EUPHORIA, BRAIN DAMAGE AND SUDDEN DEATH

Six seconds or less after a user lights up a pipe and inhales, "ice" travels to
the brain and starts affecting its function.

Smoking crystal methamphetamine, the preferred method in Hawaii, gets more of
the drug to the brain quicker than injecting or snorting it, doctors say.

"Smoking meth is almost a direct shot," said Dr. Pablo Stewart, chief of
psychiatric services at the Haight-Ashbury Free Clinic in San Francisco and a
consultant to Maui County and the Maui Drug Court.

"The drug goes into the lungs, then into the left side of the heart, and it
pumps it straight to your brain," Stewart continued.

If you were racing up a mountain, "at that point when you get to the top of the
mountain, that's what you're going to feel like," said Doug Althauser, chemical
dependency program coordinator at Kaiser Permanente. "You can get all that
feeling without ever having to get in the race."

Ice is an "exquisitely seductive drug," Althauser said. "It's very addictive."

The drug causes euphoria, intensifies emotions, alters self-esteem and
increases alertness and aggression. Users feel confident and that they can
accomplish anything.

The drug also decreases appetite, and a lack of sleep can cause a loss of
concentration, paranoia, anxiety and make users irritable. The effects can
continue for eight to 12 hours after smoking the drug.

The drug can also cause psychosis and brain damage and can damage the heart,
kidneys, lungs and digestive system. Long-term users age prematurely and can
develop skin conditions and dental problems.

An overdose can cause heart attacks, stroke and death.

Ice produces a "high" because methamphetamine ramps up the production of
dopamine, a chemical messenger or neurotransmitter that works on the pleasure
centers in the brain.

Ice causes brain cells to produce more dopamine and interferes with the brain's
ability to absorb excess dopamine, Stewart said.

People who have too little dopamine have Parkinson's disease; people with too
much dopamine suffer from hallucinations and delusions, such as schizophrenics.

A brain on ice has dopamine moving around "like pingpong balls that are just
stuck in there, and they bounce back and forth, really flooding up the
post-synaptic neuron (nerve endings stimulated by dopamine)," Stewart said.

The methamphetamine molecule can also act directly on the post-synaptic nerve
endings, Stewart said.

In simple terms, "it means your brain is turned on max," he said.

Methamphetamine use can cause people to start hearing voices and become
paranoid and delusional. Users sometimes feel there are bugs crawling under
their skin.

"The crazy thing about this is even when your neurotransmitters return to
normal when the drug wears off, in many people they stay psychotic," Stewart
said.

Althauser said about half of the patients he sees report hearing voices that
other people cannot hear. In about half of those patients, the voices never go
away, even after they stop taking the drug.

"It may not be profound where they are having full conversations with
themselves, but they are always aware that they hear voices or white noise."

If a user goes on an ice binge, at a certain point the brain will use up all
the neurotransmitters or the body will become so exhausted that all the user
can do is sleep, sometimes for days. It can take up to 10 weeks to replenish
the brain's supply of neurotransmitters, Stewart said.

The crash can be the most dangerous period for an ice user.

When a user is intoxicated, "it's sort of like you think Superman might feel.
There's a feeling of being the center of things looking out," said Dr. Tom
Leland, medical director of Community Care Services in Honolulu.

"When the drug wears off, there's an inversion of that," he said. "It goes from
'I can do no wrong,' to 'Everybody's accusing me of being a bad person.'"

An ice user going through a crash can become suicidal, depressed, anxious and
have trouble sleeping.

"All of this can be made worse if you have a pre-existing mental illness like
depression," Stewart said.

"The withdrawal symptoms of ice are so uncomfortable that there are people who
will literally do anything to not feel the withdrawal effects of ice,"
Althauser said.

Ice's violent affects can occur when a user needs to get more of the drug and
when a user is high. "It gets you fired up and whacked out," Stewart said.

The stimulant effect of ice does not only work on the brain -- and that can
cause other health problems.

The heart can speed up to the point where it is beating so fast, blood is not
pumped efficiently -- and that can lead to death, Stewart said.

Methamphetamine constricts blood vessels in the brain, which can lead to
stroke, and the coronary arteries, which can lead to a heart attack.

Ice can also cut off blood flow to the kidneys and intestines.

"Think of your finger with a rubber band around it. Tie it as tight as you can.
What happens to your finger after a few minutes?" Stewart said.

If you leave the rubber band there, eventually your finger will turn black, die
and begin to rot and fall off.

"That's literally what happens to a part of your body when you use
methamphetamine," Stewart said.

"The longer you use speed, the greater the chances are that you are going to
get some of these things," Stewart said.