Consortium Against Substance Abuse

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• Consortium Against Substance Abuse
• 119 se 1st Street
• Anadarko, Oklahoma, 73005
• 405-247-7313
• Rick Pickens, BA
• Program Director

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Meth

• The Epidemic

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• Why Should you be concerned or worry yourself
  about someone elses problem?

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• Because it could be

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Your son
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Your Brother
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Your Grandson, Uncle, Nephew, or best friend.
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• Or

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Your Daughter
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Your Granddaughter, Aunt, Niece, Grandmother.
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Effecting Everyone

• Last year, in my tribe, 63 babies were born
  addicted to Meth. This has to change.
• -Kathleen Kitcheyan, Chairwoman,
• San Carlos Apache Tribe, 2006

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Primary Illicit Drug Mentions by American Indians
Seeking Treatment 2003-2006
Drug 2003 2004 2005 2006
Cocaine 12.2 9.7 9.3 9.8
Heroin 9.8 98.0 7.2 6.9
Marijuana 33.6 29.9 29.8 30.1
Meth 34.3 27.5 31.3 31.5
Prescription 7.2 6.7 6.7 6.4
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Inter-generational Use CookingFrom the New
Yorker Magazine
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History of Meth

• Where did it come from?

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Japanese

• A . Ogata, a Japanese chemist first to
  synthesized methamphetamine via the reduction of
  ephedrine using red phosphorus and iodine in
  1919.
• The Kamikaze pilots of Japan used meth during
  there flights.
• Large stockpiles after the war lead to Japans
  first major drug epidemic.

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Germany

• One of the earliest wide spread uses of Meth was
  in WW ll by the German Army under the name
  Pervitin..
• This was given to tank crews and pilots to
  make them fight and fly longer.
• Meth was given to all German forces to include
  the elite forces of Adolf Hitler the SS.
  

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Adolf Hitler

• Hitler was given daily intravenous injections of
  meth by his personal physician from 1940 until
  the end of the war.
• It is believed it was given for depression and
  fatigue.
• It is possible that it was used to treat
  Parkinsons disease or the Parkinsons like
  symptoms which developed from 1940.
• His mistress Eva Bran was also given daily
  injections.

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U.S. Troops and Allies

• American and allied troops were given 272 million
  tablets of Dexedrine and methamphetamine
  Methedrine to fight longer. This included
  ground combat troops pilots and tank drivers.
• More of these tablets were given to U.S. troops
  during the Viet Nam war than all troops during WW
  II.

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Motorcycle Gangs

• In the 1950s Motorcycle gangs from southern
  California like the Hells Angles, and others
  realized the potential profit in meth and first
  transported it across the Mexican boarder and
  then learned to cook it.
• The slang name Crank came from hiding the
  meth in the crank case of the engine.

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Meth

• It is methamphetamine powder ranging in color
  from white, yellow, orange, pink, or brown.
• Color variations are due to differences in
  chemicals used to produce it and the expertise of
  the cook.

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Ice

• High purity methamphetamine crystals or coarse
  powder ranging from translucent to white,
  sometimes with a green, blue, or pink tinge.

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• How is it Made

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Uncle Fester-Father of Home Cooked Meth

• Pen Name Used by Steve Presler to write books in
  the early 1980s, he gained cult status after
  publishing his first book
• Secrets of Methamphetamine Manufacture
  written while he was in prison on meth charges.
  He has a degree from Marquette Univ. in Chemistry
  and Biology

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Nazi or Birch Method

• Also called the Dissolving Medal Reduction
  method. Combine ephedrine/pseudoephedrine and
  metal usually sodium or lithium and anhydrous
  ammonia (liquid fertilizer)

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Red P Method

• Uses Red phosphorus found in safety matches,
  flares, smoke bombs and the like combined with
  iodine to make hydrochloric acid used to reduce
  the precursor. Also uses muriatic acid, lye and
  other flammable solvents.

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What is in Meth

• The active ingredient in making methamphetamine
  is ephedrine or pseudoephedrine, commonly found
  in over the counter cold remedies.

