FACTORS INFLUENCING THE USE OF METHAMPHETAMINE BY DENTAL PATIENTS IN THE UNITED STATES
Review Articles differences related to an individual’ s social position and SES. 19 Methamphetamine users who belong to lower SES backgrounds may lack the resources and support to break their cycle of addiction. 3.1. Comorbidity Methamphetamine use is often compounded by existing mental health disorders, and may induced psychiatric disorders. Salo et al. conducted a sample study of 189 individuals with a history of methamphetamine abuse. The study found that a substantial number of participants also met criteria for the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition( DSM-IV) diagnoses for psychotic disorders, mood disorders, and / or other substance abuse disorders. Of the sample population, 28.6 % a psychotic disorder, about a fourth of the psychotic disorders were substance-induced. 13.2 % had methamphetamine-induced delusional disorders, and 11.1 % had methamphetamineinduced hallucinations. 20 Previous studies share similar findings, a 106 methamphetamine participant study found a correlation between methamphetamine abuse and reported lifetime history of hallucinations( 38 %) and paranoia( 63 %). Another 247 participant study of methamphetamine dependent individuals found that 45 % of participants experienced their
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first episode of paranoia while using the drug. Salo et al. study also found that participants reported a significant number of lifetime mood disorders( 32.3 %) such as depression and anxiety. 20 Moreover, previous research has highlighted the comorbid nature of methamphetamine and mood disorders. The National Epidemiologic Survey on Alcohol and Related Conditions( NESARC) conducted a 43,093 subject analysis finding that the prevalence of mood disorder among participants with amphetamine dependence was 64 %. 23, 24 In a 2012 study, Weber et al. highlighted the psycho-social impact that methamphetamine dependency and depression have on employment outcomes. The study consisted of 63 participants who had used methamphetamine, 15 who were employed, and 48 that were unemployed. Of the unemployed participants, 30( 62.5 %) were either currently diagnosed, or had a lifetime diagnosis of Major Depressive Disorder. 25 Weber et al. study highlights the psycho-social and occupational impairment that methamphetamine use has on lives. An overarching commonality for methamphetamine is the comorbid abuse of other substances. Referring back to Salo et al. study, 81 % of the participants met the criteria for a second substance abuse disorder along with their methamphetamine use. The most common past comorbid drug dependence diagnoses were alcohol( 33 %), cocaine( 27 %), and cannabis( 15 %). 20 The research indicates that cigarette use very strongly linked to methamphetamine use. A 2009 review of the data regarding the prevalence of cigarette use amongst methamphetamine users found that users reported rates of smoking between 87 %- 92 %. 26 3.2. Public Health Costs The gripping comorbid nature of methamphetamine abuse has substantial public health costs in the
United States. Publically funded substance abuse treatment programs where methamphetamine was the primary substance addiction being treated increased 255 % from 1997 to 2007. 3, 20 According to a national report compiled by the RAND Corporation, methamphetamine use cost the United States roughly $ 23.4 billion dollars in 2005. 27 An Oregon State University Hospital Emergency Department( ED) study tracked 15,038 ED visits in which 383 were methamphetamine related over a 20-week period. Of the methamphetamine related cases, patients presented with psychiatric conditions( 18.6 %), trauma( 18.6 %), skin infections( 11.0 %), and dental disorders( 9.6 %). Weekly costs for methamphetamine-related ED visits averaged $ 133,181 dollars, and an estimated annual total of $ 6.9 million dollars in hospital expenses. 28 The public costs for methamphetamine abuse extends beyond primary care settings. Law enforcement agencies across the country spend substantial amounts of resources to address methamphetamine related incidences of crime. In 2015, The National Drug Early Warning System( NDEWS) published community profiles of several regions areas across the United States. The NDEWS profiles collected drug seizure data provided by the National Forensic Laboratory Information System( NFLIS), and Drug Enforcement Administration( DEA). Methamphetamine related drug reports ranked first in the following major communities: Atlanta-Metro( 30.2 %), Los Angeles( 38 %), Denver-Metro( 27.7), and Seattle-King County( 29.5 %). While in San Francisco, methamphetamine( 10.7 %) related drug reports ranked second to cannabis( 11.3 %). 29 The interrelated nature of the methamphetamine abuse, mental health issues, and crime have detrimental systemic costs that burden individuals and communities across the nation. 3.3. Biopsychosocial / Neurological Effects Methamphetamine use has been linked to an array of physiological health issues. Once in the blood stream, methamphetamine induces an adverse concentration of monoamine neurotransmitters dopamine, norepinephrine, and serotonin that adversely impact the functioning of the central nervous system. These neurotransmitters are crucial to behaviors and cognition, and play a various roles on behavior such as motivation, attention, arousal, concentration, movement, memory, and learning. When taking the drug, methamphetamine users report feelings of euphoria, abundance of energy, increased motivation, alertness, increased self-confidence, and decreased appetite. 1, 30, 31 However, the prolonged toxicity of methamphetamine results in excessive stimulation of the sympathetic nervous system, resulting in physiological effects such as elevated heart rate, increase blood pressure, hypertension, hyperthermia, pupil dilatation, sweating, insomnia, and psychomotor agitation. 1, 31 Excessive exposure to methamphetamine has also has been linked to chronic health risks such as coronary heart disease, cardiomyopathy, pulmonary edema, stroke, and seizures. 31, 32, 33 Other effects of methamphetamine use include, dermatological infections, skin ulcerations,
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Stoma Edu J. 2017; 4( 4): 290-298 http:// www. stomaeduj. com