The ninth session of the twelfth round of Physicians’ legion was hold by Master Dezhakam as the master of ceremony and guest speaker and Ms. Qazal as the secretary with the agenda “Crystal, the Technical Discussion” on December 9, 2016 at 8 a.m.
Master Dezhakam:
In the past we went school on snowy days and the snow reached to our knees but schools didn’t shut. Nowadays schools and kindergartens will be closed if there is some snow and heavy traffic and blockades are the result.
I said to the members, “our sports matches do not shut even if stones fall from the sky.” It is not good to retreat because of little snow. If we retreat here we will get used to retreat in all careers of our life; and we will cancel our programs when facing the unimportant problems. Today’s agenda is technical and we want to cure crystal addiction. I ask Dr. Reza to tell us what kind of problems a crystal addict has and how he must treat him/her.
Dr. Reza:
We had believed that chemotherapy was not an effective way to cure crystal addiction until Matrix Method arrived. The method was carried out in 36 sessions and the patients attended just 7-11 sessions. Each session lasted for 45-50 minutes. After they came to clinics again, their tests showed that they had consumed drug.
We were searching for medicines to be ordered beside psychiatric procedures. At that time medicines like Buprenorphine or Ritalin were ordered for meth addicts and also the medicines to strengthen them because they felt weak and fatigued after ceasing meth using. After tapering Metylphenidate, the patients complained of having less energy.
When I got familiar with DST Protocol, I wonder why we should order a narcotic for the person who uses stimulants. OT prescribed for a meth addict includes single dosage of 0.3 cc, then it is doubled and afterwards it is tapered.
Some cases of congress 60’s members that referred to clinics and used pure meth without any other drugs had stable situation with the dosage and had no cravings after their treatments. Afterwards we used OT according to congress 60 protocol beside Matrix method which had some positive effects.
Master Dezhakam:
My question was left unanswered. We should first realize the cause and then find the treatment. This is a general rule in medicine.
What is the physiological cause in meth addiction?
Dr. Behnam:
I want to share my experience about the beginning of meth addiction in ladies. Most of them say that they used it for losing weight. Sexual disorders underlie using meth in most of the men. Using meth made students improve their ability to study. In my opinion, what stimulates an individual to use meth is his/ her less mental motivation and ability and s/he tries to enhance them by using meth.
Master Dezhakam:
Meth doesn’t result in losing weight but it makes individuals not sleep and eat, therefore they gradually get thin. Regarding sexual issues we should realize what is influenced by meth that some individuals indulge in sexual issues.
What is the main reason for losing weight in using meth?
Mr. Ehsan:
I have learned that using meth increases the amount of dopamine. Since some of the neurotransmitters should be saved in vesicles, after using meth, the brain is deceived and thinks that the number of vesicles has increased thus it orders to evacuate. In this stage dopamine is released in synapse space, sits on the receptors and blocks the way back and the person has a feeling of extra euphoria at which nothing can be eaten and directly leads to getting thin. We want to deprive them of something that means all their lives.
Dr. Azam:
In order to reform the issue we should first realize that the X-system has experienced a big disorder therefore all other things are influenced, too. We know that the amount of dopamine has reached to a high level in these people thus the best way is to help neurotransmitters’ system to be balanced. It is true that crystal is a stimulating substance but OT (opium tincture) is empirically useful in their treatment because of its effective alkaloids.
Master Dezhakam:
You talked sense. I think we haven’t paid any attention to the cause. We have considered it as insomnia, being unable to go to work and so on. You as physicians have to give a proper answer to addiction. The first step in addiction is to determine the cause. The common protocols would be efficient if any of them determined what the cause is. In physiology we need to know where has been affected by the cause.
Dr. Mohammad Ali:
We have witnessed salient advances in modern medicine. However, I think there is a gap between different specialties. This gap which has affected not only addiction but also all the other fields will be filled by a holistic view toward human body and various illnesses.
The treatment is common for addiction come from this holistic view in medicine. When I was a general physician and worked in addiction field, I believed I could solve all the patients’ problems by ordering different medicines for his/her different symptoms like: antihistamine for runny nose, dicyclomine for cramps, imipramine for depression and so on.
I just wanted to remove the symptoms and thought all the problems would be solved in this way. I think that it is the same in cancer, MS, ulcerative colitis which Congress 60 has recently achieved salient success in their treatment. In fact, we don’t address the main source and origin but present symptoms in the organ. Regarding neurology, we cannot certainly recognize the main problem in addiction and we just see the symptoms.
But there is a neurotransmitter view toward addiction, i.e. the activities of reward pathways, which mainly works by dopamine, increase in the period of using drugs. Therefore it seems that your theory in addiction treatment is reliable, however I believe that it has been proved. The neurotransmitter system is not active enough or has deviated from its natural route.
Dr. Masoud:
I believe that imbalance in neurotransmitters, mood or inappropriate secretion. We know that crystal cannot increase the amount of testosterone in men but it increases the audacity.
