EDITORIAL: Ending a meth habit is a long, terrible journey. Let's do all we can to lend a hand

Aug. 25--Here's what happens when you use meth: You feel super smart and competent. You experience a great rush of pure happiness. Even when that rush fades, you feel wide awake, energetic and interested in everything around you for many hours. Meth releases several times more dopamine-like effects in your brain than having an orgasm.

But here's what happens when you use meth a lot: Every time you use it, your heart rate increases, your body temperature rises, and you breathe faster. Your brain's ability to produce feelings of contentment or happiness without the drug withers. Your brain loses cognitive function, so you become more impulsive. Your decision-making skills take a nosedive, and you develop attention deficit disorder. You develop jerky movements that you can't control. You become prone to infections, gum disease, and hypertension. And the longer you use, the higher your risk for heart attack, stroke, kidney failure and Parkinson's disease.

You may also die. In fact, the state Department of Health reports that deaths attributed to meth overdoses have increased statewide from 98 in 2007 to 476 in 2017. However, researchers acknowledge these numbers are probably an undercount since some heart attacks, strokes and other causes of death may not register as meth-related. Fentanyl, which has recently started to appear in meth, also may play a role.

That's why, after being pushed to the back burner of public concern during the raging opioid epidemic, attention to meth abuse is heating up again. This prompted a recent Meth Summit hosted by the Alcohol and Drug Abuse Institute at the University of Washington.

Several of the speakers at the summit were people with lived experience of meth addiction. Like the researchers, treatment professionals and others at the summit, they point to several basic prerequisites to quelling this epidemic.

The biggest obstacles to people seeking treatment is their feeling that they are unworthy, undeserving, and likely to face more blame and judgment than support and encouragement. The stigma of addiction -- and the mental illness that is its most common companion -- are often overwhelming. People who use meth feel worthless and incompetent without it, often because they grew up being told they were.

Another tough problem is that it can take as many as two years of clean time for a person's brain function to return to any semblance of normalcy. For many months after meth use stops, people experience complete anhedonia -- the inability to feel any kind of pleasure. And the cravings for meth may never leave them. It takes an enormous amount of support, strength and persistence to leave meth behind.

Finding support for such a long term of recovery is key. "The opposite of addiction is connection," said one recovering person at the summit. "And the best treatment is time." Without sustained support from family, a faith community, or long-term therapy team, chances for success are slim.

The right conditions for complete recovery from meth addiction are uncommon. Treatment availability is improving, but it is often not long enough. And although we are headed in the right direction, we are still a long way from having integrated mental health, physical health, housing, social support and addiction services available to all who need them when they need them.

We also lack a long term commitment to reducing the biggest risk factors for addiction: poverty, toxic stress, and childhood trauma.

That's why the idea of harm reduction is so important. Harm reduction is a way of thinking and a set of services that address the public health aspects of addiction in ways that reduce the harms caused by dirty needles and contaminated drugs, and arrest the downward spiral of addiction by encouraging people with addictions to use less, to take more safety precautions, and to take better care of themselves.

Needle exchanges are the marquee harm reduction programs. Thurston County has had one since the mid-1990s, supported by a combination of state and county funding. Patrick Judkins, the program's director, says the program first started to reduce the spread of HIV/AIDS, since sharing needles for drug use is a very effective way to spread it. Over time, hepatitis and other health issues also became a bigger concern.

But the most effective feature of needle exchanges and other harm reduction programs is the relationships social workers, community volunteers, housing providers and needle exchange personnel create with the people they serve. Peer support is also key.

It is these sustained, supportive human connections that have the power to draw people back from the abyss, and awaken an awareness of their own worth and humanity. This is where the path to sobriety usually starts. That path can be very long and winding, but we need to support people at every step on that journey.


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