Transcript Slide 1

Methamphetamine
Problem and Solution
Using the
Strategic Prevention Framework
Logic Model
Many Voices One Vision
Indianapolis, Indiana
Barbara Seitz de Martinez, PhD, MLS, CPP
Indiana Prevention Resource Center
August 2, 2007
The Indiana Prevention Resource Center is funded, in part, by a contract with the Indiana Family and Social
Services Administration, Division of Mental Health and Addiction, financially supported through HHS/Substance
Abuse Mental Health Services Administration, Center for Substance Abuse Prevention, Substance Abuse
Prevention and Treatment Block Grant. The IPRC is operated by the Indiana University Department of Applied
Health Science and School of Health, Physical Education and Recreation. It is affiliated with the Department’s
Institute of Drug Abuse Prevention.
Outcomes-Based Prevention
Assessment
Evaluate
Capacity Building
Sustainability &
Cultural Competence
Implement evidenceBased PPP
Source: U.S. Department of Health and Human
Services, SAMHSA, CSAP
Strategic Plan
Meth Strategies
Substance-Related
Consequences
and Use
Community
 Crime
 Family services
 School
 Healthcare
Individual
 Physical damage
 Psychological damage
 Harm loved ones
 Family disintegration
Adapted from CSAP, Strategic Prevention
Framework, Indianapolis, Feb. 21, 2006
Intervening
Factors
Strategies
Methamphetamine
Source:
http://www.wsnia.org/articles/MethPrevCookbook/METHTRAININGSEG2-2001.pdf
Methamphetamine
Powder
Crystal
Source: DEA, Photo Library, http://www.usdoj.gov/dea/photo_library3.html
Ice / Crystal / Pipe
Methamphetamine
Powder
Source: DEA, Photo Library, http://www.usdoj.gov/dea/photo_library3.html
Bag of Ice / Crystal
Methamphetamine
Powder
Source: DEA, Photo Library, http://www.usdoj.gov/dea/photo_library3.html
Powder
Methamphetamine
Source:
http://www.wsnia.org/articles/MethPrevCookbook/METHTRAININGSEG2-2001.pdf
How It Is Stored
Administration
Smoking**
immediate, intense rush, lasting a few minutes
Injecting
immediate, intense rush, lasting a few minutes
Snorting
In 3-5 min., euphoria, long-lasting high up to 12 hrs.
Oral ingestion
In 15-20 min., euphoria, long-lasting high up to 12 hrs.
Source: NIDA, Research Report Series: Methamphetamine Abuse Addiction, 1998:3-4
Prevalence – World Wide Use
Methamphetamine
 Cocaine: 10 million regular users
 Heroin: 15 million regular users
 Meth:
42 million regular users
Source: World Health Organization, Cited by Richard Rawson (UCLA
Integrated Substance Abuse Programs, and Pacific South West Addiction
Technology Transfer Center), “Meth: A Focus on Women and Children,”
Women and Children in Recovery Conference of the Indiana Family and
Social Services Administration, Division of Mental Health and Addiction, IN
Government Building, April 7, 2005
Half-Life
 The half-life of cocaine is .5 to 1.5 hours
 The half life of meth is 9 to 24 hours
 The half-life of smoked cocaine is 1 to 1.5 hours
 The half life of smoked meth is 11 to 12 hours
Source: Minnesota Department of Health. “Implications of Route of
Administration for Cocaine and Methamphetamine for Drug Abuse and
Neurobehavioral Sequellae”
http://www.health.state.mn.us/divs/eh/meth/adminroute.pdf
Consequences of Use
Substance-Related
Consequences
and Use
Ill effects to addict:
addiction
brain damage
HIV/STDs
weight loss
paranoia
hallucination
dental damage,
fetal effects
burns
loss of children
loss of job
loss of marriage
imprisonment
family disintegration
Other effects to community:
violent crime
child abuse
child neglect
strain on child services
school personnel strained
healthcare services strained
law enforcement
judicial system
Consequences of Use: Short-term
Short-term Effects:
Rush
Wakefulness
Physical activity
Loss of appetite
Increased
respiration
Increased blood
pressure
Dopamine plays an important role in the regulation of pleasure.
