La méthamphétamine – un stimulant comme les autres ou un problème plus complexe ? Methamphetamine – just another stimulant or a more complex problem?

Résumé

La méthamphétamine (MA) fait beaucoup couler d’encre dans les médias, par sa popularité grandissante ainsi que par ses effets psychotropes et néfastes. S’agit-il d’un stimulant comme un autre, ou la méthamphétamine entraîne-t-elle des difficultés spécifiques chez ses utilisateurs ? Cet article se veut une brève revue de la documentation scientifique décrivant les raisons de sa popularité ainsi que les problèmes physiques, dentaires, psychiatriques, cognitifs et judiciaires qui y sont associés. Les profils d’utilisateurs ainsi que les traitements proposés à ce jour seront également présentés. En somme, nous tenterons d’illustrer la complexité des troubles rencontrés chez l’utilisateur de MA, les similitudes avec les utilisateurs de stimulants, ainsi que les limites des traitements actuels pour répondre aux besoins liés à cette complexité.

Mots-clés :

• méthamphétamine,
• effets,
• profils,
• effets physiques,
• effets mentaux,
• traitement

Abstract

Methamphetamine (MA) has recently become very popular in the media, due in part to its increasing popularity as well as its psychotropic effects and the negative consequences of its use. Is it a stimulant like any other, or does methamphetamine use lead to specific difficulties in its users? The aim of this article is to provide a brief review of the literature by explaining some of the reasons for its popularity in Canada as well as the physical, dental, psychiatric, cognitive and legal problems associated with its use. MA’s popularity: Regarding its popularity, MA has benefitted from multiple factors, namely its low cost for users and manufacturers, its quick and intense psychotropic effects (increased energy, sexual arousal, rapid thinking, sleeplessness, lack of appetite), its easy access, as well as its various methods of ingestion (nasal, oral, injection). MA abuse also results in a multitude of negative effects, both physical and mental. MA’s physical effects: In terms of negative physical effects, cardiac problems, skin infections, sexually transmitted (and injection-related) diseases as well as meth mouth are described. MA’s mental effects: In terms of mental consequences, two recently published Canadian studies revealing high rates of depression symptoms and of sustained psychotic symptoms in a subgroup of MA users are presented. Studies reporting various cognitive deficits in MA user are also reviewed, including reports of high prevalence of childhood attention deficit and hyperactivity disorder diagnoses among adult MA users. Furthermore, MA abusers are documented as having been highly exposed to trauma in their lives, with many presenting with post-traumatic stress disorder criteria. This manuscript also explores the reasons behind the forensic profiles of individuals using MA, particularly the increased tendency toward violent acts, the high incarceration rates of the homeless users and the high percentage of individuals diagnosed with antisocial personality disorder reported in studies. In terms of user profiles, various methods of ingestion, frequency of use as well as combination with other drugs are described, with a special focus on the frequent polysubstance abuse found in MA users and the reality of bingers. Treatment: This manuscript describes specific treatments designed for stimulant users such as MA abusers, namely the MATRIX program, as well as modifications piloted for those with comorbid depression. Pharmacological treatments, as well as antioxidant supplements, are also discussed although they have not yielded positive results with humans to date. Overall, our goal in this manuscript is to highlight the complexity of the difficulties faced by MA users as well as the limited ability of currently available treatments to address the multiple needs associated with this complexity.

Keywords:

• Methamphetamine,
• effects,
• profils,
• physical effects,
• mental effects,
• treatment