Methamphetamine goes by numerous street names, including meth, crystal meth, and glass. The medication is still used in some cases for the treatment of attention deficit hyperactivity disorder (ADHD), for weight control, and to treat sleep disorders; however, its medical use is relatively rare. Most people identify methamphetamine as a drug of abuse.
It is a tightly controlled drug that is classified in the category of Schedule II controlled substances. The medications in this category can still be used legally with a prescription from a physician, but are at the highest level of control.
The illicit use of methamphetamine is most often associated with privately manufactured forms of the drug. It can be manufactured easily with different products that can be found in drugstores, hardware stores, and supermarkets.
As a drug of abuse, it can be taken orally, smoked, snorted, or injected. Two of the most common routes of abuse are smoking forms of the drug and grinding up the drug and snorting it.
The psychoactive effects of the drug are intense and produce euphoria, very strong feelings of invincibility, and a rush of energy that will typically dissipate rather rapidly. As a result, abusers often spend hours bingeing on the drug to maintain these effects. Over time, the euphoria may be replaced with paranoia, aggression, and psychosis.
As meth is a stimulant drug, it also 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 those who develop stimulant use disorders as a result of methamphetamine abuse.
The Mechanism of Action of Methamphetamine
According to the National Institute on Drug Abuse (NIDA) and the DEA, methamphetamine works by increasing the availability of neurotransmitters in the brain, particularly norepinephrine and dopamine. This drug is a very powerful central nervous system stimulant drug. When abused, it results in:
- Euphoria and invulnerability.
- An intricately heightened awareness and increased attention.
- A rush of energy.
- Increased respiration, heart rate, body temperature, and blood pressure.
- Decreased appetite and need for sleep.
When abused, the psychoactive effects of meth are realized very quickly and wear off rapidly. The rapid onset and rapid dissolution of these desired psychoactive effects results in abusers of the drug often bingeing on it until the available amount of the drug is entirely depleted. They then attempt to find more of the drug to keep from experiencing a “meth crash.” The massive neurotransmitter release that occurs when methamphetamine is abused is followed by a massive depletion of neurotransmitters in the brain that results in the opposite effects that the drug produces. The crash consists of:
- Depression and apathy.
- Problems with attention, concentration, and memory.
- Lethargy and sleepiness.
- Increased appetite.
Because the drug produces a massive increase of neurotransmitters and then when one no longer uses the drug these neurotransmitters become significantly depleted in the person’s central nervous system, continued use/abuse of the drug can result in numerous health issues. Individuals that smoke the drug will experience a more extreme cycle of neurotransmitter increase and depletion than individuals who snort the drug, but over time chronic use of the drug is associated with numerous potential health issues whether one snorts or smokes it.
The Physical Effects of Methamphetamine Abuse
According to NIDA and research studies, in addition to the psychoactive effects mentioned above, abuse of methamphetamine is associated with a rapid development of tolerance to the drug. Tolerance refers to a physical and psychological adjustment to the drug that occurs when a person begins to use a drug on a regular basis. As the person uses the drug more frequently, the individual’s system makes adjustments that counteract the effects of the drug, and the person’s perceptual awareness of the psychoactive effects of the drug become deadened.
Individuals who abuse methamphetamine, whether they smoke it or snort it, will very quickly find that they need more and more of the drug to produce effects that were similar to the effects they initially achieved when using the drug. Moreover, as a person continues to abuse the drug, they become desensitized to the desired psychoactive effects, such as euphoria.
These initial feelings of euphoria are very salient in those without a significant history of drug abuse, but according to the incentive sensitization theory of drug abuse, as the person continues to abuse the drug, they experience diminishing returns. Instead of using the drug to produce high levels of euphoria and wellbeing, they use it to avoid the negative feelings that occur when they go without the drug. As this cycle continues, the person experiences less euphoria under the influence of the drug.
Chronic abuse of methamphetamine and rapid tolerance result in the tendency to binge on the drug for lengthy periods of time. This cycle of bingeing leads to an increase in the risk of overdose. An overdose of a powerful central nervous system stimulant like methamphetamine can be potentially fatal. Seizures can occur that can lead to significant brain damage, or heart attack or stroke may occur.
NIDA reports various physical effects of methamphetamine abuse.
- Dilated pupils, dark circles under the eyes, and bloodshot eyes
- Significant weight loss and a gaunt, unhealthy appearance
- Sores on the skin, or very dry and cracked skin
- Significant clenching and grinding of the teeth
- Tooth decay and loss of teeth as a result of the corrosive effects of methamphetamine (sometimes referred to as meth rot or meth mouth)
- Extremely bad breath
- Nosebleeds, constant runny nose, and infections in the nose (for people who snort the drug)
- Burns around the nose, mouth, or fingertips (for individuals who smoke the drug)
- Problems with overheating
- Tremors and/or twitches that develop over time
- Tolerance to methamphetamine
- A withdrawal syndrome when one attempts to stop using methamphetamine or cannot get enough methamphetamine
Long-term use of methamphetamine is associated with numerous health issues in different organ systems.
- Cardiovascular problems are not uncommon in individuals who abuse methamphetamine. These can include issues with high blood pressure, heart rhythm abnormalities, heart attacks, and even stroke.
- Respiratory issues can occur with methamphetamine abuse, particularly with individuals who smoke the drug.