In addition to other regions, dopamine is manufactured in nerve
cells within the ventral segmental area and is released in the
nucleus accumbens and the frontal cortex.
Tremors/convulsions
Hyperthermia
Source: NIDA Research Report Series: Methamphetamine & Stop_Drugs.org,
Consequences of Use: Long-term Effects
 Dependence and addiction psychosis
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
Paranoia
Hallucinogens
Mood disturbance
Repetitive motor activity
 Stroke
 Weight Loss
 Tooth damage
 Extent of brain damage (up to 50% of dopamineproducing cells in the brain)
Source: NIDA, Research Report Series: Methamphetamine Abuse Addiction, 1998:4
Burns and Scratching
Source: Bill O’Dell,
Community Prevention
Specialist, West Virginia
Prevention Resource
Center, “What’s Up with
Meth” PowerPoint, 2004
Same Woman
Source: DOJ,
DEA,
Pseudoephedrine
Brochure, Aug.
2003
Damage over time
Source: DOJ,
DEA,
Pseudoephedrine
Brochure, Aug.
2003
Repetitive Action
Source: Michael G.
Heavican, U.S. Attorney
for District of Nebraska,
Photos taken by Lincoln
police of persons
arrested for meth
possession.
1999
2001
Use: Consumption Patterns
Substance-Related
Consequences
and Use
Overall consumption data
Info about drug being consumed
 Homemade for self-use
 Street drug (imported vs. local manufacture)
 Form of the drug (powder? Ice? )
 Manner of consumption (needle? smoked?)
Adapted from CSAP, Strategic Prevention
Framework, Indianapolis, Feb. 21, 2006
Use: Consumption Patterns
Substance-Related
Consequences
and Use
Overall consumption data
Location/context of use:
Consumption in risky situations





Parties (in homes, private or public)
In school
In homes with children
At work
Association with unsafe sex (STDs, HIV)
Adapted from CSAP, Strategic Prevention
Framework, Indianapolis, Feb. 21, 2006
Use: Consumption Patterns
Substance-Related
Consequences
and Use
“There’s no such thing as a typical meth user.”
-- recovering meth addict
Who is using? Groups to target.
 Rural / urban / suburban
 White / Hispanic / African-Americans
 Heterosexual / homosexual
 Young adult / older adult / youth
 Men / women
 Substance users / polydrug users
“Q: Is meth used in
combination with other
drugs?
A: Methamphetamine users
are likely also to be users of
alcohol, marijuana and
cocaine rather than users of
drugs like heroin. “
Who is using? High-Risk Groups?
 Pregnant women
 Youth, college students
Source: Website page of
www.methfreeindiana.org:
Adapted from CSAP, Strategic Prevention
Framework, Indianapolis, Feb. 21, 2006
http://www.in.gov/cji/drugfree/
meth/faq.html accessed
1/20/07.
Consumption Patterns: Impact on Children
Substance-Related
Consequences
and Use
Overall consumption data
Info about impact upon children
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


Dangers in lab setting
Role modeling
Risk of physical/emotional neglect/abuse by parent
Risk of abuse by other adults
Adapted from CSAP, Strategic Prevention
Framework, Indianapolis, Feb. 21, 2006
Consequences: Drug Endangered Children
Patterns of Use:
Source: Bill O’Dell, Community Prevention Specialist,
West Virginia Prevention Resource Center, “What’s Up
with Meth” PowerPoint, 2004
Consequences: Drug Endangered Children
Substance-Related
Consequences
and Use
Effects upon Parenting:
1.
2.
3.
4.
