Methamphetamine
Dotaz
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Adiktologie, ISSN 1213-3841 vol. 8, no. 2, suppl. August 2008
202-311 s. : il., tab. ; 25 cm
- MeSH
- kongresy jako téma MeSH
- methamfetamin MeSH
- poruchy spojené s užíváním psychoaktivních látek MeSH
- uživatelé drog MeSH
- Publikační typ
- abstrakt z konference MeSH
- Konspekt
- Veřejné zdraví a hygiena
- NLK Obory
- adiktologie
Metamfetamin (pervitin) má jedinečné postavení na české drogové scéně. Problémové užívání je spojeno s celou řadou zdravotních komplikací a má závažné veřejnozdravotní implikace. Počet problémových uživatelů pervitinu tvoří dvě třetiny všech problémových uživatelů drog v ČR. Indikátor celoživotní prevalence a jiné indikátory týkající se užívání pervitinu české republice (ČR) jsou relativně stabilizovány. Výjimkou je populace adolescentů a populace účastníků tanečních akcí. Pokud jde o léčbu, jsou uživatelé pervitinu nejpočetnější skupinou léčených uživatelů drog a jejich počet pomalu narůstá. Léčba závislosti na pervitinu je v CR veděna výhradně abstinenčně a u vlastní závislosti na pervitinu obecně nelze počítat s větší podporou medikace. V současné době je v zahraničí stále více diskutována možnost substituční léčby pro uživatele metamfetaminu. Mezi dosavadními (schválenými) způsoby léčby v ČR nenajdeme substituční léčbu závislosti na pervitinu a dalších stimulanciích. Výsledky zahraničních studií zkoumajících efektivitu substituční léčby závislých na stimulaciích přinášejí slibné, i když ne jednoznačně přesvědčivé výsledky. Dosud však nebyla provedena kvalitní randomizovaná, dvojitě slepá, kontrolovaná, multicentrická klinická studie. Pro substituční léčbu se nabízí zejména metylfenidát hydrochlorid, modafinil a dextroamfetamin. V ČR jsou zatím registrované přípravky s obsahem metylfenidátu hydrochloridu pod komerčními názvy Ritalin® a Concreta® a modafinil pod názvem Modafinil-Teva® s uvedenou sílou.
Methamphetamine (pervitin) has a unique position on the Czech drug scene. The problem use of this substance entails a range of health consequences, as well as having serious implications in terms of public health. The problem users of pervitin account for two thirds of all the problem drug users in the Czech Republic. Pervitin use-related indicators such as that of lifetime prevalence have been relatively stable in the Czech Republic, with the exception of the populations of adolescents and dance party-goers. As far as treatment is concerned, the users of pervitin comprise the largest group of drug users in treatment, and their number is slowly growing. In the Czech Republic, the treatment of pervitin dependency is exclusively oriented towards abstinence, and no major medication support may be expected as regards this type of dependency. Substitution treatment of methamphetamine users as a therapeutic alternative has been increasingly discussed abroad. The existing (approved) treatment approaches pursued in the Czech Republic do not include substitution treatment of dependency on pervitin and other stimulants. Foreign studies investigating the effectiveness of substitution treatment of those dependent on stimulants indicate promising, although not totally convincing, results. However, no rigorous randomized double-blind controlled multicentric clinical trial has been conducted. Substances with potential for substitution treatment include methylphenidate hydrochloride, modafinil, and dextroamphetamine. Products containing methylphenidate hydrochloride which have received marketing authorisation for the Czech Republic include Ritalin ® and Concreta ® , and modafinil authorized as Modafinil-Teva ® .
