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History

Amphetamine was first synthesized in 1887 in Germany. Initially called


phenylisopropylamine, it was, for a long time, a drug in search of use, trying to
find application from decongestion to depression. In the 1930s , it was initially
marketed as Benzedrine, as an over-the-counter inhaler to treat nasal
congestion and asthma.

Methamphetamine was discovered in Japan in 1919. The crystalline powder


was soluble in water, making it a perfect candidate for injection. In the late
30s, it found use for narcolepsy and ADHD (attention deficit hyperactivity
disorder). It is still legally produced in the U.S., sold under the trade name
Desoxyn (Abbott. PDR 2001) with indications for ADHD and for short-term
therapy in exogenous obesity.

During World War II, amphetamines were widely used as stimulants to keep
the fighting men going (during the Viet Nam war, American soldiers used
more amphetamines than the rest of the world did during WWII). And after
World War II, when military surplus became available to the public,
methamphetamine abuse became epidemic.

In the United States in the 1950s, legally manufactured tablets of both


dextroamphetamine (Dexedrine) and methamphetamine (Methedrine) became
readily available and were used non medically by college students, truck
drivers, and athletes. As use of amphetamines spread, so did their abuse.
Amphetamines became a cure-all for such things as weight control to treating
mild depression.

In the 1960s, the route and degree of abuse changed dramatically with the
increased availability of injectable methamphetamine. The 1970 Controlled
Substances Act severely restricted the legal production of injectable
methamphetamine, causing its use to decrease greatly. It is at present a
Schedule II stimulant finding limited use for narcolepsy, attention-deficit
disorder, and for a limited time, as an appetite suppressant for obesity.

In the 1980s, the smokable form of methamphetamine, "ice," became


available. Like crack cocaine, it is smoked in glass pipes, emitting no odor,
with effects lasting for 12 hours or more.

In the mid-80s, methamphetamine was introduced into the fringe circle of use
in the Philippines. In less than two decades, it has broken out of the urban
subcultures and gained access access into the rural communities with
devastating impact.

In the US, its use has undergone a resurgence, a 2004 study reporting that it
has already surpassed cocaine use.

General info
In the U.S., from 2000 to 2004, methamphetamine use rose as other drug use
fell. Worldwide, according to an UNODC report, use of amphetamine reached
30 million (0.7% of the population age 15 to 64 years old). In the Philippines,
as in Thailand, Japan, Korea and Taiwan, methamphetamine is the drug of
choice; Asia accounting for 60% of meth users.

Collectively, amphetamine, methamphetamine and Ecstasy are grouped as


ATS, amphetamine-type stimulants. Synthetic drugs, production estimates are
based on seizures, and of these, 80% were amphetamine and
methamphetamine. Of the 12,000 clandestine ATS labs dismantled in 2002,
most were producing methamphetamines.

Shabu, a powerfully addictive meth stimulant, easily accessible and


affordable, is the drug of choice of over 90% of Filipino drug users.

Usually, a "fix" is used every 3 hours.

A single "pingi" or 0.1 gm costs P100. One mongo-sized "gram" costs P1,000-
2,000. (In contrast, 1997 methamphetamine prices in the U.S. ranged from
$3,500 TO $30,000 per pound, $400 TO $2,800 per ounce, and $37 per gram
in the Seattle area to $300 per gram in the New York.
A mandatory
"surprise"
Abuse patterns
Low-intensity - casual use, ingesting or swallowing, no
testing in one
precinct psychologically addiction; used for losing weight, need
found 69% for situational-wakefulness, overtime-shifts.
positive for Binge - heavy intermittent use; smoking or injection; high
drug use. can last 4-16 hours; psychologically addicted; more than
low-intensity, less than high-intensity.
The High - intensity abusers: also called speed freaks; forever
preferred seeking that quality of the "original perfect rush," usually
manner of smoking or injecting; requiring more and more drug to
use is achieve the high; psychologically addicted. The
smoking, "tweaking" stage is most dangerous.
compared to snorting, injecting, or oral ingestion i.e., dissolved in a drink.
There are geographic variations in usage: In Hawaii, 96% of users smoke it; in
San Francisco 57% of users prefer injection, 27% snort, 11% smoke.

It is easily produced in make-shift laboratories and the by-products are toxic


and hazardous.

The National Drug Law Enforcement and Prevention Center gives a


conservative estimate of at least 250,000 drug abusers, possibly over half a
million. Another conservative estimate puts the number of addicts at one
million.

