Methamphetamine, or meth for short, is a Schedule II controlled substance, per the Drug Enforcement Administration (DEA) in the United States. Methamphetamine is in one FDA-approved and legal product, Desoxyn, but is mostly synthesized in illegal laboratories and abused for the “high” it can produce. Crystal meth, also called ice or Tina, looks like glass or small crystal rocks that are usually clear or shiny blue in color. It is a crystallized version of regular meth that may be made into a pill or powder.
Crystal meth is often smoked, but may also be melted down and injected. The half-life of crystal meth is about 11 hours, the Canadian Medical Association Journal (CMAJ) publishes. While the burst of euphoria may be rather instantaneous, the effects of the drug may last several hours. In 2013, the National Survey on Drug Use and Health (NSDUH) published that 1.4 million American adults (aged 12 and older) were classified as current users of a stimulant drug like methamphetamine.
Crystal meth is generally considered to be addictive, possibly due to the euphoria its abuse can create and the inherent and natural desire to repeat things that make individuals feel good. Drug addiction treatment programs can help address cravings, reduce withdrawal side effects, and decrease potential episodes of relapse; relapse rates may be as high as 90 percent for individuals addicted to crystal meth, according to the National Institute on Drug Abuse (NIDA). A comprehensive addiction treatment can help give people the tools and coping mechanisms needed to build a strong foundation for recovery from crystal meth abuse and dependence.
The Brain on Meth
Meth is believed to increase pleasure and create its high by enhancing dopamine levels in the brain. Dopamine is a neurotransmitter, or chemical messenger in the brain, that is involved in pleasure sensations and what makes people happy. Constant artificial stimulation of this neurotransmitter may actually alter the brain’s natural production of it and make it harder to then feel pleasure with the drug.
When something makes someone feel good, dopamine levels increase; as a result, individuals are conditioned to repeat the behavior that created that effect. Over time, a reward pathway may be built, and meth may circumvent natural reward circuitry in the brain, creating a sort of shortcut to pleasure. Motivation and impulse control are also affected, as it may become more difficult to experience the same levels of pleasure or normal brain functioning without the drug after regular use of crystal meth. An urge to want to feel good may encourage someone to continue taking crystal meth, which may cause a chemical dependency on the drug and drug cravings. The more, and longer, a person uses meth, the more pronounced the dependency and drug cravings may be. NIDA published a study showing a decrease in dopamine binding to its receptors in the brains of individuals addicted to meth, as viewed through brain imaging technology.
Meth has been linked to possible brain damage and a decrease in cognitive functions, like impaired memory and learning abilities. One study published by the Washington Times even reported Parkinson’s disease-like symptoms caused by extreme meth use. Parkinson’s is a disorder of the central nervous system (CNS) that affects movement, causing muscle rigidity and tremors, and it may be caused by a depletion of dopamine in the brain. Another review in the journal Neuropsychopharmacology reported details that may contradict the belief that brain damage occurs in those abusing meth, although clinical addiction may still impair an individual’s ability to function on a daily basis.
Addiction is a chronic disease of the brain indicated in part by the inability to control drug use, and it is generally believed to involve the reward, motivation, emotional regulation, and decision-making parts of the brain. When crystal meth’s effects wear off, an individual may feel extremely fatigued, rundown, and suffer a “crash.” Someone who is addicted to meth is also likely to battle withdrawal symptoms when coming down from a meth high as the drug leaves the body. Meth withdrawal may be emotionally intense, and depression, anxiety, nightmares, and suicidal thoughts may be common. The crash is often seen as directly opposing the euphoria and energy produced by the drug’s high.
Meth and Physical Consequences of Abuse
An overdose may occur when too much crystal meth overloads the body. Symptoms may include:
- Abdominal pain and/or nausea
- Irregular heart rate
- Difficulties breathing
- Chest pain
- Loss of consciousness
Stimulant drugs like crystal meth increase heart rate, respiration, body temperature, and blood pressure while decreasing appetite and need for sleep. Too much crystal meth may raise some CNS functions to dangerous levels and cause a stroke. This is due to damage to blood vessels in the brain usually related to heightened blood pressure or a potential heart attack from an extremely elevated heart rate.
The White House Office of National Drug Control Policy (ONDCP) reports that there is one death every 13 minutes in the United States that is considered to be drug-induced.
A crystal meth overdose may result in coma or be life-threatening, and it should be treated as a medical emergency.
The Drug Abuse Warning Network (DAWN) also published that stimulant drugs, which include meth, accounted for over 3 percent of emergency department (ED) visits involving illicit drugs in 2011.
