Recoveries Of Methamphetamine Research Articles

“More human”: Using ethnographic insights to develop a posthuman framework of ‘extended recovery’ for harmful drug use

BackgroundThe enduring conceptual confusion within drug use literature and research regarding the definition of addiction arises from the lack of reconciliation between two key concepts: (1) addiction occurs when someone loses control over their behaviour, and (2) recovery can only proceed when that individual chooses to regain control. This paper uses ethnographic insights to illustrate an alternative framework based on posthumanism and extended health that can resolve this tension: ‘Extended Recovery’. MethodsEthnographic fieldwork was conducted over eight months with 12 people engaging in methamphetamine recovery in Brisbane, Australia. Thematic analysis was conducted on transcripts and field notes. ResultsTwo exemplar case studies are discussed which demonstrate the interactive ecology of families, social networks, economic circumstances, legal proceedings, health and support services, and social capital from which drug use and recovery symbiotically emerged. ConclusionExtended Recovery critiques the distinction between internal and external factors shaping the recovery of a central, self-authoring subject. Four recommendations are provided to guide policy and interventions that would align with this framework. (1) Policymakers should approach harmful drug use as a multi-dimensional health issue, treating health and illness as distributed and emergent. (2) Services should support models of care that emphasise family and social networks, rather than only individuals or populations. (3) Treatment services should be responsive to the divergent priorities of people using drugs, and the chronic nature of drug related harm. (4) Models of care should validate the forms of change and growth people can experience without being abstinent from drugs.

“We’re supposed to be a family here”: An ethnography of preserving, achieving, and performing normality within methamphetamine recovery

The perception of being abnormal, and a visceral desire to ‘feel normal again’, is a common feature of the literature on drug use and recovery. Normality is constructed, however, in response to context-dependent values and priorities, thereby legitimating certain behaviours as normative and therefore the assumed goal of people in recovery. In this paper we draw on an ethnographic study with twelve people attempting to reduce harmful methamphetamine use to explore how they engaged with ‘normality’. Semi-structured interviews and ethnographic observations were conducted across a range of settings related to participants’ recovery, including private residences, withdrawal services, doctor’s offices, counselling rooms, and court houses. We used a relational lens to conduct thematic analysis on interview transcripts and fieldnotes collected over six months, following the steps of Iterative Categorisation. Our analysis explores the central organising theme of normality as something that can be ‘preserved’, ‘achieved’, or ‘performed’ by people using methamphetamine. Findings are understood through the original concept of ‘ambient paternalism’, where neoliberal norms and values shape recovery trajectories even outside of engagement with services. Exhibiting normality enabled participants to work against the stigmatisation and moralisation of methamphetamine use by demonstrating their socio-political acceptability. Methamphetamine use could also be strategically used to enable participants to keep up with neoliberal normative standards of independent self-management. Increasing awareness of these complex repertoires of normality, and a more critical understanding of how this ideal is constructed and can impact service interactions, can support a less homogenising or coercive approach towards treatment and policy for people in methamphetamine recovery.

“There’s No Sense to It”: A Posthumanist Ethnography of Agency in Methamphetamine Recovery

The orthodox construction of agency within addiction recovery discourse is built upon a fault line between two conflicting principles: that people who use drugs in harmful ways cannot control their behavior, but that they can also regain that control through intentional effort. The conceptual confusion inherent in this framework can harm people using drugs by producing inadequate accounts of commonly invoked aspects of recovery such as “triggers,” “self-control,” and “addictive behavior.” This ethnographic study involved qualitative interviews and observations with nine people over 6 months as they engaged in recovery from harmful methamphetamine use, to explore their experiences of agency, and how these experiences could be shaped by the discourse of volition/compulsion. Thematic analysis was conducted using a posthumanist theoretical framework. We found “relapse triggers” to be diffuse aspects of particular environments rather than specific stimuli, able to provoke what would normally be considered conscious, intentional behavior rather than only autonomic or “mindless” processes. Participants also described their identities as internally divided and multiple, with drug related behaviors separated from their true selves. Finally, agency was experienced as emergent and distributed rather than as a particular resource located within individuals. Attending to these complex experiences of agency can help resolve the tension between loss of control and personal responsibility for people who use drugs, by renegotiating the historically imposed categorical distinction between volitional and compelled actions, and the cultural constructions of “addictive” versus “normal” behavior.

Addicted to the ‘life of methamphetamine’: Perceived barriers to sustained methamphetamine recovery

Aims: This qualitative study explores and characterises barriers to methamphetamine recovery that emerge from users discussing anonymously their challenges in an online discussion forum. Methods: Anonymous letters and stories (N = 202), which were submitted to an online support forum for methamphetamine users and their loved ones, were analysed in Dedoose software using grounded theory methodology. Findings: Six perceived barriers emerged from the narratives, which were categorised as internal or external. The first three perceived barriers – low self-efficacy, conflicting thoughts about methamphetamine use, and side effects of withdrawal – were related to internal barriers, and the other three perceived barriers – escaping the drug environment, friends and family prevented recovery, and inadequate drug rehabilitation programmes – were related to external barriers. Conclusions: Methamphetamine users participating in an online discussion forum faced many internal and external barriers that impeded their recovery. These identified barriers were remarkably similar to barriers reported by users seeking treatment in conventional settings or recruited from drug networks, which suggests that methamphetamine users, in general, use multiple methods to assist with recovery and face many common barriers. Developing behavioural interventions that include online components may help remove some of the barriers and improve methamphetamine recovery.