A survey of youths aged 15-30 conducted by the SWS (Social Weather


Stations) in 1996 which included youth participation in illegal activities showed
a 7% with drug use and 6% with drug pushing. In 2012, a US State
Department cited a UN report that disclosed 2.1 % of Filipinos aged 16 to 64
were using shabu. With shabu as the drug of choice among 90% of users, the
mathematics is gut-wrenching.

Methamphetamine is inexpensive and easy to make, Its illicit manufacture can


be accomplished in a variety of ways, but is produced most commonly using
the ephedrine/pseudoephedrine reduction method. Large-scale production of
methamphetamine using this method is dependent on ready access to bulk
quantities of ephedrine and pseudoephedrine.

Street meth is never pure, usually cut with a miscellany of substances,


including talc or heroin.
How meth works
Methamphetamine stimulates release of excessive amounts of the neurotransmitter dopam
Dopamine is produced in the nerve cells of the ventral tegmental area and is concerned wi
regulation in the brain. Upon entering the nerve cell, meth stimulates the release of dopam
then binds to specialized receptors of other nerve cells creating the typical "rush."

Effects
Short-term effects
The effects are similar to cocaine but last longer- 4 to 16 hours.
Heightened attention and energy
Excessive talking
Euphoria, decreased fatigue
Increased activity, increased sexuality
Decreased appetite
Increased respiration
Hyperthermia, occasionally leading to convulsions and lethal levels.

Long-term effects
Dependence
Anxiety, confusion, and insomnia
Addiction psychosis
Paranoia
Hallucinations, visual and auditory
Mood disturbances
Repetitive motor activity
Stroke
Weight loss
Violent behavior, homicidal or suicidal thoughts
'Crank bugs' - Formication (sensation of insects creeping on the skin) causing users to pic
themselves causing ulcerations on the hand and arms.
Disturbed sleep patters; decreased sleep needs
Disinterest in usual social interactions, sex, food
Cardiovascular: Inflammation of the heart lining
Stereotypy behavior - performing routine acts over and over again.

Meth mouth
An oral-dental problem unique to meth abusers wherein normal white teeth can change in a
months into twisted grayish-brown stubs that eventually fall out.
Toxicity
Signs and symptoms of toxicity include arrhythmias, excessive sweating, hypertension, hyp
insomnia, irritability, mydriasis (dilation of pupils), psychosis, seizure, rapid heart rate and t

The stimulant effects from methamphetamine can last for hours, instead of the minutes from
cocaine. Often, the meth user stays awake for days. After injecting or smoking, the immedi
high is called a "swap," short-lived, minutes long. Snorting (within 3 to 5 minutes) and inges
15-20 minutes) causes a euphoria, a 'high' rather than an intense 'rush" within 15-20 minut
high wears off, the user enters a stage called "tweaking" where he or she becomes prone t
delusions and paranoia. Some try to buffer through this stage by the use of cocaine or hero
heroin and cocaine, methamphetamine can be snorted, smoked or injected. Tweaking may
mistaken as a cocky and noisy drunkenness.

The crash happens after the tweaking. To the binge-abuser, with the depletion of body epin
the body "crashes" into a sleep, seemingly, a "lifeless" state that may last 1-3 days, during
the abuse poses no threat to anyone. After the crash, in-between binge, the abuser is in a n
stage.

Although there are no acute physical withdrawal syndrome on discontinuation of chronic us


may experience a subtle creeping in of fatigue, lethargy, anxiety, paranoia, aggression, or a
craving for the drug and even a suicidal state. Re-use or re-indulgence of methamphetamin
this train of symptomatology. It is believed that prolonged exposure can cause damage to t
dopamine-producing brain cells, with more profound damage on serotonin-containing cells
concerns as to whether this can contribute to the psychosis seen in long-term users.

Meth rehab success rate is low; 93 percent in traditional treatment programs return to abus

Hypersexual Behavior and AIDS Concerns


Meth induces hypersexual behavior, and especially with anal intercourse, HIV / viral transm
concerns are raised and unprotected receptive users are put in greater risk. Adding to the r
anal insertion of meth and consequent damage to the rectal lining that increases the likelih
transmission.

Sources / Suppliers
China-based syndicates overseeing drug-trafficking operations. Production materials smu
mainland China by drug syndicates using Hongkong and Taiwan as transhipment points.
In the Philippines, there have been reports of increasing Muslim-based operations.
Clearance & Detection Times
The usual dose of amphetamine is 5 to 10 mgmuch higher in tolerant subjects. It has a
varies between 10 and 30 hours.

