As a result, it was listed as a controlled substance by the United States Drug Enforcement Administration (DEA) in the 1980s. It is currently classified as a Schedule II controlled substance, placing it in the class with other drugs that are commonly abused but still retain some medicinal uses, such as cocaine.
The drug is most often manufactured in home laboratories that combine numerous chemicals and ephedrine or pseudoephedrine to produce a very concentrated form of the drug that can be smoked, snorted, or injected (when mixed with water). Because the drug is so dangerous, there have been targeted efforts to monitor and even reduce the availability of chemicals and other substances that are commonly used in the manufacture of the drug.
The psychoactive effects of the drug are very intense and produce very strong feelings of euphoria, invincibility, and a rush of energy that typically will dissipate rather rapidly. This results in abusers spending hours bingeing on the drug to maintain these effects. Over time, the euphoria is replaced by paranoia, aggression, and psychosis. As a stimulant drug, meth can place a significant burden on numerous organ systems, on an individual’s ability to function normally within their environment, and on society due to lost productivity and the cost of treatment for individuals who develop stimulant use disorders as a result of methamphetamine abuse.
Mechanism of Action
The National Institute on Drug Abuse (NIDA) and the DEA report that the use of meth results in a significant increase of dopamine and norepinephrine in the central nervous system. This release of these leads to significant euphoria, feelings of increased energy, and other effects.
Street versions of methamphetamine are often made with numerous toxic substances, such as drain cleaners, antifreeze, battery acids, iodine, etc., that make the drug highly unstable and dangerous to make as well incredibly dangerous to take.
In addition, the mechanism of action of the drug results in a large increase of neurotransmitters in the brain that is followed by a significant depletion of these neurotransmitters once the drug has been discontinued. This massive increase followed by massive depletion of neurotransmitters can significantly alter the functioning of a person’s central nervous system, and if continued chronically, can result in significant neurological damage in addition to damage to other organs in the body.
Signs of Abuse
The American Psychiatric Association (APA) lists the formal signs of a stimulant use disorder, which would be the formal diagnosis of a person who has developed a substance use disorder (abuse problem or addiction) related to the use of methamphetamine. Formal diagnostic criteria can only be used to diagnose a substance use disorder by a trained mental health clinician. In general, there are several categories of symptoms that are used to determine if a person has a formal substance use disorder.
- Use of the drug or medication is not within the medicinal boundaries for use of the drug (if there are medicinal uses for the drug).
- Significant distress or impairment occur as a result of the person’s substance use.
- The individual demonstrates one or more serious issues with controlling their use of the drug.
- The person demonstrates one or more negative ramifications associated with their drug use. This can occur in many different domains, such as having negative issues related to work, in personal relationships, at school, or in other important areas of life.
- The person continues to use the drug despite experiencing negative ramifications of their drug use and/or experiencing declines in their physical and mental health.
- The person develops one or more symptoms of physical dependence on the drug (tolerance or withdrawal symptoms).
In addition to the formal diagnostic signs, there are other indicators that a person may be abusing methamphetamine. These include:
- Finding drug paraphernalia, such as glass pipes, glass tubes or plastic tubes, bottles with residue in them, laboratory equipment used to make meth, like burners, beakers, etc.
- Finding numerous ingredients that are commonly used to make methamphetamine, such as pseudoephedrine or ephedrine, drain cleaners, batteries, acids, brake fluid, antifreeze, etc.
- Physical signs often associated with chronic meth abuse that can include significant weight loss; a malnourished look; dark circles under the eyes; dry, cracked, or broken skin; sores on their skin, such as red blotches or abscesses that do not heal; rapidly deteriorating dentition (often termed “meth rot” or “meth mouth”); cycles of increased energy followed by significant depression and lethargy, or significantly decreased appetite followed by periods of binge eating; cycles of significant sleep loss followed by long periods of sleeping; and tremors or twitches.
- Uncharacteristic lack of attention to personal hygiene that progressively worsens
- Changes in mental status that may fluctuate, such as periods of extreme suspiciousness, extreme energy, apathy, depression, and extreme irritability or aggression that may be uncharacteristic
- Isolation from family and friends
- Financial problems
- Selling possessions or engaging in criminal activities to get money
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Consequences of Meth Abuse
Long-term methamphetamine abuse can result in various physical and mental consequences. Some of the early signs of methamphetamine abuse include problems with skin, significant weight loss, and problems with dentition.
Skin issues and problems with teeth are often considered telltale signs that one is smoking meth.
Street meth is highly corrosive and results in the teeth being exposed to acid, and the enamel often rots away. Likewise, skin becomes very unhealthy. Numerous examples of the detrimental effects of meth abuse on physical appearance are presented from various sources. Frightening changes often occur in chronic meth abusers with just a few years of abuse.
