Methamphetamine, commonly known as “meth”, is a highly addictive stimulant drug that affects the central nervous system. While it is available as a prescription drug under the brand name Desoxyn® indicated for the treatment of attention deficit hyperactivity disorder and obesity, it is more commonly encountered as an illegal and dangerous street drug. Also known as blue, ice, crystal and speed, meth takes the appearance of a white, odorless, bitter-tasting crystalline powder that can be smoked, insufflated (snorted) or injected. When smoked or injected, the high from methamphetamine is felt instantly, peaks within 15 minutes and typically lasts 4-8 hours.
According to a 2017 survey by the National Survey on Drug Use and Health, approximately 1.6 million Americans had reported using methamphetamine in the past year, with the average age of a first-time user being 23.3 years old. While methamphetamine is accessible anywhere in the country, its use is significantly more prevalent in the western and midwestern United States.
The Drug Enforcement Agency (DEA) has identified the primary source of large-scale methamphetamine production originating from Mexican drug cartels, which smuggle the drug across the United States-Mexico border.5 Meth is also produced in the United States as well, where users and/or distributors synthesize meth in clandestine “meth labs.” Far from pristine, meth labs use crude household products to manufacture meth in filthy conditions. Below are some of the ingredients used:
Possession of these ingredients should serve as a red flag to the possibility of meth production and/or use, particularly excessive purchasing of pseudoephedrine. In 2005, the Combat Methamphetamine Epidemic Act was passed to curb meth production. The Act mandates that retailers require photo identification upon purchase, track purchase history and limit the sale of pseudoephedrine-containing products.
Meth works by flooding the brain with dopamine, our body’s natural “feel-good” chemical, as well as norepinephrine, a chemical associated with arousal and alertness. As a result, users often experience intense euphoria, hyper-confidence and a feeling of never-ending energy.
Psychological symptoms of methamphetamine intoxication include:
Physical symptoms of methamphetamine intoxication include:
While under the influence, users may feel capable of anything and often engage in high-risk behavior such as gambling, criminal activity and unprotected sex.
Due to its long-lasting stimulant properties, meth users may go several days without sleep. During this period of no sleep, known as “tweaking,” the user becomes increasingly paranoid, aggressive and prone to mood swings as the lack of sleep wreaks havoc on their mental health.
The stages of methamphetamine abuse often follow a predictable “binge and crash” pattern outlined below:
Meth addicts often exhibit a characteristic appearance.
Long term effects of meth abuse can result in profound mental changes such as paranoia, psychosis and depression. Because meth addicts will often go days without eating and neglecting person hygiene, many addicts develop “meth mouth,” characterized by severe tooth decay. A 2015 study found that out of 571 meth users, 96% had cavities, 58% had untreated tooth decay and 31% had at least six missing teeth.
Many meth users choose to inject the drug intravenously, causing the effects to be felt instantly. This is perhaps the most dangerous method of taking meth, as research has shown that injecting a drug leads to addiction the fastest. In addition, the use of dirty needles can result in skin and soft tissue infections as well as heart valve infections such as endocarditis. Many users also share needles, drastically increasing the risk of contracting blood-borne diseases such as HIV and hepatitis C. The CDC estimates that intravenous drug users accounted for approximately 9% of HIV cases in 2016.
While these are general timelines, the length of each withdrawal phase varies for each individual. Users who have been abusing meth for a longer period can expect withdrawal to last longer, sometimes up to months until complete recovery.
Addiction treatment for meth is notoriously difficult, as there are no FDA-approved treatments. Unlike drugs such as opioids and benzodiazepines, withdrawal from meth is not likely to be physically dangerous, though that does not mean it is any easier to detox from.
The immediate goal of meth detoxification is complete cessation of meth and control of withdrawal symptoms. Some health care practitioners may choose to use benzodiazepines such as Xanax to control the anxiety and aggression associated with withdrawal as the body acclimates to functioning without meth. Treatment will primarily focus on behavioral therapies to reverse the psychological damage done by meth. These therapies may include counseling sessions and group therapy as part of the rehabilitation process.
Research has been conducted on the use of naltrexone, a drug commonly used to treat opioid and alcohol addiction, in the management of meth addiction. A 2015 study9 found that naltrexone significantly reduced meth craving following detoxification. It was also found to dull the pleasurable feelings associated with meth. With drug craving being a core symptom of meth addiction that persists long after withdrawal symptoms subside, naltrexone may have utility in preventing relapse following successful detoxification from meth.
Treatment of meth addiction is a difficult process that requires the support of a qualified healthcare professional. While some attempt to quit meth on their own without help, it is significantly more effective to enroll in a treatment program that can help manage withdrawal symptoms and build strategies to prevent future use.