So how is the rising tide of methamphetamine abuse different from other drug trends? How is it similar?

How's it different? A functional drug
People take drugs primarily to feel good or to feel better. Some people use drugs to "self-medicate," or escape emotional or physical pain. And in most cases, in the short term, drugs do make you feel better. It's that "reward" of drug abuse that keeps people coming back for more.

But unlike other drugs people seek for their euphoric effects, some people seek meth--and other long-acting stimulant drugs--for very practical reasons. Meth is used as a means to an end. It is a utilitarian tool, not the final destination. It suppresses appetite so a teenage girl can lose weight. It prolongs alertness so a harried mother can keep up with children underfoot. It increases wakefulness and heightens focus.

In these contexts meth is ingested not to "get high," but rather to improve functioning and performance. Meth is used to help people "plug-in," not "drop-out." The lure of meth is the high energy, focus, and control that it brings.

In light of the multi-tasking, high-pressured, and fast-paced nature of life in the 21st century, it is easy to see its appeal across a broad spectrum of the population. Meth attracts not just thrill-seekers or party animals, but also high achievers, hard workers, and go-getters. This drug tempts both the successful and the marginalized. This is what makes meth different.

While the user may be initially impressed by the heightened endurance and energy while under the influence of meth, it just doesn't last and eventually the meth controls them. The progression from occasional use to addiction can occur in a matter of months.

Increasing amounts of meth are used (due to the resulting physical tolerance) over extended periods of time--sometimes days--during which addicts do not eat or sleep. This leads to physical deterioration, which is often more rapid and pronounced with meth addicts than with those addicted to other drugs.

Eventually most meth addicts develop strong paranoid delusions, sometimes known as "methamphetamine psychosis," where they experience visual and auditory hallucinations. Intensely paranoid and delusional, they believe that everyone is "out to get them," even innocent strangers or inanimate objects.

For those addicted to any drug, acquiring and using the drug is the primary focus of life, in spite of negative consequences (loss of employment, family, personal relationships, and physical and psychological health). A person's compulsive drug use dominates every aspect of life and addicts will do almost anything to obtain the drug, including criminal acts.

How's it similar? Treatment works
Like addiction to other drugs, methamphetamine addiction can be successfully treated. Addiction is a treatable disease and the outcomes of addiction treatment are similar to those of other chronic diseases with behavioral components, such as hypertension, diabetes and asthma.

With meth addicts an individualized assessment is critical in order to evaluate the patient for psychosis; if it's present, it needs to be stabilized. Meth addicts must also be individually assessed for cognitive damage, and the treatment course adjusted accordingly. And as with patients addicted to other substances, it is extremely important that after completing treatment, meth addicts return to a safe, supportive sober-living arrangement. Sadly, this is not always available.

So the next time you hear meth addiction characterized as an incurable, hopeless malady, consider the following:

• Analysis of 952 residential Hazelden patients, 14.2 percent of whom were methamphetamine users, found no difference in outcomes between meth users and non-meth using patients as measured by continuous abstinence rates one year after treatment, satisfaction with psychosocial functioning, and satisfaction with health functioning.
• UCLA's Matrix Model, a 16-week intensive outpatient treatment model, is effective and was the object of the national Center for Substance Abuse Treatment (CSAT) Methamphetamine Treatment Study (1998-2001), the largest randomized clinical trial of treatment of meth addiction to date.
• Iowa's Division of Behavioral Health and Professional Licensure found that 71 percent of meth users were abstinent six months after discharge.
• Tennessee's Bureau of Alcohol and Drug Abuse found that 65 percent of meth clients were abstinent six months after discharge.
• Texas Department of State Health Services found that 66 percent of meth clients were abstinent 60 days after discharge (publicly funded services 2001-2004).

Carol L. Falkowski is director of research communications at the Hazelden Foundation, and author of Dangerous Drugs: An Easy-to-Use Reference of Parents and Professionals. She has monitored drug abuse trends in Minnesota for 20 years as part of an ongoing epidemiological drug abuse surveillance network of the National Institute on Drug Abuse

Published in The Voice, Summer 2005