Insomnia
Intense sleep
Intense hunger
Depression
Binge Phase:
Physical Abuse – agitated, violent behavior
Sexual Abuse – libido increased
Neglect – intensely self-centered
Crash Phase:
Physical Abuse – violent, easily agitated
Sexual Abuse – children unprotected from others
Neglect – no supervision, neglect of child’s needs
Why Children Are More Vulnerable
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


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Shorter, closer to the ground (chemical vapors)
Growing and developing rapidly
Higher metabolic and respiration rates
Developing nervous system (more vulnerable)
Different habits, e.g., hand-to-mouth (higher risk)
Source: Richard Rawson (UCLA Integrated Substance Abuse Programs, and Pacific South West Addiction
Technology Transfer Center), “Meth: A Focus on Women and Children,” Women and Children in Recovery
Conference, IN Government Building, April 7, 2005
Consequences for Children
Adapted from CSAP, Strategic Prevention
Framework, Indianapolis, Feb. 21, 2006
Prevalence – Indiana 6th-12th Graders, 2006
Meth Use by IN Children, 2006 (IPRC)
Grade
Lifetime
Annual
Current
6th
0.5%
0.3%
0.2%
8th
2%
1.4%
0.9%
10th
3.5%
2.4%
1.2%
12th
5%
3.1%
1.5%
Indicates that IN rate is higher than U.S. rate based on MTF 2006 survey.
Source: Alcohol, Tobacco and Other Drug Use by Indiana Children and Adolescents –
2006 Survey. Indiana Prevention Resource Center, 2006
http://www.drugs.indiana.edu/survey/atod/2006/index.html. Accessed 1/20/07.
Monitoring the Future, 2006 survey, www.monitoringthefuture.org (University of Michigan, 2006) Accessed 1/21/07.
Prevalence – Indiana 6th-12th Graders, 2006
Meth Use by IN Children (%), 2006
Lifetime
Annual
Current
Gr
IN
U.S.
IN
U.S.
IN
U.S.
6
0.5
NA
0.3
NA
0.2
NA
8
2
2.7
1.4
1.8
0.9
0.6
10
3.5
3.2
2.4
1.8
1.2
0.7
12
5
4.4
3.1
2.5
1.5
0.9
Indicates that IN rate is higher than U.S. rate based on MTF 2006 survey.
Source: Alcohol, Tobacco and Other Drug Use by Indiana Children and Adolescents –
2006 Survey. Indiana Prevention Resource Center, 2006
http://www.drugs.indiana.edu/survey/atod/2006/index.html. Accessed 1/20/07.
Monitoring the Future, 2006 survey, www.monitoringthefuture.org (University of Michigan, 2006) Accessed 1/21/07.
Prevalence – Indiana 6th-12th Graders, 2006
Tranquilizer Use by IN Children (%), 2006
Lifetime
Annual
Current
Gr
IN
U.S.
IN
U.S.
IN
U.S.
6
0.5
NA
0.3
NA
0.2
NA
8
8.9
4.3
6.8
2.6
4.1
1.3
10
14.3
7.2
10.7
5.2
5.9
2.4
12
14.5
10.3
9.8
6.6
5.3
2.7
Indicates that IN rate is higher than U.S. rate based on MTF 2006 survey.
Italics indicates a statistically significant drop from 2005 to 2006 in Indiana.
Source: Alcohol, Tobacco and Other Drug Use by Indiana Children and Adolescents –
2006 Survey. Indiana Prevention Resource Center, 2006
http://www.drugs.indiana.edu/survey/atod/2006/index.html. Accessed 1/20/07.
Monitoring the Future, 2006 survey, www.monitoringthefuture.org (University of Michigan, 2006) Accessed 1/21/07.
Prevalence – Indiana 6th-12th Graders, 2006
Alcohol and Smoking Behaviors (%)
Binge Drinking
Daily Smoking
Gr
IN
U.S.
IN
U.S.
6
7
NA
3
NA
8
11
10.9
5.8
4.0
10
19.9
21.9
12.2
7.6
12
27.3+
26.5
16.9
12.2
Indicates that IN rate is higher than U.S. rate based on MTF 2006 survey.
Italics indicates a statistically significant drop from 2005 to 2006 in Indiana.
