In layman's language, meth rewires the brain, and while recovery may be possible, the brain won't be the same. Cocaine, by contrast, doesn't stay long in the brain because it almost completely metabolizes in the body.

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Causes Of Adddiction - The Dangers of Meth

As a trauma surgeon at Mercy Hospital in San Diego, where meth first gained a foothold in the United States, Dr. Michael Sise believes that meth "carries a prognosis that is worse than many cancers.

A clinical neuroscientist who specializes in nuclear brain imaging in Northern California, Dr. Daniel Amen, ranks meth's addictive character second only to heroin's. But he says it's far more dangerous to users - and the people around them - because of the paranoia and psychosis that inevitably follow.

"Our scans basically show that these people are dealing with a defective brain,'' Amen said.

In Bellingham, Dr. Greg Hipskind observes that because meth decreases the blood flow to the brain, "it dumbs you down.''

Although scientific research on meth is in its infancy, treatment guidelines issued this year by the U.S. Center for Substance Abuse Treatment say "some of the most frightening research findings about meth suggest that its prolonged use not only modifies behaviors but literally changes the brain in fundamental and long-lasting ways.''

In layman's language, meth rewires the brain, and while recovery may be possible, the brain won't be the same. Cocaine, by contrast, doesn't stay long in the brain because it almost completely metabolizes in the body.

Any physician with more than a passing acquaintance with meth, and certainly West Coast physicians who specialize in addiction medicine, describe the drug in the most graphic of terms. Their assessments have been shaped by firsthand experience trying to return meth addicts to some semblance of normalcy.

This drug is very adept - but eventually way too adept - at what it does.

Meth messages the brain's pleasure center to release more dopamine and endorphins, two natural chemicals that make people feel good.

An extra helping of these chemicals makes people feel more confident, lose weight, work quicker at a myriad of tasks and enjoy sex more.

But what's initially so enticing about meth becomes intolerable. The rate of addiction is breathtaking: Over six months of use, 94 percent of those who smoke meth become addicted, as do 72 percent who snort it. That compares with 14 percent who inject heroin and 8 percent who smoke marijuana.

(Therapeutic doses for diseases such as Parkinson's and narcolepsy may be up to 50 milligrams a day. Meth is being abused when someone uses between 250 milligrams or more, and during a binge, it is not uncommon for some to use up to 1,000 milligrams every two or three hours.)

Meth Is All About Extremes

Eager to slim down? That's what the earlier version of meth was prescribed for in the '50s and '60s. Today's more potent form can emaciate people. One Tacoma addict, a woman of average height, dropped to 80 pounds while she was pregnant. High-intensity users can shed 50 to 100 pounds.

Lust for mind-numbing sex? Meth will produce it - at first. That is why it is so popular at "raves'' in nightclubs or in the gay bathhouses in Seattle.

Eventually, the drug inhibits sexual functioning in both sexes. The consequences cited in the guidelines from the Center for Substance Abuse Treatment include men developing breasts, losing interest in sex and experiencing impotence, and women developing menstrual problems, infertility and difficulty achieving orgasm.

One of meth's most alluring qualities is extra energy. At the extreme, meth facilitates behavior that is persistent, repetitive and compulsive. The federal treatment guidelines describe these activities as stereotypical of meth use: "vacuuming the same part of the floor over and over, popping knuckles, picking at scabs, or taking apart and reassembling mechanical devices.''

Daily, Dr. Alex Stalcup, an addiction physician in Concord, Calif., treats people who have gone without sleep for as long as 10 days. The record-holder was a woman up 21 days. "Politely put, she was crazier than a barn owl,'' he says.

Obviously, that patient had not been able to restrict her meth use to recreation. In jargon, she was bingeing.

During the roller-coaster ride, the user continues to chase - but can never recapture - the intensity of the initial euphoric sensation. Over three to 15 days, he will help himself to more and more meth. He typically favors smoking or injecting it over snorting or drinking it dissolved in liquid (usually alcohol), because the payoff is so much faster and stronger.

Aggression and paranoia set in during the tweaking stage, which can persist 24 hours. (Afterwards, the body must collapse, so the user sleeps for one to three days.)

The only thing more dangerous than a tweaker is a tweaker in the company of others, notably those who are weaker. The Pierce County Sheriff's Department has documented the intersection of meth labs and domestic violence in the area surrounding McChord Air Force Base. Tweakers, with extreme sleep deprivation, need no provocation to lash out. They exist in their own world during this phase of the binge.

In his San Diego emergency room, Sise repairs the handiwork of tweakers far too often. He's stitched together the heart of a woman stabbed by the meth dealer who stole her money, removed a blood clot from the gangrenous leg of a young binger. He told a woman her daughter died of a gunshot wound suffered during an argument with her meth-using boyfriend.

People steeped in the culture of meth, be they police officers or treatment providers, say when they hear of an abnormally violent act, their first thought is meth. Two years ago an Arizona man repeatedly stabbed his 14-year-old son, then decapitated him and threw his head out the window of a van. The man, now serving a 30-year sentence, had been convinced the devil was inside the van.

Meth abusers die at higher rates from suicide, traffic accidents and murder, and commonly succumb to overdoses or malnutrition.

Ron Jackson, director of Seattle's Evergreen Treatment Center for heroin addiction, paints the difference.

"People on heroin are basically going to leave you alone unless they're desperate for money. Somebody loaded on meth is going to be much more dangerous.

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