Download PDF
Suchttherapie 2016; 17(01): 10-16
DOI: 10.1055/s-0035-1559657
Schwerpunktthema
© Georg Thieme Verlag KG Stuttgart · New York

Crystal-Meth als Herausforderung für das Suchthilfesystem – Klinische Empfehlungen

Clinical Recommendations to Meet the Different Needs of Users of Crystal-Meth
R. Härtel-Petri
Further Information

Publication History

Publication Date:
28 September 2015 (online)

Also available at
   Permissions and Reprints

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
    PubMed
  • 2 Anglin MD, Burke C Perrochet et al. History of the methamphetamine problem. J Psychoactive Drugs 2000; 3: 137-141
    PubMedGoogle Scholar
  • 3 Kraus L, Pabst A, Piontek D et al. Substanzkonsum und substanzbezogene Störungen: Trends in Deutschland 1980-2012. Sucht 2013; 59: 333-345
    CrossrefPubMedGoogle Scholar
  • 4 Gonzalez CF, Barrington EH, Walton MA et al. Cocaine and methamphetamine: differential addiction rates. Psychol Addict Behav 2000; 14: 390-396
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 6 Sucht 2012: Bericht der Suchtkrankenhilfe in Sachsen, März 2013 http://www.slsev.de/Sucht2012.pdf
    PubMed
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 9 http://www1.wdr.de/fernsehen/aks/themen/Apaan100.html
    PubMed
  • 10 http://www.ndr.de/regional/zoll483.html
    PubMed
  • 11 http://www.stern.de/panorama/crystal-meth-neonazi-drogenring-in-leipzig-vor-gericht-1974896.html
    PubMed
  • 12 Castner SA, Goldman-Rakic F. Long-lasting psychotomimetic consequences of repeated low-dose amphetamine exposure in rhesus monkeys. Neuropsychopharmacology 1998; 20: 10-28
    PubMedGoogle Scholar
  • 13 White FJ, Kalivas PW. Neuroadaptations involved in amphetamine and cocaine addiction. Drug Alcohol Dep 1998; 51: 141-153
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefGoogle Scholar
  • 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
    Google Scholar
  • 16 Darke S, Cohen J, Ross J et. al. Transitions between routes of administration of regular amphetamine users. Addiction 1994; 89: 1077-1083
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 19 NIDA Notes. 1998 PDF- http://www.drugabuse.gov/sites/default/files/rrmetham.pdf
    PubMed
  • 20 Guilarte TR. Is methamphetamine abuse a risk factor in Parkinsonism?. Neurotoxicology 2001; 22: 725-731
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 22 Garwood ER, Bekele W, McCulloch CE et al. Amphetamine exposure is elevated in Parkinson’s disease. Neurotoxicology 2006; 27: 1003-1006
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 24 Brook HL, Minassian A, Perry W. Effect of Methamphetamine dependence on everyday functional ability. Addict Behav 2010; 35: 593-598
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 28 Hoffman WF, Moore M, Templin R et al. Neuropsychological function and delay discounting in methamphetamine-dependent individuals. Psychopharmacology 2006; 188: 162-170
    CrossrefPubMedGoogle Scholar
  • 29 Johanson CE, Frey KA, Lundahl LH et al. Cognitive function and nigrostriatal markers in abstinent methamphetamine abusers. Psychopharmacology 2006; 185: 327-338
    CrossrefPubMedGoogle Scholar
  • 30 Hart CL, Marvin CB, Silver R et al. Is cognitive functioning impaired in methamphetamine users? A critical review. Neuropsychopharmacology 2012; 37: 586-608
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 32 Payer DE, Lieberman MD, London ED. Neural correlates of affect processing and aggression in methamphetamine dependence. Arch Gen Psychiatry 2011; 68: 271-282
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 35 Yamamoto BK, Moszczynska A, Gudelsky GA. Amphetamine toxicities: classical and emerging mechanisms. Ann NY Acad Sc 2010; 1187: 101-121
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 37 Rommel N, Rohleder NH, Härtel-Petri R et al. Orale Manifestationen bei Methamphetamin-Abhängigkeit. Zahnärztliche Mitteilungen 2013; 103: 34-38
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 39 Pates RM, Mitchell A. Amphetamine use in South Glamorgan. J Substance Misuse 1996; 1: 165-173
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 42 Semple S, Patterson TL, Grant I. Determinants of condom use among heterosexually-identified methamphetamine users. AIDS and Behaviour 2004; 8: 391-400
    CrossrefPubMedGoogle Scholar
  • 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
    Google Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 47 http://www.lifeormeth.com/london-i/4510297636
    PubMed
  • 48 Baekeland F. Pentobarbital and dextroamphetamine sulfate: effects on the sleep cycle in man. Psychopharmacologia 1967; 11: 388-396
    CrossrefPubMedGoogle Scholar
  • 49 McGregor C, Srisurapanont M, Jittiwutikarn J et al. The nature, time course and severity of methamphetamine withdrawal. Addiction 2005; 100: 1320-1329
    CrossrefPubMedGoogle Scholar
  • 50 Rodler R, Härtel-Petri R, Steinmann J et al. Qualifizierte stationäre Drogenentzugsbehandlung. Krankenhauspsychiatrie 2006; 17: 15-18
    Article in Thieme ConnectPubMedGoogle Scholar
  • 51 Schäfer I, Lotzin A, Milin S. Ungedeckte psychotherapeutische Bedarfe bei Stimulanzienkonsumenten. Bedeutung komorbider Störungen und traumatischer Erfahrungen. Psychotherapeut 2014; 59: 300-305
    CrossrefPubMedGoogle Scholar
  • 52 Härtel-Petri R, Rodler R, Schmeisser U et al. Increasing prevalence of amphetamine – and methamphetamine-induced psychosis. Psychiatr Prax 2005; 32: 13-17
    Article in Thieme ConnectPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 58 Schmeisser U, Härtel-Petri R, Steinmann J et al. Psychoedukation bei Sucht und Psychose. Psychiatr Prax 2007; 34: 52-54
    Article in Thieme ConnectPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 60 https://breaking-meth.de
    PubMed
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 64 http://store.samhsa.gov/product/Matrix-Intensive-Outpatient-Treatment-for-People-With-Stimulant-Use-Disorders-Counselor-s-Treatment-Manual/SMA13-4152
    PubMed
  • 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
    Google Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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-
    PubMedGoogle Scholar
  • 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
    Article in Thieme ConnectPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 71 Brackins T, Brahm NC, Kissack JC. Treatments for methamphetamine abuse: a literature review for the clinician. J Pharm Pract 2011; 24: 541-550
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 73 Elkashef AM, Rawson RA, Anderson AL et al. Bupropion for the treatment of methamphetamine dependence. Neuropsychopharmacology 2008; 33: 1162-1170
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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-
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 82 Anderson AL, Li SH, Biswas K et al. Modafinil for the treatment of methamphetamine dependence. Drug Alcohol Depend 2012; 120: 135-141
    CrossrefPubMedGoogle Scholar