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What is
Methamphetamine?
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Methamphetamine is a
powerfully addictive stimulant that dramatically affects the central nervous
system. The drug is made easily in clandestine laboratories with relatively
inexpensive over-the-counter ingredients. These factors combine to make
methamphetamine a drug with high potential for widespread
abuse. |
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Methamphetamine is
commonly known as "speed," "meth," and "chalk." In its smoked form it is often
referred to as "ice," "crystal," "crank," and "glass." It is a white, odorless,
bitter-tasting crystalline powder that easily dissolves in water or alcohol.
The drug was developed early in this century from its parent drug, amphetamine,
and was used originally in nasal decongestants and bronchial inhalers.
Methamphetamine's chemical structure is similar to that of amphetamine, but it
has more pronounced effects on the central nervous system. Like amphetamine, it
causes increased activity, decreased appetite, and a general sense of
well-being. The effects of methamphetamine can last 6 to 8 hours. After the
initial "rush," there is typically a state of high agitation that in some
individuals can lead to violent behavior.
Methamphetamine is
a Schedule II stimulant, which means it has a high potential for abuse and is
available only through a prescription that cannot be refilled. There are a few
accepted medical reasons for its use, such as the treatment of narcolepsy,
attention deficit disorder, and -- for short-term use -- obesity; but these
medical uses are limited.
What is the scope of
methamphetamine use in the United States?
Methamphetamine
abuse, long reported as the dominant drug problem in the San Diego, CA, area,
has become a substantial drug problem in other sections of the West and
Southwest as well. There are indications that it is spreading to other areas of
the country, including both rural and urban sections of the South and Midwest.
Methamphetamine, traditionally associated with white, male, blue-collar
workers, is being used by more diverse population groups that change over time
and differ by geographic area.
Based on SAMHSA's
Treatment Episode Data Set (TEDS), the rate of the primary methamphetamine/
amphetamine treatment admissions who smoked methamphetamines or amphetamines
was 50% in 2002 compared with 12% in 1992.
In 1992, 36% of smoked
methamphetamine / amphetamine admissions were referred to treatment by the
criminal justice system. By 2002, the criminal justice system was the source of
referral in 55% of the smoked methamphetamine / amphetamine treatment
admissions.
In 2002, only one State (Ohio) had a decrease in the proportion of
methamphetamine/ amphetamine admissions that smoked methamphetamines or
amphetamines. Hawaii continued to have over 90% of its methamphetamine/
amphetamine admissions that smoked the drug. In nine States, over 50% of the
methamphetamine/ amphetamine admissions smoked the drug in 2002 and for five of
these States (Colorado, Iowa, Nevada, Utah, and Washington State) their rate of
smoked methamphetamine/ amphetamine was 10% or less in 1992.
| Methamphetamine and amphetamine use is on the
rise |
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Source: SAMHSA,
2002 |
Drug abuse
treatment admissions reported by the CEWG in showed that methamphetamine
remained the leading drug of abuse among treatment clients in the San Diego
area and was second only to marijuana in Hawaii. Stimulants, including
methamphetamine, accounted for smaller percentages of treatment admissions in
other states and metropolitan areas of the West (e.g., 5 percent in Los Angeles
and Seattle and 4 percent in Texas and San Francisco). By comparison,
stimulants were the primary drugs of abuse in less than 1 percent of treatment
admissions in most Eastern and Midwestern metropolitan areas, except in
Minneapolis-St. Paul and St. Louis, where they accounted for approximately 2
percent of total admissions.
| The preferred method of taking methamphetamine varies
among geographical regions |
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Note: Calendar
year in Hawaii and San Diego; State fiscal year in San Francisco.
Source:
Community Epidemiology Work Group, NIDA 1997 |
How is methamphetamine
used?
Methamphetamine
comes in many forms and can be smoked, snorted, orally ingested, or injected.
The drug alters moods in different ways, depending on how it is taken.
Immediately after smoking the drug or injecting it intravenously, the
user experiences an intense rush or "flash" that lasts only a few minutes and
is described as extremely pleasurable. Snorting or oral ingestion produces
euphoria -- a high but not an intense rush. Snorting produces effects within 3
to 5 minutes, and oral ingestion produces effects within 15 to 20 minutes.
As
with similar stimulants, methamphetamine most often is used in a "binge and
crash" pattern. Because tolerance for methamphetamine occurs within minutes --
meaning that the pleasurable effects disappear even before the drug
concentration in the blood falls significantly -- users try to maintain the
high by binging on the drug.
In the 1980's, "ice," a
smokable form of methamphetamine, came into use. Ice is a large, usually clear
crystal of high purity that is smoked in a glass pipe like crack cocaine. The
smoke is odorless, leaves a residue that can be resmoked, and produces effects
that may continue for 12 hours or more.
| The brain -
Dopamine plays an important role in the regulation of pleasure. In addition to
other regions, dopamine is manufactured in nerve cells within the ventral
tegmental area and is released in the nucleus accumbens and the frontal cortex.
|
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What are the immediate
(short-term) effects of methamphetamine use?
As a powerful stimulant,
methamphetamine, even in small doses, can increase wakefulness and physical
activity and decrease appetite. A brief, intense sensation, or rush, is
reported by those who smoke or inject methamphetamine. Oral ingestion or
snorting produces a long-lasting high instead of a rush, which reportedly can
continue for as long as half a day. Both the rush and the high are believed to
result from the release of very high levels of the neurotransmitter dopamine
into areas of the brain that regulate feelings of pleasure.
