AMPHETAMINE. P a g e 1 14

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1 AMPHETAMINE Amphetamine, dextroamphetamine, methamphetamine, and their various salts, are collectively referred to as amphetamines. In fact, their chemical properties and actions are so similar that even experienced users have difficulty knowing which drug they have taken. Amphetamine was first marketed in the 1930 s as Benzedrine in an over-the-counter inhaler to treat nasal congestion. By 1937, amphetamine was available by prescription in tablet form and was used in the treatment of the sleeping disorder, narcolepsy, and the behavioral syndrome called minimal brain dysfunction, which today is called attention deficit hyperactivity disorder (ADHD). During World War II, amphetamine was widely used to keep the fighting men going and both dextroamphetamine (Dexedrine ) and methamphetamine (Methedrine ) were readily available. As use of amphetamines spread, so did their abuse. In the 1960s, amphetamines became a perceived remedy for helping truckers to complete their long routes without falling asleep, for weight control, for helping athletes to perform better and train longer, and for treating mild depression. Intravenous amphetamines, primarily methamphetamine, were abused by a subculture known as "speed freaks." With experience, it became evident that the dangers of abuse of these drugs outweighed most of their therapeutic uses. Increased control measures were initiated in 1965 with amendments to the federal food and drug laws to curb the black market in amphetamines. Many pharmaceutical amphetamine products were removed from the market including all injectable formulations, and doctors prescribed those that remained less freely. Recent increases in P a g e 1 14

2 medical use of these drugs can be attributed to their use in the treatment of ADHD. Amphetamine products presently marketed include generic and brand name amphetamine (Adderall, Dexedrine, Dextrostat ) and brand name methamphetamine (Desoxyn ). To meet the ever-increasing black-market demand for amphetamines, clandestine laboratory production has mushroomed. Today, most amphetamines distributed to the black market are produced in clandestine laboratories. Methamphetamine laboratories are, by far, the most frequently encountered clandestine laboratories in South Africa. The ease of clandestine synthesis, combined with tremendous profits, has resulted in significant availability of illicit methamphetamine, especially on the West Coast, where abuse of this drug has increased dramatically in recent years. Large amounts of methamphetamine are also illicitly smuggled into the United States from Mexico. Amphetamines are generally taken orally or injected. However, the addition of "ice," the slang name for crystallized methamphetamine hydrochloride, has promoted smoking as another mode of administration. Just as "crack" is smokable cocaine, "ice" is smokable methamphetamine. Methamphetamine, in all its forms, is highly addictive and toxic. The effects of amphetamines, especially methamphetamine, are similar to cocaine, but their onset is slower and their duration is longer. In contrast to cocaine, which is quickly removed from the brain and is almost completely metabolized, methamphetamine remains in the central nervous system longer, and a larger percentage of the drug remains unchanged in the body, producing prolonged stimulant effects. Chronic abuse produces a psychosis that resembles schizophrenia and is characterized by paranoia, picking at the skin, preoccupation with one's own thoughts, and auditory and visual hallucinations. P a g e 2 14

3 These psychotic symptoms can persist for months and even years after use of these drugs has ceased and may be related to their neurotoxic effects. Violent and erratic behavior is frequently seen among chronic abusers of amphetamines, especially methamphetamine. Orally Sniffed Via rectum(launch) Smoked Injected METHODS OF USE EFFECTS Insomnia Seizures / Cardiac Arrest Headaches Irregular heartbeats Teeth Grinding Dehydration / Electrolyte Imbalance Cerebral oedemic / Cerebrovascular accidents Disintegration of voluntary muscles Increased body temperature heightened fever Renal failure Jaundice Anorexia Severe depression Paranoia / Panic attacks P a g e 3 14

4 STREET NAMES E s Rounds Pille Smarties Sweets Crowns 007 s Mitsubishis Rolls Royce Ferraris Smiley Diamonds Purple Hearts Disco biscuits Packet Methamphetamine Methamphetamine has many faces. They are produced in large Mexican clandestine labs located in California or across the border in Mexico. Using precursor chemicals supplied by China, India and Rogue chemical suppliers in the United States. Mexican lab operators can produce up to 200 lbs. of Methamphetamine at a time. What was once the P a g e 4 14

5 domain of the traditional outlaw, motorcycle gang, Mexican traffickers now produce most of the Methamphetamine consumed in the United States. The violence and environmental damage associated with the production, distribution, and use of the Methamphetamine, as well as the involvement of international drug trafficking organizations, further threaten the Republic of South Africa and render Methamphetamine the third greatest drug threat. Because of the many different production methods, few of the clandestine laboratory operator and household chemicals used in manufacturing Methamphetamine, the finished product varies in color and texture, but is most commonly a shade of tan or P a g e 5 14

