A Life Is a Terrible Thing to Waste

Have you seen this scenario? A corporate director, an attorney, a physician, a successful actor'people who have worked long and hard to get where they are, along with other good, strong people in the prime of their lives'amazingly dwindling away before you, being serially destroyed. Sounds familiar, right? Well, I'm not talking about the ravages of AIDS. This is also the aftermath of crystal methamphetamine. Meth enters most people's lives quite insidiously, during good times'on the dance floor, at a party, during sex. The first experience is like falling in love, winning the lottery, having fabulous sex, and eating all the pizza, ice cream, and french fries you could want'all at once. It is equivalent to having your brain flooded with 600 times the normal amount of the 'happy' brain chemical dopamine. The euphoric effects are overwhelming and seductive. And for those on a budget, that first hit is cheap, since crystal methamphetamine is easy to produce by using such mundane household items as cold medicine. Unfortunately, crystal methamphetamine becomes the ultimate bait-and-switch scam. One never gets to repeat that first high'you can only chase it. It causes irreversible damage to the brain cells that produce serotonin and dopamine, leaving you in a perpetual state of neurochemical deficit. Most ominously, crystal is so appallingly addictive that the vast majority of those who start as 'recreational weekend users' become unwitting addicts. Medically, the effects of crystal meth are wide-ranging and ultimately tragic. Users lose interest in normal activities and feel no need for basic necessities of life'such as food, water, or sleep. They rapidly lose weight and become agitated, nervous, moody, irritable, and aggressive. It is not uncommon for a 'tweaker' to stay awake for a week at a time, leading to severe symptoms associated with sleep deprivation, including hallucinations, delusions, extreme paranoia, and violent outbursts. Users may suffer heart attacks and strokes as well as kidney, liver, and lung failure. When crystal meth users try to quit using on their own, they often are foiled by withdrawal symptoms like anxiety, fatigue, disturbed sleep patterns, drug craving, and depression. Since there are no magic-bullet drugs to treat crystal meth addiction, rehabilitation is difficult. It involves a commitment to intensive rehab programs and cognitive therapy. Rehab may take years and cost tens of thousands of dollars, and it is often met with limited success and frequent relapses. Strangely enough, gay men especially seem to have ignored these hard facts and embraced crystal meth as the hip drug du jour on the circuit-party scene. One wonders how a group with a heightened sense of its own mortality (after 20 years of bearing the brunt of the domestic AIDS epidemic) has now fallen victim to what is essentially a glamorized version of a boil-it-in-your-trailer 'biker drug.' Let's not let this become a version of reality TV. It really isn't acceptable to watch a car wreck in slow motion and stand idly by, especially if your friends are trapped inside. There is no such thing as 'recreational use' of crystal meth. Users cannot limit their intake voluntarily. That is why we all need to speak up against partying with crystal, no matter how unpopular we think our opinion may be. Don't condone its use by apathetic indifference or casual ignorance. When you tell someone that it's 'uncool' to do crystal, you're not being a right-wing antidrug zealot, you're being a friend. And just as friends don't let friends drive drunk, friends don't let friends do crystal. If you or someone you know is using crystal meth, get help. Call your doctor, go to a rehab meeting, or visit www.crystalrecovery.com for a listing of resources. Cohan is an attending physician and vice president with Pacific Oaks Medical Group, one of the nation's largest practices devoted to HIV care, located in Beverly Hills, Calif.