How to help a friend who just started using meth
November 15, 2014 4:34 AM   Subscribe

My friend showed up to my apartment around 2:30am this morning and admitted to my girlfriend and I that he started using meth for the first time on Thursday. I think he smoked at least two or three times between Thursday and coming to our place. He is now on our couch trying to sleep. We have no idea what to do. We are located in Portland, OR.

He gave us his phone and car keys and we have been trying to delete his meth contact from his old flip phone but it has not worked yet. Do we need to drive him somewhere RIGHT NOW? What will his come down be like as a first time user? He has also tried to commit suicide twice in the past six months and got out of the hospital a couple weeks ago. His fiance, who was a recovering meth addict but hasn't used in more than a year as far as we know, and him are in the process of breaking up so he does not really have a place to go. Of course he wants us to keep this secret, which we suspect is not really possible.

Thank you.
posted by Corduroy to Health & Fitness (20 answers total) 3 users marked this as a favorite
Report his dealer to the police. That's one problem solved. Don't keep his secret. His secret is killing him and you don't need to be burdened with his death. He needs to be back in the hospital. That is his place to go. If you are financially able, start putting money aside for when he gets out, to help him find a place of his own.
posted by myselfasme at 4:42 AM on November 15, 2014 [2 favorites]

Calm down. Meth isn't satan incarnate. The come down isn't that bad, and it's not physically addictive in the sense that there is withdrawal or anything like that. He's going to be tired and have a headache at worst. Just let him sleep it off and then have a conversation about it. You don't have to support the guy using meth, but you don't need to panic about it either.

What he really needs is the care of a qualified medical professional to deal with his depression and dependency issues, but using meth a couple of times in a weekend isn't what I'd consider a medical emergency. It's really not much stronger than Adderal, a drug that millions of people use daily.
posted by empath at 4:47 AM on November 15, 2014 [42 favorites]

the crisis here isn't the meth, it's that your friend is suicidal and doesn't have a safe place to stay. ask yourself what you can do to help him, but also ask yourself whether what you can do is enough or whether you can help him find people who can do more.
posted by at 5:04 AM on November 15, 2014 [27 favorites]

If he doesn't have a history of drug abuse/addiction, I wouldn't start panicking just yet. Keep an eye on him, to make sure he's ok as he comes down, and when you're able to communicate with him rationally, urge him to go back to the hospital for help with his mental health issues.

Meth's a nasty drug, and its abuse has fucked up lots of lives, but he's literally just started using it within the last 48 hours, at a very bad time in his life. The ongoing problem is his depression and suicidal behaviour, which should be your priority if you want to help him. The meth use is alarming, given his current state, but looks more like a symptom of his problems, you know?
posted by skybluepink at 5:10 AM on November 15, 2014 [7 favorites]

I tend to agree withskyblue more than empath. Meth is not the devil incarnate but it is pushing for that status It is very very good at what it does which is part do its dangers. I certainly agree that treatment for depression and anxiety is paramount but any further use of meth is an absolute no no. Do not lend money to him, warn friends about a not lending money etc. if you know his dealer, and you feel comfortable, indicate that you or others will be monitoring/report any further contacts. Continued use of meth may will postpone treatment and will certainly interfere with it. Thanks for being a friend and good luck
posted by rmhsinc at 5:46 AM on November 15, 2014 [3 favorites]

Please don't take on the responsibility of saving him from himself - you can't do it, and it will be exhausting and frustrating and demoralizing and very, very hard on you. And all for nothing - because if he wants to continue using meth, he'll do it. Even if you succeeded in deleting his dealer's number from his phone, what will that accomplish? He's the one who put it in there. If he got the number once, he can get it again.

It sounds to me like your friend needs professional mental help, not somebody to keep him from doing drugs. Let him sleep it off, then talk to him about his mental state, not the meth. Help him call his doctor or therapist and figure out how to get some treatment and get himself stabilized.
posted by something something at 6:08 AM on November 15, 2014 [12 favorites]

Agree that he does not have a meth problem – he has a problem with depression, and the meth is an expression of that.

Despite what's commonly said, rarely do people become instant drug addicts, rather it's the repeated use of drugs to avoid other problems in life that drives the addiction. If a person is depressed, and then tries meth, they'll find that whilst under the influence of meth, the depression is gone. When the meth leaves their system, they find that the depression has returned. Hence, driving them back toward meth, and the vicious circle that will subsequently lead to physical addiction. And while the circle can be vicious, it is by no means instant, or inevitable.

In terms of what his come-down will be like, from what I've seen, it will be a lot like depression, only with perhaps a bit more physical agitation. Depression mixed with a hangover perhaps.

