Methamphetamine is one of the most difficult drugs to quit because of how it interferes with dopamine levels in the brain and the pain of withdrawing from it
It’s not just the addictiveness of a drug that makes it hard to quit. It’s also the severity of its withdrawal symptoms.
The reason people keep using drugs, including alcohol, long after the pleasurable effects have ended, is that stopping makes them feel worse. To feel neutral—not even good, just not bad—requires that the drug use continue, often in higher doses, until their health fails or they overdose and die.
Methamphetamine (meth) withdrawal is among the worst of any drug, legal or illicit. Although opioid use and overdose deaths receive more attention, meth use is also on the rise. More than 10,000 deaths were blamed on meth use in 2017 alone.
How Meth Affects You
Methamphetamine is a stimulant. While opioids soothe pain, stimulants make you more alert and energetic. Both types of drugs can cause euphoria, but how meth affects you depends in part on how you use it.
Meth can be insufflated (another term for snorted), smoked in the form of crystal meth, injected, or swallowed in pill form. When snorted or injected, users experience the meth effects in a rush. Smoking or swallowing produces a slower effect.
The faster a drug affects you, the greater the likelihood of addiction. For instance, a 2006 study found that while the method of heroin use didn’t affect rates of dependence, injection users developed addiction sooner. Injection users also were more likely to have co-occurring mental health issues.
All meth users will experience increased energy, a sense that they are more awake, alert, confident, and euphoric. This is a false feeling, but fake happiness can feel like the real thing for a while.
That feeling comes from increased levels of dopamine, a feel-good chemical in the brain known as a neurotransmitter. Many activities and substances release dopamine, including eating food. Meth provides 24 times as much dopamine as eating, eight times as much as alcohol, and more than three times as much as cocaine.
These effects last a few hours, generally six to 12, with a dramatic crash after that. That crash comes from the way meth hijacks the body’s dopamine use. Dopamine is usually recycled after release, but meth increases the amount released and prevents this recycling, giving users a prolonged high.
Because the normal reserves of dopamine are unavailable, after the high comes the crash, with users feeling worse than they did before the meth use. This spurs them on to more meth use.
This vicious cycle can go on for days. Some users report that they became addicted after a single dose of meth. In addition to addiction and feeling good and energized, the short-term side effects of meth use may include: Long-term meth use can lead to even worse side effects (some permanent), including:
Meth Side Effects
In addition to addiction and feeling good and energized, the short-term side effects of meth use may include:
Long-term meth use can lead to even worse side effects (some permanent), including:
What Is Meth Withdrawal?
Individuals keep using methamphetamine despite unpleasant side effects because they are hooked twice: addicted to the pleasant effects and afraid of the consequences of no longer using meth. As in other types of drug addictions, users can experience withdrawal symptoms if they stop using methamphetamine.
Once the brain has been rewired by meth dependency or addiction, quitting causes a variety of mental and physical pains that only begin with craving more meth. Withdrawal is likely to be nearly constant for the meth detox duration. However, a full meth detox is necessary for recovery to begin.
Meth Withdrawal Symptoms
Meth withdrawal can resemble the flu—clammy skin, constipation or diarrhea, joint pain, headaches, red and itchy eyes—but is much worse, especially since people going through withdrawal know the symptoms will go away if they go back to using meth.
The timeline for meth withdrawal is broken up into two main sections: the acute phase, with mainly physical symptoms that last from about a week to 10 days; and the subacute or persistent symptoms phase, with mainly mental symptoms, such as intense craving, that can last for more than five weeks.
One of the early symptoms on the timeline for meth withdrawal is fatigue. During this time, the individual wants to do nothing but sleep. After the prolonged, artificial energy boost that meth produces, there is a severe crash. Later, insomnia may occur.
This also may lead to depression and an inability to take pleasure in anything. People’s appetite, suppressed by their meth use, may resurge, but even that may not bring joy. They may not feel like doing anything.
Some of the symptoms of withdrawal resemble those of meth use: agitation, mood swings, hallucinations. Others are the opposite: lack of energy, increased appetite, slower heartbeat (bradycardia).
