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by Dr. Godofredo Stuart
M   E   T  H   A   M   P   H   E   T   A   M   I   N   E
Street names
Chalk Crystal  Meth 
Chemical ice   Glass  Speed 
Crank Ice Tina

Amphetamine was first synthesized in 1887 in Germany. Initially called phenylisopropylamine, it was, for a long time, a drug in search of use, trying to find application from decongestion to depression. In the 1930s , it was initially marketed as Benzedrine, as an over-the-counter inhaler to treat nasal congestion and asthma.

Methamphetamine was discovered in Japan in 1919. The crystalline powder was soluble in water, making it a perfect candidate for injection. In the late 30s, it found use for narcolepsy and ADHD (attention deficit hyperactivity disorder). It is still legally produced in the U.S., sold under the trade name Desoxyn (Abbott. PDR 2001) with indications for ADHD and for short-term therapy in exogenous obesity.

During World War II, amphetamines were widely used as stimulants to keep the fighting men going (during the Viet Nam war, American soldiers used more amphetamines than the rest of the world did during WWII). And after World War II, when military surplus became available to the public, methamphetamine abuse became epidemic.

In the United States in the 1950s, legally manufactured tablets of both dextroamphetamine (Dexedrine) and methamphetamine (Methedrine) became readily available and were used non medically by college students, truck drivers, and athletes. As use of amphetamines spread, so did their abuse. Amphetamines became a cure-all for such things as weight control to treating mild depression.

In the 1960s, the route and degree of abuse changed dramatically with the increased availability of injectable methamphetamine. The 1970 Controlled Substances Act severely restricted the legal production of injectable methamphetamine, causing its use to decrease greatly. It is at present a Schedule II stimulant finding limited use for narcolepsy, attention-deficit disorder, and for a limited time, as an appetite suppressant for obesity.

In the 1980s, the smokable form of methamphetamine, "ice," became available. Like crack cocaine, it is smoked in glass pipes, emitting no odor, with effects lasting for 12 hours or more.

In the mid-80s, methamphetamine was introduced into the fringe circle of use in the Philippines. In less than two decades, it has broken out of the urban subcultures and gained access access into the rural communities with devastating impact.

In the US, its use has undergone a resurgence, a 2004 study reporting that it has already surpassed cocaine use.

General info
In the U.S., from 2000 to 2004, methamphetamine use rose as other drug use fell. Worldwide, according to an UNODC report, use of amphetamine reached 30 million (0.7% of the population age 15 to 64 years old). In the Philippines, as in Thailand, Japan, Korea and Taiwan, methamphetamine is the drug of choice; Asia accounting for 60% of meth users.

Collectively, amphetamine, methamphetamine and Ecstasy are grouped as ATS, amphetamine-type stimulants. Synthetic drugs, production estimates are based on seizures, and of these, 80% were amphetamine and methamphetamine. Of the 12,000 clandestine ATS labs dismantled in 2002, most were producing methamphetamines.

Shabu, a powerfully addictive meth stimulant, easily accessible and affordable, is the drug of choice of over 90% of Filipino drug users.

Usually, a "fix" is used every 3 hours.

A single "pingi" or 0.1 gm costs P100. One mongo-sized "gram" costs P1,000-2,000. (In contrast, 1997 methamphetamine prices in the U.S. ranged from $3,500 TO $30,000 per pound, $400 TO $2,800 per ounce, and $37 per gram in the Seattle area to $300 per gram in the New York.

  Abuse patterns  
  Low-intensity - casual use, ingesting or swallowing, no psychologically addiction; used for losing weight, need for situational-wakefulness, overtime-shifts.  
  Binge - heavy intermittent use; smoking or injection; high can last 4-16 hours; psychologically addicted; more than low-intensity, less than high-intensity.  
  High - intensity abusers: also called speed freaks; forever seeking that quality of the "original perfect rush," usually smoking or injecting; requiring more and more drug to achieve the high; psychologically addicted. The "tweaking" stage is most dangerous.  

