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Methamphetamine Problem and Solution Using the Strategic Prevention Framework Logic Model

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Many Voices One Vision

Indianapolis, Indiana

Barbara Seitz de Martinez, PhD, MLS, CPP Indiana Prevention Resource Center

August 2, 2007

Methamphetamine Problem and Solution

Using the

Strategic Prevention Framework Logic Model

The Indiana Prevention Resource Center is funded, in part, by a contract with the Indiana Family and Social Services Administration, Division of Mental Health and Addiction, financially supported through HHS/Substance Abuse Mental Health Services Administration, Center for Substance Abuse Prevention, Substance Abuse

Prevention and Treatment Block Grant. The IPRC is operated by the Indiana University Department of Applied Health Science and School of Health, Physical Education and Recreation. It is affiliated with the Department’s Institute of Drug Abuse Prevention.

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Outcomes-Based Prevention

Sustainability & Cultural Competence

Source: U.S. Department of Health and Human Services, SAMHSA, CSAP

Assessment Evaluate Strategic Plan Implement evidence-Based PPP Capacity Building

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Meth Strategies Substance-Related Consequences and Use Intervening Factors Community ™ Crime ™ Family services ™ School ™ Healthcare Individual ™ Physical damage ™ Psychological damage

™ Harm loved ones

™ Family disintegration

Strategies

Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

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Source: http://www.wsnia.org/articles/MethPrevCookbook/METHTRAININGSEG2-2001.pdf

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Ice / Crystal / Pipe

Crystal Powder

Source: DEA, Photo Library, http://www.usdoj.gov/dea/photo_library3.html Methamphetamine

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Bag of Ice / Crystal Powder

Source: DEA, Photo Library, http://www.usdoj.gov/dea/photo_library3.html Methamphetamine

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Powder Powder

Source: DEA, Photo Library, http://www.usdoj.gov/dea/photo_library3.html Methamphetamine

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How It Is Stored

Source: http://www.wsnia.org/articles/MethPrevCookbook/METHTRAININGSEG2-2001.pdf

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Administration

Smoking**

immediate, intense rush, lasting a few minutes

Injecting

immediate, intense rush, lasting a few minutes

Snorting

In 3-5 min., euphoria, long-lasting high up to 12 hrs.

Oral ingestion

In 15-20 min., euphoria, long-lasting high up to 12 hrs.

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™

Cocaine: 10 million regular users

™

Heroin: 15 million regular users

™

Meth: 42 million regular users

Source: World Health Organization, Cited by Richard Rawson (UCLA Integrated Substance Abuse Programs, and Pacific South West Addiction Technology Transfer Center), “Meth: A Focus on Women and Children,” Women and Children in Recovery Conference of the Indiana Family and Social Services Administration, Division of Mental Health and Addiction, IN Government Building, April 7, 2005

Prevalence – World Wide Use Methamphetamine

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Half-Life

™ The half-life of cocaine is .5 to 1.5 hours

™ The half life of meth is 9 to 24 hours

™ The half-life of smoked cocaine is 1 to 1.5 hours

™ The half life of smoked meth is 11 to 12 hours

Source: Minnesota Department of Health. “Implications of Route of Administration for Cocaine and Methamphetamine for Drug Abuse and Neurobehavioral Sequellae”

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Consequences of Use Substance-Related Consequences and Use addiction brain damage HIV/STDs weight loss paranoia hallucination dental damage, fetal effects

Other effects to community:

violent crime child abuse child neglect

strain on child services school personnel strained healthcare services strained law enforcement judicial system burns loss of children loss of job loss of marriage imprisonment family disintegration

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Consequences of Use: Short-term

Dopamine plays an important role in the regulation of pleasure. In addition to other regions, dopamine is manufactured in nerve cells within the ventral segmental area and is released in the nucleus accumbens and the frontal cortex.

Short-term Effects: Rush Wakefulness Physical activity Loss of appetite Increased respiration Increased blood pressure Tremors/convul-sions Hyperthermia

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Consequences of Use: Long-term Effects

™

Dependence and addiction psychosis

ƒ Paranoia

ƒ Hallucinogens

ƒ Mood disturbance

ƒ Repetitive motor activity

™

Stroke

™

Weight Loss

™

Tooth damage

™

Extent of brain damage (up to 50% of

dopamine-producing cells in the brain)

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Burns and Scratching

Source: Bill O’Dell, Community Prevention Specialist, West Virginia Prevention Resource Center, “What’s Up with Meth” PowerPoint, 2004

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Same Woman Source: DOJ, DEA, Pseudoephedrine Brochure, Aug. 2003

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Damage over time Source: DOJ, DEA, Pseudoephedrine Brochure, Aug. 2003

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Repetitive Action

Source: Michael G. Heavican, U.S. Attorney for District of Nebraska, Photos taken by Lincoln police of persons

arrested for meth possession.