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One Pot Method/Shake and Bake

• Involves mixing pseudoephedrine and the other
  chemicals in one container usually a empty soda
  bottle. This produces a low quality and a small
  quantity of meth.
• Very dangerous the bottle can explode if
  bottle cap is not tight and if opened to soon.

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Urine Extraction Pee Labs

• The body only utilizes 10 of the meth taken.
  Bizarre or disgusting as it seems people try to
  extract meth from their own urine. This process
  takes several weeks to process.

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• Where is Meth made?

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Rural out of the way places.
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Camping Trailers
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Mobile Meth lab
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Any out of the way location
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Nice homes and apartments
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Meth lab on White Mountain Apache land
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• What does a Meth Lab Look Like?

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Super Labs

• A small percentage of labs seized are labeled
  Super Labs and are capable of producing over 10
  lbs per batch.
• Super Labs are operated by Mexican National Drug
  Trafficking Organizations (MNDTOs), and supply
  the majority of meth to the market.

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Equipment from a super lab
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Clandestine Meth Lab
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Clandestine Meth Lab
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Stove top labs

• Small, stove top labs comprise the bulk of
  clandestine laboratory seizures.
• Cookers make small amounts using household
  chemicals and equipment.

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Cutting Agents for Meth

• Embalming Fluid
• Heart Medications
• Glue from Rodent Traps

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The Most Disturbing Cutting Agents

• Human DNA
• Feces
• Blood
• Urine
• .

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How is it used? 4 S

• Shooting
• Smoking
• Snorting (Nasal)
• Swallow (Pills)

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Route of Methamphetamine Administration
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Shooters Rig
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Smoke
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Meth Pipe
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More Meth Pipes
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SNORTING
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Persons Prone to Use Meth  

• Education less than a high school diploma
• Reports having dependents
• Chronic medical problem
• History of psychological problems
• Unemployed
• Underemployed (part time and/or casual work)
• Has criminal convictions
• Experienced emotional abuse within lifetime
• Experienced physical abuse within lifetime
• Experienced sexual abuse within lifetime

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Gender Distribution
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Marital Status
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Self-Reported Reasons for Starting
Methamphetamine Use
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A Major Reason People Take a Drug is they Like
What It Does to Their Brains
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Initially, A Person Takes A Drug Hoping to
Change their Mood, Perception, or Emotional State
Translation---
Hoping to Change their Brain
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Natural Rewards Elevate Dopamine Levels
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But Then
After A Person Uses Drugs For A While, Why Cant
They Just Stop?
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Their Brains have been
Re-Wired by Drug Use
Because
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Prolonged Drug Use Changes the Brain In
Fundamental and Long-Lasting Ways
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• Meth Use Signs and Symptoms
• RED FLAGS
• Not every user will display every one of these
  symptoms

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Early Meth Use Signs/Symptoms

• Euphoric high state (excessively happy)
• Paranoia
• Decreased appetite
• Increased physical activity
• Anxiety, shaking hands, nervousness
• Incessant talking
• Rapid eye movement Dilated pupils

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Early Signs/Symptoms Continued

• Increased body temperature (can rise as high
  as 108 degrees an cause death)
• Sweating not related to physical activity.

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Signs/Symptoms of Continued Meth Use

• The previous symptoms, Plus
• Weight loss
• Strong Body odor
• Shadows under the eyes
• Dry or itch skin
• Pale complexion
• Acne/Acne-type sores

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Continued use Signs/Symptoms

• Irritable and moody (mood swings)
• Picking at skin or hair
• Aggressive or violent behavior
• Depression (withdrawal)
• Severe nail biting
• Nose bleeds
• Dermatitis around the Mouth
• Lack of personal hygiene

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Signs/Symptoms of Advanced Meth Use the above Plus

• Extreme weight loss
• Hair loss
• Discolored, rotten or missing teeth
• Corneal ulcerations
• Severe mental illness symptoms similar to
• Schizophrenia (including anger and panic
• Attacks)
• Auditory and visual hallucinations

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• The best treatment for withdrawal from meth

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• Hospitalization

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Groups with High Rates of Meth Use

• Women
• Residents in Western/Midwestern Rural Areas and
  Small/Medium Cities
• Predominantly Caucasian, Increasing Numbers of
  Hispanics and Native Americans
• Gay Men

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Targeting our Children

• Meth cooks are very ingenious in the marketing of
  there product.
• Some are using milk drink mix to stop the burning
  for someone who snorts meth.
• Or are they targeting some one else.