- Klíčová slova
- klinické hodnocení, substituční léčba, závislost,
- MeSH
- amfetaminy škodlivé účinky MeSH
- centra pro terapii drogových závislostí organizace a řízení statistika a číselné údaje MeSH
- financování organizované MeSH
- intravenózní abúzus drog MeSH
- klinické zkoušky jako téma MeSH
- lidé MeSH
- methadon terapeutické užití MeSH
- methamfetamin chemie škodlivé účinky MeSH
- methylfenidát terapeutické užití MeSH
- poruchy spojené s užíváním amfetaminu prevence a kontrola MeSH
- programy řízené péče organizace a řízení statistika a číselné údaje MeSH
- stimulancia MeSH
- uživatelé drog MeSH
- Check Tag
- lidé MeSH
Methamphetamine is a potent and highly addictive psychostimulant, and one of the most widely used illicit drugs. Over recent years, its global usage and seizure have been on a rapid rise, with growing detrimental effects on mental and physical health, and devastating psychosocial impact pressing for intervention. Among the unwanted effects of methamphetamine, acute and long-term sleep impairments are of major concern, posing a significant therapeutic challenge, and a cause of addiction relapse. Unraveling mechanisms and functional correlates of methamphetamine-related sleep and circadian disruption are, therefore, of key relevance to translational and clinical psychiatry. In this article, we review the mounting evidence for the acute and long-term impairements of sleep-wake behavior and circadian activity caused by single or recurring methamphetamine usage and withdrawal. Factors contributing to the severity of sleep loss and related cognitive deficit, with risks of relapse are discussed. Key molecular players mediating methamphetamine-induced dopamine release and neuromodulation are considered, with wake-promoting effects in mesolimbic circuits. The effects on various sleep phases and related changes in dopamine levels in selected subcortical structures are reviewed and compared to other psychostimulants with similar action mechanisms. A critical appraisal is presented of the therapeutic use of modafinil, countering sleep, and circadian rhythm impairments. Finally, emerging knowledge gaps and methodical limitations are highlighted along with the areas for future research and therapeutic translation.
Methamphetamine (MA), as massively abused psychoactive stimulant, has been associated with many neurological diseases. It has various potent and neurotoxic properties. There are many mechanisms of action that contribute to its neurotoxic and degenerative effects, including excessive neurotransmitter (NEU) release, blockage of NEU uptake transporters, degeneration of NEU receptors, process of oxidative stress etc. MA intoxication is caused by blood-brain barrier disruption resulted from MA-induced oxidation stress. In our laboratory we constantly work on animal research of MA. Our current interest is to investigate processes of MA-induced alteration in neurotransmission, especially during development of laboratory rat. This review will describe current understanding in role of NEUs, which are affected by MA-induced neurotoxicity caused by altering the action of NEUs in the central nervous system (CNS). It also briefly brings information about NEUs development in critical periods of development.
- MeSH
- centrální nervový systém účinky léků růst a vývoj metabolismus MeSH
- chování zvířat účinky léků MeSH
- krysa rodu rattus MeSH
- lidé MeSH
- methamfetamin toxicita MeSH
- nervový přenos účinky léků MeSH
- neurogeneze účinky léků MeSH
- neurotoxické syndromy etiologie metabolismus patologie MeSH
- neurotransmiterové látky toxicita MeSH
- stimulanty centrálního nervového systému toxicita MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
The Czech Republic has a relatively long tradition in the addictive and problem use of methamphetamine, which is called “pervitin” locally. This paper attempts to provide as complex a picture of this phenomenon as possible by analyzing what is known about the Czech methamphetamine situation through scientific monitoring and research. It begins with a brief historical overview and then utilizes five key indicators (surveys, treatment demand, problem drug use estimates, blood borne diseases, and mortality) and some of the core indicators (namely, drug related crime, price and purity data, and estimates of market value) of drug epidemiology that were developed by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). By summarizing and carefully interpreting this data, the specifics of the Czech pervitin scene are described and future research directions are identified.
