MAMa FAQ's #10

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More information can be found in Crystal Meth: They Call it Ice.

How long does it take for a user to become addicted?

In prisons they have a saying, "Use it once, it might let you go. Use it twice, it owns your soul." And they have a point.

In the early stage of addiction, there is a process called 'sensitization'
going on, in which the brain becomes more sensitive to methamphetamine, more responsive to it, and each dose seems to work better and faster than before. Users have heard about tolerance, the process in which it takes more drug to get high each time, and they equate that with addiction.
Since they are experiencing the opposite - each high seems better than before and it takes less drug to reach intoxication, they think they must not be addicted. And yet they are using methamphetamine regularly, habitually, and even compulsively, feeling intense desire for it. They are addicted already, can't quit using without some help, but they think everything is just fine.

And in the early stages of addiction, the 'crash' afterwards is just a mild depression, not nearly as bad as a hangover after getting drunk on alcohol. The addict has heard about withdrawal symptoms as a sign of addiction, but he does not experience those on meth in the early stages.
And so he doesn't think he is addicted, even though he is using habitually and compulsively. As he continues to use, the crash gets worse, lasts longer and is more uncomfortable. Eventually the crash controls his life.

Addiction happens when the self control section of the brain in damaged by a drug. Alcohol can damage the self control tract, but it takes perhaps a year to injure it enough to cause alcoholism. Cocaine damages the self control tract too, over a period of a few weeks. Methamphetamine can damage the self control tract with just one use, and results in addiction
- habitual compulsive drug use - sometimes in a matter of days.

There is a slender little tract in the brain called median forebrain bundle, which is associated with another slender little tract called fasciculus retroflexus. These structures connect the thinking part of the brain, the place where you make decisions, with the lower parts of the brain where cravings originate. When these cells work properly, you can control your urges and cravings, your temper and impulses. When these cells do not work properly, your cravings and impulses control you.

These structures are very small, only a few hundred cells, and they are extremely sensitive to drugs of abuse. Alcohol kills these cells; it takes months or even years to do it. Cocaine kills these cells in a matter of weeks to months. Methamphetamine can kill them in one night.

This is a micrograph of the self-control cells in a rat's brain. The slide marked 'saline' is the normal healthy cells, looks like about 100-150 cells. At 2.5 hours after a single intoxicating dose of methamphetamine, those cells are swollen up, breaking down, they are dying right before your eyes. Four days after a single intoxicating dose of methamphetamine, there are about 6 cells left.

But of course you can't tell anything has changed.

Of people who try meth once, 75% use again within one week, 90% within one month, and 98% use it again within one year. You use it once, and within 7 days you are going to use it again. You thought you just chose to use it. You just wanted to use it. You had a desire to use it again, and you couldn't control that desire because these cells were already dead.

Dead cells don't come back. We learn to compensate, use other parts of the brain to do the job of the dead cells. That is what rehabilitation is all about. It is hard work, like recovering from a stroke or a head injury.

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