Methamphetamine (MA) is a powerful central nervous system stimulant and sympathomimetic that is used illegally as a recreational drug. It has also been used therapeutically for the treatment of narcolepsy, attention deficit hyperactivity disorder (ADHD), and obesity. MA is classified as a Schedule II controlled substance in the United States, meaning it has a high potential for abuse but can be administered by a doctor for legitimate medical uses. The effects of MA include increased alertness, wakefulness, euphoria, decreased appetite, and increased physical activity. These effects are mediated by increases in norepinephrine and dopamine levels in brain regions including the nucleus accumbens and prefrontal cortex. At high doses or with chronic use, MA can lead to psychotic symptoms such as paranoia and delusions. Withdrawal from MA use can lead to fatigue, depression, anxiety, and an intense craving for the drug.
MA is typically produced in clandestine laboratories using pseudoephedrine or ephedrine as starting materials. These materials are readily available over-the-counter as cold and allergy remedies. The chemical process involves reduction of the ketone group on pseudoephedrine or ephedrine to yield methamphetamine hydrochloride (crystal meth). Crystal meth appears as clear crystals with a glistening surface that break easily into smaller “rocks” which can then be smoked or dissolved in water for injection purposes. Street names for crystal meth include “crank”, “glass”, “ice”, “shards” among others. Methamphetamine powder (speed) can vary in color from white to brownish yellow depending on its purity; it may also contain impurities that give it a pinkish hue. Speed is sold either loose or packaged in capsules which are then swallowed whole or dissolved in water prior to injection. In addition to these two common forms of methamphetamine there is also Desoxyn® tablets which are FDA approved for the treatment of ADHD and obesity under close medical supervision due to their high potential for abuse .
The acute effects of methamphetamine depend on both the route of administration and dose; they are more pronounced with higher doses and after intravenous administration than after oral ingestion . Following smoking or intravenous injection , users report an initial “rush” lasting 5-30 minutes during which time they feel extremely energetic . This is followed by a period of euphoria during which time all inhibitions are lowered and feelings of well-being predominate; this stage usually lasts 30 minutes to several hours depending on dose . At very high doses visual hallucinations may occur along with paranoid ideation . After the acute effects have subsided amphetamine users often report feeling ‘wired’ but not tired; many will continue using amphetamines at this point instead of sleeping . Some individuals may experience extended periods (e.g., days to weeks) during which they forego sleep while continuing methamphetamine use (“run”); following such binges many individuals report feeling depressed , anxious , exhausted , irritable , confused , & paranoid . Although most people who use amphetamines do not become addicted many will develop tolerance requiring them to take larger & larger doses over time to achieve desired effects ; some will seek out purer forms so that they can inject or smoke rather than swallow pills thereby increasing risks associated with infection & overdose . Long term consequences associated with chronic methamphetamine abuse include damage to cardiovascular & neurological systems ; these effects become more pronounced with increasing duration & frequency of use . People who chronically abuse methamphetamine may also suffer from weight loss due weight loss suppression caused by chronic stimulation of appetite centers in brain leading some individuals look gaunt & malnourished when abstinent long enough periods allow their appetites catch up resulting binge eating behaviors much like those seen bulimia nervosa patients only without purging component typical bulimics exhibit post-binge though some meth addicts do purge via vomiting induced by stimulating vomiting reflex through Stickland maneuver where one fingers down throat until gag reflex elicited resulting vomit being expelled less frequently however addicts induce vomiting foods consumed immediately after binging so nutrients absorbed preventing any real caloric surplus being gained despite large amounts food consumed fact once addict stops binging metabolism returns baseline allowing them return pre-binge body weight if haven’t sustained too much structural damage internal organs due toxicity exposure drugs chemicals used manufacture methamphetamine long term exposure toxic chemicals used make meth especially anhydrous ammonia result organ damage multiple organ systems since damaging effect these toxins cumulative even small regular exposure eventually cause serious health problems sometimes irreversible organ failure death