Summer House

Cocaine and methamphetamine are two drugs that are often linked together because they produce similar effects and because they belong to the same class of drugs called psychostimulants. In addition, they both have the potential for causing dependence and abuse which further strengthens the bond associate between them. Though there are many similarities, a fair number of differences do also exist, which will be discussed here.
 

Where Do They Come From?
 

Methamphetamine is man made, while cocaine is derived from the coca plant.
 

Is There A Difference in the Way They Are Used?
 

Both can be smoked, injected intravenously or snorted. The difference being that methamphetamine can be taken in pill form. In addition, cocaine can be used medically as an anesthetic and as an appetite stimulant while methamphetamine has no proven medical use.

Where and By Whom Are the Drugs Used?
 

Out of the two drugs, Methamphetamine has a much more defined area of use as well as stereotype of user. Statistics show that use of methamphetamine is highest in western areas of California, Honolulu, Hawaii, and western areas of the continental United States. Urban areas of California, Oregon, Arizona, Colorado and Washington, show increased use of methamphetamines. In recent years however, use of methamphetamine has increased in rural and urban areas of the South and Midwest.
 

Cocaine use varies so there is no geographic pattern that clearly delineates where the drugs are used. Cocaine use however, is usually significantly higher in large cities and metropolitan areas as opposed to non-metropolitan areas.
 

A possible reason for the difference between cocaine and methamphetamine addiction by area is that in rural areas, cocaine is not as easily accessible. Methamphetamine however, can be made in a garage or basement with household products, making it quite easy for individuals to make their own high.
 

Do They Produce The Same Effects?
 

* Perhaps the reason why cocaine and methamphetamines are confused is because both produce a very well received rush almost immediately. This is followed by feelings of extreme happiness or euphoria which is referred to as a rush.
 

* Methamphetamine’s high can last from eight to twenty four hours and fifty percent of the drug is removed from the body in twelve hours. Cocaine’s high on the other hand, lasts from twenty to thirty minutes and fifty percent of the drug is removed from the body in one hour.
 

* Both cocaine and methamphetamine, when injected intravenously or smoked, can cause an almost immediate rush which is followed by a high.
 

* When ingested nasally, which is referred to as snorting, neither methamphetamine nor cocaine cause a rush or a high. A similar effect is produced when methamphetamine is ingested orally.

Are the Physiological Effects Similar?
 

* Both methamphetamine and cocaine can cause immediate effects of irritability, anxiety, increased heart rate, blood pressure, body temperature and possible death. Methamphetamine’s and cocaine’s short-term effects also can include increased activity, respiration, and wakefulness, and decreased appetite.
 

* Chronic use of cocaine or methamphetamine can cause dependence and possibly stroke.
 

* In either case, cocaine or methamphetamine can lead to psychotic behavior. These behaviors are characterized by hallucinations, paranoia, violence, and mood disturbance.
 

* Some data suggests that violence is more common among methamphetamine users than among cocaine users. Drug craving, paranoia, and depression can occur in addicted individuals who try to stop using either methamphetamine or cocaine.
Is there a difference in neurotoxicity?
 

* Neurotoxicity refers to the toxic damage these drugs can incur on the brain, specifically on neuron transmission. Neurons are responsible for the processing and transferring of information. Methamphetamine can be neurotoxic in animal species ranging from mice to monkeys. Methamphetamine specifically damages neurons that produce serotonin and dopamine. Since the usual doses taken by humans are comparable to the doses causing neurotoxicity in animals, it is reasonable to believe that this also causes the same effect in humans.
 

* On the other hand, cocaine does not cause neurotoxic damage to dopamine and serotonin neurons.
 

Transmission of HIV/AIDS
 

Whether discussing methamphetamine or cocaine, a risk for HIV/AIDS still exists and must be considered when engaging in any type of sexual behavior.

Miami Herald — Most everybody in this neighborhood coffee haunt has been hooked on something. The high school dropout with beauty-pageant looks has been fending off a heroin habit for two decades. The former football player says he is clean now after years of popping pain pills. Santa Claus succumbed to alcohol.

