Learning Objectives
Practitioners who complete this training module will be able to…
1.
Identify crystal meth by its various names and physical appearances, as well as
routes of administration
2.
Identify factors that place people, especially gay men, at risk for using crystal meth
3.
Understand the basic pharmacodynamics of crystal meth, and its effects on oral
and mental health
4.
Identify typical presenting features of people who have an addiction to crystal meth
5.
Understand the link between crystal meth use and changes in sexual behavior that
place a person at increased risk for acquiring/transmitting HIV and other STI’s, and
effects on overall health practices
6.
Utilize methods to effectively engage and work with a person who is using crystal
meth
7.
Locate community resources for persons at risk for or already using crystal meth
Routes of Administration
 Meth can be smoked, snorted, injected,
swallowed, or inserted anally through a
process sometimes referred to as “booty
bumping.”
 While primarily affecting dopamine and
secondarily affecting serotonin and
norepinephrine neurotransmitters, meth
alters mood in different ways depending
on how it is taken.
 The lure of meth is the sense of
increased focus, control, energy, and
decreased inhibitions that it brings.
 Unlike other stimulants, meth is
made of dangerous synthetic
ingredients that the body cannot
metabolize.
 Meth is powerfully addictive, and
people who use it frequently often
experience a rapid decline in
functioning.
 Part of the reason meth is so
addictive has to do with its effects on
dopamine.
 While a single dose of cocaine
releases approximately 400% more
dopamine than an orgasm and lasts 820 minutes, a single dose of meth
releases 1500% more dopamine than
an orgasm and can last between 6-8
hours.
Cerebral Cortex
This area of the brain
is devoted to the
senses. It enables the
individual to see, hear,
smell, and touch. It
also facilitates speech
and the understanding
of words.
Limbic System
This system
influences instinctive
behavior similar to
animal responses that
relate to survival.
Brain Stem
This is the brain’s
lowest portion. It
controls basic
functions, such as
heart rate, breathing,
eating, and sleeping.
Straight to the brain.
1. Meth enters the brain cells from the
bloodstream.
2. It provides a storm of neurochecmical
activity causing the brain to release
chemical messengers, called
neurotransmitters (NTs), which stimulate
sections of the brain.
3. Meth affects the cerebral cortex and
causes one to experience a sense of
heightened energy and euphoria, as well
as a feeling of having elevated powers of
reasoning/thinking.
4. The drug also targets the limbic area, or
“pleasure center,” which regulates hunger,
flight, fight, and sex drive.
Body-Related
 Stroke, seizures, tremors,
convulsions, headaches
 Disturbances in heart
rhythm; increased heart rate
and respiration
 Chest pain, cough,
respiratory failure
 Numbness, decreased
appetite, and over long-term,
weight loss & malnourishment
 Insomnia, hypersomnia,
fatigue
 Dry mouth, burned lips, and
especially over long-term, worn
teeth and dental problems
 Longer-term use can lead to
chemical burnout of pleasure
senses
 Skin may feel tingly, which
can lead to vigorous scratching
and other associated skin
problems.
 Dangerous rise in body
temperature or hyperthermia
Mood-Related
 Depression, anxiety,
irritability, anger
 Heightened alertness,
anxiety, or aggressiveness
 Agitated, bizarre, and risky
behavior
 Exhilaration and euphoria
 Paranoia, hallucinations,
panic reactions
 Possible psychosis and
paranoid thinking and behavior
(due to dopamine flooding)
 Suicidal ideation
 Physical and emotional
dependence
Source: NIDA InfoFacts
Other common features
of “Meth Mouth”
• Recurrent Acute
Necrotizing Ulcerative
Gingivitis (ANUG)
• Broken, atrophied, or
abscessed teeth
• Seriously bad breath
•Headaches, toothaches,
jaw and neck aches
(from tooth-grinding)
• High fever (from
infection)
• Nausea
• Difficulty eating
“Meth Mouth” and Acute Necrotizing Ulcerative Gingivitis (ANUG)
The conditions of meth mouth are not always meth-related. “Meth mouth” symptoms could be caused by a combination
of factors in the individual, including prolonged stress, poor nutrition, poor oral hygiene, and consumption of large
amounts of sugar. Similarly, not all cases of ANUG appear with people who use meth. ANUG is characterized by
redness, swelling, and erosion of the gums, which causes the mouth to be very painful to the touch—even with a swab.
