Book Review March 15, 2011

Methamphetamine Addiction: From Basic Science to Treatment

Matthew E. Layton, MD, PhD

J Clin Psychiatry 2011;72(3):420

Article Abstract

From our regular book review column.

Methamphetamine Addiction: From Basic Science to Treatment

edited by John M. Roll, PhD; Richard A. Rawson, PhD; Walter Ling, MD; and Steven Shoptaw, PhD. Guilford Press, New York, NY, 2009, 258 pages, $40.00.

A recent Associated Press newspaper article titled "Man Charged in Girlfriend’s Death," dateline Grants Pass, Oregon, reminds us of the horrible toll methamphetamine can take on individuals, their families, and society. The killer said that he "went psycho" when he stabbed his 17-year-old girlfriend more than 30 times. His aunt said that he had a good future ahead of him, but "started taking methamphetamine and things went downhill." He and his girlfriend had been dating only 3 weeks.

This is not just a concern for the rural western United States. In Methamphetamine Addiction: From Basic Science to Treatment, Dr John M. Roll and coeditors have captured the essence of methamphetamine, from its basic neuropharmacologic mechanisms to the nightmarish consequences of this drug for community systems. The comprehensive expertise the editors and contributors bring to this volume is impressive, spanning the fields of psychology; neurology; psychiatry; family, internal, and behavioral medicine; epidemiology; functional neuroimaging; multiple basic science disciplines; and the advocacy and legal realms.

Skillfully compiled and eminently readable, this volume has utility not just for addiction clinicians, teachers, and researchers, but also for those in a variety of other academic disciplines. Content relevant to sociology, anthropology, and human behavior in general is digestible enough in this book for use at an undergraduate curriculum level, yet in-depth and literature-based enough to support graduate work. Psychiatry residency, addictions medicine, and psychiatry fellowship programs may all want to take a look at this book for use in graduate medical education. The impact that methamphetamine use and dependence has on our health systems alone is significant. However, add the impacts of methamphetamine dependence on child protection services, law enforcement, the courts, and corrections systems, and the astute clinician will see how they fit into a broader context when providing care for these patients.

Well-organized and thorough, the chapters cover topics ranging from essential background information about methamphetamine itself to the drug’s epidemiology and global footprint. Acute and chronic medical and psychiatric effects of methamphetamine are addressed, as well as the frequent public health, social, and legal complications.

Evidence for psychosocial, behavioral, and pharmacologic treatments for methamphetamine dependence is presented in a fact-based manner. My PhD is in pharmacology, so I have a particular interest in the psychopharmacologic treatment results for methamphetamine dependence. While there are some positive indications, results are limited. However, as clearly outlined in the chapter titled "Psychosocial and Behavioral Treatment of Methamphetamine Dependence," evidence supports that, in fact, methamphetamine dependence can be treated quite effectively with a combination of approaches. The chapter "Treatment of Methamphetamine Addiction That Co-Occurs With Serious Mental Illness" provides detailed information and case examples demonstrating the complexity methamphetamine addiction adds when individuals have primary medical and mental illnesses, in addition to the secondary problems related to methamphetamine use, including those associated with route of administration.

Once readers establish a basic understanding of methamphetamine’s dramatic effects and extensive use, they will see how important it is that individuals with methamphetamine problems undergo a comprehensive, interprofessional, coordinated evaluation that includes an assessment of their support system. This extensive evaluation must be done in order to appropriately diagnose and treat methamphetamine dependence concurrently with other potential physical and mental problems to achieve the best possible outcomes. Coordinated efforts to prevent or limit the considerable collateral damage associated with this drug are also essential. Unfortunately, cases like the one in Grants Pass are not rare, and the consequences are devastating for all involved. If you are interested in understanding the methamphetamine "big picture," this book is for you.

Matthew E. Layton, MD, PhD

[email protected]

Author affiliation: University of Washington School of Medicine, Spokane. Potential conflicts of interest: None reported.