Why Is Meth So Addictive?

0:00:14 William Moyers
Hello and welcome to Let's Talk, a series of podcasts produced by the Hazelden Betty Ford Foundation on the issues that matter to us and the issues that we know matter to you as well. Substance use disorders, prevention, research, treatment and recovery support. I'm your host, William Moyers, joining you today from the Betty Ford Center here in Rancho Mirage, California. My guest is none other than Vice President of the West Region, Chris Yadron. Chris, welcome.

0:00:43 Christopher Yadron
Thank you very much. I'm glad to be here.

0:00:44 William Moyers
And our topic today is on methamphetamine. You were telling me before we started that it's known as crystal meth, ice, what else do we call it?

0:00:53 Christopher Yadron
Tina, crank, chalk. There's a whole number of names. The fact is crystal meth is becoming more and more of a problem once again.

0:01:01 William Moyers
Why?

0:01:02 Christopher Yadron
For a number of reasons. I think drug trends shift for a variety of reasons. Whether it's perception of harm, access, cost. One of the things that we've seen if we look historically is often times, after there's been an epidemic of opiate use, it's been followed by a big problem with stimulants. We saw it in the 70's with heroin and then cocaine in the 80's. And of course now we have a huge opioid problem in this country. But, over the last several years crystal meth has once again become a huge problem for us.

0:01:34 William Moyers
What is methamphetamine exactly?

0:01:35 Christopher Yadron
Methamphetamine it's a—it's a powerful stimulant. It's similar it's related to amphetamines. The—the presence of methyl makes it methamphetamine. Methamphetamine's typically a powder that people will snort. Crystal meth is a crystallized version of the drug that people will smoke. And it's very intense, it's very powerful and the capture rate is very high for people to become addicted.

0:02:02 William Moyers
What do you mean by the capture rate?

0:02:03 Christopher Yadron
What I mean by that is if someone were to try tobacco versus heroin, versus marijuana, from that first use to the point of developing a substance use disorder, how many individuals become addicted and it's very high for crystal meth because it's such a powerful stimulant.

0:02:21 William Moyers
There's a misnomer or there was at least at one point a belief that methamphetamine addiction could not be treated. Why was there that perception out there and is that in fact true?

0:02:32 Christopher Yadron
I don't think that’s true at all. I—I think one of the limitations that we face are providing the appropriate medication-assisted therapies that we have for some other drugs of choice that are making a real difference for example with the opioid epidemic at this point. So that's a limitation. But, I do think crystal meth addiction is very treatable. Here at the Betty Ford Center, at the Hazelden Betty Ford Foundation, we use a variety of evidence-based treatments whether it's Twelve Step Facilitation or other evidence-based psychosocial supports and treatments to intervene upon individuals struggling with this particular use disorder. One of the things that makes crystal meth so challenging is just the way it acts so powerfully on the body and on the spirit.

0:03:17 William Moyers
Mmm-hmm.

0:03:18 Christopher Yadron
But then another thing that's true about crystal meth is it also increases one's libido. And so, a person's sexuality and sexual behavior often times get wrapped up into the use of this drug. And then that makes it very difficult and very challenging to heal as well.

0:03:35 William Moyers
Interesting. So you mean for example when they tell us to stay away from people, places and things—you can't stay away from sexual activity because that's natural to the human experience.

0:03:46 Christopher Yadron
Exactly! Right? Our sexuality is wrapped up with who we are. So, the people, places and things becomes even more powerful or even more challenging for people to avoid.

0:03:55 William Moyers
Are there certain populations that are more vulnerable to the use of methamphetamine and thus addiction?

0:04:00 Christopher Yadron
Well, around the turn of the millennium, we saw a dramatic increase of crystal meth use especially in the LGBT community. It often hit rural parts of rural America very hard. And the—it got the government's attention. And by 2005, there was some legislation passed which made it very difficult to buy the supplies needed to produce crystal meth—

0:04:25 William Moyers
Yes.

0:04:26 Christopher Yadron
—In the United States. And we saw a decline. And then around 2008, it started to go back up again. And I don't think it's limited to just one community. I saw an article recently by our Medical Director from our Plymouth facility that treats our youth continuum in young adults. And Dr. Joe Lee there—

0:04:44 William Moyers
Yes. [smiles, nods]

0:04:44 Christopher Yadron
—Was talking about how it he sees an increase in it in terms of a younger increase use of the drug among a younger population. I was looking at the stats just this morning. And from 2008 to 2017, crystal meth use has actually increased eight-fold.

0:05:01 William Moyers
Wow! I didn't realize that.

0:05:00 Christopher Yadron
In that period of time. So it's continued to go up. Last year, or I should say in the year 2017, ten thousand people—ten thousand of the overdoses in term—that led to deaths—were from amphetamine use and crystal meth a big part of that.

0:05:16 William Moyers
What about among the patient population that we treat—can you give me an approximate percentage that's the number of patients who have a methamphetamine dependence?

0:05:24 Christopher Yadron
I don't have the hard numbers today but I've been speaking with some of our site directors and anecdotally they are seeing an increase as well. I was speaking with Matt Polacheck earlier, he's the Director of our site in West Los Angeles—

0:05:35 William Moyers
Yes.

0:05:37 Christopher Yadron
And he's seen a dramatic increase over the last year or two in patients presenting with a substance use disorder primarily focused on crystal meth use.

0:05:47 William Moyers
What should families look for if they sense or have a perception that their loved one might be struggling with methamphetamine? How does that manifest itself in the user?

