Crystal-Meth als Herausforderung für das Suchthilfesystem – Klinische Empfehlungen

Zusammenfassung

Auch Deutschland ist mittlerweile von der Verdrängung des d-Amphetamines durch das N-Methamphetaminhydrochlorid in seiner hochkonzentrierten Form „Crystal-Meth“ in bestimmten Drogenszenen betroffen. Es ist mit einer vermehrten Behandlungsnachfrage zu rechnen.

Diese Übersichtsarbeit fasst die Erfahrungen anderer Länder, auch mit der Amphetaminsubstitution, zusammen.

Abstract

As seen in other countries, dextroamphetamin is replaced by the N-methamphetaminehydrochloride in the almost pure form “Crystal Meth” in drugscenes favouring psychostimulants in Germany. With increasing seizures of methamphetamine and its precursors by German drug enforcement institutions, Germany is confronted with a lack of epidemiological data on abuse and little scientific work on therapeutic approaches. Preventive and therapeutic measures have to be adapted from other countries to this phenomenon emerging over the last two decades. Amphetamine replacement therapy might be one option.

Schlüsselwörter

Substitution - Amphetamin - Methamphetamin - Psychostimulantien - Designerdrogen

Key words

dextroamphetamine - methamphetamine - Germany - substitution - replacement therapy - novel psychoactive substances - central nervous system stimulants