6 white. The pink Methamphetamine is a result of the red dye in some brands of cold tablets used in the manufacturing process. Amphetamine, Dextroamphetamine and Methamphetamine. Their chemical properties and actions are so similar that even experienced users have difficulty knowing which drug they have taken. Stimulants are a class of drugs that enhance brain activity they cause an increase in alertness, attention, and energy. Crystal meth: Are you up to speed? "Tik" (crystal meth) is the latest buzzword in drug circles and is becoming increasingly popular amongst school children. The drug, known as the "stay-awake drug that makes you violent", has recently sparked a huge response from health authorities. Far more is being done to clamp down on dealers than with any other drug in South Africa. Why such a huge response? According to Grant Jardine, director of the Cape Town Drug Counseling Centre (CTDCC), the increased rate of usage of crystal meth is dramatic. "It is something we haven't seen before. It is the greatest challenge the CTDCC has ever had to face." In 2002, less than one percent of the clients at the CTDCC took crystal meth as their primary drug. In 2003, the number increased to five percent. In May 2004, a third of the patients were crystal meth users. The drug is highly addictive. According to the CTDCC, over six months of use, 94 percent of those who smoke meth become addicted. Health professionals are concerned about the devastating effects of this drug on the user - P a g e 6 14

7 amongst its many effects, crystal meth induces psychotic symptoms, such as seeing or hearing things that are not there, and violence, making it a far more dangerous drug than most other drugs available in South Africa. "The danger with crystal meth is that it is attractive to non-typical drug users," says Prof Charles Parry, researcher at the Medical Research Council (MRC). bit is attracting very young, first-time users. The South African Community Epidemiology Network on Drug Use (SENDU) which monitors drug use countrywide, found the greatest increase in users to be under the age of 20 years. In 1996, 5% of people seeking treatment were under 20 years. This shot up to 20-25% in Treatment centers such as the Crescent Clinic's Chemical Dependency Unit are treating children as young as 13 years for crystal meth addiction. Crystal meth has also been marketed as a way of losing weight, making it popular amongst many women who would not normally have taken drugs. But health professionals are also concerned about the impact of crystal meth on long-term drug users. Ted Leggett, senior researcher at the Institute for Security Studies, has done extensive research on gangsterism on the Cape Flats. He points out that crystal meth is becoming extremely popular amongst gang members. Hardened criminals taking drugs that induce violent behavior is a cause for concern. "Methamphetamine is seen as an ideal tonic to prepare gunmen for a hit, removing inhibitions, sharpening senses, and fueling aggression," says Leggett. One could therefore expect an escalation of violence amongst this already violent sector of the population. P a g e 7 14

8 "Give me a straw, please?" If you ask this question in many parts, you may get a lot more than you bargained for. Crystal meth is typically sold in straws and one straw could cost you between R40 and R60. The drug can be found in many forms, from a fine powder to larger crystals. It can be snorted, orally ingested, injected or smoked - smoking being the most common in South Africa. On the street, crystal meth has many names, including "tuk-tuk", tik, crystal, straws and globes. It has also been called "Hitler's drug", because it was allegedly used by the Nazis as a "combat drug" to fuel aggression and to help soldiers stay awake and remain focused for long periods. The powder or crystal is placed in a light bulb after the metal threading has been removed. A lighter is used to heat the bulb and the user smokes the fumes. Some users call the drug "tuk-tuk" because of the clicking sound it makes when smoked. Available in a kitchen near you The ingredients are easily accessible and many manufacturers need nothing more than their kitchens to concoct large quantities. Recipes are plenty and easily available, and you don't have to be a rocket scientist to make it. Overheads are low, making the manufacture of crystal meth a lucrative business. It is not uncommon for people to make a profit of R4 000 a day. "Because crystal meth can be manufactured at home, the problem is not only availability but that many people don't see it as illegal and don't regard it as a drug," says Prof Parry. In a step to reduce the local manufacture of the drug, ephedrine was made a Schedule 5 drug in May 2003 and is now only available on prescription. But manufacturers soon discovered other ways, such as using pseudoephedrine, found in some over-the-counter remedies. P a g e 8 14

9 What does it do? According to users, the drug gives an immediate, extremely pleasurable rush or "flush". The rush only lasts a few seconds, but is followed by euphoria (a high) which lasts for several hours. Users stay awake for hours, even days, during which they feel extremely active and energetic. They seldom get hungry and go for long periods without any food. Both the rush and the high are believed to result from the release of very high levels of the brain chemical dopamine into areas of the brain that regulate feelings of pleasure. Interestingly, recovering addicts describe the effects very differently, says Jardine. They often describe the high as a state of extreme restlessness, anxiety and an inability to sleep. They also complain of many unpleasant sensations such as of needles sticking through the skin from the inside or of insects crawling on the skin (called formication). Although the effects of the drug only last a few hours (depending on the quantity and quality), it may take days for the body to fully recover. Once the effects have worn off, users hit a low - a feeling of exhaustion and depression. Many people use the "white pipe" combination of dagga and mandrax to come down from the high. Long-term effects Crystal meth can be damaging in several ways. The drug is commonly sold as a combination of amphetamines and talcum powder, baking powder, starch, glucose or quinine. These additives can be very poisonous. Because the user never knows exactly what he is using, even an experienced user can accidentally overdose. Tolerance develops quickly, which means that higher doses of the drug need to be used to get the same effect, and/or that the drug needs to be taken more frequently or in different ways. Chronic abuse can lead to out-of-control rages, violence, anxiety, confusion, mood disturbances and insomnia. Users can become psychotic, experiencing symptoms such as P a g e 9 14

