METHYLAMPHETAMINE REVIEW A REPORT BY THE ADVISORY COUNCIL ON THE MISUSE OF DRUGS 2005 CONTENTS 1. INTRODUCTION..................................................................................................4 Historical overview ............................................................................................................................ 4 Types of methylamphetamine........................................................................................................... 5 This report.......................................................................................................................................... 5 2. MEDICAL USE OF AMPHETAMINE...............................................................6 3. ILLICIT METHYLAMPHETAMINE................................................................7 Administration, purity, dose and price............................................................................................ 8 Patterns of methylamphetamine use................................................................................................ 9 4. METHYLAMPHETAMINE AND OTHER SUBSTANCE USE .....................9 5. AMPHETAMINE & METHYLAMPHETAMINE IN THE UK....................10 History of amphetamines in the UK............................................................................................... 10 Legal status....................................................................................................................................... 11 Seizures of amphetamines............................................................................................................... 12 Amphetamine use in England and Wales...................................................................................... 13 Methylamphetamine use in England and Wales........................................................................... 13 Source of methylamphetamine used in the UK............................................................................. 14 6. PREVALENCE OF CONSUMPTION AND MANUFACTURE ...................15 Global seizures ................................................................................................................................. 16 Detection of clandestine laboratories ............................................................................................. 17 7. AMPHETAMINE EXPERIENCES IN OTHER COUNTRIES.....................17 Sweden .............................................................................................................................................. 17 Czech Republic................................................................................................................................. 18 USA ................................................................................................................................................... 19 Australia ........................................................................................................................................... 20 New Zealand..................................................................................................................................... 20 Japan................................................................................................................................................. 22 Thailand............................................................................................................................................ 23 China................................................................................................................................................. 23 8. ILLICIT METHYLAMPHETAMINE PRODUCTION .................................24 Scale of Production .......................................................................................................................... 24 Chemicals involved in the production of methylamphetamine ................................................... 24 Types of methylamphetamine syntheses........................................................................................ 24 Production processes ....................................................................................................................... 25 9. PHARMACOKINETICS AND NEUROCHEMISTRY ..................................25 The chemistry of the amphetamines .............................................................................................. 25 Pharmacokinetics of amphetamine and methylamphetamine..................................................... 26 2 Neurochemistry of methylamphetamine ....................................................................................... 27 Behavioural Pharmacology............................................................................................................. 28 10. AMPHETAMINE NEUROTOXICITY.............................................................29 Animal studies.................................................................................................................................. 29 Human studies.................................................................................................................................. 30 Neurocognitive impairment ............................................................................................................ 31 11. AMPHETAMINE PSYCHOSIS.........................................................................33 Initial description............................................................................................................................. 33 Laboratory studies........................................................................................................................... 33 The Japanese experience................................................................................................................. 34 Recent experience in the Asia-Pacific region ................................................................................ 35 12. OTHER HARMS .................................................................................................35 Overdose and mortality................................................................................................................... 35 Dependence and withdrawal........................................................................................................... 36 Blood borne viruses ......................................................................................................................... 37 Sexual health .................................................................................................................................... 37 Prenatal exposure to amphetamine................................................................................................ 38 Crime................................................................................................................................................. 38 Violence............................................................................................................................................. 39 Hazards of methylamphetamine manufacture.............................................................................. 39 13. TREATMENT ......................................................................................................40 Acute intoxication and overdose management.............................................................................. 40 Stabilization-withdrawal management.......................................................................................... 41 Amphetamine substitution pharmacotherapy .............................................................................. 42 Relapse-prevention .......................................................................................................................... 43 14. CONCLUSIONS & RECOMMENDATIONS..................................................45 Precursors......................................................................................................................................... 46 Health................................................................................................................................................ 47 Pharmacology................................................................................................................................... 47 Other Considerations: ..................................................................................................................... 47 15 References .............................................................................................................49 Appendix One: Forensic Science Service – Methylamphetamine.... Error! Bookmark not defined. 3 1. INTRODUCTION Historical overview 1.1 There are records that from the 1st century AD, Chinese herbalists prescribed ‘MaHuang’ (the dried stems from the Ephedra Vulgaris plant) for treating asthmatic conditions. In the early 20th century, the moderately potent stimulant ephedrine extracted from the ephedra plant was used for its ability to dilate bronchial passages and for symptomatic relief in milder cases of asthmatic attack and also for brochial congestion and catarrh. As supplies of ephedra became more difficult to obtain pharmaceutical companies sought to identify a synthetic substitute (Yudko, Murray-Bridges, & Watson-Hauanio, 2003). Amphetamine (AMP) had been synthesized by the German chemist Leuckhart in 1887 (originally named phenylisopropylamine) but