In my opinion if someone has a balanced X- system s/he doesn’t tend to use drugs at all. Inappropriate system of education makes the young use Ritalin. Or some other systems make them use something in order to reduce their embarrassment. Losing weight in sports activities is one of the factors which force our athletes to tend to addiction. Most of them use Ritalin.
Dr. Mohammad:
I think that the problem has originated in imbalance that is differs in various substances (for example, opium, heroine, crystal, hashish). Dopamine and serotonin are the neurotransmitters that are involved in nerve cells when using crystal or meth. Thus the meth abusers have both the sense of pleasure and happy. They feel their thoughts have been improved and are not depressed any more.
When crystal is used for a long time, the body of nerve is destroyed and afterwards dopamine and serotonin are unnecessarily released in nerve endings. Consequently we get used to the huge amount of dopamine and one’s sense of pleasure changes. Considering the treatment stages in meth addiction, the patient experiences a lot of discomfort during the first stage which lasts 10-15 days. This stage is called ‘honey moon’ in the Matrix Method. After 15 days the individual stops using meth easily. The next stage in which the body of nerve reconstructs itself lasts for 6-9 months and is called the wall period. The ten month-period that is considered for treatment is the time during which the body of nerve is busy recobstructing itself.
Dr. Reza:
Crystal and meth have existed since 1901. The question is that why people have used it for the last 20 years? Crystal was used during World War I; it was also used in medicine for losing weight. I believe that the movement of human society has had great effects on using meth and crystal. Do we have any excitements? Is there any usual euphoria which existed before among the members of our society?
In the past, dopamine system was stimulated when an individual talked to his wife. But today people experience more emotional gaps. We are much involved in daily affairs, don’t have any movements therefore no dopamine is released. Today there is an erroneous assumption that crystal can solve our problems.
Master Dezhakam:
When a patient refers to you, you measure his/her fever, heart beating, blood pressure; you ask some questions and order some tests like urine and glucose tests. These procedures determine the problem and you will start treatment. From the world viewpoint, addiction is an illness which should be controlled just like diabetes. Addicts believe that addiction is a mysterious, incurable and progressive illness. The methods you called (Matrix, URD, ….) are not treatment but they are cessation (0f using drugs). We must talk about the problem scientifically. Addiction is both a physical and mental illness. This is the start point. As Mohammad Ali said we have removed the symptoms not the causes.
Dr. Fereshta:
Addiction is a multifactor illness. For instance, some factors are involved in cancer and no causes have been recognized yet; or genetic, having no movement, nutrition, stress, and so on are the factors involved in diabetes. Thus we must take treatment into consideration in all parts.
It is the same in addiction. We should search for its origin in addicts. Genetic plays a role in addiction. The members of a family whose parents are addict are the most likely candidates for addiction. In addition, social and environmental issues have effects on people. Since more than one factor affects people to tend to addiction, it is necessary to improve one’s worldview and thought.
Dr. Mohsen:
Physiopathology has not progressed much in psychiatric diseases. They accepted that addiction was an illness but not practically. Physiopathology has worked inefficiently about the psychiatric illnesses in which body was not the single part involved. The problem is included in body (neurotransmitters), thought and worldview.
Dr. Elham:
Psychologists, psychiatrists and physicians have come to the conclusion that all types of disorders, whether psychotic, behavioral or social, are the result of brain’s function and disordered function of brain makes the individual unbalanced. This happens in addiction, too. What occurs in using crystal is related to a mental and cognitive problem which makes the neurotransmitters unsettled. Psychoses are the most common harms that may happen to meth addicts.
Master Dezhakam:
Nowadays we are in a period of time just like when someone said: “If physicians wash their hands with lime water, pregnant women don’t get puerperal fever following childbirth.” We are in a similar period. I mean that DST method, opium tincture and X- system are all theories. We cannot say we know everything.
We don’t know what happens in ‘Black Box’. For example, we know that the atom is like a circle which includes a proton and neutron in its center and an electron orbits around it. Afterwards quantum arrived and described other things about the atom.
I beg you not to search for the problem on the internet or in different books. Each of you is a medical reference. Survey the problem physiologically and based on your own knowledge. We want to know which part of a meth addict’s body has got involved. The closer we get to the answer of the question, the better we can talk about the problem and find the appropriate treatment.
If we recognize the cause we must not resort to URD or UROD, which are the most dangerous and nonscientific methods. We may have another session with this agenda again. Some of you have been working on addiction for 15-20 years. I ask you to find the answer I asked: “what is the physiologic problem of these patients?”
At the end of the session, Asqar, the traveler and the student of Mr. Meisam received the flower of liberation (the symbol of recovery from addiction) from Master Dezhakam. He was under the supervision of Dr. Azam and Dr. Elham.
Prepared by: Ali Reza Nik ravesh
Translated by: Marjan
December 9, 2016