The issue of how to deal with substance abuse has been the focus of a two-day conference in Kenora this week. Shannon Martin from the Morningstar detox centre has helped hundreds of clients over the last eight years, and she offers her comments.

After her presentation to a full audience at Seven Generations, Martin offered a few words of advice.

"Stigma and myths can be dispelled, and people are more likely to ask for help. and to talk openly about what they've been through. Most of the clients -- I've worked with hundreds and hundreds of people -- most of them are wonderful, wonderful people," she said.

The conference was meant to help shape a community response to mental health and addictions. Attendees included frontline medical staff, social workers and law enforcement officers.

"I work with people who have had a lot of struggles in their life, and they turn to severe drug abuse to deal with difficult traumas. Most people are wonderful people, who just need support. Drug addiction is fairly new to us. So, often we're scared of it. The people who are using drugs are just human, but they're in a lot of pain," Martin added.

Other speakers at the conference included Dr. Sean Moore from the emergency room at the district hospital, as well as recovering addict Jason Wildfong.

The scare campaigns may have good intentions, but they can also do a lot of damage, Martin continued. Meth users can come from all different demographics. However, it's the most desperate ones, who we see on the street. 

Most of the clients Martin sees, though, look just like everybody else. They're worried they might be treated like a junkie, rather than a human being, and it can deter them from seeking help, she said.

Martin recalled how shame and fear discouraged a man from seeking help for a decade, while he hid his habit from his common-law spouse. There are some who are able to use meth recreationally for years, without becoming homeless, she added.

The acute psychosis with hallucinations comes from heavy use, but not everybody experiences it the same way, Martin added. Some can go for years without the exhibiting psychosis, while others will get hallucinations right away.

The method of use -- snorting or injecting -- doesn't make a difference, she said. The impacts can be severe, and it can also vary from individual to individual, with influences of genetics and biology.

Based on her experience, Martin said people use meth -- and other hard drugs -- mainly to cope. They often have severe trauma dating back to childhood with ongoing traumas. This can be accompanied by depression and anxiety. 

The change in brain chemistry from trauma can lead to shame and feelings of being useless, worthless or shameful. The meth takes these away, Martin explained.

Cheaper than opiates, such as oxycontin or cocaine, meth has a longer lasting high. At $10 to $10 for a point, most will use half a point or a point at a time, she said, based on coversations with her clients.

The high can last 12 to 24 hours, providing users with more energy, be more productive, helps them lose weight quickly, enhances sex drive and boosts confidence in social activities. 

The clear crystals are crushed into powder for use. It may also be known as Ish or Jip. 

Martin emphasized meth does contain ingredients not meant for safe human consumption like battery acid, cold medicines or drain cleaners. While apparently easy to make, she added meth is also made in illegal labs, without quality control. 

Crystal meth interferes with dopamine in the brain's pleasure and reward centre. While food or sex can trigger about 150 units of dopamine in mice, meth can trigger more than 1,200 units. This is more than three times more than cocaine, or six times more than the natural brain produces, Martin underlined.

When the dopamine levels are high, people feel alert, confident, energetic, focused. Some obsessive compulsive behaviour can happen. It rids us of social norms and suppresses appetite. 

Bingeing can last three days to two weeks, and this can lead to psychosis. During this stage, users are hyper-focused, focused on minute details, attuned to people's body language, tone of voice and surroundings.

However, the crash afterwards can also be awful, as it leaves the brain and the body depleted. This impacts a person's ability to remember, focus and pay attention, as well as the habits we rely on to lead a healthy life. 

Tweaking is where the binge is wearing off, and the intense cravings set in. Hallucinations or delusions can set in.

Anger, restlessness and disturbing images -- including scenes of violence -- can occur. The images can be terrifying and disturbing for users, who start to believe they are crazy or horrible people.

In withdrawl, users need to sleep for days, stay hydrated, be fed and stay isolated. However, users in withdrawl need to be monitored for suicidal thoughts, Martin noted.

There's a depth of despair, anxiety, depression. A black hole, feelings of complete hopelessness are common descriptions. There's no pleasure or joy.

Martin says the toughest period can be between the fifth and seventh day of withdrawl.

Occasional users can take days or even weeks to replenish their brain chemistry. Enjoying a nice day, going for a walk, spending time with friends are no longer pleasurable. Even sex and food aren't rewarding. 

For regular uses, there can also be a loss of impulse control, decision-making, emotional regulation. The damage can take weeks and months to recover.

Crystal meth hijacks the brain and rewires the way it functions," Martin says, noting how easily it leads to addiction and dependence. Our body adapts to it, and it can't function normally without it."

There are also impacts on blood pressure and heart rates. 

Due to the hallucinations, delusions, cravings most aren't able to quit on their own, she adds. This means a recovery plan can include using, in order to ease the withdrawl and feelings of shame. 

Binges, though, can lead to job loss or damage to relationships. A recovery plan can help ease the damage from a relapse. Abstinence is successful for most on the first try, Martin says.

Brain damage similar to Alzheimer's can be seen in users in their 20's, along with liver and kidney damage. Long-term psychosis and overdoses are also risks from prolonged use.

Scabs, skin lesions, picking at their skin can come from repeated use of meth, along with pronounced weight loss. Infections, absesses can come from intravenous use, along with damaged blood vessels in the heart and brain. Lung damage is also seen, such as bronchitis.

Signs of an overdose can include a person overheating, acting abnormally violent, paranoid or aggressive. A person overdosing should be cooled off, kept in a quiet environment and be brought to medical attention.

A person on meth can be unpredictable, with the possibility of violence. Some tips for dealing with a person on meth include:

  • Low stimulus area
  • low light
  • escape route, not trapped (for you and patient)
  • offer alternatives, if can't offer what they want (food, water, quiet space)
  • safe
  • distract them
  • minimize questions or conversation
  • written instructions (no memory)
  • watch non-verbal cues 
  • calm, patient, reassuring, rational voice
  • don't show anger, nervousness, intolerance, laugh, joke, be dismissive
  • don't take it personal, if they don't go along

A successful recovery takes time and more than one effort, Martin emphasized.

"We can't do it on our own. It does take all of us," she said.

Offers of help and kindness are important, but it doesn't mean we need to be subjected to abuse. 

If one strategy doesn't work, then another plan or strategy can work. People are more likely to ask for help, if they feel connected and comfortable asking. 

When people are ready to get help, there are windows of opportunity, and their chance of success increases with supports in the community. A woman clean for eight months still had daily cravings, Martin noted, and they came when she was exercising at the gym, since it was activating the pleasure and reward centre of the brain.

Hallucinations and delusions can also last for months after getting clean, but they learn to differentiate between what's real and what isn't.

Half her clients went through formal treatment programs, while the other half were more informal using outpatient and community resources.

Some medications, such as anti-depressants, can assist with recovery and more are in the works.

For more information:

Meth, cocaine focus of two-day conference

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