Methamphetamine Addiction 101
Methamphetamine is a Schedule II controlled substance, according to the Drug Enforcement Administration (DEA). That means that meth has a high potential for abuse and that use that can potentially lead to severe psychological and/or physical dependence and addiction.
There are certain limited medical uses for legally-prescribed methamphetamine in a non-refillable prescription. It can be used for the treatment of attention deficit hyperactivity disorder (ADHD) and as a short-term part of a comprehensive weight-loss treatment. But the National Institute on Drug Abuse (NIDA) says such uses are limited, rarely prescribed and the dose is significantly lower than those taken by people who abuse meth.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies methamphetamine dependence and abuse under amphetamine-type substance use disorder, which falls under the broader category of stimulant use disorders.
A man-made stimulant drug, methamphetamine is taken orally, smoked, snorted or dissolved in alcohol or water and injected. Its effects are an immediate sense of euphoria, caused by a rapid release and increase in dopamine levels in the brain, especially when the drug is injected or smoked. In contrast to cocaine, another stimulant drug, when smoked, meth produces a long-lasting high and 12 hours after use just half of the drug is gone from the body. By comparison, it takes just one hour for 50% of cocaine to leave the body.
Other things about methamphetamine addiction to know:
- First use of methamphetamine by those aged 12 or older is down from a peak of 318,000 in 2004 to 144,000 in 2013, reports the 2013 NSDUH. The average age at first use was nearly 19 in 2013.
- Teen use of methamphetamine and crystal methamphetamine, along with other illicit substances such as crack and heroin, has continued to decline for the past five years, while use of other stimulants — namely Adderall and Ritalin, prescription drugs used to treat ADHD — among teens is unchanged from 2013 to 2014.
As with most addictions, the reasons behind a dependence on methamphetamine are difficult to pinpoint. Most treatment experts point to a combination of genetic and environmental factors.
For more on the causes of drug addiction, including meth addiction, visit the Drug Addiction 101 section.
Symptoms of Methamphetamine Addiction
Symptoms of a dependence on meth range from mild to intense, depending on how long the abuse or addiction has gone on. Signs include:
- Needing to take higher doses of meth, taking it more frequently or changing how the drug is taken to achieve the desired high
- Inability to feel pleasure other than when taking the drug
- Withdrawal symptoms when trying to stop taking the drug, including anxiety, intense cravings, depression and fatigue
- Mood disturbances
- Significant anxiety
- Violent behavior
Some chronic users of meth may exhibit paranoia, delusions and auditory and/or visual hallucinations. These symptoms may continue for months or years after methamphetamine use has stopped. The NIDA warns that stress can cause a spontaneous recurrence of meth psychosis in meth users who were previously psychotic.
A PBS “Frontline” report details some of the physical signs of a dependence on methamphetamine, including rotting teeth ( “meth mouth”), an unkempt appearance, constant picking at the skin as if bugs are crawling on it, loss of appetite, weight loss, eye-twitching and hyperactive, obsessive behavior (known as “tweaking”). Meth addicts are known to stay up for days on end, followed by a crash and soon leading to a resumption of using.
Due to the severe structural and functional changes methamphetamine addiction causes in the brain — specifically in the areas of emotion and memory — there may be ongoing problems with emotional and cognitive ability in someone who’s been addicted to meth.
A 2008 study concluded that meth use among youth was associated with:
- Engaging in risky behaviors
- A history of psychiatric illness
- A family environment of drug use
Studies on addiction in general have shown that genetics play a significant role in the development of addiction. Research suggests that between 40% and 60% of all types of addiction may be attributable to genes, in fact.
Adolescents who use meth can experience more damage to areas of the brain involving executive function – the ability to remember things, to organize and to reason – than do adults. That was the finding of research published in early 2015, which also linked adolescent meth use to a family history of drug use.
Meth use among people with the human immunodeficiency virus (HIV) increases the risks of difficulties in functioning cognitively (memory, thinking/reasoning, communication) as well as handling the everyday tasks of life, like managing money, taking medication, shopping for groceries and self-care.
Treating methamphetamine use disorder, which is included under amphetamine use disorder in the DSM-5, is a long, difficult process. Relapse is common and because of structural changes in the brain caused by chronic use of the drug, and cravings, hallucinations, delusions and other symptoms may reappear and/or continue for months and even years after quitting. This doesn’t mean that treatment for methamphetamine addiction is impossible, only that it takes time and requires a comprehensive treatment approach.
Before substantive treatment can begin, methamphetamine has to be cleared from the body. This is a process called detoxification, or “detox,” and is best done under medical supervision at an in-house treatment center or hospital. Detoxing from meth can take several days, as the drug remains in the body longer than some other substances. During detox, withdrawal symptoms (including intense cravings and anxiety) can be alleviated with the help of prescription medication.
While both inpatient (also called residential) and outpatient treatment programs can be used to overcome methamphetamine abuse and dependence, the stable environment provided by inpatient treatment may be the best approach. Following the detox period the person will learn about the disease of addiction, attend various types of therapy, learn and practice better ways to cope with difficult emotions and challenges and participate in activities to learn how to enjoy life without using meth. Clients also learn about relapse prevention.
For those who cannot or don’t want to attend inpatient treatment, outpatient treatment — in which the person continues to live at home or otherwise outside a residential facility — is available to help overcome meth addiction. If you attend an outpatient program you’ll check in daily and meet with an addiction counselor. Typically at a day treatment program you will be required to stay at the facility for eight hours a day for a period of time (how long depends on the course of treatment advised to you). Outpatient treatment options give you the ability to continue to work or go to school if you need to, attend to family and other obligations and not be separated from your support network for an extended period.
While there is currently no medication approved for the treatment of meth addiction, a drug approved by the FDA for the treatment of alcoholism, naltrexone, is showing promise as a potential treatment for methamphetamine addiction. In a study funded by NIDA, researchers at UCLA found that naltrexone reduced cravings for meth significantly and resulted in less arousal by the drug. The medication also lowered heart and pulse rates when study participants were shown their drug paraphernalia. Researchers also noted that naltrexone helped both men and women and produced minimal side effects, although the medication’s positive effect on men was slightly smaller. Counseling
Until there is an FDA-approved medication for use in the treatment of dependence on and addiction to methamphetamine, NIDA says that the best treatment options are behavioral therapies, or counseling/psychotherapy. These include:
- Contingency-management interventions
- Motivational Incentives for Enhancing Drug Abuse Recovery (MIEDAR) – Studies conducted in the National Drug Abuse Treatment Clinical Trials Network found that abstinence incentive interventionimproved treatment outcomes for methamphetamine users.
- The Matrix Model – A 16-week program that combines group and individual therapy and includes components to address relapse prevention, the Matrix Model has been shown to be effective in treating methamphetamine addiction.
In addition, individual counseling and group therapy are likely to be an integral part of inpatient treatment. Family counseling may also be helpful.
Self-help Support Groups
In addition to behavioral therapies, 12-step group participation is often considered essential in the long-term recovery from a dependence on or addiction to methamphetamine. These two national (U.S.) organizations have the largest reach across the country:
Sources: Crystal Meth Anonymous; Diagnostic and Statistical Manual of Mental Disorders (DSM-5); Drug Enforcement Administration; National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health; National Institute on Alcohol Abuse and Alcoholism; National Institute on Drug Abuse; Narcotics Anonymous; Nature.com; NBCNews.com; PBS “Frontline”
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