It sounds like he may feel trapped at the moment – hence the suicide attempts and hospitalisation. He's in a bad relationship that is falling apart, he doesn't have anywhere to go, thus he's choosing escapist behaviours. At the 'lighter' end, that looks like meth, and at the 'heavier' end, that looks like suicide.

As to what you can do, it depends on what you are willing to commit to and how involved in his recovery you would like to get. If you want to offer him a place to stay while he goes and gets treatment, that would be very kind and generous. It may help relieve him of the feeling of being trapped. If that's the route you go, I suggest making it a fixed period of time (2 weeks, 1 month, 2 months) and sticking to that. Also, require that he goes and takes help, making very clear that you are offering him a place to land whilst he goes and gets help, not a place to run away from his problems.

If you are not looking to become directly involved, but want to dust him off, give him a talking to, and send him on his way, the best thing that you can do is create a place of honestly and empathy.

That may look like saying to him, "Look, you have depression present, you seem to have tunnel-vision, and you're doing things right now that are hurting you. There's no magic bullet, you're going to have to work hard to get out of your relationship and change your life.

"I/We want you to succeed, and we will help you, but first you have to help yourself. Your home is not your home anymore, and you need to find a new home. If you are going to hurt yourself, I will take you to the hospital. Otherwise, you need to go and stay somewhere else. If you find a new place to stay, I will take you home to pick up your stuff, and then I will take you wherever you want to go.

"If you choose to continue this way, I/We cannot be your friends right now, so please don't call us again."

For the sake of your own life, you probably do not want to go down the rabbit hole with him. As hard as it is to say goodbye to someone in struggle, the reality is that he is creating this for himself, and only he can change it. Some people have to hit bottom for that to happen, other people self-correct relatively quickly. But where he is right now requires professional help, and to entertain helping him without him working with professionals may well draw you into a place you really don't want want to be.
posted by nickrussell at 6:36 AM on November 15, 2014 [10 favorites]

Response by poster: Thanks everyone, all your answers are very helpful. Yes, I have no interest in trying to save my friend, though I wish I could. As many of you realized, my real question was how an already suicidal person will respond to coming down from meth for the first time. He seems to be sleeping now, and we'll see what happens and talk when he wakes up.
posted by Corduroy at 9:05 AM on November 15, 2014

Yeah, the real problem here is the depression. I haven't done meth in something like fifteen years, but the comedown is the same as with any stimulant: you're tired and cranky (pun not intended) and a bit gloomy.

If you want to help, then help him find a place to live and therapeutic support for his depression.
posted by feckless fecal fear mongering at 9:12 AM on November 15, 2014 [2 favorites]

Honestly, the first time he'll probably have no bad side effects at all. It's when you do meth for long enough that you get acclimated to it and try to quit when the real depression, etc, kicks in. If everyone felt miserable after doing it once, nobody would do it a second time.

The real bitch of meth is that it's easy to get into a habit of doing it regularly without causing any problems in your life at all, until all of a sudden, it starts causing problems and you find that you can't stop.

If you have this idea of it being an instant slide into a bad episode of COPS, and then you try it one time and your world doesn't fall apart, you think 'well that wasn't so bad.' Then you do it again a couple of weeks later. Then again the next week. Then the next day, and then a year from now, it's 2 in the afternoon, you haven't slept for 4 days, you have blankets covering your windows to keep the light out and you're poking your head out to see if that goddamn helicopter is still watching your house.

I guess what I'm saying is that the wrong way to approach his meth use is with unrealistic scare tactics. He'll just think you're being silly. Talk to him about his depression, see if you can get him to make an appointment with a doctor to handle that, and that only, and tell him he can't come to your house on meth ever again.
posted by empath at 9:14 AM on November 15, 2014 [11 favorites]

It may make you feel better to have a plan in place if he does seem suicidal again. Taking him to the ER if he's willing to go with you, or calling 911 if he's not willing to go with you, are likely both very good options.

The hospital should have discharged him with a plan in place for where he should seek follow-up care, though that doesn't mean they necessarily did discharge him with such a plan. But it may be helpful to ask him what names or phone numbers they gave him in his discharge paperwork. If he doesn't know, he may be able to call the hospital and either get the information over the phone or have them mail him his records with that information. Following up on that plan could be another good step if he's not actively suicidal when he gets up.
posted by jaguar at 9:25 AM on November 15, 2014 [1 favorite]

Some resources for you and/or your friend:

If your friend shows up high (or drunk or whatever) and you don't feel you can care for him (for whatever reason), you can call police non-emergency at 503-823-3333 and ask that he be taken to the Sobering Station. If you are not familiar with it, it's a medical facility for people who are under the influence of drugs and/or alcohol and cannot care for themselves. It's completely confidential and there's no charges associated with being taken there. Police can take him there and he will be monitored until he sobers up/comes down. (Please don't be afraid of calling the police in this situation. PPB gets a bad rap but like, anywhere, there are a few bad officers who make the news and many good officers that no one ever hears about.)

