Dentistry

Stratfor on Methamphetamine Production in Mexico

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Meth Mouth – the effect of Methamphetamine use

Stratfor has an excellent piece on the production of methamphetamine in Mexico and Central America, production techniques and precursor chemicals.

Based on evidence obtained from raided laboratories in the United States and Mexico, it appears there are two primary methods of methamphetamine production in those countries: the phenyl-2-propanone (P2P) method and the reduction method.

Sometimes referred to as “building up,” P2P is considered the more difficult of the two methods. It requires more chemicals and materials and more sophisticated chemistry. In fact, the chemical process is so technical and complex that it requires several days to complete, necessitating a skillset akin to that of licit chemists. It also entails a purification step that increases the potency of the final product. While P2P produces a more potent final product, the method is subject to the competence of the manufacturers and the quality of the chemicals being used. P2P is the method most employed by Mexican criminal organizations because its two primary requisite precursor chemicals, methylamine and phenyl acetic acid, are loosely regulated in Mexico.

Reduction is the manufacturing method primarily used in Asia and the United States. This method involves mixing ephedrine or pseudoephedrine with a few easily attainable precursor chemicals. With reduction, a manufacturer can cook a small volume of meth (a few ounces) in as few as eight hours. Indeed, the key difference between the manufacturing methods is that reduction requires less time and less sophistication than P2P, and ultimately it produces an inferior product.

It should be noted that the manufacturing method has nothing to do with production scale. Either method can be used to cook large or small quantities of the drug. It can be manufactured in a hotel, apartment, home, car trunk or backpack. However, to produce meth on an industrial scale, a manufacturer would need more space. Past seizures have taken place in large warehouses (around 1,600 square meters, or 17,000 square feet), small ranches (6-40 hectares, or 15-100 acres) or even mid-sized homes.

Cost of production also differentiates the two methods. While meth is more cheaply rendered by reduction, both methods are extremely cost effective. Depending on the price of chemicals used — determined by the quantity of chemicals purchased and the legitimacy of the supplier — the cost of manufacturing 1 kilogram (2.2 pounds) of meth comes to anywhere between $150 and $4,000. The use of methylamine, which is highly regulated, expensive and, as stated, only used in the P2P method, is the key factor in this price range; substituting methylamine with a mixture of methanol and anhydrous ammonia drastically reduces the cost. According to the U.S. Department of Justice’s National Illicit Drug Prices Mid-Year 2009 report, the wholesale market price for meth is $19,720 per kilogram while its street value is $87,717 per kilogram. Needless to say, this is a huge markup.

But it is not necessarily the overall cost that determines the production method of Mexican criminal organizations, or any meth manufacturer. Rather, it is the availability of precursor chemicals that matters. Mexican manufacturers could save vast sums of money by exclusively using the cheaper reduction method. But the Mexican government’s strict regulation of ephedrine and pseudoephedrine compels criminal organizations to use other methods, such as P2P, that require less-regulated precursor chemicals.

Read all of the report and then you can watch this video on the effects of methamphetamine on the mouth. The American Dental Association authored the video.

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Dentistry

Does Saliva Quality Play an Important Role in Meth Mouth?

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The effects of Methamphetamine on the Teeth – Meth Mouth

Perhaps, according to a new study. Here is the abstract.

Methamphetamine abuse and oral health: A pilot study of “meth mouth”

Michele C. Ravenel, DMD/Carlos F. Salinas, DDS/Nicole M. Marlow, MS/Elizabeth H. Slate, PhD/Zachary P. Evans, PhD/Peter M. Miller, PhD

Abuse of methamphetamine (meth), a potent central nervous system stimulant, has been associated with significant dental disease. Current descriptions of “meth mouth” are limited in their scope and fail to illuminate the potential pathogenic mechanisms of meth for oral disease. The purpose of this pilot study was to characterize the oral health of subjects with a history of meth abuse as compared to nonabusing control subjects. A total of 28 meth abusers and 16 control subjects were enrolled. Interviews and surveys regarding meth abuse, dental history, oral hygiene, and diet were collected. A comprehensive oral cavity examination including salivary characterization was completed. We observed significantly higher rates of decayed surfaces, missing teeth, tooth wear, plaque, and calculus among meth abusers. No significant difference in salivary flow rates were noted, yet results showed significant trends for lower pH and decreased buffering capacity. These findings suggest that salivary quality may play a more important role in meth mouth than previously considered. Salivary analysis may be useful when managing a dental patient with history of methamphetamine abuse. (Quintessence Int 2012;43:229–237)

So, what causes Meth Mouth?

Dr. Bicuspid has an excellent post here.

The ADA lists the suspected causes as dry mouth, poor oral hygiene, frequent consumption of sugary and carbonated drinks, tooth grinding and clenching, and possibly the acidic nature of MA itself.