A mandatory "surprise" testing in one precinct found 69% positive for drug use.

The preferred manner of use is smoking, compared to snorting, injecting, or oral ingestion i.e., dissolved in a drink. There are geographic variations in usage: In Hawaii, 96% of users smoke it; in San Francisco 57% of users prefer injection, 27% snort, 11% smoke.

It is easily produced in make-shift laboratories and the by-products are toxic and hazardous.

The National Drug Law Enforcement and Prevention Center gives a conservative estimate of at least 250,000 drug abusers, possibly over half a million. Another conservative estimate puts the number of addicts at one million.

A survey of youths aged 15-30 conducted by the SWS (Social Weather Stations) in 1996 which included youth participation in illegal activities showed a 7% with drug use and 6% with drug pushing. In 2012, a US State Department cited a UN report that disclosed 2.1 % of Filipinos aged 16 to 64 were using shabu. With shabu as the drug of choice among 90% of users, the mathematics is gut-wrenching.

Methamphetamine is inexpensive and easy to make, Its illicit manufacture can be accomplished in a variety of ways, but is produced most commonly using the ephedrine/pseudoephedrine reduction method. Large-scale production of methamphetamine using this method is dependent on ready access to bulk quantities of ephedrine and pseudoephedrine.

Street meth is never pure, usually cut with a miscellany of substances, including talc or heroin.

How meth works
Methamphetamine stimulates release of excessive amounts of the neurotransmitter dopamine. Dopamine is produced in the nerve cells of the ventral tegmental area and is concerned with pleasure regulation in the brain. Upon entering the nerve cell, meth stimulates the release of dopamine, which then binds to specialized receptors of other nerve cells creating the typical "rush."

Short-term effects
The effects are similar to cocaine but last longer- 4 to 16 hours.
• Heightened attention and energy
• Excessive talking
• Euphoria, decreased fatigue
• Increased activity, increased sexuality
• Decreased appetite
• Increased respiration
• Hyperthermia, occasionally leading to convulsions and lethal levels.

Long-term effects
Anxiety, confusion, and insomnia
Addiction psychosis
Hallucinations, visual and auditory
Mood disturbances
Repetitive motor activity
Weight loss
Violent behavior, homicidal or suicidal thoughts
'Crank bugs' - Formication (sensation of insects creeping on the skin) causing users to pick at themselves causing ulcerations on the hand and arms.
• Disturbed sleep patters; decreased sleep needs
• Disinterest in usual social interactions, sex, food
• Cardiovascular: Inflammation of the heart lining
• Stereotypy behavior - performing routine acts over and over again.

Meth mouth
An oral-dental problem unique to meth abusers wherein normal white teeth can change in a few months into twisted grayish-brown stubs that eventually fall out.

Signs and symptoms of toxicity include arrhythmias, excessive sweating, hypertension, hyperthermia, insomnia, irritability, mydriasis (dilation of pupils), psychosis, seizure, rapid heart rate and tremors.

The stimulant effects from methamphetamine can last for hours, instead of the minutes from 'crack' cocaine. Often, the meth user stays awake for days. After injecting or smoking, the immediate rush or high is called a "swap," short-lived, minutes long. Snorting (within 3 to 5 minutes) and ingestion (within 15-20 minutes) causes a euphoria, a 'high' rather than an intense 'rush" within 15-20 minutes. As the high wears off, the user enters a stage called "tweaking" where he or she becomes prone to violence, delusions and paranoia. Some try to buffer through this stage by the use of cocaine or heroin. Like heroin and cocaine, methamphetamine can be snorted, smoked or injected. Tweaking may be mistaken as a cocky and noisy drunkenness.

