What is Methamphetamine?

Methamphetamine is a powerful, highly addictive stimulant that affects the central nervous system. Also known as meth, chalk, ice, and crystal, among many other terms, it takes the form of a white, odorless, bitter-tasting crystalline powder that easily dissolves in water or alcohol. Methamphetamine is taken orally, smoked, snorted, or dissolved in water or alcohol and injected. Smoking or injecting the drug delivers it very quickly to the brain, where it produces an immediate, intense euphoria. Because the pleasure also fades quickly, users often take repeated doses, in a “binge and crash” pattern.

Methamphetamine was developed early in the 20th century from its parent drug, amphetamine, and was used originally in nasal decongestants and bronchial inhalers. Like amphetamine, methamphetamine causes increased activity and talkativeness, decreased appetite, and a pleasurable sense of well-being or euphoria. However, methamphetamine differs from amphetamine in that, at comparable doses, much greater amounts of the drug get into the brain, making it a more potent stimulant. It also has longer-lasting and more harmful effects on the central nervous system. These characteristics make it a drug with high potential for widespread abuse. According to the 2012 National Survey on Drug Use and Health (NSDUH), approximately 1.2 million people (0.4 percent of the population) reported using methamphetamine in the past year, and 440,000 (0.2 percent) reported using it in the past month. 1% of 8th, 10th, and 12th graders have used methamphetamines in a 2012 survey.  The average age of first use is 19 years old for all methamphetamine users. 

​

Methamphetamine History

Methamphetamine is not a new drug, although it has become more powerful in recent years as techniques for its manufacture have evolved.

Amphetamine was first made in 1887 in Germany and methamphetamine, more potent and easy to make, was developed in Japan in 1919. The crystalline powder was soluble in water, making it a perfect candidate for injection.

Methamphetamine went into wide use during World War II, when both sides used it to keep troops awake. High doses were given to Japanese Kamikaze pilots before their suicide missions. And after the war, methamphetamine abuse by injection reached epidemic proportions when supplies stored for military use became available to the Japanese public.

In the 1950s, methamphetamine was prescribed as a diet aid and to fight depression. Easily available, it was used as a nonmedical stimulant by college students, truck drivers and athletes and abuse of the drug spread.

This pattern changed markedly in the 1960s with the increased availability of injectable methamphetamine, worsening the abuse.

Then, in 1970, the US government made it illegal for most uses. After that, American motorcycle gangs controlled most of the production and distribution of the drug. Most users at the time lived in rural communities and could not afford the more expensive cocaine.

In the 1990s, Mexican drug trafficking organizations set up large laboratories in California. While these massive labs are able to generate fifty pounds of the substance in a single weekend, smaller private labs have sprung up in kitchens and apartments, earning the drug one of its names, “stove top.” From there it spread across the United States and into Europe, through the Czech Republic. 

From the 2000s on, home "meth labs" using dangerous ingredients of lithium (explosive), diethyl ether (explosive), anhydrous ammonia (very toxic), and Sudafed (Pseudoephedrine) that resulted in many house fires or explosions in neighborhoods and near schools.  Subsequently, due to restrictions on availability of Sudafed, a new method of making impure brownish white methamphetamine was created called the "shake and bake" method. Methamphetamine can be made by adding the ingredients to an empty 2 liter soda plastic bottle. 

Ironically, methamphetamine, sold under the brand name Desoxyl, is a legal stimulant prescription drug in the US, albeit in much lower doses than are used for abuse. 

​

Properties of Illicit (Illegal) Methamphetamine

Acute symptoms-

Methamphetamine comes in several forms and can be smoked, inhaled (snorted), injected, or orally ingested. The preferred method of abusing the drug varies by geographical region and has changed over time. Smoking methamphetamine is currently the most common way of ingesting it, according to CEWG data.

Smoking or injecting methamphetamine puts the drug very quickly into the bloodstream and brain, causing an immediate, intense “rush” and amplifying the drug’s addiction potential and adverse health consequences. The rush, or “flash,” lasts only a few minutes and is described as extremely pleasurable. Snorting or oral ingestion produces euphoria—a high, but not an intense rush. Snorting produces effects within 3 to 5 minutes, and oral ingestion produces effects within 15 to 20 minutes.

As with many stimulants, methamphetamine is most often abused in a “binge and crash” pattern. Because the pleasurable effects of methamphetamine disappear even before the drug concentration in the blood falls significantly, users try to maintain the high by taking more of the drug. In some cases, abusers indulge in a form of binging known as a “run,” foregoing food and sleep while continuing to take the drug for up to several days.  

As a powerful stimulant, methamphetamine, even in small doses, can increase wakefulness and physical activity and decrease appetite. Methamphetamine can also cause a variety of cardiovascular problems, including rapid heart rate, irregular heartbeat, and increased blood pressure. Hyperthermia (elevated body temperature) and convulsions may occur with methamphetamine overdose, and if not treated immediately, can result in death.

