Unveiling the Crystal Meth Crisis in Rural South Africa: A Look Through Users' Experiences

Singwane and colleagues (2023) conducted some research into the under-explored world of crystal meth use in Mpumalanga, South Africa, specifically focusing on the experiences of young people in Witbank.

Why Focus on User Experiences?

Understanding the impact of crystal meth on users' lives is crucial for developing effective interventions. Their study employed the Biopsychosocial model, acknowledging the complex interplay of biological, psychological, and social factors that influence substance abuse.

Key Findings from their study (Singwane et al. 2023):

1. Stigmatization: The COVID-19 pandemic worsened the stigma surrounding crystal meth use. Users reported being called names and ostracized by their communities.
2. Family Dysfunction: Crystal meth use negatively impacted family relationships. Users reported neglecting their children and experiencing increased conflict with family members.
3. Criminal Activity: Job losses due to COVID-19 lockdowns pushed some users towards crime, like stealing and robbery, to sustain their habit.
4. Uncontrollable Urge: Participants described an intense craving for crystal meth, comparing it to an "irresistible demon."

The Biopsychosocial Model in Action

The Biopsychosocial model provided a framework to understand the findings (Singwane et al., 2023):

1. Biological Factors: The uncontrollable urge suggests potential changes in brain chemistry due to crystal meth use.
2. Psychological Factors: Turning to crystal meth might indicate coping mechanisms for dealing with the challenges of the pandemic.
3. Social Factors: Stigma, job loss, and societal pressures contribute to the negative impacts of crystal meth use.

The researchers make the following recommendations:

1. Conduct further research on the lived experiences of users across various drugs.
2. Integrate caregiver education into treatment programs to promote a biopsychosocial approach.
3. Implement an "Instant-admission" policy for substance users seeking treatment.
4. Increase the number of inpatient treatment centers to address the growing demand.
5. Strengthen law enforcement efforts to combat illicit drug trafficking in Witbank.

Conclusion:

This study sheds light on the devastating effects of crystal meth on young people in rural South Africa. By acknowledging users' lived experiences and addressing the underlying biological, psychological, and social factors, more effective interventions can be developed to combat this growing public health crisis.

References

🟥Singwane, Thembinkosi & Ramoshaba, Justin. (2023). It's like an uncontrollable demon in your body: The lived experiences of youth using crystal meth during the COVID-19 pandemic in Witbank, Mpumalanga. International Journal of Research in Business and Social Science (2147- 4478). 12. 286-294. 10.20525/ijrbs.v12i5.2726. 

Methamphetamine_A Disrupted Dialogue Between Memory and Reward

Heysieattalab and colleagues(2016) delve into the neurological underpinnings of addiction, specifically how amphetamine disrupts communication within the brain's reward and memory systems, and here is a closer look (Heysieattalab et al., 2016): 

• Hijacking the Reward System: Our brains naturally have a reward system that reinforces positive experiences by strengthening connections between neurons. This system helps us learn and remember pleasure-related things, motivating us to repeat those actions. Addictive drugs like methamphetamine interfere with this system, essentially hijacking it and causing it to prioritize the drug above all else. 
• Focus on the Hippocampus:  Heysieattalab and colleagues focused on the hippocampus, a critical brain region for memory function. It's like the brain's filing cabinet, storing information and helping us consolidate memories. Their research investigates how METH use disrupts this process. 
• METH and Impaired Memory: Normally, the hippocampus strengthens connections between neurons through a process called Long-Term Potentiation (LTP). This allows us to learn and form lasting memories. However, the study finds that METH disrupts LTP in the hippocampus, hindering its ability to function effectively. This can explain the cognitive deficits often observed in people struggling with METH addiction. 
• 
  The Reward Circuit Connection: The hippocampus doesn't operate in isolation. It communicates with other brain regions, including the nucleus accumbens (NAc), a key player in reward processing. The NAc is like the brain's pleasure center, registering and amplifying feelings of reward. METH disrupts dopamine levels in both the hippocampus and NAc. Dopamine is a neurotransmitter heavily involved in motivation, reward, and movement. By altering dopamine function in these areas, METH can further manipulate the reward system and drive addictive behaviors.
• Potential Therapies: Heysieattalab and colleagues (2016) explore using medications targeting specific NAc receptors. These medications could potentially counteract the adverse effects of METH on memory function by regulating dopamine signaling within the reward circuit. This research paves the way for developing treatments that address not just the addictive aspects of drugs like METH but also the associated cognitive impairments.