• Literatur

• 1 2011 Global ATS Assessment UNODOC, United Nations Publication Sales.No.E.11.XI.13). Seite 54 http://www.unodc.org/documents/ATS/ATS_Global_Assessment_2011.pdf
• 2 Anglin MD, Burke C Perrochet et al. History of the methamphetamine problem. J Psychoactive Drugs 2000; 3: 137-141
• 3 Kraus L, Pabst A, Piontek D et al. Substanzkonsum und substanzbezogene Störungen: Trends in Deutschland 1980-2012. Sucht 2013; 59: 333-345
• 4 Gonzalez CF, Barrington EH, Walton MA et al. Cocaine and methamphetamine: differential addiction rates. Psychol Addict Behav 2000; 14: 390-396
• 5 Kalechstein AD, Newton TF, Longshore D et al. Psychiatric comorbidity of methamphetamine dependence in a forensic sample. J Neuropsychiatry Clin Neurosci 2000; 12: 480-484
• 6 Sucht 2012: Bericht der Suchtkrankenhilfe in Sachsen, März 2013 http://www.slsev.de/Sucht2012.pdf
• 7 Härtel-Petri R, Schultheiß P, Wolfersdorf M. Stimulantienabhängigkeit in Oberfranken weiter zunehmend: Zunahme der Abhängigen von „Crystal-Speed“ 1996-1999. Nervenarzt 2001; 73 S1: 151
• 8 Piontek D, Pfeiffer-Gerschel T, Jakob L et al. Sachbericht Sekundäranalysen im Rahmen des BMG-Projekts „Missbrauch von Amphetaminen in Deutschland: Studie zur Motivation und zu den Konsumgewohnheiten von missbräuchlich Amphetaminkonsumierenden. 2014 Online: http://www.drogenbeauftragte.de/fileadmin/dateien-dba/DrogenundSucht/Illegale_Drogen/Heroin_andere/Downloads/2014-05-21_Sachbericht-Projekts__Missbrauch_von_Amphetaminen_.pdf
• 9 http://www1.wdr.de/fernsehen/aks/themen/Apaan100.html
• 10 http://www.ndr.de/regional/zoll483.html
• 11 http://www.stern.de/panorama/crystal-meth-neonazi-drogenring-in-leipzig-vor-gericht-1974896.html
• 12 Castner SA, Goldman-Rakic F. Long-lasting psychotomimetic consequences of repeated low-dose amphetamine exposure in rhesus monkeys. Neuropsychopharmacology 1998; 20: 10-28
• 13 White FJ, Kalivas PW. Neuroadaptations involved in amphetamine and cocaine addiction. Drug Alcohol Dep 1998; 51: 141-153
• 14 Wilens TE, Spencer TJ. Pharmacology of Amphetamines. In: Tarter RE, Ammerman RT. (Hrsg.) Handbook of substance abuse. New York: Plenum Press; 1998: 501-513
• 15 Hando J, Hall W. Patterns of amphetamine use in Australia. In: Klee H. (Hrsg.) Amphetamine Misuse. International Perspectives on Current Trends. Amsterdam: Overseas Publishers Association; 1997: 81-97
• 16 Darke S, Cohen J, Ross J et. al. Transitions between routes of administration of regular amphetamine users. Addiction 1994; 89: 1077-1083
• 17 Kaye S, Darke S, Duflou J et al. Methamphetamine related fatalities in Australia: demographics, circumstances, toxicology and major organ pathology. Addiction 2008; 103: 1353-1360
• 18 Australian Institute of Health and Welfare. AIHW National Hospital Morbidity Database. Separation, patient day and average length of stay statistics by principal diagnosis in ICD-10-AM, Australia, 1998–99 to 2003–04. http://www.aihw.gov.au/cognos/cgi-bin/ppdscgi.exe?DC=Q&E=/AHS/principaldiagnosis0304 (accessed Dec 2006) zit. nach Gordian W, Fulde O, Wodak A. Ice: cool drug or real problem? MJA 2007; 186: 334-335
• 19 NIDA Notes. 1998 PDF- http://www.drugabuse.gov/sites/default/files/rrmetham.pdf
• 20 Guilarte TR. Is methamphetamine abuse a risk factor in Parkinsonism?. Neurotoxicology 2001; 22: 725-731
• 21 Ricaurte G, Mechan AO, Yuan J et al. Amphetamine treatment similar to that used in the treatment of adult attention-deficit/hyperactivity disorder damages dopaminergic nerve endings in the striatum of adult nonhuman primates. J Pharmacol Exper Therap 2005; 315: 91-98
• 22 Garwood ER, Bekele W, McCulloch CE et al. Amphetamine exposure is elevated in Parkinson’s disease. Neurotoxicology 2006; 27: 1003-1006
• 23 Callaghan RC, Cunningham JK, Sykes J et al. Increased risk of Parkinson's disease in individuals hospitalized with conditions related to the use of methamphetamine or other amphetamine-type drugs. Drug Alcohol Depend 2012; 120: 35-40
• 24 Brook HL, Minassian A, Perry W. Effect of Methamphetamine dependence on everyday functional ability. Addict Behav 2010; 35: 593-598
• 25 Volkow ND, Chang L, Wang GJ et al. Loss of dopamine transporters in methamphetamine abusers recovers with protracted abstinence. J Neurosci 2001; 21: 9414-9418
• 26 Kalechstein AD, Newton TF, Green M. Methamphetamine dependence is associated with neurocognitive impairment in the initial phases of abstinence. J Neuropsychiatry Clin Neurosci 2003; 15: 215-220
• 27 Ernst T, Chang L, Leonedo-Yee M et al. Evidence for long-term neurotoxicity associated with methamphetamine abuse: A 1H MRS study. Neurology 2000; 54: 1344-1349
• 28 Hoffman WF, Moore M, Templin R et al. Neuropsychological function and delay discounting in methamphetamine-dependent individuals. Psychopharmacology 2006; 188: 162-170
