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How Meth Can Permanently Rob Your Brain of Pleasure
Cleaned-up meth addicts often feel they're facing permanent unhappiness. We ask the experts if there's a solution.
Methamphetamine addiction is a destructive act of faith. It starts as a near spiritual experience—a gift bestowed by a chemical god, a healer of long-festering wounds and insecurities, an enhancer of all that is good. The glassy-white powder seems to instantly re-create the user in a vastly improved form—braver, smarter, and sexier than ever before.
Once you ingest the drug, you gasp for air ans feel your hair standing on end. Your brain kicks into high gear and thoughts come fast with razor-sharp focus, the surrounding world captured in vivid detail and overflowing with brand-new possibilities. But that kind of high cannot last. Using crystal meth is, from a biological perspective, like borrowing from a sadistic loan shark who demands resources faster than you can reasonably replace them—and the interest rate is unimaginably high. When the drug is discontinued, the crash is brutal, the high quickly replaced by a state of bottomless depression and hopelessness. Unlike heroin and cocaine, where this agonizing after-party is relatively ephemeral, when it comes to methamphetamine, there is often a legitimate fear that the depression will last forever.
The clinical term for this state is anhedonia: the inability to experience pleasure. When once even the most trivial activities may have created an excitement bordering on euphoria, now it seems nothing—sex, romance, money or children—can make you happy.
Dr. James A. Peck, a clinical psychologist who specializes in addiction, offers the following lesson in brain chemistry: “Crystal meth forces dopamine and norepinephrine to be blasted through the brain, so when you stop using meth, there’s a definite effect on your brain, which creates the anhedonia. The jury is still out as to whether it is permanent. We do have P.E.T. scan studies showing that for some users, it takes up to two years for the brain function to return to where it was prior to the meth use.” But Peck has seen cases where the damage has been permanent. “Part of this has to do with what these drugs are composed of,” he says. “Meth is cooked up from a bunch of toxic chemicals.”
Most methamphetamine is largely compsed of ephedrine or pseudoephedrine, both of which can be found in over-the-counter decongestants such as Sudafed and Contac, although access to these drugs is nowrestricted in many states. The drug also contains elements from lithium batteries, rock salt, lye, iodine, paint thinner, drain cleaner, gasoline additives, aluminum foil, and matchbooks (red phosphorus). While methamphetamine was first synthesized in Japan at the turn of the century, it came into popular usage during World War II when the Nazis dispensed the drug to their fighting forces, with even Hitler himself reportedly a daily user. In the United States, meth gained popularity in the sixties when it was manufactured and distributed by biker gangs. Since then, the use of meth in North America has increased to epidemic proportions—due in large part to the ease and cheapness with which it can be manufactured. It can take less than $1,000 worth of ingredients to produce over $20,000 worth of meth.
With its nihilistically toxic ingredients, meth’s corrosive damage is, as expected, profound. Dr. Edward Ratush, a New York psychiatrist specializing in the treatment of both depression and substance abuse, explains, “Using Crystal meth for a substantial amount of time, especially when smoked, can put almost golf ball-sized holes in someone’s brain.” He says that the drug creates a significant amount of brain damage. “If you look at someone who has had a traumatic brain injury, from a fall or car accident, their ability to experience happiness is also effected because different parts of the brain are interdependent,” he says. “The long-term meth user experiences traumatic brain injuries as a result of longtime toxin ingestion.” Is there a way to heal this damage? According to Ratush, yes and no. “Certain problems are not repairable,” he says. “I suppose it’s theoretically possible, but I’m not sure what the exercises for that would be.”
So do long-term meth users face a hopeless scenario? Without the drug, are they condemned to an existence without pleasure? The reality appears, at best, a difficult road. Studies are looking at the potential of the anti-depressant Wellbutrin, which increases levels of dopamine, to bring the addict’s brain chemistry to normal levels. But there’s no indication that this treatment will prove effective for long-term users who have inflicted permanent damage. Some physicians have suggested a solution similar to using methadone for heroin addicts: giving those in recovery from methamphetamine certain substitutes like Adderall or Ritalin at “manageable” levels to compensate for the damage done. But it’s unlikely such a course of treatment will gain widespread acceptance. “It’s the federal government that funds most of these studies,” Peck says. “And to try and get a grant proposal for a treatment like that—it just wouldn’t go over that well.”
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One promising approach may be long-term cognitive therapy, which attempts to retrain an addict’s thinking and behavioral patterns. Ratush says, “You intellectually decide what it is that you need to be doing in life: what is healthy for you and is going to get you to a place that you want to be. And no matter how unmotivated you are, you just do it anyway. Eventually, the hope is that the enjoyment will come from the neurobiological response from doing the activities. You have to run to eventually get a runner’s high.”
The other piece of this puzzle can be found in the popular recovery sentiment of gratitude. “People who don’t eat spicy food all the time can appreciate the subtleties of a bland dish, but people who eat really spicy food all the time burn out their taste buds to an extent and they have desensitized themselves," Ratush says. "Meth does that with dopamine. A drug-free existence can seem like a very bland meal to the meth addict. Normal isn’t enough. They have a hard time appreciating experiences that are subtle, like just hanging out with their family. That is, unless they can truly appreciate losing everything they had and still see how much meaning their life has. Because then they become grateful, and normal can seem like more than they could ever imagine.”
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