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.

7 Comments to
Is There Such A Thing As Casual Crystal Meth Use?

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  1. Dr. Sack- I am commenting about your comparison of methamphetamine to adrenaline. I’m sure that you, as a scientist, don’t really believe this. Adrenaline is not a psychoactive substance. Maybe, you could use a different analogy if you are trying to present information about addiction to the lay public.

  2. Nice post. Now it is time for physicians to realize that many addicts are finding out what is available with some alleged legitimacy at the pharmacy counter.

    People coming in claiming to have ADD and need stimulants, especially asking for Adderall and other amphetamine based meds, make ‘em do the work, have the psychological testing done and then get collateral contacts to confirm they had ADD features as children. When the patients hem and haw to be compliant with the appropriate work up, tell ‘em to move on.

    You are doing yourself as a doctor a service, and making them rethink if they want to risk exposure for their fraudulent efforts!

  3. Hi David,

    Methamphetamine is a highly rewarding and re-inforcing substance, with a high potential for dependence.

    However the majority of people who use meth are indeed “casual” users, (if by this you mean occasional and non-addicted users).

    If you look at the national survey on drug use and health; ( http://www.samhsa.gov/data/NSDUH.aspx )
    .
    you can see that every year the number of people who have ever taken meth is many times higher than the number of people who have taken it in the last year.

    More significantly, less than half the people who report taking meth in the last 12 months have taken it in the last month. We know that most who report using it in the last month use it less often than once a week. Most of them are not dependent.

    By the way, methamphetamine is not a “synthetic version of adrenaline”. It is a sympathomimetic amine that fits into receptors and re-uptake pumps for (nor)adrenaline, serotonin and dopamine. Increasing adrenalin levels improves energy, alertness and endurance, (but increasing it too much can cause cardiac problems or stroke); increasing serotonin levels improves mood and sociability, (but increasing it too much may causing seizures and hyperthermia); increasing dopamine levels is very rewarding, and improves mental performance, concentration and response time, (but increasing it too much can cause obsessive repetitive behaviours, delusions of persecution, paranoia, and/or psychosis).

    The epidemiology of meth use that national surveys reveal does not support the article’s statement that only “the very very lucky” can use methamphetamine without becoming dependent.

    And while regular methamphetamine use is definitely bad for your physical and mental health, the “Faces of Meth” campaign might be more accurately titled “The Faces of Poverty and Disadvantage”.

    There are very real problems caused by methamphetamine use.
    However alarmist “worst drug ever” “instantly addicting” style journalism doesn’t help anyone to avoid or treat these problems.

    Regards,
    Paul.

  4. Paul, your reply is perfect.
    In no way am i promoting meth use because it is a highly addictive an dangerous drug.
    However, one sided articles such as this will only cause people to believe that everything you’re saying/ other similar articles are saying is a lie due to the obvious falsity of what you have written.
    I personally know people who have let meth destroy their lives and now live in psych wards or prison. However i also know people who smoke meth regularly and have done so for 10+ years and function as a normal member of society (even some who excel).
    It all depends on the person and their common sense/ willpower.
    In my opinion people who allow themselves to become addicted to meth are “very very” stupid.
    Cheers
    Zirkle

  5. I am a meth user of 20+years. I have tried various recovery methods with no success.
    I have tried rehabs, CMA ( Crystal Meth Anonymous ), Nacotics Anonymous. Etc, etc.

    Currently I have given up on the idea that these methods will be able to help me.
    The success rate of the 12 step programs is less than ten percent. (For meth users)

    I have been working on my own method of getting off of crystal that seems to be working (for me)

    I agree that addiction to methamphetamines (initially) is mostly psychological, unfortunately at 10 plus years of daily use it begins to become as physical as it is psychological. I know this from my own experience. My withdrawl symptoms include profuse sweating, high fevers, dizziness, nausea, extreme physical exhaustion, and extreme restlessness after day three of sleep I don’t have the energy to get out of bed but I am incapable of getting back to sleep. The worst part of my withdrawl is a feeling I have heard many users describe in different ways but most commonly they will describe the feeling as ” jumping out of your skin “.

    What I assume this is describing is (I have nothing to back this up) my central nervous system experiencing the lack of something it has become accustomed to having so regularly for such a long period of time.

    It is an extremely uncomfortable feeling! Imagine an electrical current not quite strong enough to do any real harm, but strong enough to give you the same effect a hiccup or sneeze could induce.

    One thing you mentioned about people that use meth is that ” methmouth” is caused by bad hygiene. I am especially offended by that . I do not have bad hygiene, I do not indiscriminately pick my face in an attempt to remove anything that may or may not exist there. I never have even once thought I was being followed by anyone, law enforcement or otherwise.

    To set the record straight and get rid of the misinformation you have here on your website about hygiene and methmouth.

    1. “Methmouth” is not caused by bad hygiene, it is caused by dehydration resulting in a lack of saliva in someones mouth. The lack of saliva allows bacteria to attack the enamel on your teeth.

    I Myself have for most of my life brushed my teeth two to three times a day and flossed on a regular basis and as a result of snoring when I sleep and lack of information I have still had to have all of my teeth removed because I thought good hygiene would protect me from that kind of thing .