Nineteen of the fallen are here tonight for therapy and healing, for a second — or a third or fourth — chance, hoping to reclaim a piece of their lives. They form a circle in the pebble garden behind KoffeeOkee, which is owned by Harold and Dawn Jonas, former users who now help others kick drug and alcohol habits and answer the question: What now?

A resort on the Atlantic in Palm Beach County, Delray Beach has another, less obvious civic profile: Florida’s sobriety capital. Like Hazelden in Minnesota and Utah’s Cirque Lodge and the communities that surround them, it is a place to dry out, clean up. Its recovery community is spirited and multilayered, a dense mesh of dozens of treatment facilities, counseling centers and residential housing that gives addicts a wide-reaching chance for recovery and permanent lifestyle change.

This is where people start over. And sometimes stay.

”You want to be here if you are struggling with an addiction,” says Anna O’Connell, 43, who has been in and out of detox for crack cocaine, heroin and alcohol over the past 20 years and attends therapy sessions at KoffeeOkee. “This is the closest thing to family; this is where you feel safe.”

Treatment for addictions that the medical community now accepts as chronic diseases ranges from private $10,000-a-month treatment centers to free coffee, counseling and karaoke at java houses such as this one, which hosts formal therapy sessions twice a week and informal gatherings even more often.

MANY, FROM ALL OVER

The size of South Florida’s recovery community is difficult to estimate because only one layer — facilities with residential treatment beds — is licensed by the state. Delray Beach alone offers more than 1,200 beds in transitional houses — a second layer — according to the South County Recovery Residence Association in Delray, which monitors halfway residences.

Every week in Delray, about 5,000 addicts attend 12-step meetings that stretch from 7 a.m. to 11 p.m. At Crossroads Club, a squat stucco complex off Lake Ida Road, about 700 people walk through the doors every day to attend 120 meetings aimed at a swath of needs, from treatment for cocaine addiction to obsessive cluttering, says Susan Miller, executive director, a recovering alcoholic.

Addicts arrive from as far away as Oregon and Rhode Island and from as nearby as South Beach. They face daunting odds: Relapse rates range from 40 to 90 percent, depending on the client’s dedication and will power, sustained treatment, and follow-up care, according to the National Institute on Drug Abuse.

”My parents sent me here to try to turn my life around,” Rani Canosa, 21, a pretty, petite college dropout offers one Monday night at KoffeeOkee. “Alcohol made me feel good. I would be really, really happy, then really, really sad, then just miserable.”

Canosa, from a Baltimore suburb, started drinking seriously as an 18-year-old freshman in college. Soon she could consume a 12-pack of beer and a half-bottle of vodka in a two-hour stretch.

She had tried treatment centers in Maryland and Pennsylvania but returned home only to relapse once she was back among friends and familiar haunts.

Canosa has been in Delray Beach since Aug. 29, out of treatment at the Wellness Resource Center in nearby Boca Raton since Feb. 5. She lives in a halfway house and works as a barista at KoffeeOkee.

”The truth is, if I was home, I would be drunk or looking to get drunk,” she says softly, never making eye contact. “I actually want to be here.”

COLLECTIVE STRUGGLE

But what distinguishes this vibrant recovery community from similar places elsewhere, is a growing sober social infrastructure, an informal network of places for people to mingle without the colossal temptations of drugs and alcohol.

”Delray Beach is a microcosm of the various layers of the recovery process,” says Howard Lerner, clinical director of the Addiction Treatment Program at South Miami Hospital. “Those struggling belong to a fraternity.”

Here, even in the midst of fighting for sobriety, addicts can go dancing at popular clubs that hold sober nights, sing karaoke at a sober coffee house, listen to live music at a sober juke joint, call in to recovery radio shows, roar into the sunset with a sober motorcycle club and pray at a Bible study just for them.

”The struggle with an addiction can be forever,” says Harold Jonas, a mental health counselor. “So all we really want is for people to be healthy and to laugh and have hope and be part of the world, not just the recovery community.”

The collective sobriety struggle here is no longer anonymous. Recovering addicts live among ”normies” and often work on Atlantic Avenue, the city’s glittering ribbon of sidewalk cafes and boutiques and galleries.