One of the major consequences of meth abuse is the development of physical dependence on the drug. Physical dependence often results in escalating binges to avoid withdrawal effects. Tolerance to stimulant drugs like methamphetamine develops rapidly, and individuals find that they need more and more of the drug to get the types of stimulating and euphoric effects they once got at significantly lower doses. Tolerance fuels the cycle of substance abuse because individuals begin to binge more frequently and for longer periods of time in order to achieve prior effects. Once tolerance is established, users never actually achieve the same level of euphoria that they achieved in the early stages of their substance use disorder.
Withdrawal from Meth
The symptoms of the withdrawal syndrome from stimulant drugs are often more emotionally based than physically based. However, individuals still feel significant urges to use the drug once it begins to leave their system. Because there is a massive depletion of neurotransmitters, users often begin to feel very lethargic, depressed, and apathetic; some people may even feel suicidal. This may fuel the bingeing process.
The timeframe for withdrawal from methamphetamine is relatively consistent.
- Withdrawal symptoms appear relatively early following discontinuation in most users, often within 12 hours.
- Withdrawal symptoms peak within a week to 10 days and then begin to subside.
- The full duration of withdrawal typically last 2-3 weeks.
- Even after most of the withdrawal symptoms have run their course, individuals often still experience frequent cravings for several weeks following discontinuation.
The prominent symptoms of withdrawal from methamphetamine appear to be:
- Excessive sleepiness, fatigue, significantly increased appetite, and weight gain
- Irritability, uneasiness, and even aggression
- Significant problems with depression and/or apathy that are often referred to by drug users as “the crash”
- Significant cravings to take methamphetamine
- Psychosis, especially issues with paranoia and delusions
- In some cases, severe emotional distress and even suicidal thoughts
Withdrawal management (medical detox) often consists of directly addressing the symptoms the individual experiences. This can include behavioral treatments, the use of mild stimulants to treat lethargy and depression, and even the use of benzodiazepines for some individuals. The withdrawal syndrome for methamphetamine is not normally considered to be dangerous in the same way that withdrawal from alcohol can be potentially fatal; however, individuals can become emotionally distraught, desperate, and make poor decisions or get involved in accidents.
Overdose potential is extremely high during the withdrawal process. Individuals with stimulant use disorders as a result of methamphetamine abuse require long-term specialized treatment following completion of a withdrawal management program.
Chronic abuse of methamphetamine can affect major organ systems, resulting in significant issues.
- The cardiovascular system is often severely effective in chronic abusers. Individuals develop problems with high blood pressure, irregular heartbeat, other heart issues, and increased potential to develop heart attack or stroke.
- Respiratory problems are common in individuals who smoke methamphetamine.
- There is a significant potential for liver damage as a result of bingeing on methamphetamine.
- As mentioned above, many chronic meth abusers experience severe issues with their skin.
- Methamphetamine abuse results in significant changes in the brain. Some of the changes may resolve to some extent with abstinence, but depending on the level of abuse, all of these problems may not resolve.
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The Effects of Methamphetamine Abuse on the Brain
- Chronic abuse of methamphetamine is associated with a significant increase in neuronal death in the central nervous system. Neuronal death occurs in numerous areas of the brain and cognitive functions can be affected, including issues with attention and concentration, the ability to form new memories, judgment and problem-solving, and movement.
- Increased death of other cells in the central nervous system, such as glial cells, may occur. These cells perform important functions, such as supporting the structures in the central nervous system, removing waste, and fighting infections.
- Decreased white matter in the central nervous system may result. The white matter in the central nervous system represents the signaling component of the neuron. When white matter is destroyed, it inhibits the ability of the neurons to communicate with one another, and this, in turn, decreases the efficiency of the functions of the brain.
- Significant damage to the veins and arteries in the brain can also occur as a result of chronic methamphetamine abuse. In the same way that methamphetamine abuse damages the cardiovascular system, it also damages the circulatory system in the brain. This can lead to an increased potential for stroke, brain damage due to a lack of oxygen, and other potentially dangerous situations.
- There may be greater susceptibility to damage from other sources, such as infections, trauma, and even due to the development of other mental health disorders.
Individuals who chronically abuse methamphetamine are at an increased risk to develop other mental health disorders that also can result in problems with their physical and mental functioning. These people are prone to developing issues with major depressive disorder, anxiety, trauma- and stressor-related disorders, and psychotic disorders.
Treatment for Meth Abuse
As mentioned above, individuals who begin a program of abstinence from methamphetamine and other drugs should become involved in intensive aftercare treatment once they have completed a medical detox program. Depending on the level of methamphetamine abuse, there may be a full recovery, or the individual may experience some level of impairment in their physical and/or cognitive functioning following completion of the withdrawal management program. However, the most important thing to remember is that the person should remain in an organized treatment program despite any setbacks or frustrations that occur.
Treatment for substance use disorders is not a short-term process. It often represents a long-term and even lifelong commitment to recovery, as the person remains connected in some form of treatment-related activity to guard against the signs of potential relapse.
Even individuals with years of abstinence may relapse. Thus, continued vigilance and long-term participation in some form of treatment-related activity for decades is typically advised.
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