A 2005 study found that the acute meth withdrawal phase ended after about a week to 10 days—though it dropped significantly after the first day—while the subacute (or persistent symptoms) period took at least another two weeks.
Even worse is post-acute withdrawal syndrome (PAWS) which can occur months after meth use has stopped, often when triggered by something reminding the former users of their meth days.
Because of these many side effects, some potentially deadly, managing withdrawal at a meth detox facility might be a good idea. It will have medical and psychological staff prepared to deal with the meth withdrawal symptoms, physical (high blood pressure, racing heartbeat) and psychological (resuming meth use, suicidal thoughts).
Meth Dependency Treatment
If meth users do manage to detox on their own, they still probably need professional treatment for meth dependency. A successful detox alone is not a successful recovery because:
- Addiction rewires the brain. Addiction is a mental as well as a physical compulsion. The brain becomes used to the artificially high levels of dopamine caused by meth use. It takes time and guidance to restore and become accustomed to normal levels of dopamine. It’s not just stopping the damage caused by meth. Repairs are necessary or the whole thing may collapse into relapse.
- People who use and abuse drugs do so for a reason. It might be as a coping mechanism, or as a way to forget an unpleasant reality or to mask a co-occurring mental health disorder (sometimes called a dual diagnosis). If the underlying cause isn’t addressed, relapse is more likely.
- Addiction is a disease but also a habit. There’s a ritual involved, often associated with people and places. If people continue to hang out with people who use meth or go to places where they bought or used meth, they are more likely to relapse.
While there are no approved medication-assisted treatment (MAT) drugs for methamphetamine abuse (as there are for opioid use disorder), only the symptoms of meth abuse, there are other therapies that can help individuals with meth use disorder become clean and stay that way.
According to the National Institute on Drug Abuse (NIDA), the most effective treatments for methamphetamine addiction are:
- Cognitive behavioral therapy (CBT). Anticipating problems and how to cope with them while staying drug-free, such as by avoiding situations, places, or people who might trigger a relapse.
- The Matrix Model. A combination of behavioral therapy, new activities, drug testing, and 12-step support such as Narcotics Anonymous. Families are also encouraged to get involved and informed.
- Contingency management. Reinforcing substance-free drug tests with cash, prizes, or other rewards.
- Motivational Incentives for Enhancing Drug Abuse Recovery (MIEDAR). A study that promoted another incentive-based method.
Drugs of abuse may be cyclical. Opioid use may be declining slightly because stimulant use is rising. Maybe the wide prescription and misuse of attention deficit hyperactivity disorder (ADHD) drugs such as Adderall and Ritalin as study and/or party drugs has made meth and cocaine seem less dangerous.
No drug is risk-free. Methamphetamine can kill users too. It’s not a safe alternative to heroin or fentanyl. In fact, opioids and stimulants are more deadly in combination than with either drug alone.
If individuals can’t stop their meth use on their own, if they can’t imagine stopping, then their meth use isn’t a choice. It’s a dependency or an addiction, and it’s time to get help.
- pbs.org – It’s not just opioids. Deaths from cocaine and meth are surging.
- nurse.plus – Meth Withdrawal Symptoms and Treatment: What You Must Know
- theconversation.com – Snorted, injected or smoked? It can affect a drug’s addictiveness
- ncbi.nlm.nih.gov– Comparing Injection and Non-Injection Routes of Administration for Heroin, Methamphetamine, and Cocaine Uses in the United States
- drugfreeworld.org– Crystal Meth & Methamphetamine Effects (the Truth About Drugs)
- ada.org – Methamphetamine use and oral health
- heart.org – Bradycardia: Slow Heart Rate
- ncbi.nlm.nih.gov – Withdrawal symptoms in abstinent methamphetamine-dependent subjects
- ncbi.nlm.nih.gov – The nature, time course and severity of methamphetamine withdrawal.
- nurse.plus – Drug Addiction: Signs and Risk Factors
- semel.ucla.edu – Post-Acute Withdrawal Syndrome (PAWS).
- drugabuse.gov – What treatments are effective for people who misuse methamphetamine?
- mayoclinic.org – Cognitive behavioral therapy
- drugabuse.gov – The Matrix Model (Stimulants): Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)
Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.
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