After smoking 22 mg of methamphetamine hydrochloride, it remains detectable in the blood


hours, at a cutoff detection level of 3 ng/mL. At 22 mg smoking dose, methamphetamine as
("Ice"), remains detectable in the urine (detection level 300 ng/mL) for 60 hours. After a con
administration of 10 mg of methamphetamine, the final detection time in urine after a single
lime of quantification (LOQ), 2.5 ng/mL) was 87.2 52 (extreme values 46-144) hours. (5)

Time was when the illicit drug use in the Philippines was mainly an indulgence of the
literati, theburgis, the artists and entertainment circle, far removed from the masa an
culture with its isolated social pockets of marijuana users. None of the hard drugs an
intravenous drug users; none of varied countercultural movements that was requisit
the growth of the drug culture. It seemed almost possible that while the drug problem
most developed countries, the Philippines would be saved from the scourge of illicit
alas, slowly and surely, the illicit drug market has successfully gained inroads into s
of users, into collegiate life, and deep into the bowels of Philippine rural life, burgeon
raging epidemic of drug addiction.

Today, "Shabu" poses a problem as serious, as frightening, as formidable, as any pr


issue confronting the Filipino society. How can a country and a system mired in corr
against the commerce of drug trade so empowered by its bottomless coffers and con
political clout? Many powerful nations have succumbed; the fanfares of their drug w
muffled, their policies inevitably compromised, shifting from prevention into contain

Sadly, I think the Filipino society confronts an impossible task. The problem is past p
Is containment still possible?

2004
Dr. Godofredo Stuart Last Up
November 2014

I wrote that more than 10 years ago


from the boondocks of tiaong,
when shabu was starting to metastasize.
cheap, the poor mans cocaine
the affordable masa drug
a hundred pesos bought a high.
whenever i could, i counseled and warned
young men caught in its addictive allure.
my advice easily countered with
hindi totoo ang sinasabi ninyo,
ok naman ang shabu.
nakakatrabaho ako ng dalawang araw,
walang tulog, walang antok.
or
nakakapagmaneho ako nang 24 oras
walang pagod, walang tulog.
a wonder drugephemeral panacea
to the hopeless treadmill of rural life.
a powerfully addictive stimulant
with its promise of pleasure and euphoria.

the scourge swelled and raged on


brought stories of despair, violence and deaths
ho-hum stories of day-to-day life.
thousands of sons and daughters
trapped in the quagmire of addiction
countless petty crimes to buy the high.
drugs paid for by sex favors.
the violent turf wars
the salvaging of drug pushers.
there was frustration among the tanods,
the police and local folk who cared.
di pa tapos ang barangay report,
naka-piyansa na.

as the drug cancer continued to spread


the powers that be turned a blind eye
government wore blinders
as drug syndicates came to our shores,
from nearby and faraway,
setting up shop in our gated communities
and countless small towns across the land
under the guise of legal commerce,
cooking shabu to feed the addicts of the world
while they fed the greed and filled the coffers
of the corrupt and the powerful
who provided protection
who for the price of a million or ten or fifty
would turn a blind eye
would provide sanctuary and deliverance.
make evidence disappear.
provide passage on the next boat to china.
the masa watched helpless
as the drug commerce prospered.
emboldened by decades
of government apathy
impotence and corruptibility
the masa resigned in collective sadness
at the ruination of their communities.
it was a sad commentary, often heard
kay marcos, di mangyayari iyan.

so in the boondocks, town folks


take ephemeral delight when they hear
of drug pushers dead in a ditch,
a drug dealer shot in the back of the head
it matters not
if it was a salvage
a local doing a charles bronson
rural vigilantism
rural extrajudicial
because in the boondocks
it is a familiar recourse for justice
for some measure of satisfaction
for lives emptied of hope.

then came duterte.


like others, when i first heard him talk,
anak ng pating! i cringed.
i told my friend if he wins im out of here.
a one-way ticket to somewhere, anywhere.

he was the hesitant candidate.


he campaigned on a simple platform
he vowed to stop the scourge of drugs.
he vowed to stop the plague of corruption.
the masa listenedvows that resonated
no matter that he cussed the pope.
no matter that he looked so unpresidential.
no matter the horrible rape comments.
no matter that he didnt have a political machinery.
no matter that his god is allah.
and hope was reborn.

the masa didnt care much about the other issues.


