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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