Meth is an extremely powerful and dangerous drug even taken on its own. Overdoses and meth induced psychosis are the culprits for many meth related fatalities and crimes committed by users. Aside from these issues, there are a variety of health complications associated with meth use. Additionally, meth is capable of many drug interactions which can increase the risk of negative side effects and even death.
Below we have detailed the 5 greatest risks that are presented by prolonged meth use.
Danger #1: Meth Overdoses
Meth related overdose is unfortunately very common, as meth is much more potent than other psychostimulants. This is evidenced by the LD50 (Lethal Dose for 50% of animals tested) for meth being 55 mg/kg in rats. For comparison, the LD50 of dextroamphetamine (a component of Adderall) in rats in 96.8 mg/kg. For cocaine in mice, the LD50 is 96 mg/kg. Given that Meth takes just over half the amount of other common psychostimulants to produce potentially fatal complications, it may not be surprising that overdoses are so much more common.
In 2016, there were 7,542 psychostimulant (including meth & cocaine) drug overdose deaths according to the CDC. This is an amazing 387% increase from 2005, which tracks an increase in purity, availability, and potency exhibited by meth across this timeline. The risk of meth overdose is greatly increased depending on the route it is taken. Shooting up meth is by far the most risky way to use it, as it is possible to inject a fatal dose in the fraction of a second it takes to push in the plunger. It is possible to overdose no matter which route meth is taken.
Signs of A Meth Overdose
An overdose on meth can result in some or all of the following symptoms:
- Tachycardia: Very fast heart rate (100+ bpm). Due to the surge of norepinephrine produced by meth use. Can increase risk of stroke or heart attack.
- Cardiac Arrest: A heart attack which can be caused by an irregular heart beat. In the case of meth, this is typically due to ventricular fibrillation or ventricular tachycardia. Caused by disorganized electrical signals telling the heart to beat in an inefficient or unsynchronized way. Can be fatal.
- Heat Stroke: Caused by meth induced hyperthermia, this is when the users body temperature reaches 104ºF or higher. Results in confusion, nausea, redness, rapid breathing, or severe headache. Can cause brain damage or death.
- Hallucination: Typically tactile (touch) in nature, but can also present as auditory or visual hallucinations.
- Psychosis: Usually a symptom of chronic meth use, it can also appear during an overdose. Symptoms can include delusional thinking, paranoia and anxiety, and violent or erratic behavior.
- Seizure: Meth induced seizures are typically of the grand mal (or tonic-clonic) variety. This means they involve a loss of consciousness and violent, involuntary muscle contractions. This can progress to Status Epilepticus and can result in brain damage or death.
- Coma: Loss of consciousness with an inability to be woken up. Can last hours or years and typically is a sign of serious brain damage.
Danger #2: Cutting Agents/Catalysts Used in Meth Production
Meth is typically rendered in crystal form as a hydrochloride salt and can be crushed down to a powder. There are currently FDA recognized legitimate uses for meth in the form of Desoxyn for treatment of narcolepsy, ADHD, and obesity. This drug is rarely used these days as much safer drugs and treatments for these conditions have been developed which pose less of a risk for abuse. The vast majority (99+%) of meth today is illicitly produced in independent, gang, or cartel run facilities. Meth produced in the US is typically derived from over the counter medications for asthma, cold, or sinus issues such as those containing ephedrine or psuedoephedrine, however most meth illicitly sold in the US today is produced at cartel facilities in Mexico and smuggled across the border.
Due to this illicit manufacture, meth can contain many different types of dangerous adulterants or cutting agents, however even “unadulterated” meth requires an array of volatile chemicals to produce. The ingredients and process to make meth are not necessarily complicated, but they can be very dangerous to someone who is unfamiliar working with highly reactive chemicals. There are many different ways to make meth and depending on the process involved, some of the reagents or catalysts used to refine the pseudo/ephedrine into meth can include:
- Acetone: A common industrial solvent and commonly found in paint thinner and nail polish remover. Highly flammable and highly toxic.
- Ammonia Anhydrous: Powerful cleaner used in household and industrial applications. Can react violently with certain metals and halogens and will corrode some rubbers and plastics. Highly toxic, flammable, and environmentally hazardous.
