LGBT Drug Treatment Blog

George Kolodner, a board-certified addiction psychiatrist, said his clinic saw an increase in crystal meth addiction beginning about two years ago, but the trend has not accelerated since then. He said crystal meth users are the most difficult patients to treat because there is no medication to prevent craving or treat the protracted post-use symptoms, such as dysphoria, or depressed mood. “‘With other substances,’ said Kolodner, ‘we can help people get off and keep off by decreasing their cravings. With crystal meth and cocaine, we don’t have that.’”

What are the differences in how crystal meth affects the body from cocaine, and, from a medical perspective, is it more damaging than cocaine?

George Kolodner: Crystal Meth and cocaine affect the body in very similar ways. in lab studies, people can not usually tell the difference. except that the effect of meth usually lasts longer than does cocaine. Medical effects and legal consequences are very separate issues.

What factors besides sexual orientation, such as harsh religious upbringing or social isolation, might factor into an individual’s vulnerability to crystal meth abuse? Does sexual orientation alone cause increased risk?

George Kolodner: Genetics has been documented as a significant factor contributing to vulnerability to alcohol and nicotine dependence. I am not aware of specific studies looking at the genetics of stimulant addiction, but I expect that this is the case and will probably be documented in the future. I do not think that sexual orientation has been documented as a factor contributing to vulnerability.

My sister has become addicted to meth. It’s a difficult situation, as she has a schizoaffective disorder as well as substance addiction. There really isn’t a lot to do if she doesn’t want to be treated; involuntary commitment is merely a very temporary palliative. We’ve had her parental rights terminated and have tried so hard to get addiction treatment for her.
How can people in rural areas advocate for a public-health response to the growth of meth use in our communities? It just seems that each family is on its own.

George Kolodner: Some national organizations exist that may provide some assistance. I would suggest that you contact Partnership for a Drug Free America and Mothers Against Drunk Driving.

Do you provide addiction treatment differently for Meth than you would for other drugs? How addictive of a substance is it, and compared with other illegal drugs? How difficult is it for someone to get clean once they’re on Meth?

George Kolodner: Like most other drug treatment programs, we treat all of the drugs similarly. The only difference with crystal meth is that there are currently no medications to assist us, as there are with alcohol, opioids, and nicotine.

Meth is highly “addictive” in that it is very reinforcing — once someone starts to use it, they tend to keep using it until it is gone, especially because it keeps people awake rather than puts them to sleep. On the other hand, there is no significant physical withdrawal syndrome when one stops so that medical detoxification is not necessary.

Right now, it is one of the most difficult substances from which to get clean. We are all looking for ways to improve our success and hoping for new medications to help us in this pursuit.