Methamphetamine is a synthetic compound that stimulates the release of dopamine and norepinephrine, a neurotransmitter closely related to adrenaline. The effects of meth are much more prolonged than the short burst of dopamine and norepinephrine that is released when neurons fire on their own.
Like all amphetamines (“speed” drugs), meth creates feelings of euphoria, intensity, and power, along with the drive to do whatever activity the user wishes to engage in. If going to clubs and dancing is your thing, then while you’re high on meth you’re up all night, feeling energized by every thump of music—at least until you start coming down.
Meth is sold legally (with a prescription) in tablet form as Desoxyn, FDA approved for the treatment of ADHD and exogenous obesity. More often, though, it’s cooked in makeshift labs and sold illegally as a powder or rock. The powder form can be snorted, smoked, eaten, dissolved in a drink, or heated and injected. The rock form is usually smoked, though it can also be heated and injected. Widely available in the 1960s, meth faded in the 1970s as controls were tightened on legal production, and cocaine took its place as the new party drug of choice. Crack cocaine dominated the 1980s, along with designer drugs like MDMA (Ecstasy), but in the early 1990s meth made a comeback, and it seems to be here to stay. According to the World Health Organization, meth is now the second most widely abused illicit drug worldwide, trailing only marijuana.
Given the drug’s immense and rapidly increasing popularity, the question naturally arises: Is there such a thing as casual meth use?
Like many other drugs, many people will try meth and a small percentage will become regular users. A subgroup of users take meth as a type of club drug – for example, to stay up all night or to have prolonged sex – but do not become dependent. Not everyone who uses alcohol becomes addicted to it; likewise, not everyone who uses meth becomes addicted.
Even though only a small portion of people who have tried meth become addicted, at present there are no effective medical treatments for meth addiction. In addition, success rates for meth treatment are among the lowest for any drugs of abuse. Methamphetamine is a highly addictive substance. There is compelling evidence that chronic meth use causes long-term changes in the nervous system that users may not fully recover from even after years of abstinence. Once a person is hooked, getting and staying clean is difficult; studies show relapse rates in the 90 percent range.
As with all substances, addiction to crystal meth involves:
1. Loss of control over use
2. Continued use despite adverse consequences
3. Preoccupation to the point of obsession
Most crystal meth addicts have a brief period of “casual” or “recreational” use. This can quickly escalate to abuse and dependency. Attempting to use meth (or any other addictive stimulant, such as cocaine) in a casual/recreational fashion is a bit like playing with matches in a room filled with dynamite. No matter how careful you are, you’re likely to blow the place up.
Nevertheless, some people will argue that meth is not addictive, and that casual use is not only possible but the norm. Usually this “non-addictive” assertion stems from the fact that meth does not precipitate the physical withdrawal symptoms we see with drugs like alcohol and heroin. However, agonizing physical withdrawal is hardly a prerequisite for addiction. As more than one user has asked, “If it’s not addictive, why can’t I stop?”
One need not look farther than the faces of meth users to understand the drug’s destructive force. Meth causes the blood vessels to constrict, cutting off normal blood flow throughout the body. The result is rapid physical deterioration that is enough to make your stomach turn. Gray, sallow, and wrinkled skin makes users look 10 to 20 years older in a matter of months. Some meth users pick at their skin, believing there are bugs crawling beneath it, causing small sores and scabs all over their bodies. Poor diet, bad personal hygiene, and tooth-grinding produce “meth mouth,” a reference to the broken, discolored, and rotting teeth common among even short-term regular methamphetamine users.
Combine these physical effects with the propensity for violence, anxiety, and paranoia associated with meth use and, no matter how you define it, meth use can hardly be considered casual or recreational. A movie, a dinner out with friends – that’s recreation. You don’t dabble in meth without facing a very real risk of addiction.
David Sack, M.D., is board certified in psychiatry, addiction psychiatry and addiction medicine. He is CEO of Elements Behavioral Health, a network of addiction treatment centers that includes Promises Malibu rehab, The Ranch outside Nashville, The Recovery Place in Florida, and Right Step treatment centers in Texas.
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Last reviewed: 21 Jun 2013