”When you are on this journey, it’s incredibly important to feel like you are not alone, to see and be around people just like you,” says nattily-dressed Jonah Yolman, now 22 months on the clean side of a wicked crack-cocaine addiction.

Yolman, 29, sitting in a Starbucks on Atlantic Avenue, quietly acknowledges two people ordering coffee who are in one of the dozens of 12-step anonymous programs. He talks casually about the familiar identifying signs of people in recovery: the relentless smoking and coffee drinking, the trails of cigarette butts and empty coffee cups and candy wrappers. And the most obvious sign: people tightly clutching books with dark covers, their 12-step guides.

”We are everywhere, living and working in this city,” says Yolman, a counselor at a local treatment facility who promotes two sober nights at area clubs. He and a partner are also launching a similar sober club night in August at a South Beach club (sobernightlife.com).

“People come here and enjoy the weather, the beaches, low-key atmosphere and try to start over.”

NATIONAL REPUTATION

In some ways, Delray’s recovery community draws its inspiration from a small, rural town in Minnesota that over the years became a magnet for recovering addicts, from marquee rock stars like Eric Clapton to the anonymous souls who came looking for peace and order.

Since 1949, addicts have famously flocked to Hazelden, which started as a farmhouse retreat in Center City for men working their way through programs based on the 12-step principles.

Over the years, teams of doctors, counselors and chaplains developed a holistic approach to rehab now emulated worldwide.

More than three decades ago, Delray’s first sober houses opened for people making the transition from residential care to independent living. The houses — a yellow clapboard with a sweeping porch on one street, a peach bungalow with a white-picket fence on another — are sprinkled within neighborhoods, around public squares, near churches.

Rents range from $125 to $175 weekly for a room and access to kitchens and family areas. Most landlords require random drug tests, and some perform bed checks or monitor whether their clients have reported to work.

Two years ago, Crossroads Centre in Antigua, a drug-treatment program founded by Eric Clapton, opened in the city. And in February, Lecreshia Hall, a Boca Raton psychiatrist, started Hallway of Life Recovery Center, a faith-based, 28-bed transitional facility for women, on a quiet residential street near downtown.

”When I did the research to find the best place to open, Delray Beach kept coming up,” says Hall, who leads Bible study on Tuesdays. “The idea of our center is to teach our clients how they can use the Bible to help in recovery.”

But Delray Beach’s national reputation as a recovery community has been unsettling for some residents.

”We don’t mind taking care of the people living here, but we don’t particularly like people coming from all over the country or the world to recover,” says City Manager David Harden. “But it’s a fact of life, and so we have tried to be supportive of the community.”

Harden says Delray Beach gives money each year to the Drug Abuse Foundation of Palm Beach County, the county’s oldest chemical-dependency treatment and prevention center. The Commission also sold city property to Crossroads Club several years ago, allowing the center to expand.

Over the years, residents have complained to city officials about the lack of security and control at some sober houses. Owners need only a landlord permit to run them, a reality that makes strict regulation difficult.

Jonas, who heads the South County association and runs the coffee shop, says problems stem mostly from unscrupulous landlords who hope to turn quick profits at the expense of fragile tenants and the surrounding neighborhood.

”You got some of these operators who don’t manage the property or the tenants, then they put the people out and leave them homeless,” Jonas says. “There are some operators we would all be better off without.”

FINDING SOLACE

Jonas came to Florida 20 years ago full of reasons to give up. But with the help of his father, who put him in a West Palm Beach treatment center, he cleaned up and stayed put.

A slight guy with a thick mustache and a thicker Philadelphia accent, Jonas sits in the lounge of his coffee shop one afternoon rattling off his story with sobriety’s detachment and confidence.

Pot by 13. Then acid and speed and cocaine. Graduation to alcohol. Bottomed out in the injection world of cocaine and heroin.

Jonas entered rehab in 1987. He married Dawn, a recovering cocaine addict (they met in a 12-step group), and went back to school, earning an online master’s degree in counseling psychology from Antioch University and a doctorate in addiction studies from International University in St. Kitts.