The crash happens after the tweaking. To the binge-abuser, with the depletion of body epinephrine, the body "crashes" into a sleep, seemingly, a "lifeless" state that may last 1-3 days, during which time the abuse poses no threat to anyone. After the crash, in-between binge, the abuser is in a normal stage.

Although there are no acute physical withdrawal syndrome on discontinuation of chronic use, a patient may experience a subtle creeping in of fatigue, lethargy, anxiety, paranoia, aggression, or an intense craving for the drug and even a suicidal state. Re-use or re-indulgence of methamphetamine will break this train of symptomatology. It is believed that prolonged exposure can cause damage to the dopamine-producing brain cells, with more profound damage on serotonin-containing cells and concerns as to whether this can contribute to the psychosis seen in long-term users.

Meth rehab success rate is low; 93 percent in traditional treatment programs return to abuse.

Hypersexual Behavior and AIDS Concerns
Meth induces hypersexual behavior, and especially with anal intercourse, HIV / viral transmission concerns are raised and unprotected receptive users are put in greater risk. Adding to the risk is the anal insertion of meth and consequent damage to the rectal lining that increases the likelihood of HIV transmission.

Sources / Suppliers
• China-based syndicates overseeing drug-trafficking operations. Production materials smuggled from mainland China by drug syndicates using Hongkong and Taiwan as transhipment points.
• In the Philippines, there have been reports of increasing Muslim-based operations.

Clearance & Detection Times
• The usual dose of amphetamine is 5 to 10 mg—much higher in tolerant subjects. It has a half lifethat varies between 10 and 30 hours.

After smoking 22 mg of methamphetamine hydrochloride, it remains detectable in the blood for 48 hours, at a cutoff detection level of 3 ng/mL. At 22 mg smoking dose, methamphetamine as base ("Ice"), remains detectable in the urine (detection level 300 ng/mL) for 60 hours. After a controlled administration of 10 mg of methamphetamine, the final detection time in urine after a single dose at the lime of quantification (LOQ), 2.5 ng/mL) was 87.2 ± 52 (extreme values 46-144) hours. (5)

Last Update November 2014
Time was when the illicit drug use in the Philippines was mainly an indulgence of the fringe literati, the burgis, the artists and entertainment circle, far removed from the masa and rural culture with its isolated social pockets of marijuana users. None of the hard drugs and the intravenous drug users; none of varied countercultural movements that was requisite or fuel to the growth of the drug culture. It seemed almost possible that while the drug problem raged in most developed countries, the Philippines would be saved from the scourge of illicit drugs. But, alas, slowly and surely, the illicit drug market has successfully gained inroads into subcultures of users, into collegiate life, and deep into the bowels of Philippine rural life, burgeoning into a raging epidemic of drug addiction.

Today, "Shabu" poses a problem as serious, as frightening, as formidable, as any present day issue confronting the Filipino society. How can a country and a system mired in corruption fare against the commerce of drug trade so empowered by its bottomless coffers and consequent political clout? Many powerful nations have succumbed; the fanfares of their drug wars drug muffled, their policies inevitably compromised, shifting from prevention into containment.

Sadly, I think the Filipino society confronts an impossible task. The problem is past prevention. Is containment still possible? 
                                                                                                                                                                ca 2004

Dr. Godofredo Stuart                                                                                                 

i wrote that more than 10 years ago
from the boondocks of tiaong
when shabu was starting to metastasize.  
          cheap, the poor man’s cocaine
          the affordable masa drug
          a hundred pesos bought a high.
whenever i could, i counseled and warned
young men caught in its addictive allure.
my advice easily countered with
          hindi totoo ang sinasabi ninyo,
          ok naman ang shabu.
          nakakatrabaho ako ng dalawang araw,
          walang tulog, walang antok.

          nakakapagmaneho ako nang 24 oras
          walang pagod, walang tulog.

a wonder drug—ephemeral panacea
to the hopeless treadmill of rural life.
a powerfully addictive stimulant
with its promise of pleasure and euphoria.