Source: Alcohol, Tobacco and Other Drug Use by Indiana Children and Adolescents –
2006 Survey. Indiana Prevention Resource Center, 2006
http://www.drugs.indiana.edu/survey/atod/2006/index.html. Accessed 1/20/07.
Monitoring the Future, 2006 survey, www.monitoringthefuture.org (University of Michigan, 2006) Accessed 1/21/07.
Prevalence – Indiana 6th-12th Graders, 2006
Current Drug Use by IN Children (%), 2006
Gr
Meth
Alcohol
Binge
Cigarettes
Marij
Tranq
Cocaine
8
0.9
20.9
11
11.6
8.2
4.1
1.1
10
1.2
33
19.9
20.6
14.6
5.9
2.1
12
1.5
42.2
27.3
26.9
17.2
5.3
3.1
Indicates that IN rate is higher than U.S. rate based on MTF 2006 survey.
Source: Alcohol, Tobacco and Other Drug Use by Indiana Children and Adolescents –
2006 Survey. Indiana Prevention Resource Center, 2006
http://www.drugs.indiana.edu/survey/atod/2006/index.html. Accessed 1/20/07.
Intervening/Causal Factors
Substance-Related
Consequences
and Use
Community
 Crime
 Family services
 School
 Healthcare
Individual
 Physical damage
 Psychological damage
 Harm loved ones
 Family disintegration
Adapted from CSAP, Strategic Prevention
Framework, Indianapolis, Feb. 21, 2006
Intervening
Factors
Community
 Availability
 Price
 Local labs, street, retail
 Social
 Social Norms
 Enforcement
Individual
 Perceptions of risk
 Perceptions of harm
Availability of Chemicals: Precursor
Source: http://www.meth-in-douglas.com/meth_info.htm
Ephedrine / Pseudoephedrine
Availability of Chemicals: Precursor
 Precursor (pseudoephedrine)
 Reagent: e.g., water reactive
metal (lithium, sodium, red
phosphorous, iodine, sodium hydroxide)
Source: DEA
 Solvent (acetone, alcohol, benzene, camp fuel,
chloroform, ethanol, ether, methanol, mineral spirits,
paint/lacquer thinner, toulene, xylene)
 Glassware and hardware
Source: IN State Police, Clandestine Laboratory Team, 2005
 Keeping Ahead of the Criminals
http://leda.lycaeum.org/index.pl?ID=8731
Keeping Ahead of the Criminals
From Phenylalanine
From: [email protected] (Speed Raver)
A surprisingly simple synthesis is possible from the amino acid phenylalanine, which
is available at health food stores for about $14 for 100 tablets. Phenylalanine
is 2-amino-3-phenylpropanoic acid, which is more or less amphetamine with a
COOH where the Ch4 should be at the end of the chain. Thionyl chloride will
replace the OH with a Cl, which falls off and is replaced by H when you give it
lithium aluminum hydride, sodium borohydride, or hydrogen gas and
nickel/platinum. If you use hydrogen and metal for that step, you'll ha v e to
reduce the carbonyl group with one of the hydrides, so best save time + effort
and use them and do both reductions at once. When that carbonyl is reduced,
you now have amphetamine. Go back up to that first one I mentioned for
upgrading amphetamine into methamphetamine.
Don’t know if this is true. Need to keep ahead of the criminals.