Detection of Methamphetamine and Morphine in Urine and Saliva Using Excitation–Emission Matrix Fluorescence and a Second-Order Calibration Algorithm

A new method was developed to determine the methamphetamine and morphine concentrations in urine and saliva based on excitation–emission matrix fluorescence coupled to a second-order calibration algorithm. In the case of single-drug abuse, the results showed that the average recoveries of methamphetamine and morphine were 95.3 and 96.7% in urine samples, respectively, and 98.1 and 106.2% in saliva samples, respectively. The relative errors were all below 5%. The simultaneous determination of methamphetamine and morphine in urine using two second-order algorithms was also investigated. Satisfactory results were obtained with a self-weighted alternating trilinear decomposition algorithm. The root-mean-square errors of the predictions were 0.540 and 0.0382 μg/mL for methamphetamine and morphine, respectively. The limits of detection of the proposed methods were very low and sufficient for studying methamphetamine and morphine in urine.

SPIN TIP SOLID-PHASE EXTRACTION AND HILIC-MS-MS FOR QUANTITATIVE DETERMINATION OF METHAMPHETAMINE AND AMPHETAMINE IN HUMAN PLASMA

A rapid and simple microanalysis method using TopTip C18 spin tips, which are new micropipette tip spin columns for solid-phase extraction, was developed and validated for quantitative determination of methamphetamine and amphetamine in human plasma. All the solid-phase extraction procedures, including conditioning, sample loading, washing, and elution, using the TopTip C18 spin tips, were performed by centrifugation. The analytes were extracted within 7–8 min from 0.1 mL of plasma. The methanol-rich eluate was injected directly into a hydrophilic interaction liquid chromatography/tandem mass spectrometer in positive electrospray ionization mode with selected reaction monitoring. The analytes were separated on an Imtakt Unison UK-silica column using a gradient with methanol and 10 mmol/L ammonium acetate buffer as mobile phase at a flow rate of 0.5 mL/min. The recoveries of methamphetamine and amphetamine spiked into plasma were 82–95% and the limit of quantification of methamphetamine and amphetamine were 2.5 ng/mL of plasma. The calibration curves were linear over the concentration range of 2.5–500 ng/mL of plasma for both compounds. The intra-day and inter-day relative standard deviations were less than 7.5%. This fast and simple method is expected to be very useful for quantitative determination of methamphetamine and amphetamine in human plasma samples.

Table of Contents

AbstractDelaware Uses Penalties and Rewards to Increase Utilization and RetentionONDCP Strategy Document Addresses Rx Monitoring, ATR, ScreeningDelaware: Not NOMsSex‐Drug Fusion Complicates Methamphetamine RecoveryHouse Passes Parity BillNo Medication‐Substance Abuse Link Found in ADHD StudyClarificationsBriefly NotedState WatchBusinessNames in the NewsComing up

Pipette tip solid-phase extraction and gas chromatography – mass spectrometry for the determination of methamphetamine and amphetamine in human whole blood

Methamphetamine and amphetamine were extracted from human whole blood samples using pipette tip solid-phase extraction (SPE) with MonoTip C(18) tips, on which C(18)-bonded monolithic silica gel was fixed. Human whole blood (0.1 mL) containing methamphetamine and amphetamine, with N-methylbenzylamine as an internal standard, was mixed with 0.4 mL of distilled water and 50 microL of 5 M sodium hydroxide solution. After centrifugation, the supernatant was extracted to the C(18) phase of the tip (pipette tip volume, 200 microL) by 25 repeated aspirating/dispensing cycles using a manual micropipettor. Analytes retained in the C(18) phase were eluted with methanol by five repeated aspirating/dispensing cycles. After derivatization with trifluoroacetic anhydride, analytes were measured by gas chromatography - mass spectrometry with selected ion monitoring in the positive-ion electron impact mode. Recoveries of methamphetamine and amphetamine spiked into whole blood were more than 87.6 and 81.7%, respectively. Regression equations for methamphetamine and amphetamine showed excellent linearity in the range of 0.5-100 ng/0.1 mL. The limits of detection for methamphetamine and amphetamine were 0.15 and 0.11 ng/0.1 mL, respectively. Intra- and interday coefficients of variation for both stimulants were not greater than 9.6 and 13.8%, respectively. The determination of methamphetamine and amphetamine in autopsy whole blood samples is presented, and was shown to validate the present methodology.

