Addiction is a fascinating, multi-faceted, and demanding public health and medical dilemma. Johnson (2010) defines addiction as “the need to continue obtaining and using a chemical substance despite one’s better judgment and good intentions.” Used interchangeably with diagnostic terminology including substance abuse, substance dependence, or a substance-related disorders, addiction may stipulate an increasing tolerance to a substance and withdrawal systems when the substance is removed from the system, and compulsive drug-taking behavior (DSSM-IV-TR, 2000). Addiction may also be used to describe a condition, propensity, or disposition that is not necessarily accompanied by use or abuse of the substance.
Specific to drug addiction, the physiological capabilities of the chemical substance relates its ability to cross the blood-brain barrier in order to manipulate neural pathways and dopamine levels. This capability was most often initially recognized as valuable in terms of medical treatments, as most drugs were initially discovered, developed, and utilized for disease treatment. However, improper utilization, debilitating side-effects, and long-term brain damage as in the case of LSD and cocaine reclassified these substances as dangerous. Modern prescription medicines such as ritalin, vicodin, and oxycontin are also of concern in terms of their improper utilization and subsequent psychological and/or physiological dependence development.
In Hawai’i, numerous factors coincide to contribute to crystal methamphetamine’s addiction prevalence. These include being a powerful stimulant, highly addictive, its low price, the state’s geographic isolation which increases the cost of and reduces the availability of other drugs, inadequate drug education, and low per-capita income among at-risk populations and related support services (Hawaii Meth Project, 2010) .
Crystal methamphetamine can increase dopamine levels 1150% more than food and 850% more than cocaine (NIDA, 2010). Due to this disturbing ability, most methamphetamine efforts are focused on use prevention. Recent studies have further examined the role of support services in curtailing methamphetamine use and associated behavior. Menza et. al., (2010) determined that therapeutic measures such as contingency management are unlikely to have a sustained effect on methamphetamine use. Kenny et al., (2011) determined that treatment utilization was low due to perceptions of an individual’s self-management of meth addiction and suggested online treatments or specialist clinics.
These assessments for treatments in crystal methamphetamine addiction support current efforts that focus on prevention. From a public health perspective, prevention is always primary and in this instance, seems entirely and direly necessary.
Johnson, M.D. (2010). Human Biology: Concepts and current issues. San Francisco. CA: Pearson Benjamin Cummings.
Kenny, P., Harney, A., Lee, N., and Pennay, A. (February 2011) Treatment utilization and barriers to treatment: Results of a survey of dependent methamphetamine users. Subst Abuse Treat Prev Policy.6(1):3.
Menza, T., Jameson, D., Hughes,J., Colfax, G., Shoptaw, S., Golden, M. (December 2010) Contingency management to reduce methamphetamine use and sexual risk among men who have sex with men: a randomized controlled trial. BMC Public Health.10:774.
National Institute on Drug Abuse (2010) The Science of Addiction. Accessed on March 16, 2011 from http://www.nida.nih.gov/scienceofaddiction/sciofaddiction.pdf
The Hawaii Meth Project (2010) Hawaii Meth Use and Attitudes Survey 2010. Accessed on March 15, 2011 from http://www.hawaiimethproject.org/About_Us/publications.php.
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