Methamphetamine (meth, crystal meth) is a very potent stimulant that increases activity in the brain and body. It can give a temporary boost to energy, alertness, confidence and wakefulness, but it can also raise heart rate and body temperature, disrupt sleep and appetite, and cause anxiety, paranoia or psychosis. Long-term use may lead to methamphetamine use disorder and serious cardiovascular, psychiatric, dental, nutritional and cognitive problems.
Not everybody is affected the same way. Risk is about how much you use, how often you use, how you use, what else you are using at the same time and your medical and mental health. In this article, find out what meth does, warning signs that need urgent care, what withdrawal may look like, and which treatments have the most evidence to back them up.
What Is Methamphetamine?
Methamphetamine is a synthetic central nervous system stimulant. Much of the methamphetamine used illegally in the United States is produced outside of medical settings and may be in the form of a powder or crystalline “ice .” It can be smoked, snorted, swallowed or injected.
Methamphetamine is not the same as taking a prescribed stimulant exactly as prescribed. The use of methamphetamine itself has few approved medical uses by the FDA, but illicit methamphetamine is unregulated and may expose a person to unpredictable potency or other substances.
What Does Meth Do to the Brain?
Methamphetamine activates multiple signalling systems in the brain, especially those using dopamine, norepinephrine, and serotonin. Dopamine is part of the reward, motivation, movement and learning pathways. Meth produces unusually large alterations in dopamine signalling that can strongly reinforce repeated use.
It is not correct to say the brain simply “ stops making dopamine.” But the reward and stress systems of the brain can change with repeated use of meth. Everyday activities may be less rewarding, there may be intense cravings, and there may be problems with mood, attention, decision making, and impulse control.
Long term meth use has been linked to changes in brain function and cognition. Research also suggests that some of the brain changes related to meth use can improve with prolonged abstinence. Recovery is individualised, and not all functions may recover at the same pace.
What Does Being High on Meth Feel Like?
When a person is intoxicated, they may feel unusually energetic, alert, talkative, confident or euphoric and may feel less need for food or sleep. Along with significant physical stress, effects can occur.
It can cause restlessness, irritability, anxiety, suspiciousness, panic, aggression, hallucinations or delusions. Repeated use, sleep deprivation, and other individual factors may be associated with severe psychiatric symptoms.
The supply of illicit drugs and the reactions of individuals are unpredictable and no description of a meth “high” should be taken to mean that such an experience is predictable or safe.
Short-Term Effects of Meth
Short term effects of methamphetamine may include:
- Faster heart rate or irregular heartbeat
- Higher blood pressure
- Increased breathing rate
- Increased body temperature and sweating
- Reduced appetite
- Dilated pupils
- Difficulty sleeping
- Restlessness or tremor
- Anxiety, panic, or irritability
- Paranoia, hallucinations, or psychosis
Even occasional use can be medically dangerous. Serious stimulant toxicity can occur with any route of administration and no single dose of illicit methamphetamine can be considered safe.
What Are the Long-Term Effects of Meth?
Health can be harmed in many ways by repeated or long-term use of meth.
Heart and circulation
Meth is bad for your heart. But long-term use can cause cardiovascular disease and dangerous heart rhythm problems, heart attack, stroke and other complications.
Mental health
Chronic meth use can be linked to anxiety, insomnia, mood disturbance, confusion, paranoia, and psychotic symptoms. Some psychiatric symptoms improve after meth is stopped; others can persist and need mental health treatment.
Thinking and memory
Research has found long-term meth use has been associated with problems with attention, learning, memory, reaction time and other cognitive functions. The severity and duration of TBI varies and some functions may improve with ongoing recovery.
Teeth, skin, nutrition, and infection risk
Meth causes dry mouth, grinding of the teeth, poor nutrition, weight loss and dental disease. Sores may develop on the skin and become infected. Sharing injection equipment also increases the risk of HIV, viral hepatitis, abscesses and other infections from injecting meth.
Can Meth Cause an Overdose?
