The need for speed: an update on methamphetamine addiction

The need for speed: an update on methamphetamine addiction

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J Psychiatry Neurosci 2006;31(5):301-13

Alasdair M. Barr, PhD; William J. Panenka, MD; G. William MacEwan, MD; Allen E. Thornton, PhD; Donna J. Lang, PhD; William G. Honer, MD; Tania Lecomte, PhD

Barr, Panenka, MacEwan, Thornton, Lang, Honer, Lecomte — Centre for Complex Disorders, Department of Psychiatry, University of British Columbia; Thornton — Department of Psychology, Simon Fraser University, Vancouver, BC

Abstract

The psychostimulant methamphetamine (MA) is a highly addictive drug that has surged in popularity over the last decade in North America. A burgeoning number of clandestine drug laboratories has led to dramatic increases in MA production, which have resulted in significant public health, legal and environmental problems. Current evidence indicates that exposure to MA is neurotoxic, and neuroimaging studies confirm that long-term use in humans may lead to extensive neural damage. These physiological changes are commonly associated with persistent forms of cognitive impairment, including deficits in attention, memory and executive function. In the present review, we provide a comprehensive description of the factors relating to MA use and the major health-related consequences, with an emphasis on MA-induced psychosis. It is hoped that increased knowledge of MA abuse will provide the basis for future treatment strategies.

Résumé

La méthamphétamine (MA), un psychostimulant, est une drogue très toxicomanogène dont la popularité a grimpé en flèche au cours de la dernière décennie en Amérique du Nord. Des laboratoires clandestins de plus en plus nombreux ont entraîné des augmentations spectaculaires de la production de MA et, par conséquent, d’importants problèmes pour la santé publique, la loi et l’environnement. Les données actuelles indiquent que l’exposition à la MA est neurotoxique et des études de neuro-imagerie confirment que l’utilisation chronique chez l’être humain peut causer des dommages nerveux étendus. On établit couramment un lien entre ces changements physiologiques et des formes persistantes de déficience cognitive, y compris des déficits de l’attention, de la mémoire et de l’exécution. Nous présentons dans cette analyse critique une description détaillée des facteurs reliés à l’utilisation de la MA et ses principales répercussions sur la santé, en insistant sur la psychose causée par la MA. On espère qu’une meilleure connaissance de l’abus de MA servira de base à de futures stratégies de traitement.


Medical subject headings: substance use disorders; animal models; brain imaging (MRI); psychoses; methamphetamine.

Acknowledgements: Drs. Barr and Lecomte are Michael Smith Foundation for Health Research (MSFHR) Scholars; Dr. Lecomte is a Canadian Institutes of Health Research (CIHR) Young Investigator. The Centre for Complex Disorders is partly funded by an Infrastructure Grant to Dr. Honer from MSFHR. This review was partly supported by CIHR Operating Grants. We received funding from the CIHR operating grants to AMB and TL and from BC Mental Health and Addictions Services.

Competing interests: None declared for Drs. Barr, Panenka, MacEwan, Thornton, Lang and Lecomte. Dr. Honer has acted as a paid consultant for AstraZeneca and has received speaker fees from AstraZeneca, In Silico Biosciences, Janssen, Wyeth and Solvay. He has received travel assistance from Eli Lilly and AstraZeneca.

Contributors: All authors contributed to the conception and design of the review. Drs. Barr, Panenka, Lang and Lecomte wrote the article; Drs. MacEwan, Thornton and Honer reviewed it. All authors gave final consent for the article to be published.

Submitted Nov. 23, 2005; Revised Mar. 6, 2006; Accepted Mar. 6, 2006

Correspondence to: Dr. Alasdair M. Barr, Centre for Complex Disorders, Department of Psychiatry, University of British Columbia, Vancouver General Hospital Research Pavilion, 828 W 10th Ave., Vancouver BC V5Z 1L8; fax 604 875-4376; albarr@interchange.ubc.ca