0:05:59 Christopher Yadron
Well like any drugs—any—any substance use disorders, you'll see behavioral changes, you'll see changes in their physical appearance or in their mood. And the stability of their mood. With crystal meth it's pretty powerful and pretty significant, so you'll see insomnia. You'll see mood swings. Intense anxiety, intense depression at times. But also uniquely characteristic of crystal meth is you may see some psychotic features or delusional behavior. And psychosis is just a way of speaking about a person's break or disconnect from reality. And that can happen in a variety of ways. It might even be as simple as tactile hallucinations. Where they feel their skin is crawling and itching.

0:06:39 William Moyers
Yes. Crawling. Mmm-hmm. [nods]

0:06:42 Christopher Yadron
And so they'll itch their skin and you'll see sores on their skin. Crystal meth use is also characterized by very your—your appetite is diminished. It's sort of a binge and crash pattern.

0:06:52 William Moyers
Hmm.

0:06:53 Christopher Yadron
So people practice very poor diet, nutritional habits, hygiene habits. And you'll see in their teeth—

0:07:00 William Moyers
Yes.

0:07:01 Christopher Yadron
A lot of decay, or or the loss of their teeth. And so between the skin sores and some of the changes in terms of their teeth, those are some physical markers that you might notice if someone is further along the path in terms of use of crystal meth.

0:07:15 William Moyers
And yet when a patient who is dependent on methamphetamine or crystal meth comes to treatment, they don't get isolated or put in a special unit. There's always a misnomer, right, that people have to go into a segregated unit? That's not true.

0:07:29 Christopher Yadron
Right. I mean there's no special unit. We're still treating people.

0:07:33 William Moyers
Right. [nodding passionately]

0:07:33 Christopher Yadron
Human beings who are suffering from substance use disorders. And like any drug of choice, it ends up leading people to a life of alienation, isolation, disconnection from themselves— 

0:07:46 William Moyers
Mmm-hmm.

0:07:46 Christopher Yadron
From others, from their Higher Power. So we're just trying to connect and create a safe and stable place for people to first of all, heal physically—

0:07:55 William Moyers
Right.

0:07:54 Christopher Yadron
And get back on track in terms of their diet and their sleep. People might be up for days using crystal meth. And they will because of the way there's an initial rush and then a high that lasts approximately 12 hours, people will cycle through again and again without resting, without sleeping. So, it's real important to just get physical rest and nutrition at the beginning of their treatment.

0:08:18 William Moyers
Mmm-hmm.

0:08:18 Christopher Yadron
And then as they become more stable, they along with other patients can begin to work on some of the psychosocial and spiritual components of the disease as anyone else would in treatment. As I said earlier, this often does get wrapped up with a person's sexuality. They also struggle because the way—because of the way crystal meth works, it releases so much dopamine in such a powerful way, people have a hard time experiencing pleasure once again. For some time. It takes a long period of sobriety and abstinence for people to get what they need. So, ongoing recovery management and support and developing a support system in a recovery community are really important and vitally important for people struggling with crystal meth addiction.

0:09:04 William Moyers
But recovery from it is possible?

0:09:06 Christopher Yadron
Absolutely! As a counselor myself over the years—

0:09:10 William Moyers
Yes.

0:09:09 Christopher Yadron
I've treated numerous people who have recovered and recovered well. Here at the Betty Ford Center, and our other sites, we see people who are able to engage long-term recovery from crystal meth addiction.

0:09:21 William Moyers
I know that with the legalization of marijuana proliferating now across the country, there has been talk that one alternative form of quote "treatment" for methamphetamine addicts is marijuana. That perhaps the application of the use of marijuana might be better for methamphetamine addict than methamphetamine would be. What—what's your take on that, Chris?

0:09:45 Christopher Yadron
My take is first of all, legal doesn't always equal safe, right?

0:09:48 William Moyers
Right.

0:09:49 Christopher Yadron
So, alcohol's legal, nicotine is legal, and yet we know there are serious health ramifications. People at this point who wish to use cannabis or marijuana, as a silver bullet, or a panacea for a whole variety of ills, I think the truth is we don't really have the research or the evidence to suggest that that's the case. Or that that would be even helpful. And there's a tremendous number of health risks associated with cannabis use. So why replace one ill for another? I think that what we offer here at the Hazelden Betty Ford Foundation in terms of comprehensive recovery for the mind, the body, the spirit is an important way to approach this from an abstinence-based perspective. Not in a narrow-minded or dogmatic way—

0:10:33 William Moyers
Mmm-hmm.

0:10:34 Christopher Yadron
But this works, it's been proven to work for—for thousands of people over the generations. So, I—we wanna continue to treat this to treat this substance use disorder effectively.

0:10:47 William Moyers
And your point as we get ready to close here is that treatment for methamphetamine addiction is not only viable, but that recovery from methamphetamine addiction is a reality for many, many people. It's just taking that first step and admitting you have a problem and finding the appropriate level of care.

0:11:05 Christopher Yadron
Absolutely. Being able to reach out and ask for help is crucial as that first step. And once an individual does that, he or she can begin to heal. In terms of their body as I said before. Get the rest that they need, get back on the path to proper nutrition. But most importantly, begin to build new relationships and healthy, sober relationships. That feed and serve the human spirit in terms of lasting recovery. So, definitely, hope and healing are very possible.

0:11:33 William Moyers
Chris Yadron, thank you very much for taking the time to bring your experience and your strength, your professional passion and your personal passion to the issue today of methamphetamine addiction and methamphetamine recovery. Chris Yadron, thank you very much. [turns to camera] And thanks to our listeners and our viewers today for joining us for another edition of Let's Talk, a series of podcasts on the issues that really matter. On behalf of our Executive Producer, Lisa Stangl, and our Blue Moon Productions crew, I'm William Moyers, we'll see ya again.