abu sayyaf, federalism
taxes, the china sea,
or the traffic.
they cared about drugs and corruption.
and when he did his signature swearing
anak ng _____!
people laughed, forgave
and, perhaps, understood
that behind the curse
from this salt of the earth
was anger, resolve, and commitment
to keep his promises.
collective hope grew.
Siya lang sa lahat ang kayang
magdala, magbigay ng pagbabago.

anak ng pusa!
he won.
a true blue un-trapo.
and im still hereand, actually cheering him on
together with the masa who voted him into office
to put an end to the culture of corruption
to raze the machineries of drug commerce
that have destroyed thousands of communities
and hundreds of thousands of lives.
and on his vows
on his war against drugs and corruption
he staked his honor,
presidency, and life

that, boys and girls, is political balls.

we all knew it would be a war


waged in unfamiliar ways.
the way he cleaned up davao
where the populace turned their blind eye.
we were forewarned.
war to be waged dutertes way
extrajudicial
vigilantism
any which way
or whatever name we choose to call
his war on drugs.

fearing for their lives


tens of thousands surrendered
before he stepped into office.
since the aegis of his edict to search out
barons, pushers, dealers and addicts,
to kill them if they resist,
hundreds of suspects have died,
in real or staged resistance,
assets, pushers, runners and mules
some say, eliminated by order of drug bosses,
corrupt public officials and colluding police,
desperate to expunge their connections
to the drug commerce.
many died by the vigilantes way
guilt assigned by a cardboard sign
that says pusher or addict
and a tucked sachet of shabu.

now priests and bishops spew their fiery sermons


preaching the value of human life
as politicians spout their cries of righteousness
ranting and raging for human rights.
all of them oblivious of the wasteland
of countless towns and lives ravaged by drugs.
one had rather
better that a thousand guilty go free
than one wrongful death.

war suffers the unavoidable deaths.


collateral damage. . .to borrow a euphemism
from the lexicon of modern wars.
but this is not real collateral damage,
many are pushers, runners,
mules and addicts being killed,
low in the hierarchy of the drug trade
sacrificial expendable potential snitches.
or murders and liquidations,
opportunities to settle old scores
done under the guise of the drug war.
and, yes, there will be wrongful deaths
some truly innocent caught in the crossfire
their deaths must burden us
in collective grief and guilt.

i am saddened by the wrongful deaths.


but im still cheering him on.
because whats the alternative?
prayers? the gods wont listen.
more laws? . . . we have enough.
return to apathy of the pre-duterte days?
the impotence of past administrations
who paid no heed, paid no mind
who wore blinders, turned a blind eye
to the unfolding drug scourge?

i cast some censure on dutertes war.


it is no longer the small battleground of davao
but thousands of battlefields
in big and small cities,
countless towns and barangays.
jails crammed and overflowed by
thousands who feared for their lives,
the assets mules runners and pushers.
and except for a token few,
most of drug barons, dealers and manufacturers,
the corrupted officials, military and policemen
still walk free.

and what of the hundreds of thousands of addicts?


while many addicts are pushers
many are hapless victims of curiosity
and experimentation gone awry.
the countrys medical system lacks the
capability for a true drug rehabilitation program.
the government has failed
on social and health problems of lesser scale.
what more, in an epidemic of this magnitude.
of a drug addiction with 92% recidivism.

the war on drugs has just started


but we have crossed the rubicon.
there is no turning back.
lest we go back to the old days
of hopelessness and helplessness
when the empire of drugs ruled
and razed through countless lives.
lest the drug lords dance with the devil anew
emboldened, once again
by the apathy and greed
of the powers that be.

it will be long long war


not a three-month war or six or a year.
the commerce too rich to be given up.
shabu will merely recede into the shadows
selling clandestine highs
while kingpins and drug lords
figure out their next moves
patiently waiting and reassured
at their chosen sanctuaries
that duterte will not win his war
or that he will not last the war
or that six years is an easy wait
for them to reclaim the land.
unless we see kingpins
dangling on a noose
or strapped on a chair
unless we hear
the cracking of firing squads.

we are all spectators in this war


flashing daily images and stories of death
one image records a casualty of war
the same image evokes the pieta.
some rave and cheer
some rant and rage
many sit on the fence, out of harm's way
hopeful, wondering where it goes.
while we stand conflicted at this crucial crossroad
i pray, hope duterte survives the bounty on his head,
and i dream, wish for him victory on his war on drugs.

august 5, 2016