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Why such a huge response?
According to Grant Jardine, director of the Cape Town Drug Counselling Centre (CTDCC), the increased rate of usage of crystal meth is dramatic. “It is something we haven’t seen before. It is the greatest challenge the CTDCC has ever had to face.”

In 2002, less than one percent of the clients at the CTDCC took crystal meth as their primary drug. In 2003, the number increased to five percent. In May 2004, a third of the patients were crystal meth users.

The drug is highly addictive. According to the CTDCC, over six months of use 94 percent of those who smoke meth become addicted.

Health professionals are concerned about the devastating effects of this drug on the user – among its many effects, crystal meth induces psychotic symptoms, such as seeing or hearing things that are not there, and violence, making it a far more dangerous drug than most others available in South Africa.

“The danger with crystal meth is that it is attractive to non-typical drug users,” says Prof Charles Parry, researcher at the Medical Research Council (MRC).

It is attracting very young, first-time users. The South African Community Epidemiology Network on Drug Use (SENDU), which monitors drug use countrywide, found the greatest increase in users to be those under the age of 20 years. In 1996, 5% of people seeking treatment were under the age of 20. This shot up to 20-25% in 2003. Treatment centres such as the Crescent Clinic’s Chemical Dependency Unit are treating children as young as 13 for crystal meth addiction.

Crystal meth has also been marketed as a way of losing weight, making it popular among many women who would not normally have taken drugs.

Health professionals are also concerned about the impact of crystal meth on long-term drug users. Ted Leggett, senior researcher at the Institute for Security Studies, has done extensive research on gangsterism on the Cape Flats. He points out that crystal meth is becoming extremely popular amongst gang members. Hardened criminals taking drugs that induce violent behaviour is a cause for concern.

“Methamphetamine is seen as an ideal tonic to prepare gunmen for a hit, removing inhibitions, sharpening senses and fuelling aggression,” says Leggett. One could therefore expect an escalation of violence within this already violent sector of the population.

“Give me a straw, please?”
If you ask this question in many parts, you may get a lot more than you bargained for. Crystal meth is typically sold in straws, one of which could cost you between R40 and R60. The drug can be found in many forms, from a fine powder to larger crystals. It can be snorted, orally ingested, injected or smoked – smoking being the most common method in South Africa.

On the street, crystal meth has many names, including “tuk-tuk”, "tik", "crystal", "straws" and "globes". It has also been called “Hitler’s drug”, because it was allegedly used by the Nazis as a “combat drug” to fuel aggression and help soldiers stay awake and remain focused for long periods.

The powder or crystal is placed in a light bulb from which the metal threading has been removed. A lighter is used to heat the bulb and the user smokes the fumes. Some users call the drug “tuk-tuk” because of the clicking sound it makes when smoked.

Available in a kitchen near you
The ingredients are easily accessible and many manufacturers need nothing more than their kitchens to concoct large quantities. Recipes are plentiful and readily available, and you don’t have to be a rocket scientist to make it.

Overheads are low, making the manufacture of crystal meth a lucrative business. It is not uncommon for people to make a profit of R4 000 a day.

“Because crystal meth can be manufactured at home, the problem is not only availability but that many people don’t see it as illegal and don’t regard it as a drug,” says Prof Parry.

In a step to reduce local 'kitchen' manufacture, ephedrine, the drug from which crystal meth can be produced, was made a Schedule 5 drug in May 2003 and is now only available on prescription. But manufacturers soon discovered other ways, such as using pseudoephedrine, found in some over-the-counter remedies.

What does it do?
According to users, the drug gives an immediate, extremely pleasurable rush or “flush”. The rush only lasts a few seconds, but is followed by euphoria (a high) that lasts for several hours. Users stay awake for hours, even days, during which they feel extremely active and energetic. They seldom get hungry and go for long periods without any food. Both the rush and the high are believed to result from the release of very high levels of the brain chemical dopamine into areas of the brain that regulate feelings of pleasure.

Interestingly, recovering addicts describe the effects very differently, says Jardine. They often describe the high as a state of extreme restlessness, anxiety and an inability to sleep. They also complain of many unpleasant sensations such as of needles sticking through the skin from the inside or of insects crawling on the skin (called formication).

Although the effects of the drug only last a few hours (depending on the quantity and quality), it may take days for the body to fully recover. Once the effects have worn off, users hit a low - a feeling of exhaustion and depression. Many people use the “white pipe” combination of dagga and mandrax to come down from the high.

Long-term effects
Crystal meth can be damaging in several ways. The drug is commonly sold as a combination of amphetamines and talcum powder, baking powder, starch, glucose or quinine. These additives can be very poisonous. Because the user never knows exactly what he is using, even an experienced user can accidentally overdose.

Tolerance develops quickly, which means that higher doses of the drug need to be used to get the same effect, and/or that the drug needs to be taken more frequently or in different ways.

Chronic abuse can lead to out-of-control rages, violence, anxiety, confusion, mood disturbances and insomnia. Users can become psychotic, experiencing symptoms such as paranoia, hallucinations and flight of ideas (jumping from one topic to the next). The paranoia can result in homicide or suicide.

The drug causes increased heart rate and blood pressure and can lead to irreversible damage to blood vessels in the brain, producing strokes. Other effects include respiratory problems and irregular heartbeat.

Crystal meth affects many parts of the central nervous system. According to the treatment guidelines issued by the US Center for Substance Abuse Treatment, “some of the most frightening findings about meth suggest that its prolonged use not only modifies behaviours, but literally changes the brain in fundamental and longlasting ways”.

There is also an increased risk of being infected with HIV or other sexually transmitted infections, because many people become more sexually active when on a high, often describing hours of wild sex with little concern for safer sex.

Look out for these warning signs
For obvious reasons, early intervention will give an addict the best chances of recovering. Is someone you know in trouble? These are the signs of crystal meth abuse:

• Loss of appetite and weight loss
• Aggression
• Dilated pupils
• Rapid speech
• Anxiety
• Psychotic symptoms (hallucinations and delusions)
• Headaches
• Over-confidence
• Insomnia
• Changes in dress, friends and slang
• Drug paraphernalia: light bulbs, glass straws (so-called "lollies" or "popeye")

- Ilse Pauw, Health24
 

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