Long-term crystal meth abuse can be especially detrimental to body systems, potentially causing side effects such as:
- Kidney failure or kidney damage
- Respiratory issues
- Respiratory issues
- Cardiac arrhythmia or irregular heart rate
- Drastic weight loss and malnutrition, possible anorexia
- Skin sores or infections
- Increased risk for contracting hepatitis or HIV/AIDs (IV drug users)
- Dental issues or “meth mouth”
- High blood pressure
- Scarring near injection site (if an IV drug user) and collapsed veins
- Damage to nerves in brain
- Infection in the lining of the heart
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There are physical and mental health effects that occur as a result of long-term crystal meth use and addiction that are specific to the drug, creating a detox experience that is strikingly different from opiate drugs, alcohol, and other sedatives. The symptoms of detox can include:
- Extreme dysphoria (e.g., a sense of hopelessness, suicidal ideation, severe depression, etc.)
- Inability to focus or concentrate
- Increased appetite
- Irritability or agitation
- Intense cravings for more crystal meth
- Paranoia and anxiety
- Inability to sleep
The timeline in which these symptoms appear will vary from person to person. However, in many users with high-dose methamphetamine dependencies, withdrawal symptoms can begin within a few hours of the last dose, gain in intensity, and then plateau and remain for several days up to a month or longer.
Factors to Consider
The intensity of withdrawal symptoms associated with crystal meth detox, as well as how long detox lasts, will be impacted significantly by a number of factors that will vary from person to person, including:
- Dosage at time of cessation of use: Crystal meth is a street drug that is manufactured on the black market by a wide range of individuals, all of whom use a different combination of toxic chemicals and ingredients; thus, it is not standardized in dose. From region to region and even from batch to batch, the potency of crystal meth will vary significantly. For the individual in recovery, however, one of the primary factors informing the experience of detox is how much crystal meth a person uses daily in order to maintain a sense of normality. In general, higher doses per day will create a proportionately more intense experience with withdrawal symptoms during detox, and withdrawal symptoms may begin and peak more quickly as well.
- Time spent actively abusing drugs: Just as a larger daily, “normal” dose of crystal meth will contribute to a more intense detox experience, a longer amount of time spent living in active methamphetamine addiction will usually lead to more time spent dealing with withdrawal symptoms and a more rapid onset of withdrawal.
- Other addictive drugs used at the time of detox: The use of other drugs regularly in combination with crystal meth, especially if there is physical dependency on these drugs as well, will contribute significantly to the detox experience. For example, those who use heroin in combination with crystal meth will not only experience withdrawal symptoms related to crystal meth use but withdrawal symptoms related to the use of heroin as well. It is important to note that not only will the physical withdrawal symptoms potentially be more widely varied but the psychological symptoms, especially cravings, will also be intensified.
- Body chemistry: Each person is unique in how their body performs and functions, and these differences are amplified according to the use of different substances in different amounts as well as other factors. Two people can share the same height, weight, and gender as well as the same dose in crystal meth addiction and the same length of time spent using, and still have a different experience during detox. How the brain and body respond to stimuli is based on genetic makeup, and for that reason, the detox experience is truly unique for each individual.
- Co-occurring mental health issues: When a person has a dual diagnosis, or a diagnosis of both addiction and a mental health disorder, the experience of detox will be further altered. For example, if anxiety is an underlying disorder, then it is likely that the symptoms of paranoia and anxiety will be heightened during detox and may require medical intervention. Similarly, if depression is an ongoing issue, then it may be that the experience of depression during crystal meth detox is an exceedingly significant issue and one that requires monitoring to ensure that the client stays safe.
The combination of these issues will come together differently for each client in recovery, creating a unique detox experience that will require a unique set of treatment and therapeutic tools.
Physical vs. Psychological Withdrawal Symptoms
It is a myth that only drugs that trigger intense physical withdrawal symptoms are addictive. The fact is that even though physical withdrawal symptoms are not the primary characteristics that define crystal meth detox, the psychological withdrawal symptoms are extremely difficult to navigate without professional help and support. Especially important to note is the need for immediate psychiatric care if anxiety or depression becomes overwhelming in the days following the last dose of crystal meth.
Cravings and Relapse
An issue that is unique to crystal meth detox is the return of intense cravings. Though many people find that their cravings are strongest in the first weeks after they stop taking their drug of choice and then only return in recovery when they are facing significant issues, many people report that their cravings for crystal meth return without instigation anywhere from six months to a year after initial detox.
This is significant because the experience can be unexpected, and many find that they feel unprepared. Spending six months or more in active recovery can give the false notion of security, but if the drug of choice during addiction was crystal meth then it is especially important to remain vigilant and connected to recovery resources on a long-term basis.
- Seek professional treatment. Do not attempt an at-home detox. It is unknown how any individual will respond in terms of psychological symptoms, and medical monitoring is imperative.
- Consider medication options. There are no medications currently on the market that are labeled for the treatment of withdrawal symptoms associated with crystal meth detox; however, there are a number of medications available that can help to minimize symptoms and make them more tolerable.
- Seek peer support. It can be extremely helpful to talk to others who are going through the same process at the same time. Sharing what works and what doesn’t, talking about cravings, and venting frustrations can help to create a community and reinforce the fact that no one is alone in addiction recovery.