”You come out of a situation like that broken and with very little to hold on to,” Jonas says. ‘You come out of treatment and you say, `Now what?’ ”

So Jonas and his wife — who recently celebrated her 22nd clean year — began working to answer this huge question, working to help define what life after treatment really means.

In 2000, they launched sober.com, a Web clearinghouse for 30,000 recovery programs nationwide. And for 10 years, he operated a recovery residence in Delray Beach. She runs a home for women in recovery.

Two years ago, they opened KoffeeOkee, in many ways ground zero for the recovery community. Inside is a cozy mix of velvet wingback chairs and bistro tables and a small cafe offering every coffee, tea and juice imaginable but absolutely no alcohol. The walls are covered with bulletin boards offering testimonials, treatment and housing ads, and calendars outlining the month’s sober activities.

A piano sits in the corner with a dried white rose on top, a delicate memorial to Valerie, a drug counselor who died a year ago.

Of an overdose.

Palm Beach Post — She has a strong grip and broad shoulders and a rage that was so out-of-control she was called The Hulk.

Jen is just 22 and already has suffered years of abuse, from a boyfriend who burned her, beat her and tried to drown her, and from her own self-directed rage.

She believed she found a release and control over her anger and pain by cutting herself.

"It was sick and twisted," she said, curled up in a couch that wrapped its arms around her. "I would have the biggest smile on my face watching the blood run down my leg."

She tried to kill herself nine times, drank and took every kind of drug she could get.

It took courage and knowing that she was hitting bottom, but she finally got the guts to go to her father, who knew little about her abusive and addictive lifestyle, she said. He helped her find The Orchid Recovery Center in Delray Beach.

The staff there, in turn, helped her find a path toward peace through, among other treatments, yoga training.

Enter Angel Lucia, whose mission is to help heal women in recovery through yoga and meditation at her Bindu Yoga Studio in West Palm Beach.

Lucia partners with The Orchid and teaches at the facility and in her own studio.

Jen clearly has a loving addiction to Angel, who nods encouragingly at her while Jen talks about her horrendous experiences.

Nearby are the tranquil-looking yoga mats, candles, books and tapes that are an important part of this lifestyle.

The women in recovery are a close-knit group. They don’t like outsiders watching their yoga, but Jen explains how she is going from an enraged self-mutilator to accepting that life can hold joy for her.

"She winds us all down," Jen, who has been sober a little more than four months, says.

"I can come in angry, jumpy, and the yoga releases all the bad emotions. I like the breathing techniques."

Jen says she is clinically depressed, bi-polar and suffering from short-term memory loss. Yoga and the camaraderie of Angel and the addicted women in recovery at The Orchid have helped her become more centered, she says. She’s starting to like her life.

Angel smiles knowingly. She, herself, had an alcoholic father who threw the family into turmoil. She knows what it’s like to walk on eggshells around a person who can explode at any moment.

She attended family rehabilitation with her parents.

It was yoga and meditation that helped her physically unwind from the effects of a former career as a surgical assistant and a past laden with strained family relations.

"Mentally, I felt more balanced," she says of the yoga she learned and is teaching. "I moved into a more neutral state."

Now, she says, she takes what she knows works for her and tries to transfer it to her students.

"I can’t say I’m floating," she explains. "I can stop and reflect on what is building up in me. What is it and how can I reduce that? If I hold it, it will make me ill."

She watches Jen look at her with a little half-smile. You can almost imagine this powerful young woman she is helping, and whose fists could put Angel on the floor, breathing softly and learning to control her runaway emotions.

"She does have that understanding from having been through something like what we are going through," says Jen.

"When I’m with Angel, I turn off that cellphone, and I am moving and getting that hour of focus."

Angel says some of the women moan and groan and fight off her efforts to help them, not physically, but by withdrawing. She sends them out of the room until they re-engage.

Jen defends that kind of self-protective behavior.

"The feelings are new to us. Any kind of emotion is a shock and completely hard to deal with," she says of women who have learned to numb themselves with drugs and alcohol.

"She helps to keep people sober. She helps with acceptance of a lot of things and letting go. My anger has gone from major to manageable."

