What is Methamphetamine Addiction?
Methamphetamine is a potent artificial stimulant drug that is highly addictive. It is often sold in a solid, crystalline form called crystal methamphetamine, crystal meth, or simply meth or crystal. It is chemically related to amphetamine, a drug with some legitimate medical uses, but methamphetamine is an illicit drug that is illegal to use or possess.
Methamphetamine is typically consumed by heating the crystals and inhaling the vapors produced. It can also be ground into a powder and inhaled through the nose, swallowed, or mixed with water or alcohol and injected.
The drug produces a quick, intense high characterized by feelings of euphoria, alertness, and energy. The effects are fast to develop, and they last longer than those of many drugs, with the high typically lasting between 6 and 24 hours. However, the depressed mood that follows the high often encourages users to consume multiple doses in succession to maintain the high.
Symptoms of Methamphetamine Addiction
Methamphetamine works by increasing a brain chemical called dopamine, a naturally occurring substance that stimulates the brain’s pleasure centers and produces well-being feelings. As meth use continues, the brain’s response to dopamine changes, causing the user to need higher and more frequent doses of the drug to feel well. A dependency on the drug develops, and if the user stops using, they will have unpleasant and potentially harmful symptoms of withdrawal.
Signs of methamphetamine addiction include:
- Inability to stop using even when you try
- Intense cravings or intrusive thoughts about using methamphetamine
- Continuing to use even when your drug use is causing harm
- Failing to meet your responsibilities because of methamphetamine use
- Needing more of the drug as time goes on
- Taking risks to get and use the drug
- Feeling unwell when you stop using methamphetamine
Symptoms of methamphetamine withdrawal include:
- Psychotic episodes (mental breaks with reality)
What Causes Methamphetamine Addiction?
Methamphetamine addiction seems to occur when repeated exposure to the drug changes how the brain responds to dopamine, a chemical that enables communication between nerve cells in the brain. Some studies have suggested that the use of the drug may change how different parts of the brain communicate with one another. Eventually, those parts of the brain are unable to communicate normally without the presence of the drug. The result is unpleasant withdrawal symptoms that only go away with more drug use.
Most people who use methamphetamine just once do not become addicted. However, meth has an exceptionally high addiction liability, meaning that it is more likely than many other drugs to trigger dependency in its users.
Also, some factors increase the likelihood that a given individual will develop a methamphetamine dependence. These risk factors include:
- Family history. People who have close relatives who have suffered from drug addiction are more likely to develop an addiction themselves.
- Abuse of other substances. Methamphetamine abuse often occurs in conjunction with the abuse of other drugs or alcohol.
- Use in childhood or adolescence. The earlier in life that methamphetamine is first used, the more likely the user will develop an addiction.
- Mental illness. Drugs are often used as a coping tool by people with depression, anxiety, post-traumatic stress disorder (PTSD), and other mental illnesses.
Is Methamphetamine Addiction Hereditary?
The reasons that people become addicted to methamphetamine and other drugs are, without question, complex. Some of the most critical factors that increase the risk of addiction are environmental; that is, they come from outside the user and influence their behavior. Peer pressure may push an individual toward drug use. Furthermore, living in an environment where drug use is prevalent increases the likelihood of drug use.
However, scientists have long recognized that there seems to be an inherited genetic component to addiction risk. People who have a drug-addicted parent are at a greater risk of addiction themselves, and studies that have ruled out external influences strongly suggest that the increased risk comes from genes.
The exact genetic mechanism that increases addiction risk, however, has not yet been determined. Many different genes may be involved, and addiction may stem from a complicated interaction between multiple genes and other factors.
One study has identified a gene that may be linked specifically to methamphetamine addiction susceptibility. According to a Boston University School of Medicine study, the heterogeneous nuclear ribonucleoprotein H1 (Hnrnph1) gene seems to produce a sensitivity to the effects of methamphetamine. The gene has not been linked to a sensitivity to other stimulants, such as cocaine or amphetamines.
How is Methamphetamine Addiction Detected?
In the early stages of chronic abuse, meth users will often attempt to hide their drug use. As the addiction progresses and the drug use becomes more intense, the abusive behavior typically becomes more apparent. Early detection of dependence is essential because the sooner a user gets treatment, the better their chance of recovery.
Warning signs that a loved one might be abusing or addicted to methamphetamine include:
- Loss of interest in social interaction or pleasurable activities
- Hyperactivity or restlessness
- Dilated pupils
- Irritability, moodiness, or agitation
- Insomnia or altered sleep patterns
- Reduced appetite or weight loss
- Burns on the fingers or lips
- Bouts of lethargy, depression, fatigue, or sleepiness
How is Methamphetamine Addiction Diagnosed?