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Use: Consumption Patterns

Substance-Related Consequences

and Use

Overall consumption data

Info about drug being consumed

™ Homemade for self-use

™ Street drug (imported vs. local manufacture)

™ Form of the drug (powder? Ice? )

™ Manner of consumption (needle? smoked?)

Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

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Use: Consumption Patterns

Substance-Related Consequences

and Use

Overall consumption data Location/context of use:

Consumption in risky situations

™ Parties (in homes, private or public)

™ In school

™ In homes with children

™ At work

™ Association with unsafe sex (STDs, HIV)

Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

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Use: Consumption Patterns

Substance-Related Consequences

and Use

Who is using? Groups to target.

™ Rural / urban / suburban

™ White / Hispanic / African-Americans

™ Heterosexual / homosexual

™ Young adult / older adult / youth

™ Men / women

™ Substance users / polydrug users

Who is using? High-Risk Groups?

™ Pregnant women

™ Youth, college students

Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

“There’s no such thing as a typical meth user.” -- recovering meth addict

“Q: Is meth used in combination with other drugs?

A: Methamphetamine users

are likely also to be users of alcohol, marijuana and

cocaine rather than users of drugs like heroin. “

Source: Website page of www.methfreeindiana.org: http://www.in.gov/cji/drugfree/ meth/faq.html accessed

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Consumption Patterns: Impact on Children

Substance-Related Consequences

and Use

Overall consumption data

Info about impact upon children

™ Dangers in lab setting

™ Role modeling

™ Risk of physical/emotional neglect/abuse by parent

™ Risk of abuse by other adults

Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

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Consequences: Drug Endangered Children

Source: Bill O’Dell, Community Prevention Specialist, West Virginia Prevention Resource Center, “What’s Up with Meth” PowerPoint, 2004

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Substance-Related Consequences

and Use

Binge Phase:

Physical Abuse – agitated, violent behavior Sexual Abuse – libido increased

Neglect – intensely self-centered

Crash Phase:

Effects upon Parenting:

1. Insomnia

2. Intense sleep 3. Intense hunger 4. Depression

Physical Abuse – violent, easily agitated

Sexual Abuse – children unprotected from others Neglect – no supervision, neglect of child’s needs

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Why Children Are More Vulnerable

™ Shorter, closer to the ground (chemical vapors)

™ Growing and developing rapidly

™ Higher metabolic and respiration rates

™ Developing nervous system (more vulnerable)

™ Different habits, e.g., hand-to-mouth (higher risk)

Source: Richard Rawson (UCLA Integrated Substance Abuse Programs, and Pacific South West Addiction Technology Transfer Center), “Meth: A Focus on Women and Children,” Women and Children in Recovery

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Consequences for Children

Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

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Prevalence – Indiana 6th-12th Graders, 2006

http://www.drugs.indiana.edu/survey/atod/2006/index.html. Accessed 1/20/07.

Meth Use by IN Children, 2006 (IPRC)

Grade Lifetime Annual Current 6th 0.5% 0.3% 0.2%

8th 2% 1.4% 0.9%

10th 3.5% 2.4% 1.2%

12th 5% 3.1% 1.5%

Source: Alcohol, Tobacco and Other Drug Use by Indiana Children and Adolescents – 2006 Survey. Indiana Prevention Resource Center, 2006

Indicates that IN rate is higher than U.S. rate based on MTF 2006 survey.

http://www.drugs.indiana.edu/survey/atod/2006/index.html. Accessed 1/20/07.

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Prevalence – Indiana 6th-12th Graders, 2006

Meth Use by IN Children (%), 2006

Lifetime Annual Current

IN U.S. IN U.S. IN U.S.

6 0.5 NA 0.3 NA 0.2 NA 8 2 2.7 1.4 1.8 0.9 0.6 10 3.5 3.2 2.4 1.8 1.2 0.7 12 5 4.4 3.1 2.5 1.5 0.9 Gr http://www.drugs.indiana.edu/survey/atod/2006/index.html. Accessed 1/20/07.