Often, people who have ANUG neglect their oral hygiene; have compromised immune systems because of malnutrition,
stress, or chronic diseases like HIV.
Why does meth use cause ANUG?
Meth use causes ANUG for the following reasons:
 While high and during a crash, people who use meth neglect their basic hygiene.
 While high, people who use meth have a suppressed appetite, but their bodies still need energy, which
results in craving candy and sugary drinks.
 During highs, people who use meth do not sleep, which weakens their immune system.
 Meth causes excessive sweating and diarrhea which leads to dehydration. People who use meth will most
likely turn to soda or sugary drinks to re-hydrate.
 Meth causes dry mouth because of excessive sweating and dehydration. Dry mouth increases the amount of
bacteria in a person’s mouth, which produces acid. The increased acid leads to quicker tooth decay.
 Because people who use meth can experience extreme alertness and excitement while high, they often grind
their teeth and clench their jaws.
 When people who use meth smoke the meth, the chemicals in meth are vaporized and heated. This irritates
the mouth and cause sores, which can become infected if left untreated.
 When people who use meth snort meth, the chemicals drain down the back of the throat, which leads to
corrosion.
 Meth also causes the constriction of blood vessels, which over time, completely kills the blood vessels to the
gums.
Info from Martin S. Spiller, DMD (2000)
Although not representative of all people who use meth, the following are some
typical characteristics:
 More common in individuals who identify as males between the ages of
19 and 40.
 People who use meth regularly or who are currently “high” may present
with a lot of “nervous energy”—jittery, anxious, and talkative with wideopen eyes (despite their sensitivity to light).
Characteristics of people who are clinically addicted to meth and have been
using for a longer period of time include the following:
 Weight loss, skin lesions, tooth decay
 Loss of bone strength, liver damage, seizures and convulsions,
pneumonia, heart disease, strokes, aneurisms, Parkinson’s disease, and
ulceration of the cornea (from smoking methamphetamine).
Remember: Not all people who use meth present with these
characteristics, and it may not be possible to tell whether someone uses it
occasionally. However, knowing this information may be relevant to care
management considerations.
Another category also exists for
people who use meth only on
occasion and who do not
experience the problems
associated with greater-intensity
use.
• The use of meth for sexual reasons has been found to be more common among men
who are HIV positive.
• Men who use crystal meth have been found to be three times more likely to have
unprotected receptive anal sex than men who do not use crystal meth.
Further information & resources…
Treatment & referral resources…
Comprehensive resources for gay men on physical, sexual
spiritual health and substance use:
http://www.lifelube.org
Center on Halsted - State of Illinois AIDS/HIV & STD
Hotline: 1-800-243-2437 (1-800-AID-AIDS); Online Referral
Database: www.centeronhalsted.org/hot/admin/survey.cfm
Resources for professionals in addictions and recovery fields:
http://www.ATTCnetwork.org
Diffusion of Effective Behavioral Interventions (DEBI):
http://www.effectiveinterventions.org
Howard Brown Health Center - Crystal Clear:
773-388-1600
www.howardbrown.org/hb_services.asp?id=41
AIDS Foundation of Chicago: Crystal Meth & HIV/AIDS
http://www.aidschicago.org/prevention/meth.php
Haymarket Center: 1-866-945-5786
www.hcenter.org
Test Positive Aware Network (TPAN):
http://www.tpan.org
Lake Shore Hospital: 1-800-888-0560
www.chicagolakeshorehospital.com
ONDCP, DOJ & HHS collaboration on meth resources:
www.methresources.gov
Crystal Meth Anonymous: CMA Meeting Directory
http://www.crystalmeth.org/find-a-cma-meeting.html
Resources on prevention, intervention, treatment & recovery:
www.drugfree.org/
CMA Chicago:
www.crystalmethchicago.org
Self-test developed by Narcotics Anonymous:
http://www.friendsofchoices.org/TTT_meth.htm
CAGE and CAGE-AID assessment tools:
http://pubs.niaaa.nih.gov/publications/inscage.htm
http://www.associatedneurologists.com/cage.html
Substance Abuse Treatment Facility Locator Sponsored by
the Substance Abuse and Mental Health Services
Administration (SAMHSA):
http://findtreatment.samhsa.gov/
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