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Strawberry Flavored Meth
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Children

• Children who live in and around the area of the
  meth lab become exposed to the drug and its toxic
  precursors and byproducts.
• 80-90 of children found in homes where there
  are meth labs test positive for exposure to meth.
  Some are as young as 19 months old.

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Children

• Children can test positive for methamphetamine
  by
• Having inhaled fumes during the manufacturing
  process
• Coming into direct contact with the drug
• Through second-hand smoke.

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Children

• Children have a greater skin surface area per
  pound than do adults, making them more
  susceptible to environmental contaminants.
• They also eat, drink, and breathe faster, and are
  more likely to put hands and other objects in
  their mouths.

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Children

• Inquisitive nature of young children makes them
  more prone to accidentally consuming toxic
  chemicals that are sometimes kept in unmarked
  containers in the refrigerator.

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The Children of Meth
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Found covered in battery grease from playing with
an old car battery.
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Meth Lab Fire Victim
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Sleeping children showing signs of injury of
living in a meth house
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Some children have only tears when rescued from
their deadly environment
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This baby died due to complications of being
burnt over 30 of his body after being left in
the house that parents were making meth in. Both
ran out of the house then realized they had left
their son in the house. They left before the
funeral but were later arrested buying chemicals
to make meth
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• Physical effects of Meth
• The User

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Meth Sores Or Meth Bugs

• The body only uses 10 of the meth put into it.
  Only a small percent can be disposed through the
  urine and blood system. It has to go some where
  so the most noticeable way is pushing out through
  the skin leaving red bumps.

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Meth not a great injection able drug
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Dental problems

• Cased by the lack of salvia and the chemicals
  in the meth.

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• The Look of Meth

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• A
• Slow
• Death
• By
• Meth

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• Dangers of Meth Labs

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Meth Lab Overview

• Being in or near a meth lab is extremely
  dangerous both while the drug is being cooked and
  after the location has been deserted. There is a
  high risk of fire, explosion and exposure to
  fumes. The ingredients leaves behind six pounds
  of residue for each pound of meth manufactured.

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Signs of a Potential Meth Lab

• Strong smell that might resemble cat urine, or an
  unusual chemical smell like ether, ammonia or
  acetone.
• Little or no traffic during the day, but lost of
  traffic at extremely late hours
• Extra effort to cover windows or reinforce doors.
• Residents never putting their trash out

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• Lab materials surrounding the property (lantern
  fuel cans, red chemically stained coffee filters,
  glass jugs and duct tape).
• Vehicles loaded with trunks, chemical containers,
  or basic chemistry paraphernalia, glassware,
  rubber tubing, ect.
• Inhabitants smoking outside due to fumes

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Consequences of Meth Production

• The real consequences of a meth Lab are the
  deaths of the persons who cook it .
• The next four slides are Graphic in nature
• Turn away if you have a weak stomach.

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Meth Lab Consequences..
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• The Epidemic of Meth usage is harming many
  families, and children are being effected. The
  manufacturing of this drug will stop if the
  communities educate themselves and their
  children of the effects of this drug has on the
  person. The community must pull together to
  stop the dealers and
• manufacturers from invading where we live.

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Join the Battle

• Learn all you can about Meth
• What is Meth
• What is it made from
• The signs and symptoms of Meth use
• Meth lab indicators
• Talk to your family and children about Meth

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The Battle Continued

• Insure the school system knows about Meth
• Know how to respond if you believe a lab is in
  your area
• Remember the Children
• Call the Police

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The Battle Continued

• The economic cost of Methamphetamine use in the
  U.S. reached 23.4 billion in 2005, this
  including the burden of addiction, premature
  death, drug treatment, child care, cleaning of
  lab sites. This does not take into account the
  future needs of the meth user.
• What would you do with 1 billion dollars?