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Short-term effects of
methamphetamine
»increased attention
»decreased fatigue
»increased activity
»decreased appetite
»euphoria and rush
»increased respiration
»hyperthermia |
Methamphetamine has toxic
effects. In animals, a single high dose of the drug has been shown to damage
nerve terminals in the dopamine-containing regions of the brain. The large
release of dopamine produced by methamphetamine is thought to contribute to the
drug's toxic effects on nerve terminals in the brain. High doses can elevate
body temperature to dangerous, sometimes lethal, levels, as well as cause
convulsions.
What are the long-term effects of
methamphetamine use?
| Long-term methamphetamine
abuse results in many damaging effects, including addiction. Addiction is a
chronic, relapsing condition, characterized by compulsive drug-seeking and drug
use which is accompanied by functional and molecular changes in the brain. In
addition to being addicted to methamphetamine, chronic methamphetamine abusers
exhibit symptoms that can include violent behavior, anxiety, confusion, and
insomnia. They also can display a number of psychotic features, including
paranoia, auditory hallucinations, mood disturbances, and delusions (for
example, the sensation of insects creeping on the skin, called "formication").
The paranoia can result in homicidal as well as suicidal thoughts. |
Long-term effects of
methamphetamine
»dependence
»addiction psychosis
»paranoia
»hallucinations
~mood disturbances
»repetitive motor activity
»stroke
»weight loss |
With chronic use,
tolerance for methamphetamine can develop. In an effort to intensify the
desired effects, users may take higher doses of the drug, take it more
frequently, or change their method of drug intake. In some cases, abusers
forego food and sleep while indulging in a form of binging known as a "run,"
injecting as much as a gram of the drug every 2 to 3 hours over several days
until the user runs out of the drug or is too disorganized to continue. Chronic
abuse can lead to psychotic behavior, characterized by intense paranoia, visual
and auditory hallucinations, and out-of-control rages that can be coupled with
extremely violent behavior.
Although there are no
physical manifestations of a withdrawal syndrome when methamphetamine use is
stopped, there are several symptoms that occur when a chronic user stops taking
the drug. These include depression, anxiety, fatigue, paranoia, aggression, and
an intense craving for the drug.
In scientific studies
examining the consequences of long-term methamphetamine exposure in animals,
concern has arisen over its toxic effects on the brain. Researchers have
reported that as much as 50 percent of the dopamine-producing cells in the
brain can be damaged after prolonged exposure to relatively low levels of
methamphetamine. Researchers also have found that serotonin-containing nerve
cells may be damaged even more extensively. Whether this toxicity is related to
the psychosis seen in some long-term methamphetamine abusers is still an open
question.
What are the medical complications of
methamphetamine use?
Methamphetamine can
cause a variety of cardiovascular problems. These include rapid heart rate,
irregular heartbeat, increased blood pressure, and irreversible,
stroke-producing damage to small blood vessels in the brain. Hyperthermia
(elevated body temperature) and convulsions occur with methamphetamine
overdoses, and if not treated immediately, can result in death.
Chronic methamphetamine abuse can result in inflammation of the heart lining,
and among users who inject the drug, damaged blood vessels and skin abscesses.
Methamphetamine abusers also can have episodes of violent behavior, paranoia,
anxiety, confusion, and insomnia. Heavy users also show progressive social and
occupational deterioration. Psychotic symptoms can sometimes persist for months
or years after use has ceased.
Acute lead poisoning is
another potential risk for methamphetamine abusers. A common method of illegal
methamphetamine production uses lead acetate as a reagent. Production errors
may therefore result in methamphetamine contaminated with lead. There have been
documented cases of acute lead poisoning in intravenous methamphetamine
abusers.
Fetal exposure to
methamphetamine also is a significant problem in the United States. At present,
research indicates that methamphetamine abuse during pregnancy may result in
prenatal complications, increased rates of premature delivery, and altered
neonatal behavioral patterns, such as abnormal reflexes and extreme
irritability. Methamphetamine abuse during pregnancy may be linked also to
congenital deformities.
How is methamphetamine different from
other stimulants, like cocaine? Methamphetamine is
classified as a psychostimulant as are such other drugs of abuse as amphetamine
and cocaine. We know that methamphetamine is structurally similar to
amphetamine and the neurotransmitter dopamine, but it is quite different from
cocaine. Although these stimulants have similar behavioral and physiological
effects, there are some major differences in the basic mechanisms of how they
work at the level of the nerve cell. However, the bottom line is that
methamphetamine, like cocaine, results in an accumulation of the
neurotransmitter dopamine, and this excessive dopamine concentration appears to
produce the stimulation and feelings of euphoria experienced by the user. In
contrast to cocaine, which is quickly removed and almost completely metabolized
in the body, methamphetamine has a much longer duration of action and a larger
percentage of the drug remains unchanged in the body. This results in
methamphetamine being present in the brain longer, which ultimately leads to
prolonged stimulant effects.
| Although both methamphetamine and
cocaine are psychostimulants, there are differences between them. |
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Methamphetamine |
vs. |
Cocaine |
Man-made
Smoking produces a high that lasts 8-24 hours
50% of the drug is removed from the body in 12 hours
Limited medical use |
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Plant-derived
Smoking produces a high that lasts 20-30 minutes
50% of the drug is removed from the body in 1 hour
Used as a local anesthetic in some surgical
procedures |
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