Burnt by Ice

By Dr.Mahmud Mazlan - The Star, Wednesday, 11 June, 2008

Crystal methamphetamin is currectly a popular drug among youths. WHEN May had her first puff of Ice, she never thought that she would be addicted to the substance, which looks exactly like table salt. "The reason is simple. I wanted to lose weight. At that time, I knew about drugs, but I didn't know how they looked like or how to take them," says the 28-year-old.                But when May saw a friend taking Ice, she was told that it's ok to take it. According to her friend, unlike heroin, Ice does not cause addiction. "Apparently not, you do get addicted," she laments. "Back then, I lost a lot of weight, to the point I was almost anorexic, but now I've put on a lot more (weight) back on, so I'm feeling much better," says May, who is currently going for treatment.                After seeking treatment, May now has a stable job and income, and is able to take care of her daughter at home. Ice, the nickname for crystal metamphetamine, is currently a popular drug among youths, says consultant in addiction medicine Dr Mahmud Mazlan. While heroin remains the most prevalent drug addiction in Malaysia, methamphetamine addiction is currently ranking first in terms of new cases. "Chances of recovery (for metamphetamine addiction) is good if hospitalisation and proper medication and psychosocial intervention is properly administered," Dr Mahmud says. In his experience in Malaysia, more than two-thirds recover after one year of treatment if medications and initial hospitalisation is utilised. Otherwise, the success rate is less than 10%.               " (Methamphetamine) is classified as a stimulant drug and unlike opiates (like heroin and morphine), it has three major differences in causing addiction,"he explains. For starters, you don't have to take methamphetamine daily to become addicted. Once or twice a week of regular methamphetamine use can cause dependence. Unlike heroin- which causes withdrawal a few hours after the last injection - withdrawal symptoms for methamphetamine starts after two weeks of abstinence, says Dr Mahmud, adding that without immediate withdrawal symptoms, many people addicted to methamphetamine thought that there were none.                 However, methamphetamine causes more brain and blood vessel damage than heroin does. According to Dr Mahmud, while heroin only causes permanent impairment to the reward system in the brain, methamphetamine can cause stroke, heart attacks and permanent psychosis (resembling schizophrenia) with chronic use. "It can also result in aggressiveness, sexual crimes and suicidal behaviour because of severe depression when (users) stop for more than two weeks," Dr Mahmud says.                Besides, methamphetamine is also associated with memory loss and severe dental problems. There are three main groups that use Ice, says Dr Mahmud. Men or sex workers use it to enhance their sexual performances; people involved in industries that value high performance may use it to increase work performance; and people addicted to other drugs like heroine and ecstasy may use it as a pleasure drug.                 Luckily for May, her family detected her habit just in time, because for her, ultimatums do not work for a person who is already hooked on drugs. "You can't just tell a person on drugs to stop by themselves, it doesn't work that way. I wasn't given a choice to go for rehabilitation, but if I were given one then, I wouldn't have gone for it. So there must be some sort of intervention somewhere," May says. "The process of rehabilitation was long, and I'm still in the process. I don't take drugs anymore, but I'm taking medication now. It's like substituting one drug for another; the only difference is that one of them is legal."                 Going through treatment, May had her share of withdrawal symptoms. "When you have withdrawal, you get very depressed. Some people get depressed to the point of being suicidal; some people get schizophrenia - they hear voices; and some experience very extreme paranoia. And it is very real," says May."And it is very difficult to accept that you are experiencing schizophrenic symptoms because of drugs. It's like you've become crazy." "Eventually I want to stop medication, and I wish I can be a responsible mother and a responsible citizen too.                 " When asked of her advice to young people out there, rather than just a straight "don't try it", May advises them to read up about drugs. "For those who have never tried it, read up about the street drugs out there. There are some designer drugs that can really mess up your brain. "And also, know more about the symptoms and the kinds of people who take drugs, and stay away from them. That is perhaps the only way," she adds.                  Coming from a drug user, I was curious. If everyone were to take her advice, wouldn't drug addicts feel deserted? May's answer was, "wouldn't you seek therapy?" "(When you feel deserted), you would feel very conscious and know that 'its not cool to take drugs'," May said. But if drug addicts really want to stop, May suggests that they seek help. "It is affordable. If you can afford drugs, I'm sure you can afford to pay for medication," May said.

Ketamine Abuse Among Rave Seekers

Ketamine has been increasingly abuse since 5 years ago especially among youth in the club scenes. It started off in big cities like Kuala Lumpur and Penang, and became more common in other cities in the country for that past 3 years. It had been marketed by the drug pusher as a club drug that does not produced urine drug test positive. It gained wide acceptance when more police raids were conducted in clubs and rave parties. At that particular time, many were caught positive for drugs such as ecstasy and eramine 5. Ketamine instantly became an alternative of getting high without the fear of been caught with positive urine drug test. This increased demand was easily met with increased trafficking of ketamine from south Asia. For the past 3 years, newspapers had highlighted seizures of ketamine from couriers at the local airports. Most of these seizures were coincidental, and it was widely belief that less than 5% of the ketamine were seized.

Ketamine became popular among Chinese youth, with more girls took this drug than ever before when compare it other drug of abuse. The other factor that contributes this upsurge of ketamine abuse is that whenever a new drug appears in the market, people are unaware of its complications because complications usually developed 2 to 3 years after its use. It is also been marketed as a cool drug because it needs only to be snorted through the nostrils (nose) and does not require any apparatus. The drug pushers were able to falsely convince the youth that the drug was not addictive and not harmful.

Unfortunately as any illicit drugs that alter the mind, ketamine exerts its complication among a subpopulation of the users. Heavy user of ketamine developed typical symptoms of drug dependence. These symptoms are
• Unable to stop or reduce the use of ketamine
• Needs to use ketamine to work, study or any function of daily activities.
• Resort to lying or stealing to get money to buy ketamine.
• Start to have reduced functioning in work, study or social activities.
• Needs higher dose of ketamine in order to get similar high of the drug.

These symptoms are typical of drug dependence and the users have lost the ability to control their drug use. Even though they know the ketamine have wreck havoc to their life, they continue to use it and give all sorts of reason on the need to continue its use.

Usually after a year of developing the drug dependence, physical complications start to set in. The 2 most common complications are acute gastritis and cystitis (inflammation of urinary bladder).

1. Acute gastritis

This condition occurs because ketamine cause the stomach to shrink and increase secretion of gastric juice. The pain occurs at the central top part of the abdomen (epigastria). Reduction of ketamine use will result in severe epigastric pain, and they continue taking more dosage of ketamine which subsequently resulted in the stomach to shrink and increase gastric juice further. Usually standard medical treatment for gastric ulcer does not work because the user continues taking the ketamine.

2. Acute Cystitis

This is a major complication of prolonged ketamine use. Ketamine causes the lower part of the brain to send strong signals to the urinary bladder to constrict. This prolonged constriction resulted in the urinary bladder to shrink and the person will not able to hold his urine. He will need to urinate every few minutes and many of them unable to go out from the house without a need to use the pampers. They also suffer from urgency, pain in passing urine, blood in the urine and lower abdominal pain. Some of them have severe shrink of the urinary bladder that resulted in the ureter(the tube from the kidney to the urinary bladder) to kinked and resulted in urine backflow which will then caused kidney damage.

Ketamine abuse can be treated with medications that reduce the ketamine effects and specific drug counselling to reduce the craving for the drug. Those that suffer from the complications of the urinary bladder may require admission to a specialised medical drug treatment centre that can treat both the urinary bladder and the ketamine addiction.

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