SAN ANTONIO – Recovery is a long road for everyone, but for some, there are extra barriers.
That’s the case with methamphetamine, which affects the brain in a very different way, and is extremely addictive.
The KSAT Solutionaries team found out about a unique treatment being used for both.
Meth use is rampant in our community and across the country.
More than two and a half million Americans are using methamphetamines, which include hundreds of thousands here in Texas, according to the National Institutes of Drug Abuse.
The National Institutes of Health reports that overdose deaths involving methamphetamine nearly tripled from 2015 to 2019 among people ages 18-64 in the United States.
A UT Health San Antonio doctor said he’s seen a tenfold increase in his patients over the last decade.
A local facility, Alpha Home, reports 50% of their clients now come in with meth addiction.
Using meth for a long time or in high quantities physically damages the brain so much that researchers have equated it to a traumatic brain injury.
Relating those together, a lightbulb went off for experts and out came a unique solution: using the same simple therapy for both TBI and meth recovery.
“What led me to my substance use basically was relationship. It was kind of like, ‘If you love me, you’ll use with me.’ And I was really scared but I did it and it was so powerful, like, I had to have it,” said Dana Snider.
Snider was 19 when she tried methamphetamine.
“From there on, it was on and off until I was 35 years old. You know, with losing my kids, destroying relationships, selling drugs because now I have to support my habit. Doing things that I didn’t ever think I was going to ever do,” Snider said.
She didn’t realize how many other young people were just like her, and had such easy and cheap access to meth.
“Around the age of 16 I tried cocaine. But at 17 I tried meth, and that’s what really got me,” said Ashley Criado.
Criado fell into the same darkness, initially finding sobriety, but it didn’t stick
“I ended up relapsing when my youngest at the time was about six months old, and I lost my three children. I was homeless. I experienced a lot in that time. But October 4th, 2018, I came back to Alpha Home. And so my sobriety date is October 5th, 2018,” Criado said.
Both Criado and Snider wound up at Alpha Home, a long-time San Antonio residential treatment center and home for women with substance use disorder.
“I’ve been sober for six and a half years,” Snider said.
It was in rehab that they started to learn the biology of what had happened to their brain.
They were surprised to hear all the damage that had been done.
“I remember in class, I was crying. I was like, ‘Am I ever going to, you know, be smart?’” Snider said through tears.
Snider would soon find that her education would extend further than she’d ever thought possible, but what she was learning in the moment was terrifying.
She was taught that meth can destroy brain cells in crucial areas, more so than a lot of other drugs.
That brain injury is usually to the prefrontal cortex, which controls things like personality, decision making, long-term planning.
There is also typically damage to the hippocampus, which controls memory and learning.
“A lot of hallucinations and delusions. I would see things that weren’t there, hear things that others could not hear,” Criado said.
Doctors report about a third of people that use methamphetamines experience psychotic events, and another third of those are going to experience continued psychosis even after they stop using meth.
“One of the biggest things was the jolting. My eyes would jolt. It would be like you see on a TV screen how it kind of goes like into a squiggle,” Snider said.
There were also simple things she just couldn’t seem to manage, even though she was fully committed to recovery.
“It was very irritating to me. I couldn’t pick up on appointments. I was trying to do the things I needed to do, but it was very hard to remember stuff,” Snider said.
“Someone that’s in persistently psychotic state, unfortunately may not have the organization, attention and wherewithal to seek treatment, particularly in a complicated health system,” said Addiction Medicine Physician Dr. Curtis Bone with Be Well Texas.
Be Well Texas is a state-wide, all-encompassing addiction program run through UT Health San Antonio.
Bone said with those intense symptoms in addition to attention problems and planning abilities, patients have trouble retaining treatment, even if they want it.
“When you have a learning disability, whether it’s something you’re born with or something that you’ve damaged because of drug usage, you still need that unique support for whatever it is that you’ve got,” said Alpha Home CEO Liza Jensen.
In her work, Jensen learned something very interesting about these meth-induced brain injuries.