the scourge swelled and raged on
brought stories of despair, violence and deaths
ho-hum stories of day-to-day life.
          thousands of sons and daughters
          trapped in the quagmire of addiction
          countless petty crimes to buy the high.
          drugs paid for by sex favors.
          the violent turf wars
          the salvaging of drug pushers.
there was frustration among the tanods,
the police and local folk who cared.
          di pa tapos ang barangay report,
          naka-piyansa na.

as the drug cancer continued to spread
the powers that be turned a blind eye
government wore blinders
as drug syndicates came to our shores,
from nearby and faraway,
setting up shop in our gated communities
and countless small towns across the land
under the guise of legal commerce,
cooking shabu to feed the addicts of the world
while they fed the greed and filled the coffers
of the corrupt and the powerful
          who provided protection
          who for the price of a million or ten or fifty
          would turn a blind eye
          would provide sanctuary and deliverance.
          make evidence disappear.
          provide passage on the next boat to china.
the masa watched helpless
as the drug commerce prospered.
          emboldened by decades
          of government apathy
          impotence and corruptibility
the masa resigned in collective sadness
at the ruination of their communities.
it was a sad commentary, often heard
          kay marcos, di mangyayari iyan.

so in the boondocks, town folks
take ephemeral delight when they hear
          of drug pushers dead in a ditch,
          a drug dealer shot in the back of the head
          it matters not
          if it was a salvage
          a local doing a charles bronson
          rural vigilantism
          rural extrajudicial
because in the boondocks
it is a familiar recourse for justice
for some measure of satisfaction
for lives emptied of hope.

then came duterte.
like others, when i first heard him talk,
          i cringed and told my friend
          if he wins i’m out of here.
          a one-way ticket to somewhere, anywhere.

he was the hesitant candidate.
he campaigned on a simple platform
he vowed to stop the scourge of drugs.
he vowed to stop the plague of corruption.
the masa listened—vows that resonated
          no matter that he cussed the pope.
          no matter that he looked so unpresidential.
          no matter the horrible rape comments.
          no matter that he didn’t have a political machinery.
          no matter that his god is allah.
and hope was reborn.

the masa didn’t care much about the other issues.
          abu sayyaf, federalism
          taxes, the china sea,
          or the traffic.
they cared about drugs and corruption.
and when he did his signature swearing
          anak ng _____!
people laughed, forgave
and, perhaps, felt
that behind the curse
from this salt of the earth
was anger, resolve, and commitment
to keep his promises.
collective hope grew.
          Siya lang sa lahat ang kayang
          magdala, magbigay ng pagbabago.

and, he won. a true blue un-trapo.
and i’m still here—and, actually cheering him on
together with the masa who voted him into office
to put an end to the culture of corruption
to raze the machineries of drug commerce
that have destroyed thousands of communities
and hundreds of thousands of lives.
and on his vows
on his war against drugs and corruption
          he staked his honor,
          presidency, and life

that, boys and girls, is political balls.

we all knew it would be a war
waged in unfamiliar ways.
the way he cleaned up davao
where the populace turned their blind eye.
we were forewarned.
          war to be waged duterte’s way
          any which way
          or whatever name we choose to call
          his war on drugs.

fearing for their lives
tens of thousands surrendered
before he stepped into office.
since the aegis of his edict to search out
barons, pushers, dealers and addicts,
to kill them if they resist,
hundreds of suspects have died,
in real or staged resistance,
assets, pushers, runners and mules
some say, eliminated by order of drug bosses,
corrupt public officials and colluding police,
desperate to expunge their connections
to the drug commerce.
          many died by the vigilante’s way
          guilt assigned by a cardboard sign
          that says “pusher” or “addict”
          and a tucked sachet of shabu.

now priests and bishops spew their fiery sermons
preaching the value of human life
as politicians spout their cries of righteousness
ranting and raging for human rights.
all of them oblivious of the wasteland
of countless towns and lives ravaged by drugs.
          one had rather
          better that a thousand guilty go free
          than one wrongful death.

