Methamphetamine

A powerful video on the effects of methamphetamine use. It cuts off at the end, but I think this is the best one on the net.



A brief summary of a recent patient encounter I had with a polysubstance abuser.

Ms. A is a 27 year old white female I recently had as a patient. She had a long history of drug abuse, including Heroin, Cocaine, Club drugs, and Amphetamines. She presented to the hospital with diffuse body aches, restlessness, high heart rate, an increased WBC count (usually a marker of infection), no fever, and a history of several weeks of nausea with occasional vomiting. In the hospital she was hysterical, crying loudly and sometimes writhing in pain and rocking back and forth. The initial differential diagnosis was broad, but high on the list for me was opiate withdrawal or possible (viral) infection. She was tested for influenza, blood and urine cultures were sent to rule out an infection of her body fluids, and a urine drug screen was sent. She was negative for all things tested for except her urine came back as positive for Amphetamines.

This young patient was on daily Methadone (a long acting opiate) via a Methadone clinic for prior Heroin addiction, reportedly in remission. Certainly a requisite for participating in such a clinic is that you are otherwise drug-free. During my initial interview with her she completely denied any past or current drug use. It took the urine drug screen, some detective work, and further interviewing with her to tease out the extensive drug history. And in all likelihood she came to the hospital with the knowledge that she could likely get a "fix", or opiate pain medications (at taxpayer expense) by putting on just the right act. Or another way of looking at it is that she was truly in "pain", but this pain was somatization of the psychological and physical stress she was putting her body through with administration and withdrawal (when money or supply ran out) of street drugs, often laced with dangerous impurities.

I did my best to rule out any fixable medical conditions, got the Substance Abuse specialists at the hospital to come see her, kept her comfortable while she was at the hospital, and then sent her on her way. Before she left I gave my best shot at an inspirational / motivational speech about the dangers of drugs and how she had much good life ahead of her. I'm not hopeful it sank in, as this patient looked to be pretty deep in the hole.