Induced
PubMed: 25373627
DOI: 10.1007/s40263-014-0209-8 -
Clinical Obstetrics and Gynecology Mar 2019Stimulant use, including cocaine, methamphetamines, ecstasy, and prescription stimulants, in pregnancy is increasingly common. In the United States, stimulants are the... (Review)
Review
Stimulant use, including cocaine, methamphetamines, ecstasy, and prescription stimulants, in pregnancy is increasingly common. In the United States, stimulants are the second most widely used and abused substances during pregnancy and pregnant women using stimulants in pregnancy are at increased risk of adverse perinatal, neonatal, and childhood outcomes. In this review, we describe the pharmacology, pathophysiology, and epidemiology of stimulants, summarize the maternal and neonatal effects of perinatal stimulant use, and outline treatment options for stimulant use disorders among pregnant women. Development of effective treatment strategies for stimulant use disorders identified among pregnant women are urgently needed.
Topics: Alkaloids; Central Nervous System Stimulants; Cocaine; Female; Humans; Methamphetamine; N-Methyl-3,4-methylenedioxyamphetamine; Pregnancy; Pregnancy Outcome; Prenatal Exposure Delayed Effects; Substance-Related Disorders; Systematic Reviews as Topic; United States
PubMed: 30601144
DOI: 10.1097/GRF.0000000000000418 -
Pharmacological Research Jun 2017Methamphetamine (METH) is a powerful central nervous system stimulant which elevates mood, alertness, energy levels and concentration in the short-term. However, chronic... (Review)
Review
Methamphetamine (METH) is a powerful central nervous system stimulant which elevates mood, alertness, energy levels and concentration in the short-term. However, chronic use and/or at higher doses METH use often results in psychosis, depression, delusions and violent behavior. METH was formerly used to treat conditions such as obesity and attention deficit hyperactivity disorder, but now is primarily used recreationally. Its addictive nature has led to METH abuse becoming a global problem. At a cellular level, METH exerts a myriad of effects on the central and peripheral nervous systems, immune system and the gastrointestinal system. Here we present how these effects might be linked and their potential contribution to the pathogenesis of neuropsychiatric disorders. In the long term, this pathway could be targeted therapeutically to protect people from the ill effects of METH use. This model of METH use may also provide insight into how gut, nervous and immune systems might break down in other conditions that may also benefit from therapeutic intervention.
Topics: Animals; Brain; Central Nervous System Stimulants; Delusions; Depression; Gastrointestinal Tract; Humans; Immune System; Methamphetamine; Psychoses, Substance-Induced
PubMed: 28302577
DOI: 10.1016/j.phrs.2017.03.009 -
Emergency Medicine Practice Nov 2023Management of patients who are acutely intoxicated with methamphetamine (a member of the substituted amphetamine class of drugs) can be resource-intensive for most... (Review)
Review
Management of patients who are acutely intoxicated with methamphetamine (a member of the substituted amphetamine class of drugs) can be resource-intensive for most emergency departments. Clinical presentations of the methamphetamine sympathomimetic toxidrome range from mild agitation to rhabdomyolysis, acute kidney injury, seizures, and intracranial hemorrhage. High-quality evidence on how to best manage these patients is lacking, and most research focuses on symptomatic interventions to control patients' agitation and hemodynamics. This review analyzes the best available evidence on the diagnosis and management of emergency department patients with substituted amphetamine toxicity and offers best-practice recommendations on treatment and disposition.
Topics: Humans; Methamphetamine; Emergency Service, Hospital; Amphetamine
PubMed: 37877728
DOI: No ID Found -
Ugeskrift For Laeger Mar 2023Hyperthermia is a severe complication to intake of methamphetamines due to generalised overactivation of metabolism and muscle activity combined with vasoconstriction....
Hyperthermia is a severe complication to intake of methamphetamines due to generalised overactivation of metabolism and muscle activity combined with vasoconstriction. In this case report, a patient presented to the emergency department after injection of 2 g "crystal meth", and advanced into fatal hyperthermia and organ failure in the intensive care unit. Treatment of substance-induced hyperthermia is symptomatic and reducing metabolism with benzodiazepines and actively lowering body temperature with ice packs and cold intravenous fluids are appropriate interventions. Dantrolene may be used but is still to be properly investigated.
Topics: Humans; Methamphetamine; Fatal Outcome; Malignant Hyperthermia; Hyperthermia, Induced
PubMed: 36999287
DOI: No ID Found -
Harm Reduction Journal Jul 2023Opioid and methamphetamine co-use is increasing across the USA with overdoses involving these drugs also rising. West Virginia (WV) has led the US in opioid overdose...
BACKGROUND
Opioid and methamphetamine co-use is increasing across the USA with overdoses involving these drugs also rising. West Virginia (WV) has led the US in opioid overdose death rates since at least 2013 and rising co-use of methamphetamine with opioids has played a greater role in deaths over the last 5 years.
METHODS
This study used rapid ethnography to examine methods and motivations behind opioids and methamphetamine co-use from the viewpoint of their consumers. Participants (n = 30) were people who injected heroin/fentanyl also using methamphetamine who participated in semi-structured interviews.
RESULTS
We found multiple methods of co-using opioids and methamphetamine, whether alternately or simultaneously and in varying order. Most prioritized opioids, with motives for using methamphetamine forming three thematic categories: 'intrinsic use', encompassing both inherent pleasure of combined use greater than using both drugs separately or for self-medication of particular conditions; 'opioid assisting use' in which methamphetamine helped people manage their existing heroin/fentanyl use; and 'reluctant or indifferent use' for social participation, reflecting methamphetamine's low cost and easy availability.
CONCLUSIONS
Methamphetamine serves multiple functions among people using opioids in WV. Beliefs persist that methamphetamine can play a role in preventing and reversing opioid overdose, including some arguments for sequential use being protective of overdose. 'Reluctant' uptake attests to methamphetamine's social use and the influence of supply. The impact on overdose risk of the many varied co-use patterns needs further investigation.
Topics: Motivation; Methamphetamine; Heroin; West Virginia; Fentanyl; Heroin Dependence; Interviews as Topic; Self Medication; Pleasure; Social Interaction; Health Knowledge, Attitudes, Practice; Humans; Male; Female; Adult
PubMed: 37438812
DOI: 10.1186/s12954-023-00816-8 -
Medicine, Science, and the Law Apr 2021The term 'amphetamine' refers to a class of synthetic drugs which includes methamphetamine. The latter is a globally popular drug of abuse which induces euphoria,... (Review)
Review
The term 'amphetamine' refers to a class of synthetic drugs which includes methamphetamine. The latter is a globally popular drug of abuse which induces euphoria, affecting cognitive/psychomotor performance and sleep. It also provokes risk taking and violent behaviour. The central effects of methamphetamine are due to the overproduction of neurotransmitters, resulting in high levels of dopamine. In recent years, there have been significant increases in cases of methamphetamine abuse in North and South America, Australia and Asia due to its ready availability and low cost. The following review examines changing trends in methamphetamine use and problems that arise diagnostically in medico-legal cases in determining the significance of post-mortem blood levels, the relationship of these to ante-mortem levels, the possible effects on physical and psychological behaviours and the possible contribution of the drug to a lethal episode.
Topics: Amphetamine-Related Disorders; Autopsy; Blood Chemical Analysis; Diagnosis; Female; Forensic Toxicology; Humans; Internationality; Male; Methamphetamine
PubMed: 33423599
DOI: 10.1177/0025802420986707