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Methamphetamine

Methamphetamine is a central nervous system stimulant drug that is similar in structure to amphetamine. Due to its high potential for abuse, methamphetamine is classified as a Schedule II drug, and is available only through a prescription that cannot be refilled. Although methamphetamine can be prescribed by a doctor, its medical uses are limited, and the doses that are prescribed are much lower than those typically abused. Most of the methamphetamine abused in this country comes from foreign or domestic super labs, although it can also be made in small, illegal laboratories, where its production endangers the people in the labs, neighbors, and the environment.

How is methamphetamine abused?

Methamphetamine is a white, odorless, bitter tasting crystalline powder that easily dissolves in water or alcohol and is taken orally, intranasally (snorting the powder), by needle injection, or by smoking.

How does methamphetamine affect the brain?

Methamphetamine increases the release of and blocks the reuptake of the brain chemical dopamine, leading to high levels of the chemical in the brain—a common mechanism of action for most drugs of abuse. Dopamine is involved in reward, motivation, the experience of pleasure, and motor function. Methamphetamine's ability to release dopamine rapidly in reward regions of the brain produces the intense euphoria, or rush, that many users feel after snorting, smoking, or injecting the drug.

Chronic methamphetamine abuse significantly changes how the brain functions. Noninvasive human brain imaging studies have shown alterations in the activity of the dopamine system that are associated with reduced motor skills and impaired verbal learning.¹ Recent studies in chronic methamphetamine abusers have also revealed severe structural and functional changes in areas of the brain associated with emotion and memory,^2,3 which may account for many of the emotional and cognitive problems observed in chronic methamphetamine abusers.

Repeated methamphetamine abuse can also lead to addiction (a chronic, relapsing disease characterized by compulsive drug seeking and use, which is accompanied by chemical and molecular changes in the brain). Some of these changes persist long after methamphetamine abuse is stopped. Reversal of some of the changes, however, may be observed after sustained periods of abstinence (e.g., more than 1 year).⁴

What other adverse effects does methamphetamine have on health?

Taking even small amounts of methamphetamine can result in many of the same physical effects as those of other stimulants, such as cocaine or amphetamines. These effects include increased wakefulness, increased physical activity, decreased appetite, increased respiration, rapid heart rate, irregular heartbeat, increased blood pressure, and hyperthermia.

Long term methamphetamine abuse has many negative health consequences, including extreme weight loss, severe dental problems (meth mouth), anxiety, confusion, insomnia, mood disturbances, and violent behavior. Chronic methamphetamine abusers can also display a number of psychotic features, including paranoia, visual and auditory hallucinations, and delusions.

Transmission of HIV and hepatitis B and C can be consequences of methamphetamine abuse. The intoxicating effects of methamphetamine, regardless of how it is taken, can also alter judgment and inhibition and can lead people to engage in unsafe behaviors, including risky sexual behavior. Among abusers who inject the drug, HIV, AIDS, and other infectious diseases can be spread through contaminated needles, syringes, and other injection equipment that is used by more than one person. Methamphetamine abuse may also worsen the progression of HIV and AIDS and its consequences.

What treatment options exist?

Currently, the most effective treatments for methamphetamine addiction are comprehensive cognitive-behavior interventions, such as the Matrix Model (a behavioral treatment approach that combines behavioral therapy, family education, individual counseling, 12-step support, drug testing, and encouragement for non-drug related activities). Contingency management interventions, which provide tangible incentives in exchange for engaging in treatment and maintaining abstinence, are also effective. There are no medications at this time approved to treat methamphetamine addiction.

References

1. Volkow, N.D., Chang, L., Wang, G.J., et al. (2001). Association of dopamine transporter reduction with psychomotor impairment in methamphetamine abusers. American Journal of Psychiatry 158, 377-382.
2. London, E.D., Simon, S.L., Berman, S.M., et al. (2004). Mood disturbances and regional cerebral metabolic abnormalities in recently abstinent methamphetamine abusers. Archives of General Psychiatry 61, 73-84.
3. Thompson, P.M., Hayashi, K.M., Simon, S.L., et al. (2004). Structural abnormalities in the brains of human subjects who use methamphetamine. Journal of Neuroscience 24, 6028-6036.
4. Wang, G.J., Volkow, N.D., Chang, L., et al. (2004). Partial recovery of brain metabolism in methamphetamine abusers after protracted abstinence. American Journal of Psychiatry 161, 242-248.