A full picture of methamphetamine

Herbert C. Covey, a field instructor with the Colorado Department of Human Services, has produced a one-size-fits-all treatise on methamphetamine that effectively serves his premise: that a collaborative approach is needed to combat methamphetamine addiction. By choosing 13 writers whose professional relationships to the meth issue vary (treatment, law enforcement, child welfare, etc.), Covey succeeds in presenting the detailed information about the drug that each perspective can offer.

Covey intends the book as a resource for professionals working with active addicts, people in recovery, and family members. This approach works, as in a very practical way Covey and his contributing authors walk readers through the entire experience of encountering methamphetamine.

So the reader comes to understand what exactly a methamphetamine laboratory consists of, how meth is made, and the significant hazard that the environment of these makeshift labs poses. From the law enforcement perspective, the reader senses the frustration of raiding a lab and finding children who were not known to be there because communication with child welfare services was lacking.

Kathryn M. Wells, MD, a pediatrician who has worked closely with the Alliance for Drug-Endangered Children, explores in detail meth's medical effects, including those on pregnant women. Colleen Brisnehan, an environmental protection specialist with the state of Colorado, walks the reader through the steps of properly cleaning up an abandoned meth lab.

Understanding the drug

Covey describes the history of methamphetamine (street names: speed, crystal, ice, crank, chalk), its current prevalence, and the paradoxes associated with the stimulant (it can be legally prescribed as a treatment for attention-deficit disorder and it is illegally made in clandestine labs and has euphoric effects resembling cocaine's).

A Schedule II drug in the United States, meaning it cannot be bought, sold, or possessed without a prescription, meth suppresses appetite and increases attention and energy. Low-intensity users tend to use it for a specific purpose, such as staying alert for a task or losing weight. High-intensity users try to maintain the euphoria.

A long list of potential short-term negative effects includes increased respiration, higher pulse rate, higher blood pressure, increased body temperature, convulsions, irritability, hyperexcitability, grinding of teeth, nervousness, dilated pupils, and death. Long-term effects can include severe physical and psychological dependence, violent behavior, paranoia, cognitive impairment, auditory hallucinations, and severe depression.

Withdrawal from meth is prolonged, usually with physical duress. Users in withdrawal suffer from depression and are initially unable to experience pleasure, according to Covey's text. They also might experience fatigue, paranoia, aggression, and psychotic symptoms that can persist for months or years.

Treatment success can happen

Chapter author Nicolas Taylor, PhD, director of an outpatient addiction treatment center in Colorado, makes an important contribution in effectively dispelling the myth that methamphetamine addicts can't be treated successfully. Taylor maintains that success hinges on maximizing multiple community resources and disciplines to address myriad issues such as medical complications, unemployment, unstable housing conditions, lack of social supports, and child care needs.

Ownership of treatment plans needs to be shared among county caseworkers, vocational rehabilitation counselors, nonprofit and for-profit treatment providers and hospitals, drug screening entities, sober friends and family, housing authorities, physicians, other health care providers, support groups, community leaders, religious leaders, and neighbors, Taylor writes. Treatment providers lead the process, but must incorporate all relevant players into the plan in a transparent way, he insists.

Taylor emphasizes the importance of individualized treatment. But at the end of the day, good treatment is good treatment, involving case management, inpatient and detox when necessary, and outpatient care for stabilized clients. Meth has its own subversive subculture, presenting special challenges for recovering addicts in terms of staying away from bad influences. This drives home the point that comprehensive case management, including cognitive therapy, is needed to further recovery.

However, the text states, it is important to note that there is no truly unique approach exclusive to meth. Previous treatment models used with cocaine addiction, such as the Matrix Model, have shown success with meth addiction. But the bottom line here is that the collaborative approach to treatment appears to be more critical than the treatment approach selected.