July 20, 2013
Health care providers, law enforcement officers, even current and former addicts can agree on one thing — methamphetamine use destroys the body.
Over time, addicts face increased risk of heart attack, psychosis and paranoia, extreme anorexia, decreased brain function and rotting teeth.
“We’re very good at identifying meth users,” said Dr. Rodger Campbell, medical director at Bothwell Regional Health Center’s Emergency Department. “Their appearance is usually enough to let us know they’re either using or have used in the past. They typically have very poor nutrition, they’re sometimes dangerously thin, they’ve got scars and open wounds from picking at their skin, they’re hyper-vigilant and anxious. They’re not hard to spot.”
According to the National Institute on Drug Abuse, meth acts as a stimulant to the central nervous system, increasing the release of dopamine, which results in a euphoria or rush in the “reward” regions of the brain. Chronic use significantly changes how the brain functions and studies have shown it can result in severe structural and functional brain changes. First-time users report feelings of increased wakefulness, physical activity, decreased appetite, rapid heart rate and increased blood pressure. Chronic users can display psychotic features including paranoia, hallucinations and delusions.
“We deal with psychotic users from time to time; usually they’re brought in by law enforcement who are trying to decide if they need to come to (the Emergency Department) or jail,” Campbell said. “We had one patient who came in, very agitated, tweaking. He ran out of the room, in just a gown, smashed into a locked door and then jumped over the registration desk and ran out into the parking lot. The officers who brought him in were still there, they had to use a Taser to subdue him.”
Sedation is the only treatment for meth users undergoing a psychotic episode, Campbell said.
“The only thing we can really do is sedate with something like Valium,” he said. “And it takes a lot of sedation to get them under control. If there’s an underlying mental health issue, such as if they’re going to be a danger to themselves, we’ll call a psychiatric treatment facility but they don’t like taking meth users. They don’t have the security or staff to treat them in that psychosis state.”
Campbell said while his department may see low-level or first-time meth users daily, they also see one to two a month on the “bad end of the spectrum.”
“If they’re coming here, they’re in pain, and that means whatever the problem is has been going on for a while,” he said. “The biggest complication from meth use, that I see on a daily basis, is the risk of MRSA. I’d estimate 50 to 60 percent of our meth patients have it.”
Methicillin-resistant Staphylococcus aureus (MRSA) is caused by a strain of staph bacteria resistant to antibiotics and can cause potentially life-threatening infections.
Another complication from chronic use, and the one that’s most often easily spotted in users, is “meth mouth.” According to the American Dental Association, meth mouth is a combination of symptoms that cause tooth rot and decay. Usually the only treatment option is extraction of the tooth, said Katy Trail Community Health Dental Clinic Dentist, Dr. Bethany Vandevender.
“At that point, when (a meth user) is coming in for care, there’s so much decay the tooth isn’t saveable,” Vandevender said. “Meth users crave sugar and they’re not good about hygiene, so when they’re drinking soda after soda and not brushing all the sugar off their teeth, it causes cavities. You’ll see a lot of dark brown or black along the gumline, especially the upper teeth, and those cavities just turn the tooth soft. Once it gets to a certain point, it has to be removed.”
Vandevender said typical patients at the Dental Clinic are in severe pain and come in on an emergency basis. Payment for the services is sometimes an issue, she added.
“It costs $100 per tooth to extract,” she said. “We are a clinic and we have a sliding scale for payment. But if you’re a chronic user and need to get all your teeth pulled, you’re looking at more than $3,000 worth of dental work, and that doesn’t include the cost for dentures. Even if a patient had dental insurance, most of the time it’s capped at $1,000.”
Meth mouth doesn’t happen overnight, Vandevender said, but once it starts it’s difficult to recover from. Much like meth patients in the ED, usually by the time a user takes steps to seek medical treatment, it’s too late to do much.
There are no medical treatment options for meth abuse. Unlike heroin addicts who may use methadone to wean themselves off the opiate, the only way for an addict to overcome the addiction is to stop completely. This can lead to other complications, however, including typical withdrawal symptoms — shaking, sweats, paranoia, insomnia — as well as anhedonia, an inability to experience pleasure, a symptom that can last for months.
“The thing about meth is even though we know it’s dangerous, it’s still a relatively new drug,” Campbell said. “It’s only been really in the public eye since the 1990s and while some studies are being done, we still don’t know what kind of long-term health effects it’s going to have on people’s bodies and brains.”
WHAT LEADS TO METH MOUTH?
• Lack of saliva. Saliva is needed to neutralize harsh acids and reduce bacteria in the mouth. Meth dries up the salivary glands, letting the acids and bacteria build up and rot teeth and gums.
• Decreased blood flow. Meth causes blood vessels to shrink, reducing the supply of blood to the teeth and gums, leading to infections and disease.
• Tooth grinding or clenching. Meth users often clench and grind their teeth, causing cracks in the tooth and mouth sores.
• Bad hygiene. Meth users typically pay little attention to oral hygiene, causing bacteria to build up in their mouths.
• Poor diet. Meth dehydrates users and causes them to crave sugary drinks, which adds to bacteria buildup.
— Source: methproject.org