THE HIGHEST HIGHS THE LOWEST LOWS

Emergency department physician Jack Stump, who first sounded an alarm
about methamphetamine in the early 1990s, shows a PET scan reflecting
how drugs erode the brain. The red-colored portions are the most
damaged. (DAVE OLSON/The Columbian)

Years before brain scans proved his theory, Dr. Jack Stump figured the
toxic brew known as methamphetamine irreversibly damaged the areas
that control behavior and emotion.

An emergency room doctor in Medford, Ore., in the early 1990s, Stump
saw a steady increase in meth users.

Aggressive, twitchy and ranting, these meth users couldn't settle
down.

They came to the hospital for different reasons: Maybe they burned
themselves making a batch of the superstimulant or had provoked a
fight with police. Maybe they had picked their skin bloody because
they were hallucinating, believing they were covered in bugs. Maybe
their teeth had rotted because their mouths had stopped producing
cleansing saliva.

Every user would eventually tell Stump they needed meth just to try to
feel normal. So they'd use it again and again.

As one patient later said, "'This once' turned into a thousand times."

The costs of methamphetamine addiction are so great that Clark County
commissioners recently increased the sales tax to raise an estimated
$6 million to combat meth on a number of fronts, including prevention
and treatment.

Commander Rusty Warren of the Clark-Skamania Drug Task Force said up
to 80 percent of identity theft and related crimes are committed by
meth addicts.

The most prevalent drug in the area is marijuana, he said.

"However, the most destructive is meth," Warren said.

So just how good does that first shot of meth feel?

Consider it in terms of dopamine, a feel-good chemical released when
you do pleasurable activities, said Stump, now an emergency room
doctor at Southwest Washington Medical Center who lectures nationwide
on meth's destructiveness.

Savoring a meal, for example, raises a person's dopamine level to
150.

An orgasm rates 200 on the dopamine chart.

Methamphetamine goes a step further and attaches itself to the
dopamine-producing nerve cells, triggering a flood that shoots a
person's dopamine level to 1,050.

And while the after-bliss of food or sex lasts minutes, that first
meth high can last 16 hours. Users go on binges to avoid the comedown
and end up staying awake for two weeks. They can do this, often going
without food, because meth also causes the adrenal glands to pump out
the "fight or flight" chemical that, among other things, suppresses
appetite.

For days, the user feels energized and euphoric, Stump said. But too
much of a good thing can be bad, and sustained levels of dopamine can
turn users psychotic.

Brain can't handle drug

The inevitable crash is equally dramatic, causing numbing depression
and the need to sleep as long as 72 hours. When the users wake up,
they are singularly focused on getting more meth, even though they'll
never get as high as the first time.

Instead, Stump said, the unrelenting flow of chemicals exhausts the
brain.

Unlike drugs from natural sources the brain recognizes, such as
cocaine (derived from the coca plant), heroin (opium poppies) and
alcohol (fermented fruit or grain), meth causes such a supernatural
pleasure simply because our brains were never meant to be able to handle it.

So after that first high, everything falls apart.

Dopamine production, for example, shuts down. So the normal, small
bursts of dopamine -- the ones a sober person feels when his baby
falls asleep in his arms or he cuddles with his wife -- don't happen
anymore for users.

Dr. Stump said researchers have mapped the brains of meth addicts. The
decay the drug causes in the areas responsible for cognitive
functioning and memory resembles the injured brain of a person with
Parkinson's or Alzheimer's.

Unlike with those incurable diseases, the meth-damaged brain can
partially heal after two years or so of sobriety, Stump said. But
imagine a meth brain as a piece of Swiss cheese. While the holes may
grow smaller over time with sobriety, in the least-resilient users the
damage can be permanent.

Physical toll evident

A user's appearance suffers, too.

Superior Court Judge John Nichols said he can spot meth addicts right
away when they enter his courtroom.

Often malnourished, the addicts are bone-thin.

"They've got dry hair sticking out, and blotches on their skin,"
Nichols said.

The judge said he's often shocked to learn an addict's age.

"They look 45, and they are 25," Nichols said.

Bernard Veljacic, a Clark County deputy prosecuting attorney, can
rattle off stories about the meth addicts he has encountered during
his years in the department's drug unit: the real estate agent who
tried meth once at a party and ended up losing his home, job and
marriage; the shackled defendant who flipped out and had to be
restrained by a half-dozen officers.

Or the suspects he charged with an additional crime -- worth up to an
extra year in prison -- after they tried smuggling meth into the Clark
County Jail inside their rectums or vaginas.

"They'll give away sex for it, kill for it, and they'll steal from
their own mother," Veljacic said.

He recalled a father who sobered up in Superior Court's drug court,
where defendants stay out of jail if they stay clean. The man had
shared how dead he'd felt when he wasn't high.

"His first son was born and he couldn't feel anything," Veljacic said.
"(Meth) literally steals your joy."

"What is life without those joys?" Veljacic said. "Instead it's
supplanted by this artificial high, forever fleeting, and it's never
as good as the first time."

Stephanie Rice covers the courts. She can be reached at 360-759-8004
or stephanie.rice@columbian.com.

Did you know?

* Methamphetamine belongs to a class of central nervous system
stimulants called amphetamines. It was first made in the 1800s by
Japanese and German chemists.

* Meth was used by Axis and Allied troops in World War II to stay
awake during missions.

* Evolving recipes and methods have raised meth's power. While recipes
vary, the most common form in Clark County is a blend of red
phosphorus and iodine (which make hydriodic acid), water, and
pseudoephedrine.