In 2012, the National Survey on Drug Use and Health reported that about 16,000 methamphetamine prescriptions were filled. However, it also found that approximately 1.2 million Americans reported using methamphetamines in the past year, with 440,000 reporting use in the past month, almost all of it in the form of crystal meth. That makes crystal meth more than twice as used as heroin, with only 808,000 past-year users reported in the same period.
Most of this illicit methamphetamine is in the form of methamphetamine hydrochloride, better known as crystal meth, crystal, ice, speed, crank, and several other street names. For decades, crystal meth was often seen as a substitute for crack cocaine, MDMA, and other drugs. However, it now has a much bigger market for regular users. Crystal meth use was previously tied to low-income neighborhoods, but users today come from all social classes and income levels.
In this article, we will contextualize crystal meth use in the United States as well as the options normally available for cases of methamphetamine use disorders.
A Brief History of Crystal Meth Use in the United States
Methamphetamine was first synthesized in Japan by chemist Nagai Nagayoshi in 1893 from ephedrine, a stimulant chemical that naturally occurs in plants such as ephedra. Crystalline methamphetamine was later created in 1919, by another Japanese chemist, Akira Ogata.
Soon after, crystal meth was being used all over the world in pill form for weight loss as well as to treat narcolepsy, and asthma. During World War II, all the belligerents issued methamphetamines to their troops to help keep them awake.
In the United States, methamphetamine use steadily increased in the Post War years. It was widely prescribed for weight loss and depression. Outside of medically prescribed use, it became popular with students, athletes, and truck drivers for improving mental concentration. In the 1960s, water-soluble injected methamphetamines were identified as a major addiction problem, which led to the banning of most forms of methamphetamine by 1970.
In the period following meth prohibition, outlaw biker gangs started to gain a monopoly on American crystal meth production and distribution. Lower-income rural communities were often the ones most affected by crystal meth, as it was cheaper than other illicit stimulant drugs such as crack cocaine. The types of users began to expand during the 80s, with crystal meth becoming popular in different club scenes as well as with white-collar professionals.
Today, crystal meth use is no longer a problem tied to a few subcultures. Due to massive demand, crystal meth is both imported into the country and domestically produced, mostly by organized crime syndicates. But as synthesizing crystal meth from readily available ingredients is relatively simple, a growing number of people are making their own meth on stovetops and microwaves. These small meth labs are dangerous to the people making them as well and the communities surrounding them due to the risk of fire, toxic fumes, and life-threatening injuries.
Today, while opioids, cannabis, and alcohol tend to take the lion’s share of the discussions on drug use, crystal meth is rapidly gaining attention. The low prices of crystal meth have made it extremely attractive to drug users in a time when incomes have stagnated. With about one million chronic users of crystal meth today, the number is only likely to go up over the next few years due to wider accessibility compared to other drugs.
How Is Crystal Meth Used?
Crystal meth can be smoked, snorted, or ingested. According to the Centers for Disease Control and Prevention, about 22 percent of users prefer to inject methamphetamines.
As with other stimulant drugs, crystal meth is often used as a way to prevent tiredness and improve alertness when in physically and mentally demanding jobs. Truck drivers have been identified as a group with elevated stimulant use, including that of methamphetamines and crack cocaine. Medical students in demanding programs are also considered to be a group that is more likely to misuse stimulants, including methamphetamines.
Methamphetamines are also popularly used to aid in weight loss and as a performance-enhancing aid. Crystal meth is also used to increase libido and sensations from sexual intercourse.
How Does Crystal Meth Work in the Human Body?
Crystal meth boosts the production of dopamine in the brain. This causes the brain and the rest of the central nervous system (CNS) to become more active. This leads to the effects we normally associate with meth use. Repeated meth use can change how the brain normally works so that the user develops a compulsion to find and use meth.
What Are the Risks of Crystal Meth Use?
Even when medically prescribed, methamphetamine use carries some risks. Crystal meth produced in an illicit laboratory is also likely to be adulterated with toxic chemicals, which can have unpredictable or harmful effects.