Monitoring the Future, 2006 survey, www.monitoringthefuture.org (University of Michigan, 2006) Accessed 1/21/07.

Source: Alcohol, Tobacco and Other Drug Use by Indiana Children and Adolescents – 2006 Survey. Indiana Prevention Resource Center, 2006

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Tranquilizer Use by IN Children (%), 2006

Lifetime Annual Current

IN U.S. IN U.S. IN U.S.

6 0.5 NA 0.3 NA 0.2 NA 8 8.9 4.3 6.8 2.6 4.1 1.3 10 14.3 7.2 10.7 5.2 5.9 2.4 12 14.5 10.3 9.8 6.6 5.3 2.7 Gr http://www.drugs.indiana.edu/survey/atod/2006/index.html. Accessed 1/20/07.

Monitoring the Future, 2006 survey, www.monitoringthefuture.org (University of Michigan, 2006) Accessed 1/21/07.

Source: Alcohol, Tobacco and Other Drug Use by Indiana Children and Adolescents – 2006 Survey. Indiana Prevention Resource Center, 2006

Indicates that IN rate is higher than U.S. rate based on MTF 2006 survey. Italics indicates a statistically significant drop from 2005 to 2006 in Indiana.

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http://www.drugs.indiana.edu/survey/atod/2006/index.html. Accessed 1/20/07.

Monitoring the Future, 2006 survey, www.monitoringthefuture.org (University of Michigan, 2006) Accessed 1/21/07.

Source: Alcohol, Tobacco and Other Drug Use by Indiana Children and Adolescents – 2006 Survey. Indiana Prevention Resource Center, 2006

Alcohol and Smoking Behaviors (%)

Binge Drinking Daily Smoking

IN U.S. IN U.S. 6 7 NA 3 NA 8 11 10.9 5.8 4.0 10 19.9 21.9 12.2 7.6 12 27.3+ 26.5 16.9 12.2 Gr

Indicates that IN rate is higher than U.S. rate based on MTF 2006 survey. Italics indicates a statistically significant drop from 2005 to 2006 in Indiana.

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Current Drug Use by IN Children (%), 2006

Gr Meth Alcohol Binge Cigarettes Marij Tranq Cocaine

8 0.9 20.9 11 11.6 8.2 4.1 1.1

10 1.2 33 19.9 20.6 14.6 5.9 2.1

12 1.5 42.2 27.3 26.9 17.2 5.3 3.1

http://www.drugs.indiana.edu/survey/atod/2006/index.html. Accessed 1/20/07.

Source: Alcohol, Tobacco and Other Drug Use by Indiana Children and Adolescents – 2006 Survey. Indiana Prevention Resource Center, 2006

Indicates that IN rate is higher than U.S. rate based on MTF 2006 survey.

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Intervening/Causal Factors Substance-Related Consequences and Use Intervening Factors Community ™ Crime ™ Family services ™ School ™ Healthcare Individual ™ Physical damage ™ Psychological damage

™ Harm loved ones

™ Family disintegration

Community

™ Availability

ƒ Price

ƒ Local labs, street, retail

ƒ Social ™ Social Norms ™ Enforcement Individual ™ Perceptions of risk ™ Perceptions of harm

Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

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Availability of Chemicals: Precursor

Source: http://www.meth-in-douglas.com/meth_info.htm

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™ Precursor (pseudoephedrine)

™ Reagent: e.g., water reactive metal (lithium, sodium, red

phosphorous, iodine, sodium hydroxide)

™ Solvent (acetone, alcohol, benzene, camp fuel,

chloroform, ethanol, ether, methanol, mineral spirits, paint/lacquer thinner, toulene, xylene)

™ Glassware and hardware

Source: IN State Police, Clandestine Laboratory Team, 2005

Source: DEA

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™

Keeping Ahead of the Criminals

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Keeping Ahead of the Criminals

From Phenylalanine

From: [email protected] (Speed Raver)