- Be patient. It takes time for the body to process out the toxins that built up during active addiction. Detox is part of that process, and it is well worth it to remain focused on getting through withdrawal symptoms to arrive, on the other side, free of drug dependence.
When It’s Time for Help
Methamphetamine addiction brings outward physical signs, changes in behavior, and emotional signs that family members and loved ones can watch out for. Emotions may seem to be on a constant rollercoaster for someone addicted to crystal meth, with high highs when under the drug’s influence, and low lows when the drug wears off.
While on crystal meth, individuals will likely be talkative, have high energy, and may have extreme focus and be excitable. They may not be hungry and may stay awake for hours or even days. Changes in sleep patterns may be one of the more noticeable signs of addiction or abuse outside of erratic and unpredictable emotions. When high, users have no apparent need for sleep, and upon crashing, users may sleep for days at a time and be very fatigued. The crash may also bring about general malaise, apathy, or even depression, anxiety, and irritability.
Drug tolerance, as in the need to take more drugs every dose, is a possible symptom of addiction. Someone who becomes tolerant to crystal meth may continue to take more of the drug and create a psychological and physical dependence on it. Once this occurs, the individual may experience withdrawal symptoms when the drug is removed from the body. These symptoms can be emotionally powerful and include depression, lack of ability to feel pleasure, suicidal thoughts and behaviors, restlessness, trouble concentrating, insomnia, and generally not feeling well.
Long-term meth use may have some additional negative behavioral effects and may induce paranoia, anxiety, psychosis including delusions and auditory or visual hallucinations, confusion, insomnia, and intense mood swings.
It may also possibly increase aggression and lead to violence. The Herald Sun reports that violent and property crimes increase with crystal meth abuse.
Risky behaviors increase in individuals addicted to drugs, and individuals may continue to use crystal meth no matter what the cost to them personally, emotionally, physically, or socially. Job or school production may slide, and individuals addicted to meth are likely to spend most of their time involved with the drug in some way and shirk other responsibilities and obligations in consequence. Activities they previously enjoyed may be dropped, and they may withdraw socially and be secretive about drug usage.
Those addicted to crystal meth may be called tweakers and may be prone to violent outbursts, commit crimes to obtain drugs, and may pick at their skin to try and ward off hallucinated insects. They may also suffer from tremors and are likely to appear malnourished. Stimulant drugs decrease appetite and may cause individuals to lose a lot of weight rather quickly.
Personal hygiene also suffers. One of the indicators of chronic crystal meth abuse or addiction may be poor dental hygiene, often called meth mouth where teeth may rot and fall out.
Programs designed to help individuals addicted to crystal meth will range in structure and level of care, depending on the level of dependency an individual may have. For instance, someone who injects or smokes crystal meth in large amounts for a long time may be more dependent than someone who uses less of the drug for a shorter amount of time. Personal biology, mental health issues, medical history, and genetics may also make someone more predisposed to becoming addicted than someone else.
While family history and genetics may account for about 50 percent of a person’s risk for developing an addiction, according to the American Psychological Association (APA), just because a family member was addicted to drugs does not mean that the person’s relations are guaranteed to go down the same path. Environmental factors are thought to account for the other half of the risks for drug dependency or addiction. Childhood trauma, high levels of stress, drug abuse at a young age before the brain is fully developed, peer pressure, and a poor support system may all contribute to increasing the odds of abusing and becoming addicted to crystal meth.
Co-occurring mental or medical disorders may also influence drug dependency and side effects of drug abuse and addiction, as well as potentially interfere with treatment. Eating disorders and anorexia may be potential side effects of crystal meth abuse. Co-occurring disorders may be best treated with teams of specialists working together in an integrated care plan, as multiple disorders may complicate treatment. All these factors should be taken into account with a thorough drug screening and evaluation prior to treatment program admission in order to find the right level of care.
Treatment programs range from outpatient, or intensive outpatient, to residential programs. Family and personal budget and finances, insurance, work or school obligations, family situation, and geographical proximity to a treatment program all need to be discussed and evaluated when choosing a drug treatment program.
Residential treatment offers the highest level of care with the most options available for families and individuals. Medical detox occurs while an individual is monitored 24 hours a day, seven days a week, for a period of time until all crystal meth is safely out of the brain and body.
Currently, there are no medications approved for meth detox or addiction treatment; however, pharmaceuticals are often used during detox and recovery to mitigate specific symptoms and withdrawal symptoms. For instance, the San Francisco Chronicle reports that antidepressant medications may help reduce methamphetamine withdrawal symptoms.
Both outpatient and residential programs most often include group and individual therapy sessions that focus on behavior modification and how to change negative and self-destructive behaviors and actions into more positive ones going forward. Counseling, education, and life skills or occupational training may be part of most treatment programs, as well as recovery services that likely include peer support groups and 12-Step programs. Crystal meth treatment programs should be specifically tailored to fit an individual’s unique set of circumstances.