Yes. Methamphetamine can be deadly in an overdose, sometimes called stimulant toxicity or “overamping.” Warning signs may include chest pain, racing or irregular heartbeat, extreme agitation or confusion, dangerously high body temperature, seizures, hallucinations or psychosis, symptoms of stroke, trouble breathing, or loss of consciousness.
For a suspected stimulant overdose or other medical emergency, call 911. If it is safe to do so, stay with the person and reduce heat and stimulation until help arrives. Administer naloxone if available if opioids may also be involved. Naloxone itself will not reverse methamphetamine toxicity, but it can reverse an opioid overdose.
Methamphetamine can be mixed with illegally made fentanyl and the person may not know it. That’s one reason people who use illicit stimulants, and people close to them, might benefit from having naloxone on hand and knowing how to use it.
What Does Meth Withdrawal Feel Like?
Repeated use of meth can lead to a “crash” and withdrawal symptoms when a person stops using or greatly reduces use. Symptoms early on may include extreme fatigue, increased sleep, irritability, increased appetite, depressed mood and intense cravings.
After the initial stage, some people continue to have depression, anxiety, insomnia, paranoia, low motivation, or difficulty feeling pleasure. According to ASAM/AAAP guidance, post-acute symptoms can last weeks to months.
Managing meth withdrawal does not involve any one medication that “detoxes” meth from the body. Clinical care emphasises safety, sleep, nutrition, psychiatric symptoms, co-occurring substance use, and keeping the person connected to treatment.
Withdrawal from stimulants can cause depression and suicidal ideation. Seek immediate help if a person has suicidal intent, cannot stay safe or develops severe psychosis. If you are in the United States, call or text 988 for a mental health, suicide or substance use crisis. Call 911 if it’s a medical emergency.
How Can You Tell If Someone May Be Using Meth?
There’s no single behaviour that proves someone is using meth. Patterns may include unusually prolonged wakefulness, rapid or pressured speech, reduced appetite and weight loss, marked restlessness, repeated periods of exhaustion or “crashing,” worsening dental problems, paranoia or significant mood and behavioural changes.
If you’re worried about someone, look for changes you can see, not labels. Choose a time when the person is calm. Share your concern without debating motivation. Suggest professional evaluation. If the person is severely agitated, psychotic, threatening or medically unstable, safety and emergency care take priority.
What Treatment Works for Methamphetamine Use Disorder?
Methamphetamine use disorder is treatable, but treatment should be evidence-based, not a one-size-fits-all “detox” program.
Contingency management has the strongest evidence for stimulant use disorder and is recommended by the ASAM/AAAP clinical guideline as a primary component of treatment. It gives structured positive reinforcement for goals of treatment. Other treatments include cognitive behavioural therapy, Community Reinforcement Approach and the Matrix Model.
Currently, there are no FDA-approved medications for stimulant use disorder. Certain medications, including combinations such as bupropion and naltrexone, may be used off-label by appropriately trained clinicians for selected patients. Treatment decisions should be made on a case-by-case basis and may also be influenced by co-occurring conditions such as depression or another substance use disorder.
Treatment may include medical evaluation, individual counselling, psychiatric care, assistance with sleep and nutrition, harm-reduction planning, and treatment for other substance use.
Getting Help in Elizabeth, New Jersey
If you’re struggling with substance use, such as cravings that lead to use, or if your use is affecting your health, work, relationships or safety, a professional assessment can help you get the level of care that’s right for you.
Mercy Recovery Center is an outpatient addiction treatment center operated by physicians in Elizabeth, New Jersey. The website lists treatment for stimulant use disorder, individual addiction counselling, treatment planning and services for co-occurring anxiety or depression.
Telehealth is listed as a service as well, although the current pages on Mercy have inconsistent language about telehealth in the states where telehealth is available. Telehealth may be available for eligible patients, please check with the center to confirm eligibility until the site is standardised. I would recommend just saying that
Outpatient treatment is not indicated in all situations. Severe intoxication, unstable medical problems, acute psychosis, high suicide risk, or need for ongoing surveillance may necessitate emergency or higher level of care.
If you or someone you love is struggling with methamphetamine use, we at Mercy Recovery Center can discuss whether our outpatient services are right for you.