- Significant liver and kidney damage is associated with chronic methamphetamine abuse.
Methamphetamine abusers will also begin to display changes in their behavior. They may begin to opt out of important personal and professional obligations. There is nearly always a significant decline in productivity. This can occur in school, at work, or in personal aspects of life.
Chronic abuses of methamphetamine will often begin to neglect their personal hygiene and self-care. This can lead to an increased potential to contract infectious diseases or develop certain forms of cancer. Chronic use of methamphetamine is associated with the development of a stimulant use disorder.
Some of the above issues may resolve with continued abstinence from meth, whereas others may not. For instance, liver damage may resolve if the individual becomes abstinent in the early stages of deterioration of the liver, but over time, the damage may not be reversible. This is also true with damage to other organ systems.
Issues with dentition often require professional intervention in order to be corrected. Problems with the skin can resolve with treatment and abstinence, but some individuals may find they have issues with dry skin for many years following abstinence from methamphetamine.
Behavioral issues associated with methamphetamine abuse may fully resolve. For instance, tolerance to the drug may resolve to some extent; however, the desensitizing effects of the chronic abuse of methamphetamine may leave an individual open for a more rapid deterioration to further substance abuse if they break their abstinence. The damage to personal and professional relationships may never fully resolve as a result of chronic methamphetamine abuse. Issues with the legal system that can occur as a result of chronic methamphetamine abuse may have long-lasting ramifications and, in some cases, may significantly alter the course of a person’s life.
Methamphetamine Abuse and the Central Nervous System
The central nervous system consists of the brain and spinal cord. It is the control center for all of a person’s actions and bodily functions. The existing body of empirically based research investigations regarding the long-term effects of methamphetamine abuse suggests that there are numerous effects to the central nervous system.
- Neurons in the brain and spinal cord die. When neuronal death is massive, the situation may not be reversible.
- There are some areas of the brain where significant neuronal death is known to occur.
- The prefrontal and frontal cortex, which are involved in attention, reasoning, and problem solving
- The parietal lobe, which is involved in use of nonverbal memories and to visualize and manipulate objects in the real world
- The hippocampus, which is a crucial structure for the development of new memories
- The striatum, a structure that is very important in directing attention and body movements
- Numerous subcortical structures, which are important in movement and the ability to resist impulsive types of behavior
- There is significant death of other cells in the brain and spinal cord, such as the glial cells, which function as support structures, to fight infections, and to develop important substances like myelin, which is crucial in the ability of neurons to communicate with one another.
- Numerous studies find disruptions in the white matter of the brain (myelin) in chronic abusers of methamphetamine. This is the fatty sheath around the axons of neurons that helps the neurons effectively communicate and send signals to one another. Disruptions of myelin can lead to numerous issues, including problems with movement, difficulty thinking, and tremors.
- Decreases in the availability of neurotransmitters, such as dopamine, epinephrine, and acetylcholine, can occur. This can lead to emotional issues, such as depression, and increased vulnerabilities to other psychiatric problems. It can also lead to issues with experiencing pleasure from activities that normally give pleasure.
- Increased levels of neurotoxic damage in the central nervous system can lead to significant brain damage that results in functional issues.
- Damage to the cytoskeleton of the neurons can occur. This is the support structure of neurons, and can lead to the collapse of the cells.
- Damage to the veins and arteries that feed the central nervous system may occur. This can result in areas of the brain becoming damaged due to a lack of oxygen, and it can lead to an increased potential to develop stroke.
Research studies have also found that chronic abusers of methamphetamine are more vulnerable to suffering traumatic brain injuries than individuals who did not abuse the drug. Individuals who have compromises to the brain and spinal cord as a result of methamphetamine abuse and also experience a traumatic brain injury are far less likely to experience significant recovery.
The results of chronic methamphetamine abuse on the central nervous system can lead to numerous cognitive issues.
- Problems with the ability to concentrate
- Issues with judgment
- Problems controlling emotional impulses, such as compulsive anger, depression, or other impulsive issues
- Issues with the development of new memories
- Problems coordinating movement with intentions
- Mood swings, chronic issues with depression, and feelings of hopelessness
- Increased risk to be diagnosed with some other psychiatric disorder, including another substance use disorder, depression, an anxiety disorder, and even serious disorders like bipolar disorder and psychosis.
The research indicates that many of the above cognitive issues and changes in the brain that occur as a result of chronic methamphetamine abuse may not fully resolve even with long-term abstinence. For instance, individuals with chronic histories of methamphetamine abuse are at an increased risk to develop cardiac issues or even stroke over their lifetime compared to individuals who have not abused methamphetamine. These individuals will also often continue to demonstrate problems with cognition that represent significant damage to the central nervous system such as issues with maintaining attention and problems with emotional control or impulse control.
Individuals who have histories of a stimulant use disorder as a result of methamphetamine abuse are also at an increased risk for relapse. Those who relapse may find themselves returning to chronic and uncontrolled use of methamphetamine quite quickly. This is because the changes in the pathways in the brain that occur as a result of methamphetamine abuse do not fully remit.
Moreover, individuals with a history of methamphetamine abuse may be more vulnerable to developing other types of substance use disorders. This is why individuals with histories of substance use disorders should remain in recovery-related activities for many years following their initial abstinence. While the effects of methamphetamine abuse can be substantial, complete and sustained recovery is possible with proper treatment and support.