    Thank you for your time, I appreciate the good things I think you are doing.

    Navarre

  6. Navarre is quite correct.

    Media stories often claim meth damages teeth because it is acidic, despite the fact that methamphetamine is actually an alkaline substance.

    Methamphetamine and other amphetamine type stimulants such as MDMA do cause tension in the jaw muscles and this can result in tooth grinding, however the main reason for damage to teeth is as Navarre mentioned chronic dry mouth (xerostomia).

    Paul.

  7. As a young man, I used high purity crystalline methamphetamine intravenously and very regularly for nearly 15 years, and like Navarre never developed delusions of persecution or suffered a psychotic episode.

    I have spent the subsequent 14 years working for a harm reduction agency and in mental health, and roughly 60% of the people referred to my projects identify methamphetamine as their principle drug-of-concern.
    Many of these people have developed delusions or experienced an acute episode of psychosis, however this is not the most common mental health problem amongst methamphetamine users.
    Far, far more prevalent are chronic problems with depression, mood regulation, and energy, due to physiological dependence on the substance.

    re Methamphetamine addiction being “psychological”.
    To say that “meth addiction is all in your head” is true, (in the sense that all human experience actually takes place inside your head) but rather misleading. The idea that there is a qualitative difference between physiological addiction and psychological addiction is based on the old Cartesian dichotomy between mind and body. In fact there is no such division- brain chemistry affects state of mind, and vice-versa. Psychoactive substance use affects both state of mind and brain chemistry. There is a complex set of feedback loops nested within these two simple sentences.

    Regular meth use (more often than once per week?) depletes monoamine stores. The dysthemia, anhedonia, depression, lack of energy, and problems with memory, concentration, sexual function and mood which many regular users experience on abrupt abstinence are caused by this, and by the fact that your nervous systemn responds to chronic use of any psychoactive substance by down-regulating the neurotransmitters the particular drug releases.

    The brain is a responsive and adaptive organ. It is designed to respond to changes in the environment or in the body’s internal chemistry in order to maintain homeostasis. Your nervous system does not know what methamphetamine is. Regular meth use is “interpreted” by the brain as dysregulation of, or excess release of, noradrenalin, serotonin and dopamine- the response of your brain is to release less of these chemicals naturally, and to make receptors for these neurotransmitters less responsive to them, in an attempt to normalise it’s internal chemistry.
    These changes in brain chemistry are the neurochemical basis to physical dependence.

    If you use meth regularly enough to neuroadapt to the drug’s presence, then you will not function normally without some of the drug in your systemn. Abrupt withdrawal will make you feel pretty crappy for a period of weeks – in some cases 2 or 3 months – while your brain gets its act together and works out how to regulate those chemicals again and while your body rebuilds stores of the precursors for these chemicals. In terms of causation, these symptoms have little to do with psychology- it is a physiological dependence.

    Very heavy use (daily dosing, toxic doses, sustained long term regular use) can significantly modify (or damage) brain structure as well as brain chemistry. This is because dopamine is neurotoxic. It is normally stored away safely in vesicles in the neuron, and released in tiny measured spurts, then rapidly cleaned up by re-uptake pumps and stored away again. Meth occupies the dopamine re-uptake pump and reverses its flow, spewing huge amounts of this neurotransmitter into the synapse. Dopamine is not toxic to neurons (it doesn’t kill brain cells) but excess dopamine does cause axonal pruning (it breaks the connections between brain cells).
    These damaged axons do grow back, in a process called re-arborisation. However animal studies demonstrate that toxic dosing regimes can cause damage that takes up to 12 months of abstinence to repair itself. These studies reinforce anecdotal evidence that heavy meth users can experience serious withdrawal symptoms for 3 to 9 months after abrupt withdrawal.

    When you learn anything, new pathways are physically burned in your brain, connecting neurons that were not connected before.
    (If this is the first time you have encountered this information, then reading this paragraph has subtly changed the structure of your brain, just now).

    When someone uses a dependence forming drug like meth regularly, the person’s nervous system will also form associations between places, people, or events that are associated with drug use. If they always use when in certain situations, with certain people, or to deal with certain social situations or stresses, then these “cues to relapse” are physically hard-wired into their brain. This form of conditioning is the basis of any drug addiction.

    As your brain is just seeking homeostasis, (and as this level of your nervous system is just concerned with immediate, short term results), when someone habituated to a serious dependence abstains abruptly they experience strong urges to relapse; quite simply this is the quickest and easiest way for your nervous system to revert to “normal” function.

    Substantial anecdotal evidence and some small controlled trials suggest that a tapered withdrawal of reducing doses makes the incidence and severity of withdrawal symptoms much less severe. Without supervision, most people dependent on street amphetamines are not able to consistently stick to a reduction regime.

    Agonist replacement pharmacotherapy would be possible in cases of serious methamphetamine dependence. Prescribing and supervising oral dosing of methamphetamine, (or, alternatively, sustained release dexamphetamine) would allow heavily dependent people to reduce to abstinence with much less severe symptoms and much less disruption to their quality of life and day-to-day functioning, in a similar fashion to methadone or heroin prescription for opiate dependent people.

    Regards,
    Paul.

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