Friday, April 29, 2005

morning question

"Will I be good to my neuronal terminals today?"

Suppose you ask yourself that question, and the answer is "no." Do not bother with the rest of that day. It will not be worth the effort.

One of the really lovely things about methamphetamine is the way it damages the terminals of neurons involved with dopamine and serotonin. It chainsaws them. Not a good thing, really, because dopamine is that most excellent neurotransmitter which gives you a feeling of reward when something you do goes well. It's the brain's way of giving itself a nice box of Godivas.

He was asleep when I got report from the nurse on the previous shift. Four-point leather restraints held each limb to the bedrails.

Smoking crystal meth causes the brain to flood with massive amounts of dopamine, initiating a brief intense rush.

It took several staff members and a host of security people to get him there. Somehow he had persuaded the night crew that he would be okay if taken out to smoke a cigarette. He ditched the staff member assigned to watch him and went to look for his soulmate among the bushes near the parking area, so I was told, and police were notified.

The dopamine peak soon subsides, the pleasant feelings ebb away gradually, and the user feels empty and cranky. Tweaking.

A previous incident with the police initiated his little stay with us to begin with. After a crystal binge he swore he saw his most honored loved one doing it in a car with someone else. (Hallucinations? Poor romantic choice? Both?) As she's the mother of his child, (so presumed,) this upset him greatly, and he got weird with a knife or something. The cops tasered him to no great effect, and he took a couple bean-bag-bullets to the chest, too, before he was subdued.

To dispel the emptiness, the user does more methamphetamine. And each time the drug is used, it further impairs the ability of the brain to produce and deploy dopamine in ways that make one feel pleasure naturally. Eventually the habitual user becomes completely devoid of the ability to experience pleasure, except in those meth-induced fitful respites.

He slept most of the morning. Then the calming effects of the medicines began to wear off. He yelled obscenities, struggled with the leathers, and alarmed the watcher at his bedside, who felt that the wrist leathers needed to be re-secured. When we did that he got an arm loose and everything went to hell for a bit.

So goes the downward spiral of methamphetamine addiction, taking with it the twisted and broken ends of the neuronal terminals that allow a person to feel good. Period.

We managed to hold down his arm while calls went out to other staff people and Security. After a couple hours of struggle, and the administration of some sedatives and anti-psychotics, he went to sleep again.

Almost all meth addicts relapse, since there is no other way for them to experience anything positively, really. Love, beauty, a fine meal, a happy ending... nope, nothing there. Banished. Gone like two Beatles.

Then the love of his life came to visit. We did not want her there, afraid that he would wake up, see her, and go off again. There she sat. There he did lay, tied to the bed with leather belts, medicated into submission.

"He really doesn't do drugs that much," she said.

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