Low to moderate doses of crystal meth is associated with the following:
- Weight loss
- Loss of appetite
- Heart palpitations
- Increased blood pressure
- Increased body temperature
- Sensitivity to light
- Insomnia/disturbed sleep
- Muscle spasms
Higher doses can present other risks to the user. These include:
- Personality changes
- Uncontrollable twitching
- Tooth grinding
- Panic attacks
Long-term use of crystal meth has been linked to the following:
- Damage to teeth, mouth, and nasal tissue
- Kidney and liver damage
- Damage to blood vessels
- Breathing problems
- Increased risk of infection from injection sites
- Unhealthy weight
- Violent behavior
- Increased risk of strokes and heart attacks
- Severe methamphetamine use disorder
- Brain damage
What Is Methamphetamine Use Disorder?
Methamphetamine use disorder refers to the compulsive misuse of methamphetamines, including but not limited to crystal meth. It is a type of substance use disorder (SUD) as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). As with other substance use disorders, methamphetamine use disorder is now the preferred term to describe the diseases formerly known as methamphetamine addiction and methamphetamine abuse.
Signs of a Methamphetamine Use Disorder
Even with drugs with such a profound effect on users such as crystal meth, substance use disorders are not necessarily obvious. In some cases, they will only become apparent when the patient starts having withdrawal symptoms or other physical and mental health issues.
Under the DSM-5, methamphetamine use disorders are diagnosed under 11 criteria. Cases can be mild, moderate, or severe depending on how many items applied in the past year.
Criteria for methamphetamine use disorder include the following:
1.) Taking over the medically recommended dosage of methamphetamine 2.) Frequent attempts to stop using methamphetamines 3.) Dedicating more time to finding methamphetamines or recovering from the effects 4.) Constant cravings for methamphetamines 5.) Missing obligations due to methamphetamine use 6.) Continuing methamphetamine despite clear problems 7.) Getting high or avoiding withdrawal is now the biggest motivation 8.) Engaging in dangerous behavior when on methamphetamines 9.) Continuing methamphetamine use despite health issues directly caused by the drugs 10.) Needing larger doses or needing to take doses more frequently 11.) Experiencing methamphetamine withdrawal symptoms
If one or more of these criteria apply to you, you may want to immediately seek the help of a qualified clinician for a full diagnostic test and to learn more about your options for treatment. Please note that only a physician can make a diagnosis of methamphetamine use disorder.
Treatment of Methamphetamine Use Disorders
Behavioral therapy, particularly cognitive therapy, is now the most effective known approach for treating methamphetamine use disorders, including those related to the use of crystal meth. Encouraging patients to engage in non-drug related habits and activities is also a common feature of many programs aimed at helping methamphetamine use disorder patients. Another approach that shows promise is the use of incentives, as seen in programs such as Motivational Incentives for Enhancing Drug Abuse Recovery (MIEDAR).
Recovery programs tend to use a combination of approaches, including behavioral therapy, group therapy, individual counseling, regular testing, family education, professional training, and many others.
Withdrawal management may sometimes be necessary to help a patient safely detoxify traces of methamphetamines in their system. This has to be done in a supervised setting, as the compulsion to find drugs may cause the patient to act against their self-interest. This is also so that prompt medical intervention can be given as needed.
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Unlike alcohol and many other drugs, there are currently no known medications to counteract the effects of meth use, nor are there medications that are known to improve the chances of prolonged abstinence. This makes treatments of methamphetamine use disorders highly dependent on therapy and on treating physical conditions brought about by meth use.
With crystal meth likely to gain more ground in the coming years, we are likely to see more and more cases of methamphetamine use disorders in our healthcare system. By understanding the context of crystal meth use, the effects of its use, and the available treatment options, you can be better prepared should you or someone you know be at the risk of having a methamphetamine use disorder. If you believe that you or someone you know is addicted to crystal meth or has another type of substance use disorder, contact a qualified clinician.