Health

The drug that makes users “CRAZY”

Dr Satparkash

To the horror of the urban parents, rich or poor, a new drug has penetrated the society. Youths have been targeted by an unseen power to go for a tablet, popularly known as Yaba, that promises an instant euphoria but soon replaced by deadly effects. Over the last two years this deadly drug has not only become more affordable with its price slumping, it has also started taking its toll on our youths.

What is Yaba?
Yaba, the Thai word for “crazy medicine”, is a tablet form of methamphetamine (a addictive and powerful stimulant). These synthetically produced pills contain 25-30 mg of methamphetaimine and 45 to 65 mg of caffeine. Tablets are available in variety of flavours (including grape, orange, vanilla) and colors (most commonaly reddish-orange or green) Various logos (commonaly “WY” or “R” ) adorn yaba tablets, which are the size of the end of a drinking straw. Yaba looks and tastes so much like candy that many young users (often including ecstasy users) underestimates its harmfulness. Methamphetamine is also available in powder (“crystal”) form, which can be processed into a rock (“ice”) or liquid form.

How is Yaba used?
Yaba tablet typically are consumed orally. Another common method is called chasing the dragon. A user places the yaba tablet on aluminum foil and heats it from below. As the tablet melts, vapours rise and are inhaled. The drug may also be administered by crushing the tablet into powder, which is then snorted or mixed with a solvent and injected.

What are the risks?
Yaba is a powerful central nervous system stimulant with longer lasting effects . The effects produced by yaba will be dependent on the dose taken. Some effects include:
* Euphoria
* Insomnia
* Dehydration
* Paranoid feeling
* Irritability and aggression
* Hot flashes, dry mouth and sweating
* Damage to the small blood vessels in the brain
* Increased alertness, wakefulness, and physical activity
* Increased heart rate, blood pressure, respiration, and body temperature

Effects of chronic abuse include:
* Tremors
* Hypertension
* Hallucinations
* Psychotic episodes
* Paranoid delusions
* Violent behaviour
* Hyperthermia and convulsions
* Agitation, anxiety, and nervousness
* Mental confusion and memory loss
* Psychosis similar to schizophrenia ( characterised by paranoia, picking at the skin, itself absorption, and visual and auditory hallucinations)

The other risks are rapid heart rate, increased blood pressure, and damage to the blood vessels in the brain that can lead to a stroke. Regular use of the drug can result in inflammation of the heart lining.

Overdose can cause hyperthermia ( elevated body temperature), convulsions, and death.

Although most users administer yaba orally, those who inject the drug expose themselves to additional risks, including contaracting HIV (human immunodeficiency virus ), hepatitis B and C, and other blood borne viruses.

Addiction / Tolerance / Withdrawal
Methamphetamine in all forms is very dangerous and has high potential for abuse and dependence. Moderate to choronic use of yaba and other methamphetamines may lead to physical and psychological dependence, and even death. Abuse is characterised by consuming increasingly higher dosages during a period of 3 to 10 days with no sleep, in an attempt to maintain the initial high. However, no amount of the drug can achieve this effect so users may become frustrated, unpredictable, and violent. When an individual goes through withdrawal from high dose of yaba, as well as all other forms of methamphetamine, severe depression and suicidal urges often results.

MANAGEMENT OF ALL METHAMPHETAMINE DEPENDENCE
The different types of interventions that are available are as follows:

1.Pharmacological Treatment
Various medicines are available that prevent a build up of the neurotransmitters inside the addicts brain following consumption of methamphetamine. However, these medicines do not work to prevent a relapse.

As a part of Relapse Prevention, the most promising treatment to date is the Naltrexone Implant. Naltrexone is a blocker of the intoxicant effects of all chemicals and also has strong anti -compulsive properties which makes the implant the preferred modality of pharmacological intervention in different centres in the world.

Naltrexone implants appear to give effective blood levels for TWELVE WEEKS UP TO ONE YEAR. The implant is usually inserted under local anaesthesia after detoxification is over and 2-3 doses of the oral Naltrexone have been given. It is inserted through a 1 cm incision in the lower abdomen or at the back of the upper arm. The implant is inserted 3-4mm under the skin.

Advantages of Implants
- Makes relapse almost impossible while the implant is effective.
- Avoids the need to supervise Naltrexone and the arguments it can cause.
- Makes it impossible to 'forget' to take Naltrexone.
- Probably reduces craving even more than oral Naltrexone because there is no point in craving for what you can't have.

2. Psychosocial treatment
Once the medical strategies have been initiated, psychotherapy becomes the mainstay of treatment to help the addict unlearn several unhealthy habits and to re-learn healthy behavioural patterns.

3. Forced Abstinence
To allow the reward centres in the brain to come back to a normal state, the brain needs to be free of exposure to any kind of methamphetamine. This is best enforced for a period of 8 to 10 weeks. In this interval, the Naltrexone and Psychotherapy have worked towards stabilising the mind and brain of the addict following which, he/she can be gradually exposed to the earlier environment.

Source: webmd.com

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