Pure methamphetamine is a white, odorless, crystalline powder; pharmaceutical methamphetamine (Desoxyn) is available as an oral tablet; illicit forms of the drug may be encountered in powder, pill, or “rock” form.1,3,4 The drug can be swallowed, smoked, injected, or snorted.1,3 Methamphetamine stimulates the activity of monoamine neurotransmitters (i.e., dopamine, norepinephrine, and serotonin) in the brain, resulting in increased energy, boosted mood, increased feelings of well-being, and wakefulness. Like other stimulant medications, the meth-associated boost in dopamine activity serves as a powerful reinforcer of repeated use.1,4
Smoking and injecting meth rapidly introduces the drug into the bloodstream, where it then quickly travels to the brain. Using meth via these fast-onset routes results in a rapid, pleasurable rush which strengthens the drug’s abuse potential as well as certain health risks.5 With snorting or oral ingestion, the onset of effects is relatively slower—a euphoric high may still be achieved but without quite the same reinforcing rush of smoking or injection.5
The 2017 National Survey on Drug Use and Health indicates a lifetime prevalence of meth use at 5.40% for those ages 12 and over.6 In 2018, according to the Monitoring the Future Study, .70% of 12th graders had tried methamphetamine at some point in their lifetime, with .50% having used it in the past year.7
Methamphetamine has powerful central nervous system stimulant properties and a very high potential for addiction development due to its effects on the motivation and reward centers of the brain.
Dopamine levels in these circuits are naturally boosted by actions important for survival, including eating, having sex, and bonding with family and friends. By artificially increasing dopamine in these brain areas, methamphetamine use gives users unnaturally intense feelings of pleasure and they are strongly motivated to repeat that action again and again.1
Although crystal meth abuse can produce intense feelings of pleasure and energy, there are also many negative effects that accompany its use. Some common side effects of crystal meth abuse include:1,2,3,4,6
There is no safe way to use crystal meth. Crystal meth can be dangerous and life-threatening anytime that you use it, due to potential seizures, sudden cardiovascular events, or accidents or assaults resulting from erratic or violent behaviors. Methamphetamine abusers may soon feel that taking the drug is more important than eating or sleeping, and they are often unable to stop even when faced with overwhelmingly adverse drug-related outcomes, such as severe health issues, losing a job, or getting arrested. This compulsion to continue using a drug despite the starkly adverse consequences is a hallmark of addiction.2
Methamphetamine use may result in a relative depletion of dopamine, which could explain why the intense meth high is followed by a “crash” and feelings of apathy, depression, and hopelessness. Many users attempt to avoid these symptoms by using the drug repeatedly and often in increasing amounts to maintain the high for hours or days.1,2,4
Methamphetamine use may result in a relative depletion of dopamine, which could explain why the intense meth high is followed by a “crash” and feelings of apathy, depression, and hopelessness.
This binge pattern of use further drives the development of compulsive patterns of use, physiological dependence, and addiction.
Some methamphetamine abusers may binge for days to weeks without sleep, a pattern known as “tweaking.”8 Users in this state (“tweakers”) often become extremely paranoid, aggressive, and irritable.8 Tweakers are no longer able to achieve the desired high by taking more methamphetamine, and this pushes them into a dangerous state where the effects of sleep deprivation and overwhelming feelings of frustration set in, potentially making them mentally unstable and unpredictable.8
Continued crystal meth use over an extended period of time can have devastating mental and physical health consequences and can greatly impair functioning in many areas of life. Some risks associated with chronic crystal meth abuse include:1,2,3,4,5
The longer the drug is used, the higher your risk of developing any of these long-term effects of crystal meth use. Additionally, the longer you continue to use meth, the more likely it is that you will develop an addiction.
Methamphetamine is associated with several physical and mental symptoms that arise shortly after the effects of the drug wear off. This acutely-felt period of withdrawal is sometimes called a crash.1 If an individual has used methamphetamine long enough to develop physical dependence, they may be likely to experience intensely unpleasant and sometimes dangerous withdrawal symptoms once they stop using the drug. These symptoms include:1,2,3,5
Some of these symptoms may reflect a compensatory reaction to certain neglected areas of health commonly seen in chronic meth users. Abusers will often forgo eating and sleeping while under the influence of this drug because of the energizing effects of methamphetamine and its abnormal influence on motivation pathways in the brain.8 Therefore, symptoms such as increased appetite and fatigue may reflect a natural physiological attempt to return to a healthy state. These symptoms typically subside within 1 to 2 weeks of continuous abstinence, adequate nutrition, and improved sleeping behaviors.