In a study in ISRN Dentistry (June 26, 2011), street samples of MA had pH levels from 3.02 to 7.03, with 72% of samples below the critical pH point of 5.6, i.e. able to cause significant damage to tooth enamel if abused by a route that brings MA into contact with the oral cavity.

Although this would seem to indicate that injecting MA rather than smoking or snorting it may lead to less enamel damage, this hasn’t been borne out by the research. Researchers at the University of California, Los Angeles (UCLA) reported in the Journal of the American Dental Association that, among abusers of MA, IV users actually had a higher prevalence of oral disease and missing teeth than those who smoked MA, probably due to more advanced addiction and greater self-neglect.

“Those who use MA may make the transition from noninjecting drug use to injecting drug use, as their dependence on MA becomes more severe,” Vivek Shetty, DDS, DMD, professor of oral and maxillofacial surgery at the UCLA School of Dentistry and lead author on the JADA study (March 2010, Vol. 141:3, pp. 307-318), told DrBicuspid.com.

“The injected substance has almost 100% bioavailability, and the onset of the drug high is fairly rapid, generally 15 to 30 seconds.”

It is interesting that IV Meth users have more dental disease than those that smoke the drug. One would think that the constant heat and dehydration of the oral tissues would contribute to more dental destruction. But, perhaps, the more intense rush from IV drug use leads to more self-neglect.

In any case, salivary analysis of patients may give dentists a better idea of the mechanism of addiction and how to combat it at an early stage.

Watch below an embedded video below from a dentist colleague, Dr. Mitchell A. Goodis, DDS in Northern California and his interview of the many methamphetamine user patients, whom he has treated.

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Consumer Healthcare Products Association

Kentucky to Settle for Compromise Methamphetamine Legislation?

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Methamorphosis as a result of chronic Methamphetamine abuse

Looks like methamphetaime making precurors pseudoephedrine and ephedrine’s best friend, the Consumer Healthcare Products Association (CHPA) is working its lobbying magic again.

A compromise bill aimed at curbing methamphetamine production in Kentucky would place further restrictions on the sales of over-the-counter cold and allergy medicines containing pseudoephedrine.

Last week, Sen. Robert Stivers, R-Manchester, withdrew a bill that had made it to the Senate floor. That bill would have required a prescription for all medicines containing pseudoephedrine, except those in liquid or gelcap form.

The new bill would only require a prescription for the medicines after a patient has purchased 3.6 grams per month and a maximum of 15 grams annually. Gelcaps and liquids would still be excluded.

The bill would also prohibit anyone convicted of a meth-related offense from buying the drugs without a prescription for five years.

Stivers said the new bill, Senate Bill 3, gives people who use the medications “adequate opportunity without incurring medical expenses or the cost of a prescription to access these on a monthly basis and an annual basis.”

Currently, purchases are limited to 9 grams per month and 120 grams annually.

Legislation aimed at requiring a prescription has been opposed by several senators and the Consumer Healthcare Products Association, an industry group that has spent hundreds of thousands of dollars on advertising and lobbying against the bills presented by Stivers.

Yet, Kentucky had 1,200 Meth Labs discovered in 2011, which is an increased number from the previous year.

This is all about money folks and just for a few drug manufacturers. I detailed the story earlier here.

Kentucky like other states should simply require a prescription for pseudoephedrine and be done with the hometown or local Meth Lab. Then, law enforcement can concentrate on the importation of methamphetamine from Mexico.

These compromise bills, including electronic tracking systems are just BS and not as effective.

Who are the drug companies trying to fool?

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Cocaine

Methamphetamine Watch: $2.55 Million Worth of Meth and Cocaine Seized in California – Smuugled in From Mexico

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Photos courtesy of the U.S. Border Patrol

Another day and more Mexican smuggling of methamphetamine and cocaine.

Two people were arrested Friday by U.S. Border Patrol agents on suspicion of smuggling more than $2.55 million worth of illegal narcotics.

The arrests, announced Monday, were made at the Highway 86 Border Patrol Checkpoint near the Salton Sea.

According to the U.S. Border Patrol, agents arrested a 40-year-old woman after a dog team searched the 2004 Chevrolet Malibu the Mexican national was driving.

They found a hidden compartment holding 11 packages of cocaine, weighing about 27 pounds, with a street value of about $880,000.

A 42-year-old man was arrested about 10:45 p.m. after a dog team searched the 2004 Honda Accord the Mexican national was driving.

Agents found 42 vacuum-sealed packages of methamphetamine hidden in several compartments in the car.

More poison for Californians and probably other Americans.

Good work on the part of the United States Border Patrol.

The United States needs to lock down the Mexican border.

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