war suffers the unavoidable deaths.
collateral damage. . .to borrow a euphemism
from the lexicon of modern wars.
but this is not real collateral damage,
many are pushers, runners,
mules and addicts being killed,
low in the hierarchy of the drug trade
sacrificial expendable potential snitches.
or murders and liquidations,
opportunities to settle old scores
done under the guise of the drug war.
and, yes, there will be wrongful deaths
some truly innocent caught in the crossfire
their deaths must burden us
in collective grief and guilt.

i am saddened by the wrongful deaths.
but i’m still cheering him on.
because what’s the alternative?
          prayers? the gods won’t listen.
          more laws? . . . we have enough.
          return to apathy of the pre-duterte days?
          the impotence of past administrations
          who paid no heed, paid no mind
          who wore blinders, turned a blind eye
          to the unfolding drug scourge?

i cast some censure on duterte’s war.
it is no longer the small battleground of davao
but thousands of battlefields
in big and small cities,
countless towns and barangays.
jails crammed and overflowed by
thousands who feared for their lives,
the assets mules runners and pushers.
and except for a token few,
most of drug barons, dealers and manufacturers,
the corrupted officials, military and policemen
still walk free.

and what of the hundreds of thousands of addicts?
while many addicts are pushers
many are hapless victims of curiosity
and experimentation gone awry.
the country’s medical system lacks the
capability for a true drug rehabilitation program.
the government has failed
on social and health problems of lesser scale.
what more, in an epidemic of this magnitude.
of a drug addiction with 92% recidivism.

the war on drugs has just started
but we have crossed the rubicon.
there is no turning back.
lest we go back to the old days
of hopelessness and helplessness
when the empire of drugs ruled
and razed through countless lives.
lest the drug lords dance with the devil anew
emboldened, once again
by the apathy and greed
of the powers that be.

it will be long long war
not a three-month war or six or a year.
shabu is a gold mine of immeasurable riches
to fuel the needs of power and greed.
shabu will merely recede into the shadows
selling clandestine highs
while kingpins and drug lords
figure out their next moves
patiently waiting and reassured
at their chosen sanctuaries
that duterte will not win his war
or that he will not last the war
or that six years is an easy wait
for them to reclaim the land.
          unless we see kingpins
          dangling on a noose
          or strapped on a chair
          unless we hear
          the cracking of firing squads.

we are all spectators in this war
flashing daily images and stories of death
one image records a casualty of war
the same image evokes the pieta.
some rave and cheer
some rant and rage
many sit on the fence, out of harm's way
hopeful, wondering where it goes.
we stand conflicted at this crucial crossroad
but we have seen an alternative to apathy
and the possibility of change.
i pray, hope duterte survives the bounty on his head,
and i dream, wish for his victory on his war on drugs.

august 5, 2016

Graphic / Sabog! © Godofredo Stuart / StuartXchange
IMAGE SOURCE: File:Methamphetamine-3d-CPK.png / W:Methamphetamine/ Sbrools / 5.8.07 / GNU Free Documentation License / Wikipedia
OTHER IMAGE SOURCE: Methamphetamine Chunks / IOWA Department of Public Safety / Division of Narcotics Enforcement/ IOWA DPS
Sources and Suggested Readings
History/Effects: Narconon 
NIDA Research Report - Methamphetamine Abuse and Addiction NIH Publication No. / 98-4210 Printed April, 1998
Meth abuse at work continues to grow / USA Today. July 5, 2005
Methamphetamine Abuse Sweeping America / Laura Brasseur. Internal Medicine World Report. Vol 20 No 7. July 2005
Detection Times of Drugs of Abuse in Blood, Urine and Oral Fluid
/ Alain G. Verstraete / Ther Drug Monit • Volume 26, Number 2, April 2004
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