The National Methamphetamine
Drug Conference
Treatment: Implications for Prevention and Law Enforcement
Chair: Everett Ellinwood, M.D.,
Duke University
Recommendations:
- Comprehensive assessment and treatment with effective referral from a wide variety of sources.
- Conduct research to identify and develop effective treatment modalities across the spectrum of methamphetamine abuse.
- Develop empirically-based prevention and education strategies for at-risk populations.
First, we need effective referral with comprehensive assessment and treatment. Effective referrals are needed so clients do not get lost in the system; this includes referrals from family, medical emergency rooms, drug courts, and the workplace. We developed the acronym P.A.T.O.A., which stands for Patient Assessment and Treatment with Outcome Assessment. We must tie outcome assessment to treatment programs. We also recommend long-term financial care because many methamphetamine abusers are depressed and without energy for six months to a year.
Second, our group thought it important to conduct research to identify and develop effective treatment modalities across the spectrum of methamphetamine use. By "across the spectrum" we mean: The youth who is beginning to experiment with methamphetamine or other drugs; the blue-collar worker who is using methamphetamine daily for eight hours but who is not yet into a heavy binge pattern; or the housewife who is trying to reduce her weight.
These types of cases must be distinguished from the more intense, neurotoxic individual who has, as Dr. Leshner pointed out, lost a third of his or her dopamine neurons. Also, clinical research shows that females develop a sensitization to addictive behavior much faster than males. The heavy user is quite different from the casual user who, in turn, is different from the first-time experimenter. We must be able to treat different types of users.
Finally, we thought a prevention and education strategy should be empirically developed and targeted at specific at-risk populations such as youth, housewives or truck drivers. We should learn how to integrate unions and business groups that have drug-free programs into this strategy. Video conferencing to rural areas and mobile medical offices would also help.
