University of California, Los Angeles

The University of California, Los Angeles is presented as a major source of research and clinical expertise on methamphetamine addiction, from brain imaging and treatment design to the practical management of withdrawal, relapse, and drug cues. Its significance in the narrative lies not in a claim that one institution can solve addiction, but in the way its researchers help the narrator replace certainty and blame with evidence about a complex, recurrent condition.

Research and the methamphetamine epidemic

Researchers associated with the University of California, Los Angeles appear within a wider account of a drug problem spreading beyond its earlier concentration in western cities. The book describes methamphetamine use as an epidemic affecting communities across the Midwest, South, and East Coast, with consequences for hospitals, rehabilitation facilities, jails, and law enforcement. National survey results cited in the account show the growing scale of concern: in 2006, 40 percent of a random sample of 3,400 drug enforcement agencies identified methamphetamine as their most significant drug problem. Treatment admissions for methamphetamine addiction rose from 28,000 annually in 1993 to about 150,000 in 2005, more than a fivefold increase.

The narrative places this spread alongside a warning against treating addiction as an affliction confined to one social group. Users, it says, come from different classes, races, and backgrounds; addiction appears in both affluent and poor communities. That broad reach gives research and treatment work associated with the University of California, Los Angeles a public-health context: the problem cannot be understood solely through an individual family’s experience or explained by a single demographic profile.

Brain imaging and the effects of methamphetamine

Edythe London, a pharmacologist and professor of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at the University of California, Los Angeles, studies brain function in methamphetamine users. In 2000, she created brain images from a group of sixteen users. After the participants had entered the hospital and passed through the first days of withdrawal, she used positron emission tomography scans to map brain activity. The scans measured blood flow and biochemical reactions through radioactive tracers; magnetic resonance images supplied structural backgrounds against which the activity could be compared.

London combined the participants’ scans into an average image and compared it with an average drawn from a control group. In the resulting map, blue marked areas where activity in the methamphetamine users’ brains was significantly lower, while yellow and red showed areas of higher activity. The image gave the narrator a visible comparison between the users’ brains and those of the control group, turning the abstract question of damage into an observed difference in brain function. The book presents the image as evidence relevant to the condition of users entering rehabilitation, not as a complete account of any one person’s future or a guarantee about recovery.

Other evidence discussed alongside University of California, Los Angeles research emphasizes the drug’s risks. A laboratory test conducted at the University of California, Los Angeles found methamphetamine in eight of ten tablets sold as ecstasy at clubs in that city. Psychiatrist and researcher Tom Newton, also associated with the institution, concluded from a survey of suicidal tendencies among drug users that methamphetamine could induce depression severe enough to make people feel suicidal. The account also describes chronic effects that may include deteriorating memory and mental acuity, physical impairment, and damage associated with strokes. These findings make clear why the book treats methamphetamine as a distinctive clinical challenge rather than simply another intoxicant.

Treatment expertise and its limits

Richard Rawson, associate director of the Integrated Substance Abuse Programs at the University of California, Los Angeles, is one of the book’s leading sources on rehabilitation. He criticizes expensive, highly promoted programs that apply much the same treatment to every addiction, comparing their results to a paint job that does not last. The criticism is not that all rehabilitation is useless: programs may draw on Alcoholics Anonymous principles and include counseling, group sessions, life-skills training, family work, and medical consultation. The problem, as the account presents it, is that practices can become an untested patchwork and may not address methamphetamine’s particular demands.

Walter Ling, a neurologist who directs a program at the University of California, Los Angeles, likewise cautions against assuming that programs are effective simply because they are run by trained clinicians. Treatment methods vary, and some are not supported by strong evidence. The institution’s researchers are therefore represented not only as authorities offering answers, but also as critics of an uneven rehabilitation system. Their concerns sharpen the book’s central distinction between entering treatment and receiving a sustained, appropriate course of care.

Rawson and colleagues at the University of California, Los Angeles founded Matrix-based rehabilitation centers, adapting a program first developed for cocaine addiction to methamphetamine treatment. The approach aims to keep patients in treatment long enough to practice cognitive and behavioral strategies. Patients learn to avoid situations associated with relapse where possible, or to reframe them when avoidance is not realistic. They practice interrupting habitual reactions to anger and disappointment, recognizing how a small or apparently incidental episode of drug use can prime a more extensive relapse, and identifying a choice point at which another activity can replace the old response.

The account also explains cueing: a person, place, object, sound, or other reminder can trigger craving and a return to drug use. For Nic, the drug scenes and music in the film Requiem for a Dream, which many viewers found bleak, could instead make getting high more appealing. This example connects the University of California, Los Angeles research on cues to the family narrative: a trigger need not look dangerous to an observer in order to carry powerful meaning for the person in recovery. The Matrix model’s proposed alternative is to recognize the trigger and choose a different action, such as calling a sponsor or counselor, attending a meeting, or exercising. The book stresses that learning such responses may require months or years rather than a brief intervention.

Clinical guidance and continuing recovery

The University of California, Los Angeles researchers consulted in the book agree that treatment should begin with assessment. If a patient is experiencing methamphetamine psychosis, medication may be needed to address the acute symptoms. Additional psychiatric conditions are common, but withdrawal can resemble other illnesses, making diagnosis difficult. Some clinicians would treat depression routinely; others advise waiting until a patient has been off methamphetamine for at least a month before diagnosing and treating secondary conditions.

The experts are divided over whether inpatient or outpatient treatment is more effective. Inpatient care offers close monitoring and a controlled setting but can be difficult to translate into everyday life after discharge, when relapse may occur. Outpatient treatment brings recovery work into the patient’s ordinary environment, but also leaves more opportunities to use drugs. The preferred plan described by most of the experts combines the longest feasible inpatient stay with a gradual transition to comprehensive outpatient care, beginning with several sessions a week and tapering over a year or longer.

They also caution against introducing behavioral and cognitive therapies too early in withdrawal. Supportive measures such as massage, acupuncture, exercise, and carefully monitored sedatives may help patients endure its worst stages. In outpatient care, practical assistance with a schedule can help structure the time between sessions, while drug testing and meaningful consequences for relapse are described as important components. Behavioral therapies can then be introduced gradually and adjusted to the patient’s capacity to participate. Medication and psychotherapy may be appropriate when another condition, such as depression, bipolar disorder, or acute anxiety, is also present.

Contingency management provides another treatment strategy discussed in connection with research at the University of California, Los Angeles. In this approach, patients receive modest rewards for drug-free urine samples, with incentives ranging from vouchers for practical needs to passes for recreation. Clinical trials cited in the book found that adding these rewards to cognitive and behavioral treatment produced two to three times as much abstinence as cognitive and behavioral treatment alone. The evidence supports a specific conclusion about the program combination, not a claim that a single method ensures lasting recovery.

That restraint matters to the book’s wider account of addiction. Rawson describes repeated treatment as common among heavy users, and the narrator considers recovery an ongoing process rather than a cure that must succeed on its first attempt. The reported benefits of treatment may include reduced drug use and illegal activity even when relapse occurs; nonetheless, each relapse can be lethal. Through its researchers, clinical programs, and evidence about both benefit and limitation, the University of California, Los Angeles helps frame recovery as sustained work under uncertain conditions—not a simple contest of will, and not a promise that treatment can control every outcome.