To determine whether or not a patient has a methamphetamine addiction, a doctor will look for indications that the patient is using the drug, as well as a pattern of use that suggests dependency. Diagnostic steps can include:
- Blood and laboratory tests. These tests will look for indications that the patient is using methamphetamine. They will also look for conditions that may be caused by methamphetamine use.
- Medical and psychological history. The doctor will determine whether the patient has a history of substance abuse or mental illness. The doctor will also ask the patient directly about the frequency and intensity of methamphetamine use or the presence of withdrawal symptoms.
- Family history. The doctor will look for evidence of abuse of drugs among the patient’s family members.
- Psychological evaluation. A formal diagnosis of abuse of methamphetamine is made by comparing the patient’s condition with criteria contained in the Diagnostic and Statistical Manual of Mental Disorders – 5th Edition (DSM-V).
The symptoms that indicate methamphetamine abuse include:
- Strong desire to take the drug
- Tolerance (a need for an increased amount of methamphetamine to maintain its effects)
- Withdrawal symptoms
- Use of more of the drug than the user initially intended to use
- Desire to quit, or unsuccessful attempts to stop using the drug
- Spending significant time, effort, and money to acquire the drug
- Drug use interferes with important activities or obligations
- Drug use continues even when the user knows it causes harm
- Drug use in dangerous locations or situations
The symptoms’ presence will determine whether the user can be diagnosed with a mental illness called stimulant use disorder. The presence of 2-3 of the symptoms will indicate a mild form of the disorder. The presence of 6 or more symptoms indicates a severe disorder.
How is Methamphetamine Addiction Treated?
Researchers are looking for medications that may counter the changes that methamphetamine makes in the brain or alleviate some of the cognitive impairments caused by chronic methamphetamine use.
In addition to drug-based therapies, behavioral or group-based psychotherapies are also commonly used to treat methamphetamine addiction. In general, drug-treatment organizations recommend that dependent users enter a treatment program that lasts at least 90 days.
- Medications. The antidepressant bupropion (brand name Wellbutrin) has shown the ability to improve the drug-use behavior of low-to-moderate users of methamphetamine. Modafinil, a drug used to treat narcolepsy, has shown promise in helping methamphetamine users to avoid relapse once they have begun a treatment program.
- Contingency Management Therapy (CM). This type of therapy, also called motivational therapy, rewards patients for successfully abstaining from drug use. The rewards, monetary or otherwise, are given to patients when they successfully reach milestones of abstinence. This approach is also used to treat cocaine dependence, and it’s beneficial as the first step in a broader treatment plan.
- Cognitive Behavioral Therapy (CBT). This type of psychotherapy helps drug users to recognize the triggers that prompt their drug use. The therapy also focuses on developing strategies and techniques for dealing with those triggers when they occur. CBT is effective at preventing relapses once the patient has begun to abstain from drug use.
How Does Methamphetamine Addiction Progress?
Even in the short term, methamphetamine use can have detrimental effects on the user, including anxiety, paranoia, and aggressive or violent behavior.
An overdose of methamphetamine can be fatal and is a risk even for the casual or first-time user. Overdoses often occur when an inexperienced user mimics an experienced user’s behavior or when a user relapses after a period of abstinence. Signs of a methamphetamine overdose include:
- Chest pain
- Heart arrhythmia
- High or low blood pressure
- Breathing difficulties
- Hyperthermia (elevated body temperature)
Long-term health consequences of methamphetamine use can include:
- Depressed mood. A “crash” after each high typically leads to a period of lethargy and low mood.
- Withdrawal symptoms. These symptoms include lethargy or restlessness, depression, increased appetite, suicidal thoughts, and intense cravings for the drug.
- Planning, organizational, and reasoning deficits
- Pulmonary arterial hypertension (damaging high blood pressure in the lungs)
- Psychosis or other mental illness
- Dental problems. Methamphetamine users typically neglect oral hygiene.
- HIV or other sexually transmitted infections. Methamphetamine users often engage in risky sexual behavior.
Many of the severe health problems caused by chronic methamphetamine use can take years to resolve after the patient stops using the drug. Some of the effects may be permanent.
How Is Methamphetamine Addiction Prevented?
Research suggests that drug-education programs can reduce methamphetamine use and abuse among young people, particularly in communities where the drug is prevalent. Studies of education and drug-abuse-prevention programs in rural Iowa, for example, showed the programs appear to have reduced methamphetamine use among high-school students after those students participated in the programs as middle-schoolers.
Methamphetamine Addiction Caregiver Tips
- Don’t support abusive behavior. You may be tempted to try to protect your loved one from the consequences of their drug use. However, the insulation you provide can get in the way of their motivation to quit. Instead, be loving and encouraging, but don’t help them get away with the behavior that’s hurting them.