‘Tweaking 12‐Step’: the potential role of 12‐Step self‐help group involvement in methamphetamine recovery

To determine from a review of the available literature the extent to which involvement in 12-Step mutual support groups could play a role in the recovery process for individuals abusing or dependent on methamphetamine. Review of the literature on outcomes associated with 12-Step meeting attendance and involvement in 12-Step activities among substance abusers, particularly those who abuse stimulants. There are few if any data available on methamphetamine abusers and their use of 12-Step approaches. Evidence derived from work with alcohol- and cocaine-dependent individuals indicates that involvement in 12-Step self-help groups, both attending meetings and engaging in 12-Step activities, is associated with reduced substance use and improved outcomes. Although involvement in 12-Step fellowship improves outcome, many individuals do not engage on their own in 12-Step activities, and there are high rates of dropout from such groups. There are a number of evidence-based therapies available to assist clinicians in facilitating 12-Step involvement; however, these have not been used with methamphetamine abusers. While there are some potential barriers to adopting manualized treatment interventions into clinical practice, the familiarity, in community-based practice, of the 12-Step approach may make this easier. More actively integrating 12-Step approaches into the treatment process may provide low- or no-cost options for methamphetamine abusers and increase the capacity for providing treatment. Further research and evaluation are necessary to determine the extent to which methamphetamine abusers do engage in 12-Step self-help programs, whether they prefer more general (e.g. Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous) or drug-specific (e.g. Crystal Meth Anonymous) meetings, the rate of dropout and the outcomes associated with their involvement. Further, the efficacy of efforts to facilitate involvement of methamphetamine abusers in such 12-Step groups needs to be determined.

Simultaneous determination of methamphetamine and amphetamine in human urine using pipette tip solid-phase extraction and gas chromatography–mass spectrometry

Methamphetamine and amphetamine were extracted from human urine samples using pipette tip solid-phase extraction (SPE) with MonoTip C 18 tips (pipette tip volume, 200 μl), in which C 18-bonded monolithic silica gel was fixed. A sample of human urine (0.5 ml) containing methamphetamine, amphetamine, and N-methylbenzylamine as internal standard (IS), was mixed with 25 μl of 1 M sodium hydroxide solution. The mixture was extracted into the C 18 phase of the SPE tip by 25 repeated aspirating/dispensing cycles using a manual micropipettor. Analytes retained in the C 18 phase were then eluted with methanol by five repeated aspirating/dispensing cycles. After derivatization with trifluoroacetic anhydride, analytes were measured by gas chromatography/mass spectrometry with selected ion monitoring in the positive-ion electron impact mode. Recoveries of methamphetamine, amphetamine, and IS spiked into urine were more than 82.9, 82.2, and 78.2%, respectively. Regression equations for methamphetamine and amphetamine showed excellent linearity in the range of 0.25–200 ng/0.5 ml. Limit of detection was 0.04 ng/0.5 ml for methamphetamine and 0.05 ng/0.5 ml for amphetamine. Intra- and inter-day coefficients of variations for both stimulants were not greater than 10.8%. The data obtained from actual determination of methamphetamine and amphetamine in autopsy urine samples are also presented for validation of the method.

Solid-phase extraction in amphetamine and methamphetamine analysis of urine.

A systematic evaluation that compares the recoveries of methamphetamine and amphetamine from spiked urine using C8, C18, strong cation exchanger (SCX), and C8-SCX mixed procedures (solid-phase extraction) is reported. Optimized experimental conditions including pH of the sample, solvent composition, and urine concentration for different solid-phase extraction sorbents were studied. The largest recoveries--greater than 86% for methamphetamine and greater than 88% for amphetamine--were achieved with a mixed adsorbent (C8-SCX) and mixed elution solvent CH2Cl2-i-propanol-NH4OH (78:20:2) at pH 6. The concentration of the urine matrix did not affect the extraction efficiency. The detection limits of methamphetamine and amphetamine in urine were obtained at 0.03 and 0.07 micrograms/mL, respectively, using gas chromatographic-mass spectrometric analysis operated in the electron impact mode.

Methamphetamine detection from meconium and amniotic fluid in guinea pigs depends on gestational age and metabolism.

Significant adverse perinatal effects of maternal methamphetamine use have been reported, but little is known about factors influencing methamphetamine screening test results during the perinatal period. We tested the hypothesis that gestational age would affect quantitative recovery of methamphetamine in meconium and amniotic fluid. Time-bred guinea pigs received an intraperitoneal (i.p.) injection of 1 mg/kg methamphetamine at either 44 days (0.65 of term, n = 5), 50 days (0.74, n = 8), 56 days (0.82, n = 9) or 63 days (0.93, n = 4) gestation. At 1 or 7 days after i.p. methamphetamine, meconium and amniotic fluid were collected for quantitative methamphetamine assay by gas chromatography-mass spectrometry. Recovery from amniotic fluid and meconium 1 day after injection was influenced by gestational age. Greater values in amniotic fluid and meconium and a higher percentage of positive samples were seen in older fetuses. Collectively at all gestational ages, combined testing of amniotic fluid and meconium yielded detectable methamphetamine or its metabolites in 87% of guinea pigs 1 day after injection. However, methamphetamine was not detectable 1 week after injection in any sample (n = 63) at either 0.74 or 0.82 of term except for one positive amniotic fluid sample. Finally, demethylation of methamphetamine to amphetamine was higher in older fetuses.(ABSTRACT TRUNCATED AT 250 WORDS)