The abuse of methamphetamine—a drug that can be manufactured from common household chemicals and over-the-counter cold remedies—is no longer only common among high school teens from the rural Midwest. Attracted by the drug’s ability to promote weight loss, wakefulness, and increased activity, adults in their 30s and 40s from urban and suburban neighborhoods also have been found to abuse the drug. While in the 1990s methamphetamine was regarded mostly as an all-night rave party drug for teens, today public health officials have identified methamphetamine abuse as a more widespread and routine substance abuse problem.
As methamphetamine abuse begins to cross all age and social lines, the epidemic poses major public health concerns including potential transmission of ]]>hepatitis B]]> and ]]>C]]> and ]]>HIV/AIDS]]>. In an effort to curtail the production of methamphetamine in makeshift basement or garage labs, some states have instituted strict controls over access to cold medications found at the corner drug store.
What Is Methamphetamine?
Commonly known on the street as crystal meth, speed, meth, ice, crystal, or glass, the drug is taken orally, injected, snorted, or smoked. While best known as substances of abuse, methamphetamine and other closely related substances do have legitimate medical uses. Attention deficit hyperactivity disorder is a condition for which medical prescription may be appropriate. Most methamphetamine users probably do not take this drug for clinical conditions, nor do they receive it by prescription from their doctor. The abuse potential of the drug is high because users can easily develop a tolerance for it, requiring higher doses to achieve stimulation, and eventually leading to even greater dependence.
Short-term Effects: From High to Low
As a potent psychomotor stimulant that works directly on the brain and spinal cord, the immediate effects of methamphetamines are similar to those of cocaine. They include:
- Sense of well-being
- Increased alertness/wakefulness
- Increased stamina
- Decreased appetite
- Increased sexual arousal
Due to its slow release into the bloodstream, methamphetamine’s effects can last up to twelve hours. The general sense of well-being that methamphetamines produce is due to higher levels of dopamine, a neurotransmitter responsible for brain functions that control movement and emotions such as pleasure and pain. The euphoria, however, soon gives way to a phase of high agitation and a subsequent “crash” when users can fall asleep for 24-48 hours. This phenomenon may result in a binge and crash cycle in which users binge on the drug to prolong the euphoria.
Methamphetamines also cause an increase in heart rate, blood pressure, and body temperature. These properties can have fatal results in those who overdose (a toxic reaction can occur with as little as 50 milligrams). Without intervention, death may result from extremely high body temperature (which can rise to as high as 108ºF [42ºC]), convulsions, and cardiovascular collapse.
Signs of Abuse
Physical and behavioral symptoms of continued meth abuse include:
- Rapid weight loss
- Dilated pupils
- Dry or itchy skin
- Impaired speech
- Tooth grinding
- Shortness of breath
- Incessant talking
- Pulling of hair or skin
- Disinterest in normal activities
- Severe depression
In addition, younger methamphetamine users are prone to a phenomenon dentists are calling “Meth mouth,” in which teeth are blackened and rotted to the point of the gum line. This is apparently because younger users are more susceptible to the corrosive effects of some ingredients used to synthesize methamphetamines. Also, the drug itself dries up saliva, which is the mouth’s natural cavity fighter.
Long-term Health Consequences
Over time, frequent meth use interferes with the normal ability to feel pleasure. Methamphetamine dependence can also produce other undesirable psychological effects, among them:
- Aggressive, violent behavior
- Tremors and/or convulsions
- Hallucinations (visual and auditory)
- Paranoia (including the perception of insects crawling on the skin)
- Schizophrenia-like psychosis
Additionally, long-term meth abuse leads to diminished brain and motor function due to a decrease in dopamine function. (The excess production of dopamine that occurs with meth use eventually damages the very nerve cells that release it.) Long-term users often exhibit problems with verbal learning skills and significant memory loss similar to that seen in Alzheimer’s disease. Motor damage may develop in the form of tremors and loss of agility that mimic symptoms of Parkinson’s disease.
Furthermore, long-term users suffer from irreversible cardiovascular damage as a result of the stress exerted by rapid, irregular heartbeats, ]]>high blood pressure,]]> and extremes in body temperature. Respiratory disorders may also result, as well as irreparable damage to the small blood vessels in the brain—making them stroke-prone. Finally, those who handle the corrosive chemicals used to make methamphetamines place themselves at risk for severe lung damage, organ failure, and even death.
Most treatment and recovery programs involve some type of cognitive behavioral intervention, including 12-step programs and family therapy, to prevent relapses. In addition, methamphetamine recovery support groups and anti-depressants medications are used to try to keep people drug-free. An important challenge in methamphetamine dependence treatment is that the brain and thinking changes that meth brings about make many forms of psychotherapy less effective. Researchers continue to study ways to effectively treat this condition.
Extra Caution for Younger Abusers
Although evidence shows that some function can return after prolonged and permanent abstinence in adults, the long-term effects of methamphetamine use among adolescents may not be as promising. Since brain development continues through early adulthood, the drug’s negative effect among teen users, who are usually 12-17 years old, could mean long-term impairment of brain function and altered behavior. Prenatal exposure has been shown to cause fetal growth retardation as well as cardiac and brain abnormalities. Researchers are trying to determine whether side effects of abuse, like memory loss, poor motor coordination, mood disruption, and the inability to feel pleasure, persist into adulthood—even well after a teen has ceased using the drug.
National Clearinghouse for Alcohol and Drug Information
National Institute on Drug Abuse
US Drug Enforcement Administration
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Last reviewed November 2009 by ]]>Brian Randall, MD]]>
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