- MeSH
- dítě MeSH
- lidé MeSH
- methamfetamin farmakologie škodlivé účinky toxicita MeSH
- mladiství MeSH
- mortalita MeSH
- poruchy spojené s užíváním psychoaktivních látek prevence a kontrola MeSH
- prevalence MeSH
- školy MeSH
- zakázané drogy dějiny škodlivé účinky MeSH
- zločin trendy MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- financování organizované MeSH
- krysa rodu rattus MeSH
- lidé MeSH
- mateřské chování účinky léků MeSH
- matka - expozice noxám MeSH
- methamfetamin farmakokinetika farmakologie metabolismus MeSH
- modely nemocí na zvířatech MeSH
- poruchy spojené s užíváním amfetaminu MeSH
- prenatální poškození MeSH
- těhotenství účinky léků MeSH
- výzkum MeSH
- zpožděný efekt prenatální expozice MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- lidé MeSH
- těhotenství účinky léků MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- přehledy MeSH
Since methamphetamine reemerged in China, it has become a severe problem. Following the epidemic of methamphetamine in western countries, the methamphetamine use entered in China in the late 1990s. In the last decade, new type drugs, including methamphetamine, MDMA and ketamine, rapidly spread from some cities in southeast coast to other inland areas. The impact of methamphetamine abuse on public health and social stability has drawn government's attention to solve the problem. Chinese government has adopted complex measures both in treatment and prevention of methamphetamine abuse. However, the different characteristics of methamphetamine from traditional addictive drugs such as heroin call for China to adjust its policy and strategy on drug control. With the continuous efforts by government and changing attitudes of public to drug, we believe methamphetamine abuse would be brought under control in China. Dr. Lin Lu is Director of China‘s National Institute on Drug Dependence (NIDD), and a Professor in the Department of Psychiatry and Pharmacology at Peking University. Before taking the position at NIDD, China, he worked at NIDA/IRP, NIH in the United States, focusing on the area of the neurobiology of cocaine withdrawal and relapse. NIDD is China‘s premiere national organization focusing on addiction, from basic science to clinical treatment. Its departments include neuroscience, epidemiology, medication development, clinical pharmacology and an addiction treatment center. In 2005, Dr. Lu organized NIDD‘s Methadone Maintenance Treatment program (MMT), Since 2006, Dr. Lu has researched harm reduction efforts in China. Professor Lu has worked in the addiction field for 19 years. In that time he has pub- lished more than 100 peer-reviewed papers ranging from molecular to behavioral issues of addiction. As a clinical physician, he also published more than 50 papers on treatment and medication development for addiction and depression. Dr. Lu was trained as a clinical doctor and received his Ph.D. after working as a physician in the field of mental health and addiction. His development of an internet-based psychotherapy and suicide-management program for patients with mental health and addiction problems won him recognition as an expert in addiction treatment in China. During Dr. Lu‘s five years at NIDA/NIH, he published more than 20 papers in interna- tional peer-reviewed journals such as Nature, Neurosciences, Trends in Neurosciences, J o u r n a l o f Ne u r o s c i e n c e , B i o l o g i c a l Psychiatry, Neuropsychopharmacology, and Psychopharmacology.
This presentation will provide both a brief historical overview and update addressing the current methamphetamine manufacturing and distribution epidemic in the United States. In the United States, problems arose in the late 1960‘s and into the 1970‘s when methamphetamine, a powerful stimulant became popular. Methamphetamine (DL-methamphetamine) was trafficked by outlaw motorcycle organizations (i.e., Hells Angels). We saw the manufacturing process change in the 1980‘s when manufacturers started utilizing both ephedrine and pseudoephedrine as their primary precursors. This resulted in the twice as potent D-methamphetamine becoming the methamphetamine currently being abused globally. The methamphetamine epidemic resulted in hundreds of small toxic labsâ and the arrival of Mexican National Drug Trafficking Organization (MNDTO) with their super labs. With the arrival of the MNDTO, we currently deal with industrial size manufac- turing sites operating primarily in California and select regions throughout the United States. This manufacturing has resulted in the United States addressing both a national and worldwide control on precursor chemicals. By controlling precursor chemicals, we saw a considerable drop in our national methamphetamine manufacturing problem. In addition to the tons of finished methamphetamine manufactured and distributed in the United States, the collateral damage (i.e., Drug Endangered Children) associated with manufacturing has heavily impacted our country. We estimate since 2000, over seven million pounds of laboratory waste has been discarded in the agricultural regions of the Central Valley of California alone. This presentation will consist of both slides and video to show the most current laboratory seizures and trends. Robert Pennal, is a California Department of Justice, Special Agent Supervisor assigned to the Bureau of Narcotic Enforcement. He is currently the Commander of the Fresno Methamphetamine Task Force. He been assigned to Methamphetamine Clandestine Laboratory Investigations for the last 22 years and has investigated over 800 labo- ratories. The majority involved the manu- facturing of methamphetamine by Mexican National Drug Trafficking Organizations (MNDTO). In addition to his task force duties, he still presents intelligence briefing and con- ducts law enforcement conference through- out the United States and Canada. He has provided intelligence briefings to the last three Directors of the Office of National Dr ug Control Policy (ONDCP), Of f ice of the President, and the Congressional Methamphetamine Caucas. I n 2 0 0 2 h e w a s r e c o g n i z e d a s t h e „Outstanding HIDTA Task Force Commander of the Year“ by ONDCP. He also provided expertise and direction in both the production of numerous methamphetamine documentaries (i.e. Frontline „Meth Epedemic“) and contributed to printed narcotic training materials. He also currently sits on the National Methamphetamine & Chemical Initiative (NMCI) committee.