Adds Angel, "Yoga helps us to fill a spiritual void. I’m another bridge for them to that. I don’t want to say that I’m better than anyone else this way, but I know what I’ve overcome and know how to apply it to them."

NEW YORK (Reuters Health) - Young adults who abuse amphetamines may be raising their risk of suffering a heart attack, a new study shows.

Texas researchers found that among more than 3 million 18- to 44-year- olds hospitalized in their state between 2000 and 2003, those who were abusing amphetamines were 61 percent more likely than non-users to be treated for a heart attack.

What’s more, the rate of amphetamine-linked heart attacks rose by 166 percent over the 4-year study period. That compared with a 4-percent rise in cocaine-related heart attacks, the researchers report in the journal Drug and Alcohol Dependence.

"Most people aren’t surprised that methamphetamines and amphetamines are bad for your health," lead researcher Dr. Arthur Westover said in a statement.

"But we are concerned because heart attacks in the young are rare and can be very debilitating or deadly," added Westover, an assistant professor of psychiatry at the University of Texas Southwestern Medical Center at Dallas.

Amphetamines stimulate the central nervous system and some are used to treat attention-deficit hyperactivity disorder, or ADHD. But they are also frequently used illegally; one potent form of amphetamine, methamphetamine, is a growing problem in many U.S. cities.

Cases of heart attack in young people have been linked to amphetamine abuse before, but the current study appears to be the first large- scale look at the epidemiology of the problem.

Westover and his colleagues used a statewide database to examine information on more than 3.1 million 18- to 44-year-olds discharged from Texas hospitals between 2000 and 2003. Overall, 11,011 of these patients (0.35 percent) were treated for a heart attack.

The database also contained information on whether a patient had been diagnosed with any type of drug-abuse problem. The researchers found that patients with a diagnosis of amphetamine abuse or dependence were at increased risk of suffering a heart attack.

Amphetamines have various effects that could precipitate a heart attack, Westover and his colleagues point out. The drugs are well known to speed up heart rate and blood pressure, but they can also trigger spasms in the heart arteries and promote blood clotting.

In people who already have "plaque" deposits in their heart arteries, amphetamines may cause a plaque to rupture, which can then lead to a heart attack.

Besides the risk to individual amphetamine users, Westover said, "we’re also concerned that the number of amphetamine-related heart attacks could be increasing."

"We’d rather raise the warning flag now than later," he added. "Hopefully, we can decrease the number of people who suffer heart attacks as the result of amphetamine abuse."

Utah — “Methamphetamine addiction has the worst long-range organic effect on the brain of any drug,” said Glen Hanson, University of Utah Addiction Center director.

Hanson’s blunt comment defines extent of the the public health problem in meth-damage control in Utah.

He was speaking at an all-day meth workshop before 30 participants; family members, caregivers and health care professionals in Roosevelt on June 21.

Addiction of any kind is a learned repetitive behavior, but meth is the worst, ” explained Hanson, “It alters the brain biology in ways similar to Alzheimer’s or Parkinson’s disease.”

Why would anyone choose to damage their brain to such a degree? The answer, because “it feels good,” may be the best an addict can offer after treatment.

Simplistic as it sounds, it is not wrong. Meth over-stimulates the “feel-good” portion of the brain and can severely damage a person’s cognitive abilities.

“The brain is a network of 100 billion cells that transmit information by making 2,000 connections individually,” Hanson said, telling the group why an addict’s ability to communicate has been compromised.

“Stimulated brain cells respond by releasing dopamine to anything that feels good” he continued. “Over-stimulated brains release too much dopamine. Then the free radicals that are chemically abundant in dopamine will eventually destroy portions of the brain.”

Meth stimulates the release of dopamine in excess. The more an addict uses the more they crave. It affects the cognition system in the brain by “turning-off” the prefrontal cortex.

As a consequence, meth addicts loose inhibitory control, tending to act on impulse rather than reason. They overreact to situations, tending toward rage.

This is partly due part to the “damage to the orbitofrontal cortex which ultimately inhibits saliency,” said Hanson. “The addict becomes motivated most by getting and using meth over anything else.”

It fouls up the meth addict’s ability to appreciate consequences like taking care of their children, themselves or being cognizant of others.

