Clinical Aspects of Methamphetamine

Abstract

Research topics on methamphetamine that are garnering increased attention include: (1) cellular mechanisms of action of methamphetamine and their relationship to neurotoxicity; (2) the interplay between the limbic brain circuitry underlying reward and the frontal brain that exercises control over the limbic brain, and (3) the disinhibition of the limbic brain resulting from functional or structural disconnection from the executive brain. As knowledge emerges about these complex interactions, researchers and clinicians face new challenges as well as new opportunities for the development and implementation of pharmacological and behavioral treatment strategies to address methamphetamine dependence. Regardless of the advances in scientific understanding of the neurobiological phenomena associated with methamphetamine abuse, utilization of such knowledge often occurs with much delay and sometimes never happens. The "real world" in which clinical researchers conduct investigations of new treatments and in which clinicians treat clients is not always receptive to findings from human laboratory studies or even Phase III trials, and implementation of research proven practices never occur in an optimally timely manner without first overcoming various obstacles. The first part of any solution to the problem of methamphetamine abuse involves greater awareness by all those involved in pertinent disciplines, from basic scientists to primary care physicians. Clearly, clients must also be educated about what happens to them when they use methamphetamine and when they cease using. To accomplish at least part of that awareness raising, new curricula need to be developed and refined at all levels, in academic institutions at the undergraduate and postgraduate levels and in community practice settings, where clinicians may seek and find definitive training in the science and practice of addiction medicine. (PsycINFO Database Record (c) 2016 APA, all rights reserved). (chapter)