Second, there is a relatively new facility that is a sub-acute mental health facility called Telecare Crisis Assessment and Treatment Center (CATC) - (503) 232-1099. Patients have to be referred by way of Multnomah County but I believe that can be done from a hospital.

The Multnomah County Crisis Call Center at (503) 988-4888 is staffed by some really excellent people. They can direct your and/or your friend to the appropriate resources.

Likewise, the Alcohol and Drug Helpline at 1-800-923-HELP (1-800-923-4357) has some great resources as well.

Good luck.
posted by Beti at 9:26 AM on November 15, 2014 [6 favorites]

No drug is satan incarnate but when coupled with mental illness and friends who use the drug, who are also perhaps suffering from mental illness, it can be. nickrussell above provides excellent advice.

On preview: and this is going to seem especially cruel as you are trying to be helpful and I admire that "As many of you realized, my real question was how an already suicidal person will respond to coming down from meth for the first time." But you didn't ask that. And you stated "we have been trying to delete his meth contact from his old flip phone" so you are obviously interested in your friend not doing meth in the future.

This is how it happens. It's to your eternal credit being a friend but you need to draw some lines to protect yourself.

The comedown from doing meth once is more like a first hangover as opposed to quitting any drug used over the long term.
posted by vapidave at 9:40 AM on November 15, 2014 [1 favorite]

Hi! Former meth-user-with-suicidal-ideation here.

Potassium is good. As are liquids. Banana smoothies are pretty much ideal. But really, any kind of food and drink.

He may be feeling like his brain is starting to eat itself. Obviously there are some things that need to be said. But long conversations may just spiral into incoherence and fragmentation.

After the obvious statements and check-ins have been established, with a plan of action set up (even if it's just a plan-to-have-a-plan), it might be helpful to do something like sit next to your friend on the sofa and watch a bunch of TV episodes, or go rake leaves in the yard, or something that can give his brain the equivalent of a banana smoothie.
posted by sockelganger at 11:28 AM on November 15, 2014 [15 favorites]

Report his dealer to the police

This is a flat-out insane suggestion. Even leaving aside the morality of it, do you really want to get yourself involved in trying to send possibly dangerous people to jail? It's not your business and life is not a TV show. The "dealer" is probably just another troubled person like your friend who happened to give him some drugs, and this person has absolutely nothing to do with you at all.

As correctly noted above, your friend's mental health is the real issue.
posted by drjimmy11 at 6:38 PM on November 15, 2014 [13 favorites]

Amphetamines are actually used to treat otherwise treatment-resistant depression, so your friend self-medicating with methamphetamine is not necessarily the end of the world. The dangers of street methamphetamines are primarily the uncertain purity and high (above therapeutic) dosages.

Your friend needs treatment for depression. IMO, the best thing you can do for him is to encourage him to seek psychiatric care to obtain safe, legal drugs to help him instead of buying risky street drugs.

SSRIs can take a while to work, but Wellbutrin is a very fast-acting antidepressant. And if neither SSRIs nor Wellbutrin work, he may be able to eventually get Adderall (amphetamine salts) by prescription.
posted by Jacqueline at 12:55 AM on November 16, 2014

Your friend is trying to "other" himself by doing what he considers to be othering behavior. You can show him this is pretty futile by pointing out that methamphetamine is routinely prescribed to children for ADD.

The chances that few doses of meth will cause physical problems is rather slim. Seriously, it takes at least a few days of near constant use before serious problems begin to appear and really more on the order of a few weeks. One of the bigger problems is that the "meth" that he used may not even be methamphetamine at all, but a mixture of various other stimulants and cuts. He is using an unknown mixture at best, in other words.

Yes, I am an ex user.
posted by telstar at 2:13 AM on November 16, 2014 [2 favorites]

Yeah using meth once or twice doesn't automatically turn you into a slavish addict. I've known people who used it semi-regularly without becoming stereotypical addicts.

Totally agree that ratting out your friend's dealer is a very bad idea indeed. As in terrible.

But I also do not believe, given your description of the broader context, that this is in fact his first time doing meth. I call bullshit on that. How sure are you he's not an addict who's been hiding it?
posted by spitbull at 10:02 AM on November 16, 2014

Response by poster: spitbull, I am suspicious this isn't his first time because he has been saying he hasn't been able to sleep every time I've talked to him since he got out of the hospital a couple weeks ago. I haven't asked him yet about that, but I plan on doing so. But what about my description specifically makes you suspicious? His ex-partner being an addict?
posted by Corduroy at 10:26 AM on November 16, 2014

posted by spitbull at 6:43 PM on November 16, 2014

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