Book review - The Methamphetamine Crisis: Strategies to save addicts, families, and communities

Issue: BCMJ, Vol. 49, No. 9, November 2007, page(s) 502 Pulsimeter
James A. Wilson, MD

The Methamphetamine Crisis: Strategies to save addicts, families, and communities. By H.C. Covey (ed). Westport: Praeger, 2006. ISBN 9780275993221. Hardcover, 276 pages. $70.01 (amazon.ca)–$101.95 (chapters.indigo.ca).

This is a multi-authored book from the US that attempts to chronicle the current status of what has been called a national methamphetamine epidemic by the majority of the officials working in US drug enforcement and treatment jurisdictions around that country.

Despite the overly repetitious messages delivered by the various contributing authors, the basic message is one of optimism. The majority of the authors are experienced nonmedical and paramedical professionals who write about what can be done not only for chronically addicted meth users but, more importantly, for the large number of children who are frequently living in extremely dangerous environments where methamphetamine is being used or manufactured.

Many current (and most older) publications have tended to dismiss the possibility that chronically addicted meth users are treatable, and permanent child apprehension recommendations abound. The contributors to this publication, however, not only provide a consistent sense of optimism, they also provide useful information regarding the safety of first responders, community case workers, and the at-risk children they are mandated to remove from physical environments described by many first responders as more dangerous than a war zone.

In addition to some frightening information about the enormous social impact of meth use and manufacture, there are extremely useful chapters describing the biochemistry of methamphetamine, its manufacture, and the serious medical impact of addiction. There are sections dedicated to the recognition of meth labs as well as to the clinical recognition features of meth-addicted individuals. This is followed by some useful sections dedicated to current treatment recommendations with realistic outcome goals supported by reasonable outcome statistics from a number of highly regarded US treatment facilities and addictionologists. 

There are strong recommendations for flexible, open communications and policies among the multitude of agencies and professional individuals that are required to deal with meth use and manufacture, and several examples are provided that describe how some communities have successfully dealt with their meth problems. There is also a section describing effective legal strategies involving a “drug court” that includes some amazing statistics on how the introduction of a simple, dedicated drug court essentially saved one community. 

Additionally, there are several testimonials written by meth users now in post-treatment that provide the reader with a glimpse into the seamy world of meth addiction. The gut-wrenching stories of these individuals and the ease with which they became addicted and quickly inculcated into the dangerous culture of meth-addiction was so similar that anyone with adolescent children (particularly females) reading this book will immediately become an aggressively watchful parent.

Though this book was written for a US audience of nonmedical and paramedical professionals, it will resonate just as strongly for Canadians. The methamphetamine problem is a significant and growing problem in this country and the strategies described in this book are likely useful as a template that could be modified to fit into our mostly inadequate drug treatment infrastructure. 

I recommend this book for anyone involved in clinical medicine irrespective of the size of their community, the nature of their practice, or the demographic of their patient population. If you’re practising medicine you are going to see clinical and social problems secondary to meth abuse or manufacture. This book will help you.

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