Need help navigating life with diabetes? You can always Ask D'Mine!
Welcome again to our weekly Q&A column, hosted by veteran type 1, diabetes author and community educator Wil Dubois. This week, Wil responds to a serious question about a potentially touchy topic -- drug use and diabetes. Yes, we're taking about the not-so-legal kind, a la Walter White of Breaking Bad.
Anonymous asks: What does meth do to a diabetic? I’m just wondering 'cause I did some last night and I feel terrible.
Wil@Ask D’Mine answers: First things first: No one here is going to encourage any illegal drug use. Let me just say that up front.
Meth, formally known as Methamphetamine, and commonly known as crystal, speed, crank, glass, cyropto, getgo, tick tick, and redneck cocaine, is a central nervous system stimulant. It puts the body into overdrive, and makes people feel like superheroes, at least for a while. It was originally synthesized in 1919 but hit the big time during World War II when militaries on both sides of the conflict used meth to keep their soldiers alert. German Luftwaffe pilots used it the most, even calling it Hermann-Göring-Pillen, crudely translated into “the boss’s pills.” After the war it was popular with long--haul truck drivers and bored housewives until the FDA lowered the boom on it in the 1970s.
That’s when meth got its second life. Since the 70s it’s soared in popularity as a generally illegal controlled substance. I say generally, because while there is still an FDA-approved version called Desoxyn, meth is most commonly a street drug made by biker gangs, Mexican drug traffickers, the Russian and Czech mobs, stovetop entrepreneurs, and cable TV stars. The United Nations Office on Drugs and Crime estimates worldwide production of meth at 500 metric tons a year, with a user/abuser base of 24.7 million.
Does that number look familiar?
Ironically, that’s the much-publicized estimated number of people with diabetes in the United States, a number that has been touted in almost every newspaper article on the subject of diabetes since 2008 (this number was just updated to 29.1 million last year).
Of course, I’m not saying that all PWDs are meth users… But speaking of meth users, why do people take meth in the first place? Probably because when you take it you get a strong, sustained “rush” that can last half an hour. By comparison, a crack cocaine rush lasts only a few minutes. The meth rush is then followed by a high that can last half a day, or more.
Or so I’ve read. I’ve never done it. But hey, it sounds good so far.
And there’s more. According to Wikipedia, meth is used recreationally “to increase sexual desire, lift the mood, and increase energy, allowing some users to engage in sexual activity continuously for several days straight.”
Really? Sign me up!
Oh. Wait. I’d better check the side effects first. Let’s see here…. reduction in brain volume, crumbling bones and teeth, increased risk of Parkinson’s, cerebral hemorrhage, psychosis…
Maybe a sexathon isn’t worth the risk… even for me.
Apparently, meth is highly addictive and one of the hardest drug habits to “kick.” Sadly, it also carries a long list of negative health consequences, waaaaaay longer than my shortlist above. You can read about all the short-term side effects here and all the long-term side effects here. But the most dramatic side effect, to me, is one that you can see with your own eyes: The rapid aging effect that meth seems to bestow on users. Just spool up the phrase meth before and after pics in you Internet browser’s image search function. Warning: It’s not a pretty sight, and the sheer volume of images is absolutely mind-boggling.
Oddly, or perhaps not, given the overly paternal nature of our health care system, American sources don’t have a lot of good info on meth and the Big D. We have to turn to the Aussies for the straight dope on this kind of dope. Diabetes Australia has an excellent frank and honest pamphlet called Drug Use and Type 1 Diabetes which reports that meth—and other stimulants—increase the risk of hypos because the amped-up body burns through carbs and sugar in the blood at a marathon pace. I might have paraphrased that a bit for literary license, although they do advise eating 6-7 jellybeans for meth hypos.
Even though the pamphlet is aimed at T1s, they also mention in passing an interesting side effect of meth on our T2 cousins. It seems that meth has the opposite effect on the insulin-rich. Meth increases stress hormones that reduce endogenous insulin secretion, driving extreme hyperglycemia.
Huh? Maybe meth isn’t a good choice for any of us D-folks.
The Aussies also worry about the fact that anyone in an alerted state is likely to forget his or her insulin. Let’s be honest, engaging in sexual activity continuously for several days straight, sans insulin, will land you dead from DKA, right? Granted, DKA with a smile on your face, but dead nonetheless.
Also, slightly off topic but interesting: one study of meth users, and the biochemical effects of long-term use, suggests that using meth can increase your risk of developing diabetes. Of course, you already have diabetes, so that’s a non-issue for you. But I thought I should mention it.
But enough about how you feel at the time you take it and what the meth might do to you. Why did you feel terrible the next day? Ah, that’s the rub with these kinds of drugs.
As a meth user comes down off a binge (which can be days of repeated use until the body no longer reacts to the “positive” aspects of the drug), they enter a phase called “tweaking” not unlike alcohol DT’s where the user feels intense itching and the sensation of insects crawling under his or her skin. This is followed by a crash, a deep sleep that can last three days. Again, this could be a bad phase for someone who needs to inject insulin to live for more than three days. Had enough? Sorry, we’re not done yet. Apparently the crash is followed by a hangover of epic proportions. Up to two weeks. And let’s not even talk about withdrawal; apparently it’s literally painful. No wonder meth is a hard habit to kick.
As much fun as parts of it sound, given the high price, I think I’ll pass, thanks anyway.
Oh, and one more warning. Remember, at the start of our discussion, that long list of entities that manufacture meth? Do you think the stovetop entrepreneur in Tennessee is making the same strength meth that the Czech mob is? The batch you buy in the alley today might not be the same strength as the batch you bought last week. And if you think the side effects of meth use are scary, take a look at the side effects of overdose. Hint: The list includes heart attack, kidney failure, seizures, stroke, and more. Oh. Right. And death. We have a similar problem in my state with heroin overdoses in regular users, due to variable strengths in the supply chain.
I suspect that you felt terrible because the meth, while perhaps fun while it lasted, took its toll on your body on its way out. Plus, being that you have a diabetic body, it might have taken a larger toll on you than it might if you didn’t have diabetes. (Of course, if you didn’t have diabetes and you use that crap long enough, you might have joined us anyway!)
Additionally, you could have had a bad low in the night to add to the pounding the meth gave you, which could explain why you feel like shit today. Still, you should be happy that you feel terrible. You are probably lucky to be alive at all.
All of this brings me to one of my General Rules for Life: If it makes you feel terrible, just don’t do it again. Even if it means missing out on sex continuously for several days straight.
This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.