Meth - Ley Flashcards
Meth causes the release of DA, S, and NE where?
CNS and PNS
t/f: meth crosses the bbb
true
meth use is comorbid for which psych conditions?
anxiety depression ADHD mania conduct d/o obesity ASPD
when do most meth users see dependence?
young; around 13-17; used multiple substances and used daily
What is the attraction of meth?
desire to cope with emotional stress
stay awake
enhance sex
reduce weight
how can you take meth?
smoke it snort it eat it drink it shoot it
about what percent of teens say it would be easy for them to get ahold of meth?
1 in 4
why are most children in HI in foster care?
meth moms
compared to cocaine users, how do meth users look?
- more likely to be single, white, unemployed
- use daily and at younger age
- experience depression and thoughts of self harm
- more family issues, more weed
- more HIV pos
meth stimulates release and (pre/post) synaptic uptake of S, D, and NE
presynaptic
it takes (single/multiple) doses of meth to impair cognitive fxn
one fucking dose
how is meth metabolized?
hepatic hydroxylation and dealkylation
inhibitors of which CYP decreases meth elimination?
2D6
when does meth plasma concn peak?
2.6-3.6 hours
what is the half life of meth?
10 hours
how many percent above baseline does meth increase dopamine?
1200%
how long does the cocaine high last?
15-30 minutes
how long does the meth high last?
8-24 hours
t/f: street meth is highly PURE
true; 90-100% pure in crystal
tolerance to meth is….
IMMEDIATE
what are the acute effects of meth?
Heightened awareness, grandiosity, feeling of being alive, sexual arousal, increased self confidence.
Single doses improve cognition.
Nervousness, insomnia, jerky movements, anxiety, sweating, palpitations, incessant talking, confusion, irritability, bruxism, hyperthermia, dizziness, pupillary dilation, impaired speech, tremors, vision loss.
what are the common causes of death from meth?
homicide
suicide
MVAs
sales/distribution
What are the biological causes of death from meth?
stroke CV collapse pulmonary edema MI renal failure
what are the long term psychological effects of meth?
chronic anxiety depression anger panic paranoia tinnitus
what are the greatest areas of volume loss from chronic meth use?
limbic system (emotion and reward) hippocampus (memory)
what are the cognitive changes in the first few weeks of meth use?
deficits in decision making, accuracy, and speed
Frontal lobe damage in meth is related to…
the amount of use; may contribute to craving
What explains affective dysregulation in meth use?
metabolic abnl’s in the limbic system
meth use results in reduced (DA/S) transporter density
S
t/f: meth is neurotoxic
true
What are the effects on the newborn born to a crack mom
/
low birth weight smaller subcortical brain volume poor visual recognition increased aggression impaired social adjustment difficulties with math and language
what causes meth mouth?
vasoconstriction decreased salivary flow vomiting bruxism high sugar abandon oral hygeine
what are the withdrawal sx from meth?
Symptom clusters
Hyperarousal (agitation, craving, dreams)
Vegetative symptoms (sadness, anhedonia, increased appetite)
Anxiety
Dysphoria, affective instability, sleep disturbance
Apathy syndrome
most of our meth treatment comes from the model from what other drug?
coke
What are the major tx models for meth?
CBT
contingency model
matrix model
What are the challenges in treating meth addiction?
poor treatment engagement and drop out, high relapse rate, dysphoria and cognitive impairment
the matrix models uses what three approaches?
cognitive
behavioral
psychological
What are the goals of the matrix model?
educate about addiction
involve family
12 step
testing
what can you give a recovering meth addict to deal with dysphoria, craving, and cognitive impairment/
SSRI
what does buproprion do for a meth head?
reduces the desire to use
what types of agonist replacements can you give a meth head?
modafinil, ritalin
What do you give a meth user for pain?
baclofen
What do you give a meth head to lower hyperarousal, anxiety, and withdrawal symptoms?
mirtazapine