In conclusion, Heysieattalab and colleagues' (2016) study highlighted how Meth addiction disrupts communication within the brain's memory and reward circuitry, and by understanding these changes, scientists can develop more comprehensive treatment strategies to combat addiction and its consequences.

References

1. Heysieattalab, Soomaayeh & Naghdi, Nasser & Hosseinmardi, Narges & Zarrindast, Mohammad-Reza & Haghparast, Abbas & Khoshbouei, Habibeh. (2016). Methamphetamine-Induced Enhancement of Hippocampal LTP Is Modulated by NMDA and GABA Receptors in the Shell-Accumbens. Synapse (New York, N.Y.). 70. 10.1002/syn.21905. 

Dreams and the Therapeutic Relationship

Understanding Dreams in Trauma: Beyond Repression

This blog post explores the role of dreams in individuals with trauma, particularly those with borderline or psychotic presentations, and here, we delve more deeply than the Freudian concept of repressed unconscious, examining the idea of an "unrepressed unconscious" shaped by early experiences (Scalabrini et al. 2021):

• The Compulsion to Repeat

Trauma survivors often experience dreams that seem to repeat the traumatic event. This repetition isn't a conscious choice but rather a way for the mind-body system to initially process what it couldn't handle. These dreams lack the symbolic language of neurosis and instead focus on raw emotions and sensory details.

• The "Unrepressed Unconscious"

Freud's theory emphasized repressed memories, those actively pushed down. However, for traumatized individuals, especially those with pre-verbal experiences, the trauma may be "unrepressed" - lodged in the amygdala (our emotional center) and influencing us unconsciously.

• The Role of Memory Systems
  

Our memory systems play a crucial role. Repressed memories involve active forgetting and are linked to conscious thought. Unrepressed memories, often from pre-verbal stages, reside in the implicit memory system, with the amygdala playing a central role.

• Dreams as a Bridge

Traumatic dreams can bridge the implicit (bodily) and explicit (narrative) memory systems. Triggers in daily life or therapy can reactivate these memories, leading to dreams that express them in sensory and emotional ways.

• The Importance of Nightmares

Nightmares, often accompanied by intense emotions, are crucial to processing trauma. They represent an initial attempt to verbalize what was previously nonverbal. Through dreams, patients can integrate these experiences into their conscious awareness. A safe and supportive therapeutic relationship is essential. By focusing on bodily sensations and verbalizing emotions, therapy helps patients utilize dreams as a symbolic tool to work through past experiences.

• Beyond the Neurotic Spectrum

Severely borderline and narcissistic patients may have difficulty with dreams or remembering them. This difficulty is linked to problems with symbolizing emotions. The body receives emotions but doesn't connect them to feelings, leading to a "short circuit" where emotions remain trapped in the body. (Scalabrini, et al, 2021)

Conclusion

Dreams in trauma offer a window into the "unrepressed unconscious." By understanding the link between implicit memory, emotions, and dreams, therapists can help patients utilize dreams for healing and integration.

References

1. Scalabrini, A., Mucci, C., & Esposito, R. (2021). Dreaming the unrepressed unconscious and beyond: repression vs dissociation in the oneiric functioning of severe patients. Research in Psychotherapy: Psychopathology, Process and Outcome, 24(2). https://doi.org/10.4081/ripppo.2021.545