- Protect yourself. If your loved one is violent or abusive, remove yourself from situations that put you in danger. Take steps, too, to prevent your loved one from exploiting you financially to support their drug use.
- Be firm and consistent. Your loved one will almost certainly move repeatedly between blaming you for their problems and expecting your help. The vacillations are challenging to cope with, but you’ll do the most good if you stay consistent in the way you respond to your loved one’s behavior.
- Find the support you need. Don’t spend all your energy on taking care of your loved one without taking care of yourself. Pay attention to your physical health, and get help from a therapist and/or a support group when you need it.
Many people with methamphetamine dependence also suffer from other brain-related issues, a condition called co-morbidity. Here are a few of the disorders commonly associated with methamphetamine addiction:
- About a third of people with methamphetamine dependence suffer from mood disorders such as depression.
- More than a quarter of people with a methamphetamine addiction experience symptoms similar to those of schizophrenia, including hallucinations and delusions. In about a quarter of these cases, the symptoms are judged to be caused by the drug.
- About a quarter of people with methamphetamine dependence also have an anxiety disorder of some kind.
Methamphetamine Addiction Brain Science
Methamphetamine creates feelings of euphoria by increasing the levels of dopamine in the user’s brain. Dopamine is a neurotransmitter chemical, a kind of compound that helps the brain’s nerve cells communicate with each other. Dopamine is released when we do something pleasurable–like eat our favorite foods or have sex–so the artificially high level of the dopamine produced by methamphetamine results in an intense good feeling.
The problem is that long-term use of meth changes how the brain’s nerve cells respond to dopamine, making it more difficult for the user to experience good feelings. Eventually, the drug promotes a rewiring of the brain’s nerve circuitry that effectively prevents parts of the brain from communicating with each other.
It’s this rewiring that causes long-term neurological effects in methamphetamine users, including depression, anxiety, and problems with decision-making, memory, and motor skills. It may take years for the damage to improve even after the user entirely abstains from drug use, and in some cases, the impairments may be permanent.
Methamphetamine Addiction Research
Title: Pilot Study of the Effect of Ibudilast on Neuroinflammation in Methamphetamine Users (Ibudilast)
Principal Investigator: Milky Kohno, PhD
VA Portland Health Care System
Methamphetamine addiction is a serious health problem in the United States. There are no medications that a doctor can give someone to help them stop using methamphetamine. More research is needed to develop drugs for methamphetamine addiction. Ibudilast (the study drug) is a drug that could help people addicted to methamphetamine.
The investigators are interested to know if the study drug can help some symptoms that methamphetamine can cause, specifically inflammation in the brain. Inflammation has been shown to affect decision-making. The study drug has anti-inflammatory properties; however, it is unknown whether the drug will reduce inflammation in the brain.
Title: The Intermittent Oral Naltrexone Enhanced With an Ecological Momentary Intervention Study
Principal Investigator: Glenn-Milo Santos, Ph.D., MPH
University of California, San Francisco
San Francisco, CA
This is a double-blind, placebo-controlled phase 2b trial in which 150 MSM who use meth will be randomly assigned (2:1) to receive 12 weeks of as-needed intermittent oral naltrexone 50 mg enhanced with an EMA-informed EMI platform or receive as-needed placebo with EMA-informed EMI. The 12-week treatment period is consistent with other pharmacotherapy trials for substance use disorders. The proposed sample size is also consistent with other phase 2b trials for substance use treatment. Upon enrollment, participants will complete daily EMA assessments and weekly visits for behavioral surveys and sweat testing for meth metabolites, study drug dispensing and counseling for substance use. Safety laboratory assessments and vital signs will be completed monthly. Efficacy (Specific Aims 1-3) will be assessed upon trial completion as measured by proportion meth-positive sweat samples; PrEP and ART adherence by drug levels and viral load testing; and sexual risk behavior data accounting for PrEP use and viral suppression. Long-term treatment effects will be evaluated 3 months post-treatment.
Title: rTMS for Craving in Methamphetamine Use Disorder
Principal Investigator: Brandon J. Cornejo, MD, PhD
Veterans Affairs Portland Health Care System
This project’s primary aim is to use a randomized, single-blind, sham-controlled study to investigate if high-frequency repetitive trans magnetic stimulation (HF-rTMS) can modulate cue-induced craving in adult methamphetamine (METH) users. The investigators hypothesize that HF-rTMS directed at the left dorsolateral prefrontal cortex (DLPFC) will reduce craving for METH compared to sham-controlled rTMS in adults with methamphetamine use disorder (MUD) as evidenced by validated measures of METH craving. Neurobiologically, the investigators anticipate rTMS mediated stimulation of the DLPFC to inhibit cue-induced craving through potential disruption of active circuitry.