Posted by: gdevi | June 18, 2013

Review Excerpt: David Sheff, Beautiful Boy (2008)

I am reading a very interesting and deeply moving memoir by David Sheff entitled Beautiful Boy (2008) about coming to terms with his young son Nic’s meth addiction. You might know Sheff from his columns for the NY Times and other magazines. There must be very few horrors, barring wars and famine, that must be hard for a parent to watch than to see your child slowly die of drug addiction. And to know that there is nothing you can do to stop it from taking place. This book captures this feeling of helplessness, outrage, and sheer desperation very powerfully. I will post a full review later, but I wanted to note this excerpt here. This book is half memoir, half reportage, and Sheff gives very concise and precise information about the whole meth industry as well as its addiction treatment industry. If you know about meth addicts — it is an epidemic in my community of Lock Haven, PA as well as many rural communities in central PA — drug abuse itself is the problem — at least 8-10 teenagers die in my community each year from drug abuse — high school students usually — what is evident is that it is one of the hardest addictions to treat, harder than heroin or cocaine. The percentage of recovery after detox is in the single digits, if there is any at all. Sheff interviews Prof. Edythe London, professor of Psychiatry and Biobehavioral Sciences at the UCLA School of Medicine about the pharmacology of the drug inside the human body. Dr. London shows him the PET scans of the brains of sixteen meth users, and the PET scans of the control group:

“She explains that the picture is the average of sixteen addicts’ brains, combining PET scans, which chronicle the activity, and MRIs, which provide a highly accurate background structure. These images are superimposed on the average of brains in the control group. London has assigned colors to the images. The result is before me: a map showing the stark difference between addicts’ and normal brains. It is a lateral cross-section, with the gray matter–the MRI structure–in gray. Blue patches indicate where the activity in the brain of the meth user is significantly lower than the control group’s brains. Yellow to red are “hot,” meaning that there is significantly more activity in the addicts’ than the others’ brains.

London stares intently at the screen. After a few moments, she sighs. “It’s beautiful, but sad.”

My mind goes to Nic. Assuming he is an average meth user, the largest sweep of the hottest colors, the size and shape of a small tailless mouse, is located in the posterior cingulate. Pointing to the patch, yellow in the center radiating out to a circle of Halloween orange, London explains, “What is turned on here is exactly what turns on while people feel pain.” The operative word is while. She goes on, “A person stops using methamphatemine, and this is awaiting them.” Clinicians who work with meth addicts already know that addicts are often depressed, argumentative, anxious, and unwilling to engage in treatment–exactly like Nic–but London’s scans reveal that these conditions have a biological basis. In addition, they indicate a level of severity unrecognized before. It led her to conclude that meth addicts may be unable, not unwilling, to participate in many common treatments, at least in the early states of withdrawal. Rather than a moral failure or a lack of willpower, dropping and relapsing may be a result of a damaged brain.

She explains that severe cognitive impairments may make patients incapable of participating in therapies that require concentration , logic, and memory. . . . There are many spots of “hot” brain activity that correlate to trait (ongoing) and state (situational) anxiety, far more than the control subjects. The picture is unique to this drug, London explains. “Scans of brains of heroin, cocaine, or alcohol abusers do not show changes like these.”

The images also suggest cognitive impairments. A blue patch in the medial orbitofrontal cortex is worrisome to London because activity in this area is related to decision-making ability. . . . “In the meth users, at least in the first weeks, the cognitive strategies that the brain is using are abnormal,” London says. This means that, in addition to the biologically rooted high anxiety and depression, people getting off meth have severely impaired cognitive functioning. (pp. 134-137)

Here is a song about meth abuse from one of my favorite bands, Old Crow Medicine Show’s Methamphetamine.

“Summer of Love.”  Whatever.

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