“It is believed to be in some research studies, very similar to somebody who has a traumatic brain injury,” she said.
Traumatic brain injuries cause similar symptoms to those described after meth use: potential for increase in impulsivity, problems with attention and organization, problems with those executive function tasks if the the injury impacts those parts of the brain.
The connection between the two has been researched by the National Library of Medicine and studied by SAMHSA, the Substance Abuse and Mental Health Services Administration.
Jensen mentioned military practices that the VA was using a therapy called contingency management with their traumatic brain injury patients.
Research shows they soon found it also worked for veterans with substance use disorder.
“What they have found that is effective is somebody who gets rewarded immediately to help reinforce the learning of a skill or behavior. And the way we do that is that we constantly give them positive reinforcement for what they’re doing right,” Jensen said.
“There are decades of research, that demonstrate the effectiveness of contingency management,” Bone said.
However until recently, it hadn’t been used in these recovery spaces.
Alpha Home’s Contingency Management program is a level system that rewards clients for hitting weekly treatment goals, like attending classes or meetings.
Rewards are then given out in group settings, in front of peers.
Level 1 is backpack. (Given during a client’s 1st Community Group on week 1)
Level 2. Journal. (Given between Day 14-29)
Level 3. Highlighters. (Given between Day 30-44)
Level 4. Bracelet. (Given after 45+ days)
On the other end, if clients are not successful they fill out a learning experience form and do extra chores. They also continue getting support from their staff and peers.
Jensen said the type of reward isn’t what’s important. It’s the hit of dopamine the brain gets from accomplishing a task and getting encouragement for it.
“30 other people are saying, ‘Yay, way to go!’ That feels good when you’ve got cheerleaders on your side,” Jensen said.
So why does that simple thing work physiologically?
“Methamphetamine is similar to other substances in that it interacts in the reward pathway and cause the release of dopamine. Euphoria makes people feel good,” Bone said.
But when the person stops taking the drug, the brain still needs that reward pathway stimulated, and it’s not easy to match the power of something like methamphetamine.
“So this provides kind of a bridge, you might say, to allow for time to recover, for that prefrontal cortex to get engaged,” Bone said.
Be Well Texas uses contingency management, too, and has the funding to give monetary rewards for small actions.
“Engaging with recovery communities, for example, or reading certain texts, going to appointments, meditating,” Bone said.
The answer both centers have found aligns with the research that medications helping with cravings combined with behavioral therapies, like contingency management, tend to work the best.
“It gets better. There’s light at the end of the tunnel,” Snider said.
Snider and Criado are perfect examples of that.
“I’ve been teaching the Monday morning recovery planning. I’m going to be switching to anger management on Thursdays,” Criado said.
Both women got degrees and have become counselors at Alpha Home, and are using contingency management with their own clients.
“It’s more of a small paper that we call push-ups. It’s like, ‘Hey, good job,’ and we post it on their door,” Snider explained.
She can see first-hand, the reaction.
“They love it. They start taking ownership of what they’re doing. They start getting honest,” Snider said.
They both emphasize brain health, even more so for their clients recovering from meth.
“Giving out crossword puzzles or word search, like ‘Here, exercise your brain a little bit.’ We do math problems sometimes at the beginning of class,” Snider explained.
“Doing anything to challenge your brain because of the neuroplasticity, right? Your brain’s going to be able to heal itself,” Criado said.
That healing has a beautiful ripple effect.
Both women are reunited with their kids and finding true joy in their lives. They say it’s worth every second of the work it took to get there.
They join the researchers and doctors in emphasizing that prevention is key in the form of education and they hope the community will begin spreading this life-saving information.
They also hope more addiction recovery centers and doctors will use contingency management programs for their patients.
However, for someone already using meth, or any drug, it’s never too late to get help.
Be Well Texas has a 24/7 help line, and can connect you or a loved one to almost any type of service. Those services include in person and virtual counseling, statewide treatment, housing and recovery services, distribution of naloxone, and even the ability to cover costs of some treatments.
Reach out, and call 888-85-BEWELL or (888) 852-3935. You can also go to their website.
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