Meth! Meth! Meth!…. errr, Cocaine?

July 2, 2007

Drug and Alcohol Dependence has an article in preprint from Falck and colleagues entitled Perceived need for substance abuse treatment among illicit stimulant drug users in rural areas of Ohio, Arkansas, and Kentucky. I’ve been waiting for this since a poster version was presented a year ago at the CPDD annual meeting. Fascinatingly this was the meeting in which the Congressional lobbyist hired by the College outlined why Congress was going to be all about Methamphetamine because every time you turned around there was another popular media report on the ravages of METH, METH overrunning the resources of local sheriff’s departments and emergency rooms, etc. Congressional interest has a way of turning into funding priorities, for example NIDA launched an RFA for a Cooperative Agreement (U-mechanism, meaning they are serious) on Immunotherapeutic products specifically for METH addiction.

The Falck et al. is fascinating because it took a look at stimulant (amphetamine, cocaine, methamphetamine primarily) users (at least once in past 30 days) in rural America. You can tell from the title of the article that we’re talking the stereotypical METH country going by popular media. So what’s interesting here? For me the most interesting thing is the descriptive stats on the users. Daily use of METH in the entire sample was 8% (35% “nondaily” use), as contrasted with Amphetamine (2.4% daily; 13% nondaily), Crack Cocaine (17.6% daily; 41.6% nondaily) and Powder Cocaine (7.7% daily; 40.9% nondaily) use.

So, umm, METH is only about the same magnitude of problem (drug-use wise) and maybe a little smaller than good old cocaine?

I’m not saying we shouldn’t be wary of trends and emerging/spreading drugs of abuse but one wonders whether funding priorities are driven by a dispassionate review of the “problem” and whether funding-by-AP-story is the best approach.

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4 Responses to “Meth! Meth! Meth!…. errr, Cocaine?”

  1. r wilmot Says:

    LOL! One can always recognize if the white powder is coke or meth by the sensations one feels in their lungs… through breathing. Coke expands the alveoli
    much more than meth… no wonder the Inca’s took it to climb mountains… wait… people can actually feel their alveoli expand… with training… LOL!

    Development of Immunotherapeutic Products for the Treatment of Methamphetamine Addiction … are these like antibuse– you get sick when you use or do they just “block euphoria”

    LOL! Yes… it’s best to go with AP for funding!
    Look at Passages in Malibu–they are all over NIDA’s web pages…

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  2. drugmonkey Says:

    are these like antibuse– you get sick when you use or do they just “block euphoria”

    These methods are not like antabuse/disulfiram for alcohol abuse. These immune approaches work by lowering the proportion of the ingested dose which can get into the brain. Immune-generated antibody molecules attach themselves to the drug molecules and prevent them from crossing into the brain.

    I put up a brief overview here
    http://scienceblogs.com/drugmonkey/2008/01/would_you_vaccinate_against_dr.php

    this approach has obvious limits because the user can simply take more drug but I believe there is probably a niche for users who are trying to be abstinent. It might prevent that first relapse from turning into a binge.

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  3. r wilmot Says:

    ” …the user can simply take more drug…” If the user is attempting to achieve the same expected sensations… does not due to this dose limiting effect, and takes more drug… would he not be in danger of ever dosing?

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  4. drugmonkey Says:

    no more or no less than under non-immunized conditions. Unless there was some freaky non-linearity in the way the antibody sucked up drug ….and you were within the range of what someone was going to be able to do under real world conditions…and….

    That’s why there are clinical trials. You take a promising medication and try to determine if it can work within acceptable risk levels in the target population. These approaches are in clinical trials for nicotine and cocaine dependence, have to see how it works in practice.

    as I said, I predict these approaches are going to have a fairly narrow application. nevertheless, there are a LOT of drug abusers and we have a limited clinical toolset when it comes to helping people get off drugs. a success, even if for a limited percentage of the clinical problem, is a big win. Even a leveraged win because of the downstream effects success will have in bringing more addicts under care.

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