Most of the pleasurable effects of methamphetamine are believed to result from the release of very high levels of the neurotransmitter dopamine. Dopamine is involved in motivation, the experience of pleasure, and motor function, and is a common mechanism of action for most drugs of abuse. The elevated release of dopamine produced by methamphetamine is also thought to contribute to the drug's deleterious effects on nerve terminals in the brain. 

Short term symptoms:

• Increased attention and decreased fatigue

• Increased activity and wakefulness

• Decreased appetite

• Euphoria and rush

• Increased respiration

• Rapid/irregular heartbeat

• Hyperthermia

 

Long term use symptoms and effects- People who use methamphetamine long-term may experience anxiety, confusion, insomnia, severe weight loss, mood disturbances and display violent behavior. They may also show symptoms of psychosis, such as paranoia, visual and auditory hallucinations, and delusions (for example, the sensation of insects crawling under the skin) with picking at the skin due to these symptoms. Extreme weight loss is common and dental decay is prominent.  Rapid ageing of the face occurs with a person appearing much older than their biological age after using methamphetamine for more than 2 years.  After 10 years of use, the facial features have aged 25 years. Chronic methamphetamine use is accompanied by chemical and molecular changes in the brain. Imaging studies have shown changes in the activity of the dopamine system that are associated with reduced motor skills and impaired verbal learning. In studies of chronic methamphetamine users, severe structural and functional changes have been found in areas of the brain associated with emotion and memory, which may account for many of the emotional and cognitive problems observed in these individuals.

Some of these brain changes persist long after methamphetamine use is stopped, although some may reverse after being off the drug for a sustained period (e.g., more than 1 year).  Other long term effects are the contraction of HIV or AIDs due to needle sharing. 

​

Tolerance- 

Tolerance develops extremely quickly for methamphetamine ranging from hours to days.  The subsequent needed escalation of dose can cause cardiac dysrhythmias, heart attack, and death. There is no cross tolerance between cocaine and methamphetamine. 

​

Overdose Symptoms-

The relative risk of overdose leading to death is only slightly less than that of opioids.  It is only because there are less users of methamphetamine that the numbers dying from methamphetamine are significantly lower than opioids.  

• Agitation (severe)

• Chest pain

• Coma or unresponsiveness (in extreme cases)

• Heart attack

• Irregular or stopped heartbeat

• Difficulty breathing

• Very high body temperature (may be fatal if not immediately addressed)

• Kidney damage and possibly kidney failure

• Paranoia (pronounced)

• Seizures

• Severe stomach pain

• Stroke

• Death

 

Withdrawal Symptoms-

Typically withdrawal from methamphetamine is frequent since the pattern of binge use lasts for 2-3 days then the person comes down from using methamphetamine for a short period.  Some people use Oxycontin or other opioids to make the withdrawal less severe after binging. 

• Intense craving for methamphetamines

• Sleep disturbances

• Shaking and tremors

• Fever, chills, and profuse sweating

• Nausea and vomiting

• Hypertension

• Heart palpitations

• Respiratory failure

• Seizures

• Coma

• Death

 

Longterm outcome-

Methamphetamine for many people becomes all consuming.  In order to afford to continue to purchase the drug, the user will engage in destructive behaviors, becoming deceptive to a spouse, friends, and parents about relationships with newfound "friends" (users or suppliers of methamphetamine).  The amount of time spent away from home continues to expand and responsibilities at work and home are neglected over and over again with increasing absences becoming impossible to explain.  Spouses, children, and friends assume the user is having an affair or engaged in some other activities they do not understand, and the methamphetamine user ignores pleas to change their ways, seek counseling, or even discuss the issues.  Usually divorce ensues unless the spouse is also a methamphetamine user.  Weight loss and rapid aging occur.  There is loss of job and career, seemingly without a care from the methamphetamine user.  The user abandons their children, shares needles, and eventually engages in illegal activity (especially prostitution for women or theft for men) in order to buy methamphetamine.  They contract sexually transmitted diseases that may create cancer in their bodies or destroy their immune system with AIDs. When supplies become unaffordable users resort to making their own.  Ultimately they are abandoned completely by spouse, parents, childrens, and anyone in their former circle of friends.  The pattern of use continues for years.  The user recognizes they are addicted, and may have become a drug dealer, but simply no longer care.  The rush of methamphetamine exceeds that of cocaine, and lasts for 12 hours per dosage compared to 1 hour for cocaine. Abandoned by everyone in their lives, having destroyed relationships, careers and their health, methamphetamine users may die alone, still seeking one more hit of methamphetamine that has become their god and their master. 

​

​