• 29 Johanson CE, Frey KA, Lundahl LH et al. Cognitive function and nigrostriatal markers in abstinent methamphetamine abusers. Psychopharmacology 2006; 185: 327-338
• 30 Hart CL, Marvin CB, Silver R et al. Is cognitive functioning impaired in methamphetamine users? A critical review. Neuropsychopharmacology 2012; 37: 586-608
• 31 Sekine Y, Ouchi Y, Takei N et al. Brain serotonin transporter density and aggression in abstinent methamphetamine abusers. Arch Gen Psychiatry 2006; 63: 90-100
• 32 Payer DE, Lieberman MD, London ED. Neural correlates of affect processing and aggression in methamphetamine dependence. Arch Gen Psychiatry 2011; 68: 271-282
• 33 Gouzoulis-Mayfrank E, Daumann J. Neurotoxicity of drugs of abuse – the case of methylenedioxy amphetamines (MDMA, ecstasy), and amphetamines. Dialog Clin Neurosci 2009; 11: 305-317
• 34 Yu S, Zhu L, Shen Q et al. Recent Advances in Methamphetamine Neurotoxicity Mechanisms and Its Molecular Pathophysiology. Behav Neurol 2015; in Print- Epub 2015 Mar 12: http://dx.doi.org/10.1155/2015/103969
• 35 Yamamoto BK, Moszczynska A, Gudelsky GA. Amphetamine toxicities: classical and emerging mechanisms. Ann NY Acad Sc 2010; 1187: 101-121
• 36 Boyer EM, Thompson N, Hill T et al. The relationship between Methamphetamine use and dental caries and missing teeth. J Dent Hyg 2015; 89: 119-131
• 37 Rommel N, Rohleder NH, Härtel-Petri R et al. Orale Manifestationen bei Methamphetamin-Abhängigkeit. Zahnärztliche Mitteilungen 2013; 103: 34-38
• 38 Milin S, Lotzin A, Degkwitz P et al. Amphetamin und Methamphetamin – Personengruppen mit missbräuchlichem Konsum und Ansatzpunkte für präventive Maßnahmen. Hamburg: Zentrum für Interdisziplinäre Suchtforschung (ZIS); 2014
• 39 Pates RM, Mitchell A. Amphetamine use in South Glamorgan. J Substance Misuse 1996; 1: 165-173
• 40 Matsumoto T, Kamijo A, Miyakawa T et al. Methamphetamine in Japan: the consequences of methamphetamine abuse as a function of route of administration. Addiction 2002; 97: 809-817
• 41 Sattah MV, Supawitkul S, Dondero TJ et al. Prevalence of and risk factors of methamphetamine use in northern Thai youths: results of an audio-computerassisted self-interviewing survey with urine testing. Addiction 2002; 97: 801-808
• 42 Semple S, Patterson TL, Grant I. Determinants of condom use among heterosexually-identified methamphetamine users. AIDS and Behaviour 2004; 8: 391-400
• 43 Anderson R, Flynn N. The Metamphetamine-HIV-Connection in Northern California. In: Klee H. (Hrsg.) Amphetamine Misuse, international Perspectives on current Trends. Overseas Publishers Association; Amsterdam: 1997: 181-197
• 44 Shoptaw S, Reback CJ. Methamphetamine use and infectious disease-related behaviours in men who have sex with men: implications for interventions. Addiction 2007; 102 (Suppl. 01) 130-135
• 45 Mayer KH, Skeer MR, O’Cleirigh C et al. Factors associated with amplified HIV transmission behavior among American men who have sex with men engaged in care: implications for clinical providers. Ann Behav Med 2014; 47: 165-171
• 46 Thu Vu NT, Maher L. et al. Amphetamine-type stimulants and HIV infection among men who have sex with men: implications on HIV research and prevention from a systematic review and meta-analysis. J Int AIDS Soc 2015; 18: 19-27
• 47 http://www.lifeormeth.com/london-i/4510297636
• 48 Baekeland F. Pentobarbital and dextroamphetamine sulfate: effects on the sleep cycle in man. Psychopharmacologia 1967; 11: 388-396
• 49 McGregor C, Srisurapanont M, Jittiwutikarn J et al. The nature, time course and severity of methamphetamine withdrawal. Addiction 2005; 100: 1320-1329
• 50 Rodler R, Härtel-Petri R, Steinmann J et al. Qualifizierte stationäre Drogenentzugsbehandlung. Krankenhauspsychiatrie 2006; 17: 15-18
• 51 Schäfer I, Lotzin A, Milin S. Ungedeckte psychotherapeutische Bedarfe bei Stimulanzienkonsumenten. Bedeutung komorbider Störungen und traumatischer Erfahrungen. Psychotherapeut 2014; 59: 300-305
• 52 Härtel-Petri R, Rodler R, Schmeisser U et al. Increasing prevalence of amphetamine – and methamphetamine-induced psychosis. Psychiatr Prax 2005; 32: 13-17
• 53 McKetin R, Lubman DI, Baker AL et al. Dose-related psychotic symptoms in chronic methamphetamine users: evidence from a prospective longitudinal study. JAMA Psychiatry 2013; 70: 319-324
• 54 McKetin R, Lubman DI, Najman JM et al. Does methamphetamine use increase violent behaviour? Evidence from a prospective longitudinal study. Addiction 2014; 109: 798-806
• 55 Bramness JG, Gundersen OJ, Guterstam J et al. Amphetamine-induced psychosis – seperate diagnostic entity or primary psychosis triggered in the vulnerable?. BMC Psychiatry 2012; 12: 221