Anxiety is a common and, in some cases, expected reaction that many drug abusers experience during withdrawal.1 For example, it could be because a person who is addicted to methamphetamine has come to rely on it as a crutch to deal with the stresses of normal life, and it may be scary for them to imagine life without it.
Anxiety is a common and, in some cases, expected reaction that many drug abusers experience during withdrawal.
It is normal for individuals who are dependent on any drug to be anxious and fearful of stopping, even if drugs are actually causing them harm. Fortunately, this anxiety will also fade with time.
After someone stops taking meth, they often experience the feeling that nothing in life is pleasurable, a reaction known as anhedonia.9 This phenomenon may sometimes be a preamble to a developing depression. Abusers in withdrawal usually also feel powerful cravings for the drug that can be nearly impossible to resist by willpower alone.9
Cravings and depression are frequently the most challenging symptoms of methamphetamine withdrawal and, because of their association with relapse and suicidal ideation, the ones that require the most attention from the treatment team.5 Because meth has such powerful and disruptive effects on the brain’s reward and motivation centers, these symptoms may be more long-lasting than other withdrawal effects and could persist for more than 5 weeks after the last use.10 This is because it takes time for these brain pathways to heal and return to normal functioning.
The journey from methamphetamine dependence to recovery can take several months and, for many, maintaining a healthy, drug-free lifestyle is a lifelong process. This section briefly describes the steps along this journey and what to expect.
The initial phase of recovery from methamphetamine addiction is the crash that follows the high of drug use. Individuals who are crashing often feel depressed, fatigued, and irritable.2 These symptoms will pass in hours or days if a person is not yet dependent on the drug. In cases of significantly severe dependence, or if the last use was a heavy binge, they may also experience paranoia and psychosis requiring the temporary use of sedatives or antipsychotic medications.
The journey from methamphetamine dependence to recovery can take several months and, for many, maintaining a healthy, drug-free lifestyle is a lifelong process.
After the crash, a person addicted to methamphetamine will continue to experience several withdrawal symptoms, as discussed above. Fatigue, anxiety, and appetitie changes will usually subside within days or weeks. Detox program staff will provide watchful supervision throughout the withdrawal period, offering supportive medications for particularly troublesome symptoms and escalating the level of care in the event of any severe withdrawal associated developments (e.g., suicidal thoughts).
Depression and craving may last several weeks or months after withdrawal from methamphetamine and can be treated with antidepressants.4 Should withdrawal psychosis emerge, it may be managed with antipsychotics.10
There are currently no medications approved for use in the treatment of people with methamphetamine dependence or addiction, so the primary therapies employed are behavioral.1,3,5 These treatments can last between 4 weeks and a year, depending on the program chosen. Some behavioral therapies that have been shown to be effective in methamphetamine addiction include:1,3,5
Detoxing from chronic methamphetamine abuse is an uncomfortable process that can have certain dangerous complications. Many people experience paranoid and irrational thoughts and may present a danger to themselves or others. Furthermore, depression during detox may be associated with suicidal thoughts and attempts. Additionally, cravings for methamphetamine during detox are so powerful that many abusers will eventually give in and return to drug use despite their sincere desire to stop.
Medical professionals at detox facilities are familiar with the challenges of withdrawing from methamphetamine. They provide a supportive environment that allows for:
Finally, detox facilities can provide crucial support for those who are suffering from mental health issues caused or worsened by their methamphetamine use. Oftentimes, depression and psychosis are serious and ongoing consequences of abusing this drug, requiring long-term management through counseling and medication. Staff at detox centers can assist their clients by connecting them with programs and resources available to address these mental health challenges.
Because of the high rate at which methamphetamine abusers return to drug use after detox, it is advisable for anyone undergoing withdrawal from methamphetamine to enter a drug treatment program immediately after completing the detox process. There are several types of drug treatment programs available depending on your specific needs.
Inpatient treatment facilities offer round-the-clock support in a controlled environment for about 4 to 12 weeks, or longer, if needed. Oftentimes, inpatient programs are affiliated with a detox center, so clients can enter treatment seamlessly after withdrawing from methamphetamines. These intensive programs can help recovering individuals address their addiction in a safe place, with other people going through the same process and separated from people and places that are associated with their drug use.
For those who want or need extended support, sober living facilities offer a supportive environment for those transitioning out of treatment into a life in recovery.
Outpatient treatment facilities run only during the day and allow patients to return home in the evening. This type of program can be beneficial to individuals with work or home obligations and a solid network of support at home. For people who live alone or with other drug abusers, the outpatient option may not be the best.
If you or a loved one is struggling with methamphetamine addiction, you do not have to face it alone. There is help, no matter what your situation.