A surprisingly simple synthesis is possible from the amino acid phenylalanine, which is available at health food stores for about $14 for 100 tablets. Phenylalanine is 2-amino-3-phenylpropanoic acid, which is more or less amphetamine with a COOH where the Ch4 should be at the end of the chain. Thionyl chloride will replace the OH with a Cl, which falls off and is replaced by H when you give it lithium aluminum hydride, sodium borohydride, or hydrogen gas and

nickel/platinum. If you use hydrogen and metal for that step, you'll ha v e to reduce the carbonyl group with one of the hydrides, so best save time + effort and use them and do both reductions at once. When that carbonyl is reduced, you now have amphetamine. Go back up to that first one I mentioned for

upgrading amphetamine into methamphetamine.

http://leda.lycaeum.org/index.pl?ID=8731

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Chemicals: Reagant

Source: http://www.meth-in-douglas.com/meth_info.htm

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Total lab busts: 6,435 Indiana Prevention Resource Center

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Map: Meth Lab Busts, 2006

Total lab busts, 993

Indiana Prevention Resource Center

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Total lab busts, 993 Indiana Prevention Resource Center Source: IN State Police, 2007 Map: Meth Lab Busts, 2006

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Incomplete Data

™

Not all labs are found

™

Not all agencies report all seizures

™

Not all agencies that report to the Indiana State

Police also report to the DEA

™

We have no way to know for other states what

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Intervening/Causal Factors Substance-Related Consequences and Use Intervening Factors Community ™ Crime ™ Family services ™ School ™ Healthcare Individual ™ Physical damage ™ Psychological damage

™ Harm loved ones

™ Family disintegration

Social Values

™ Overachievement ™ Thinness ideal

™ Economic success

™ Letting others set your goals ™ Seeking the ‘high’

™ Thrill of risk taking

Individual

™ Coping mechanism ™ Peer pressure

Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

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Substance-Related Consequences and Use Intervening Factors Community ™ Crime ™ Family services ™ School ™ Healthcare Individual ™ Physical damage ™ Psychological damage

™ Harm loved ones

™ Family disintegration Community ™ Availability ƒ Price ƒ Retail ƒ Social ™ Social Norms ™ Enforcement Individual ™ Perceptions of risk ™ Perceptions of harm Strategies Address problems identified and causal factors

Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

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Strategies Substance-Related Consequences and Use Intervening Factors Community ™ Crime ™ Family services ™ School ™ Healthcare Individual ™ Physical damage ™ Psychological damage

™ Harm loved ones

™ Family disintegration Community ™ Availability ƒ Price ƒ Retail ƒ Social ™ Social Norms ™ Enforcement Individual ™ Perceptions of risk ™ Perceptions of harm ™ Coping Mechanism ™ Peer Pressure Strategies Reduce availability Legislation/Policy Dye in anhydrous Awareness campaigns Community action Curricula / programs Trainings – CPS, School

Provisions for DEC Healthcare workers Law enforcement Support Networks

Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

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Strategies Substance-Related Consequences and Use Intervening Factors Strategies

Legislation controlling the sale of ephedrine by retailers (7/05)

Meth Law Senate Enrolled Act 444

•Limits amount of purchase •Records names of purchasers •Database to track purchases •Tracking log books

Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

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Strategies Substance-Related Consequences and Use Intervening Factors Strategies

•IN Drug Endangered Children Response Protocol

•IN Drug Endangered Children Comprehensive Care Protocol •Policy and Planning Strategies – lab clean-ups

•Enforcement Strategies – highway patrols, campaigns

•Precursor Chemical Control Strategies – tags on ammonia tanks •Prevention/Drug Demand Reduction Strategies – education

•Property Remediation/Meth Lab Clean-up Strategies – loans •Treatment Strategies – Transition help for reentry from prison

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Strategies Substance-Related Consequences and Use Intervening Factors Strategies

IN Criminal Justice Institute Meth Data Repository Indiana Meth Watch Program (CJI)

Meth Free Indiana Coalition

Midwest Governors Association Regional Meth Summit Governor’s Commission for a Drug-Free Indiana

Strategic Prevention Framework State Incentive Grant

Adapted from CSAP, Strategic Prevention Framework, Indianapolis, Feb. 21, 2006

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Prevention Is Prevention

™

Goal: To delay/reduce/eliminate initiation

™

Goal: To promote parenting & life skills

™

Goal: To promote a drug-free lifestyle

™

Goal: To promote positive values

™

Goal: To promote healthy communities

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Thank you so much!

Contact:

Indiana Prevention Resource Center

800 / 346-3077

812 / 855-6776

References

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