http://leda.lycaeum.org/index.pl?ID=8731
Chemicals: Reagant
Source: http://www.meth-in-douglas.com/meth_info.htm
Red Phospherous
Map: Meth Lab Busts, 2006
Total
lab
busts:
6,435
Indiana
Prevention
Resource
Center
Map: Meth Lab Busts, 2006
Indiana Prevention Resource Center
Source: IN State Police, 2007
Total lab busts, 993
Map: Meth Lab Busts, 2006
Total lab busts, 993
Indiana Prevention Resource Center
Source: IN State Police, 2007
Incomplete Data
 Not all labs are found
 Not all agencies report all seizures
 Not all agencies that report to the Indiana State
Police also report to the DEA
 We have no way to know for other states what
percent of lab seizures are being reported to the DEA
Intervening/Causal Factors
Substance-Related
Consequences
and Use
Community
 Crime
 Family services
 School
 Healthcare
Individual
 Physical damage
 Psychological damage
 Harm loved ones
 Family disintegration
Adapted from CSAP, Strategic Prevention
Framework, Indianapolis, Feb. 21, 2006
Intervening
Factors
Social Values
 Overachievement
 Thinness ideal
 Economic success
 Letting others set your goals
 Seeking the ‘high’
 Thrill of risk taking
Individual
 Coping mechanism
 Peer pressure
Intervening/Causal Factors
Substance-Related
Consequences
and Use
Community
 Crime
 Family services
 School
 Healthcare
Individual
 Physical damage
 Psychological damage
 Harm loved ones
 Family disintegration
Adapted from CSAP, Strategic Prevention
Framework, Indianapolis, Feb. 21, 2006
Intervening
Factors
Community
 Availability
 Price
 Retail
 Social
 Social Norms
 Enforcement
Strategies
Address problems
identified and
causal factors
Individual
 Perceptions of risk
 Perceptions of harm
Strategies
Substance-Related
Consequences
and Use
Community
 Crime
 Family services
 School
 Healthcare
Individual
 Physical damage
 Psychological damage
 Harm loved ones
 Family disintegration
Intervening
Factors
Community
 Availability





Price
Retail
Social
Social Norms
Enforcement
Individual
 Perceptions of risk
 Perceptions of harm
 Coping Mechanism
 Peer Pressure
Adapted from CSAP, Strategic Prevention
Framework, Indianapolis, Feb. 21, 2006
Strategies
Reduce availability
Legislation/Policy
Dye in anhydrous
Awareness campaigns
Community action
Curricula / programs
Trainings – CPS, School
Provisions for DEC
Healthcare workers
Law enforcement
Support Networks
Strategies
Substance-Related
Consequences
and Use
Intervening
Factors
Strategies
Legislation controlling the sale of ephedrine by retailers (7/05)
Meth Law Senate Enrolled Act 444
•Limits amount of purchase
•Records names of purchasers
•Database to track purchases
•Tracking log books
Source: http://www.in.gov/cji/methfreeindiana/newlaw.html Accessed 1/20/07
Adapted from CSAP, Strategic Prevention
Framework, Indianapolis, Feb. 21, 2006
Strategies
Substance-Related
Consequences
and Use
Intervening
Factors
Strategies
•IN Drug Endangered Children Response Protocol
•IN Drug Endangered Children Comprehensive Care Protocol
•Policy and Planning Strategies – lab clean-ups
•Enforcement Strategies – highway patrols, campaigns
•Precursor Chemical Control Strategies – tags on ammonia tanks
•Prevention/Drug Demand Reduction Strategies – education
•Property Remediation/Meth Lab Clean-up Strategies – loans
•Treatment Strategies – Transition help for reentry from prison
http://www.in.gov/dcs/policies/decresponseprot.html
Strategies
Substance-Related
Consequences
and Use
Intervening
Factors
Strategies
Meth Tip Hotline: 877-855-6384
IN Criminal Justice Institute Meth Data Repository
Indiana Meth Watch Program (CJI)
Meth Free Indiana Coalition
Midwest Governors Association Regional Meth Summit
Governor’s Commission for a Drug-Free Indiana
Strategic Prevention Framework State Incentive Grant
Adapted from CSAP, Strategic Prevention
Framework, Indianapolis, Feb. 21, 2006
Prevention Is Prevention
Goal:
Goal:
Goal:
Goal:
Goal:
To delay/reduce/eliminate initiation
To promote parenting & life skills
To promote a drug-free lifestyle
To promote positive values
To promote healthy communities
Multiple strategies across multiple domains
Thank you so much!
Contact:
Indiana Prevention Resource Center
800 / 346-3077
812 / 855-6776
[email protected]