• 56 Hatzipetros T, Raudensky JG, Soghomonian JJ et al. Haloperidol treatment after high-dose methamphetamine administration is excitotoxic to GABA cells in the substantia nigra pars reticulata. Neuroscience 2007; 30; 27: 895-902
• 57 Verachai V, Rukngan W, Chawanakrasaesin K et al. Treatment of methamphetamine-induced psychosis: a double-blind randomized controlled trial comparing haloperidol and quetiapine. Psychopharmacology (Berl) 2014; 231: 3099-3108
• 58 Schmeisser U, Härtel-Petri R, Steinmann J et al. Psychoedukation bei Sucht und Psychose. Psychiatr Prax 2007; 34: 52-54
• 59 Wunderlich R, Härtel-Petri R, Rodler R et al. Selbstbehandlungsversuche methamphetaminabhängiger Patienten – Längerfristige Katamnese stationär entgifteter Patienten. Nervenheilkunde 2008; 27 (Suppl 11a) 34-35
• 60 https://breaking-meth.de
• 61 Obert JL, McCann MJ, Marinelli-Casey P et al. The matrix model of outpatient stimulant abuse treatment: history and description. J Psychoactive Drugs 2000; 32: 157-164
• 62 Shoptaw S, Rawson RA McCann et al. The Matrix Model of outpatient stimulant abuse treatment: Evidence of Efficacy. J Addict Dis 1994; 129-141
• 63 Rawson RA, Marinelli-Casey P Anglin et al. A multi-site comparison of psychosocial approaches for the treatment of methamphetamine dependence. Addiction 2004; 99: 708-717
• 64 http://store.samhsa.gov/product/Matrix-Intensive-Outpatient-Treatment-for-People-With-Stimulant-Use-Disorders-Counselor-s-Treatment-Manual/SMA13-4152
• 65 Nowinski J, Baker S, Carroll K. Twelve Step Facilitation Therapy Manual: A Clinical Research Guide for Therapists Treating Individuals with Alcohol Abuse and Dependence. Rockville, MD: National Institute an Alcohol Abuse and Alcoholism; 1992
• 66 Rawson RA, McCann MJ Flammino et al. A comparison of contingency management and cognitive-behavioral approaches for stimulant-dependent individuals. Addiction 2006; 101: 267-274
• 67 Roll JM, Petry NM, Stitzer ML et al. Contingency management for the treatment of methamphetamine use disorders. Am J Psychiatr 2006; 163: 1993-1999
• 68 Knapp WP, Soares B, Farrell M et al. Psychosocial interventions for cocaine and psychostimulant amphetamines related disorders. Cochrane Database of Systematic Reviews 2007; 3: CD003023-
• 69 Datzer S, Härtel-Petri R, Schiller M et al. Rückfallrate metamphetaminabhängiger PatientInnen nach niedrigschwelligem Drogenentzug – Ergebnisse einer mittelfristigen Katamnese. Suchttherapie 2002; 3: 48-51
• 70 Karila L, Weinstein A, Aubin H-J et al. Pharmacological approaches to methamphetamine dependence: a focused review. Br J Clin Pharmacol 2010; 69: 578-592
• 71 Brackins T, Brahm NC, Kissack JC. Treatments for methamphetamine abuse: a literature review for the clinician. J Pharm Pract 2011; 24: 541-550
• 72 Shoptaw S, Huber A, Peck JY et al. Randomized, placebo-controlled trial of sertraline and contingency management for the treatment of methamphetamine dependence. Drug Alcohol Depend 2006; 85: 12-18
• 73 Elkashef AM, Rawson RA, Anderson AL et al. Bupropion for the treatment of methamphetamine dependence. Neuropsychopharmacology 2008; 33: 1162-1170
• 74 Jayaram-Lindström N, Hammarberg A, Beck O et al. Naltrexone for the treatment of amphetamine dependence: a randomized, placebo-controlled trial. Am J Psychiatry 2008; 165: 1442-1448
• 75 Pérez-Mañá C, Castells X, Torrens M et al. Efficacy of psychostimulant drugs for amphetamine abuse or dependence. Cochrane Database of Systematic Reviews 2013; 9: CD009695-
• 76 Charnaud B, Griffith V. Levels of intravenous drug misuse among clients prescribed oral dexamphetamine or oral methadon: a comparison. Drug Alcohol Depend 1998; 52: 79-84
• 77 Galloway GP, Buscemi R, Coyle JR et al. A randomized, placebo-controlled trial of sustained-release dextroamphetamine for treatment of methamphetamine addiction. Clin Pharmacol Ther 2011; 89: 276-282
• 78 Longo M, Wickes W, Smout M et al. Randomized controlled trial of dexamphetamine maintenance for the treatment of methamphetamine dependence. Addiction 2010; 105: 146-154
• 79 Miles SW, Sheridan J, Russell B et al. Extended-release methylphenidate for treatment of amphetamine/methamphetamine dependence: a randomized, double-blind, placebo-controlled trial. Addiction 2013; 108: 1279-1286
• 80 McGregor C, Srisurapanont M, Mitchell A et al. Symptoms and sleep patterns during inpatient treatment of methamphetamine withdrawal: a comparison of mirtazapine and modafinil with treatment as usual. J Subst Abuse Treat 2008; 35: 334-342
• 81 Hester R, Lee N, Pennay A et al. The effects of modafinil treatment on neuropsychological and attentional bias performance during 7-day inpatient withdrawal from methamphetamine dependence. Exp Clin Psychopharmacol 2010; 18: 489-497
• 82 Anderson AL, Li SH, Biswas K et al. Modafinil for the treatment of methamphetamine dependence. Drug Alcohol Depend 2012; 120: 135-141