10 paranoia, hallucinations and flight of ideas (jumping from one topic to the next). The paranoia can result in homicide or suicide. The drug causes increased heart rate and blood pressure and can cause irreversible damage to blood vessels in the brain, producing strokes. Other effects include respiratory problems and irregular heartbeat. Crystal meth affects many parts of the central nervous system. According to the treatment guidelines issued by the US Center for Substance Abuse Treatment "some of the most frightening findings about meth suggest that its prolonged used not only modifies behaviors, but literally changes the brain in fundamental and long-lasting ways". There is also an increased risk of being infected with HIV or other sexually transmitted infections because many become more sexually active when on a high, often describing hours of wild sex with little concern for safer sex. Look out for these warning signs For obvious reasons, early intervention will give an addict the best chances of recovering. Is someone you know in trouble? These are the signs of crystal meth abuse: Loss of appetite and weight loss Aggression Dilated pupils Rapid speech Anxiety Psychotic symptoms (hallucinations and delusions) Headaches Over-confidence Insomnia Changes in dress, friends and slang Drug paraphernalia: light bulbs, glass straws (so-called lollies or popeye) P a g e 10 14

11 Amphetamine (UPPER) causes pupils to dilate. AMPHETAMINE-TYPE STIMULANTS (ATS) ATS can be divided into two subgroups, namely CNS stimulants and hallucinogenic ATS. In 2002, the Forensic Science Laboratory of the South African Police Service (SAPS) analyzed more than dosage units in connection with more than ATS-related cases. The police also raided several illicit ATS production facilities during the same year in response to an increase in the illicit manufacturing of methcathinone. The ATS listed below are controlled in South Africa and are listed as Undesirable Dependence-Producing Substances in Part III of Schedule 2 of the Drugs and Drug Trafficking Act, 1992 (Act No 140 of 1992). CNS stimulants The main drugs in this group are - amphetamine (street names: Bennies, Dexies, Benzedrine); methamphetamine (street names: Ice, Meth, Crystal); and methcathinone (street name: CAT). The effects of CNS stimulants The sought-after effects of these drugs are - a feeling of well-being, exhilaration and euphoria; increased alertness and energy; P a g e 11 14

12 delayed hunger and fatigue; and an enhanced ability to perform manual and intellectual tasks. The possible short-term effects of these drugs are - loss of appetite; faster breathing; increased heart rate; raised blood pressure; dilated pupils; strange, erratic, at times violent behavior; The possible effects of large doses are - hallucinations; talkativeness; a sense of power or superiority; restlessness; hyperexcitability; and irritability which can lead to anxiety and paranoid psychosis. convulsions; seizures; death from respiratory failure; stroke; cerebral hemorrhage; and heart failure. The possible effects of excessive doses are - The possible long-term effects of these drugs are destruction of the tissue in nose if the drugs are sniffed; respiratory problems if the drugs are smoked; contraction of infectious diseases if the drugs are injected; abscesses if the drugs are injected; malnutrition and weight loss; disorientation; P a g e 12 14

13 indifference; confusion and exhaustion due to a lack of sleep; an increased tolerance to the drugs; a psychological dependence on the drugs; and paranoid psychosis. When a person stops using these drugs, he/she will go through a period of excessive sleeping followed by a period of depression. Hallucinogenic ATS The main drugs in this group are - 3,4-Methylenedioxymethamphetamine (MDMA) (street names: Ecstasy, XTC, E, Adam and various names catalogued in the 2003 Logo Index); 3,4-Methylenedioxyamphetamine (MDA) (street names: Ecstasy, XTC, E and various names catalogued in the 2003 Logo Index); and 3,4-Methylenedioxyethylamphetamine (MDEA) (street names: Ecstasy, XTC, E, Adam and various names catalogued in the 2003 Logo Index). The effects of hallucinogenic ATS The sought-after effects of these drugs are - a feeling of emotional closeness to others (empathy); increased sociability; and increased physical and emotional energy. The possible short-term effects of these drugs are - fatigue and depression after use of the drugs is stopped; restlessness, anxiety and intense visual and auditory hallucinations with larger doses; nausea and vomiting; a rise in blood pressure and heart rate; and death from heatstroke. damage to nerve tissue; brain damage; and The possible long-term effects of these drugs are - P a g e 13 14

14 liver damage. Chemical safrole used as a precursor in manufacturing hallucinogenic ATS is reasonably anticipated to be a carcinogen, that is, a substance that can cause cancer, according to the Ninth Report on Carcinogens (PB , 2000). References Terminology and Information on Drugs, Revised Edition, United Nations Office for Drug Control and Crime Prevention, New York, Merck Index, 13th Edition, Merck & Co., Inc., Whitehouse Station NJ, P a g e 14 14