“Meth addicts may steal from or abuse their family members with little conscience,” the researcher explains. “All they think of is the drug, because the reward portion of their brain is on all the time.”

Hanson referred to the amygdala reward-region of the brain, which processes memory and emotional control. Damage to the region and the adjacent hippocampus region leaves the addict agitated and often aggressive.

Once these areas are damaged the memory portion of the addict’s brain often fails to recover even with treatment.

“Rehabilitating cognitive systems requires exercise,” explained the researcher. “Sometimes that means establishing new pathways in the brain around damaged portions that will never return.”

“Treatment is lengthy,” he continued, “requiring five to seven months for brain function to stabilize and restore saliency. It’s hardest for meth addicts because their familial support systems are often irreparably damaged. They’ve hurt the very people they need most.”

In the end, there are successful treatments to re-develop cognitive skills through mental exercise. One way, Hanson explained is through literacy education, which seems to help re-establish cognitive functions.

So, why with all this wreckage would anyone choose to use meth? Hanson’s research suggests that there is a strong sociocultural component contributing to the meth scourge in Utah.

“Meth abuse demographics indicate that it is the primary drug of choice among women,” he explained. “Thirty-seven percent of all women in treatment are addicted to meth. Men use it too, but represent fewer addicts in treatment than women.”

Some women are attracted to meth as it is readily available, cheap and long-lasting in effect. Others discover more energy, weight loss or help with social inhibitions through meth abuse.

“In Utah, there’s a sociocultural tendency of women toward perfection,” said Paul Smith, eastern Regional Director of the Division of Child and Family Services. “Perfect wife. Perfect mother. Perfect beauty. Too much pressure toward perfection drives the social component of meth abuse.”

“Whatever the cause, abuse is only part of addiction,” Hanson said. “Only 15 percent of users become severely addicted, which means 85 percent of users are out there managing their drug use.”

Why people become addicted may, in part, be genetic. For example, researchers found that many women in treatment suffer from other repetitive disorders like smoking or alcoholism.

The most interesting connection was re-occurrence of attention deficient-hyperactivity disorder. The familial connection of ADHD or alcoholism may include a predisposition toward drug addiction among family members.

There’s also the social aspect of addiction. Meth tends to stay in the family. A documentary shown at Saturday’s seminar showed women frankly admitting that, “My daughter introduced me to meth and then I gave it to my sister, and so on.”

Hanson notes that addictions like alcoholism re-occurs in families, but there is hope. Children removed from addictive families show no greater addiction rates than children from non-drug abuse families.

However, children left in addictive families are almost certainly going to experiment with drugs. Addictions, particularly those with long-term treatment requirements like meth are a burden on Utah society.

“Forty-seven percent of women in treatment for meth addiction have children,” Hanson continued. “Worse still, 45 percent of female meth addicts end up in prison. Incarcerated women cost the state $30,000 each and an additional $33,000 for each child placed in foster care. All totaled, jailed addicts cost the state about $100,000 a year.”

Treatment, on the other hand, costs the state about $15,000 per person. More recently, the treatment alternative has become policy in the criminal justice system of Utah. The effort is to stop the revolving door of prison addicts.

“New strategies for treatment are highly successful, but the addict must remain in rehabilitation,” said Hanson. “Judges are learning that success requires mandated, long-term compulsory treatment. I guess they figured that success means more taxpaying Utahns.”

Sun Sentinel — South Florida is tops in all the wrong things again, this time in prescription drug overdose deaths, with Palm Beach County leading the state in fatal methadone overdoses last year, and Broward ranking second in deaths involving the anti-anxiety drug Xanax and third in oxycodone fatalities.

No one knows why South Florida owns this tragic distinction, but one thing is clear: It proves why crackdowns on doctor shopping and unscrupulously run "pill mills" are so essential. And why they deserve an even higher ranking on the law enforcement priority list.

Drug addiction is not a victimless problem. Even if it’s not your loved one who’s hopelessly hooked, your safety may be affected because addicts often turn to crimes like burglary or robbery to feed their habit.

So combating addiction, and reducing the incidence of overdoses, is a societal, not just a personal, responsibility.