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Education and Prevention

• It is CASA vision and mission to educate and
  prevent the use and meth in our communities.
  That is why this program was developed to be
  presented to any tribe or group. It is our
  prayers that we as a community can combat this
  dreadful plague that is affecting many in our
  tribes.

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Consortium Against Substance Abuse

• MET Program
• Meth Education and Treatment

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• The MET Program consist of two components
• Meth Education and Prevention
• Two Hour PowerPoint Presentation
• Meth Outpatient Treatment
• Modified Matrix Outpatient Program

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Matrix Intensive Outpatient Program

• This program is an evidenced based developed by
  the Matrix Institute of Addictions in 1986 with
  over 20 years of research and development.
• The length of the program is 16 weeks (144
  Hours).
• Curriculum is manualized consisting of the
  following
• Individual or co-joint sessions
• Early Recovery
• Relapse Prevention
• Family Education

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Changes to Program by CASA

• Reduced the number of group hours from 9 to 6 per
  week.
• 3 hours of Matrix group per week and 3 hours of
  Womens group per week.
• 1 individual session monthly
• Program is 52 weeks (324 hours)
• 24 Hour contact with staff

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Reasons for Change

• Family Court and DHS requirements
• Work (for child support and other
  responsibilities, food and shelter. Clients
  must have six months of stable home and all
  utilities paid before family can be reunited)
• Seeking work
• School
• Parenting classes
• And any other requirements by courts, DHS or ICW

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Goals of Program

• Negative Urinalyses , Breathalyzer and Alcohol
  Swabs. (Two failed test Client will be
  discharged from program and required to attend
  Inpatient treatment, then return to program)
  Agency has list of medications that will cause
  false positives . Clients must list all meds
  upon application to program
• 98 attendance of groups and complete all
  assignments. (Clients must have valid excuse to
  miss groups)
• Reunite family with out any involvement from DHS
  or ICW.

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First Group

• Six Female and one Male clients enrolled into the
  program all single mothers.
• Three with a diagnoses of Meth addiction, Two
  with meth as a secondary diagnoses and two with a
  alcohol diagnoses.
• Two had their children taken due to Meth in the
  blood at birth of their children.
• Two had their children removed from the home for
  neglect.
• One had her children removed for violation of the
  school attendance regulations.
• One gave her children to family to raise due to
  her meth use.
• Two left the program.

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Issues and Concerns

• Transportation Gave rides if needed
• Money Suggested possible employment
• Loneliness Suggested attending church or other
  D/A free social functions
• Lack of Family Support Encouraged family to
  attend family education program
• Guilt and Shame of having children taken away
• Crisis, Crisis, Crisis, Crisis Staff must be
  ready to handle crisis.
• .

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Results

• No failed Urinalysis, Breathalyzers or Alcohol
  Swabs.
• One has 23 months clean time
• Two have 16 months clean and sober time
• One has 17 months clean and sober time
• Four have their children returned with out any
  DHS or ICW involvement
• One has his children with supervision
• Four have graduated.
• Three clients relapsed in the first two months
  but expressed their disappointment in themselves
  in group.

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What was Learned from First Group

• Be ready for Crisis
• Complete a comprehensive Biosocial and ASI
  (Addiction Survey Index)
• All clients need reassurance
• Balance compassion and empathy
• Understand client needs are not just D/A
• Be Flexible
• Help Client develop a spiritual program
• Let client talk

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Presentation Credits

• Bureau of Indian Affairs
• Indian Health Service
• Nation Institute on Drug Abuse
• National Drug Intelligence Center
• Substance Abuse and Mental Health Services
  Administration
• Communications News Network (CNN)
• Navajo Department of Law Enforcement

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• QUESTIONS