- Ethyl Ether: Used as an inhaled anesthetic, a refrigerant, and a solvent. Very flammable and an irritant.
- Iodine: Necessary compound for healthy thyroid function and mental development.
- Lithium: While used medicinally as a mood stabilizer, raw lithium metals and ions are used in battery and capacitor production. Can react violently with water. Highly flammable and corrosive.
- Red Phosphorous: Also known as phosphine, it is used as a pesticide as well as in the manufacture of semiconductors, flame retardants, and incendiary weapons. Highly flammable, highly toxic, very corrosive, and environmentally hazardous.
- Sodium: Used in metallurgy and industrial chemical applications as well as sodium vapor use in street lights. Reacts violently with water or moisture in the air. Highly toxic, flammable, and environmentally hazardous.
- Sodium Hydroxide: Also known as caustic soda, it is the main ingredient in lye and drain or oven cleaner. Used in electroplating, explosives manufacturing, and petroleum products. Highly corrosive and environmentally hazardous.
As mentioned above, there is a wide range of different chemicals used in the production of meth. These are required for pseudo/ephedrine synthesis or reduction and depending on the quality of production, may or may not make it into the finished product. This is a byproduct of the manufacturing process and as such can not truly be considered an adulterant or cutting agent, even though the presence of these chemicals is unwanted. Cutting agents are used by some manufacturers, but more commonly by distributors, traffickers, and dealers as they can cheaply “increase” the amount of meth they have by mixing in cheaper additives.
Some of the more common additives used may include:
- Caffeine: Active stimulant drug in coffee. Found in many different food and drink items and safe when used normally.
- Methylsulfonylmethane (MSM): Sulfur compound which is found in many plants, food, and drinks. It is fairly inert chemically and is sold as dietary supplements which anecdotally claim to provide allergy relief and helping ease joint pain.
- Niacinamide: A type of Vitamin B3, it is found in many foods and drinks as well as being formed naturally in the body from ingesting niacin. It is safe for human use in moderate amounts.
- Ketamine: A strong dissociative anesthetic used in human and veterinary medicine.
- Isopropylbenzylamine: A compound used as a reagent in organic chemistry, it has a very similar chemical structure to meth. This means that it looks, weighs, feels, and behaves the same way when exposed to heat, making it an effective cutting agent.
- Fentanyl: A very powerful synthetic opioid painkiller more commonly found as an adulterant in heroin. Beginning in 2016, the DEA has been finding it more and more frequently as a meth cutting agent.
Sometimes the color of the meth will be altered depending on the agent(s) used or impurities from production. There have been reports of meth that is clear, white, pink, green, purple, and yellow. Pink meth is probably made from precursor cold medications with red coatings that were not completely cleaned before synthesis. In at least 1 case, even sidewalk chalk has been found as a cutting agent in white meth¹.
When other powerful drugs are used as a cutting agent, the risks to the user escalate drastically. In particular fentanyl and ketamine are very dangerous alone, and when mixed with meth the effects can be extremely dangerous and very unpredictable.
Danger #3: Deadly Drug Interactions with Meth
With meth being so potent and neurologically active, it is possible to have many interactions with other drugs. Some of the most reactive drugs are MOAIs or any type of drug that modifies catecholamine function. These include many kinds of SSRI (Selective Serotonin Reuptake Inhibitor), SNRI (Selective Norepinephrine Reuptake Inhibitor), SNDRIs (aka Triple Reuptake Inhibitors), as well as a many other drugs and compounds for a variety of conditions or treatments. Be sure to talk to your doctor about potential interactions, but just a few specific drugs or compounds with which serious interactions are known include:
- Cymbalta (Duloxetine)
- Prozac (Fluoxetine)
- Wellbutrin (Bupropion)
- Regimex (Benzphetamine)
- Celexa (Citalopram)
- Cocaine (Benzoylmethylecgonine) – Surprisingly, cocaine is still sometimes used in legitimate medicine today (2020).
- Pristiq (Desvenlafaxine)
- Redux (Dexfenfluramine)
- Tenuate (Diethylpropion)
- Lexapro (Escitalopram)
- Spravato (Esketamine)
- Fen-Phen (Fenfluramine)
- Luvox (Fluvoxamine)
- Azedra (Iobenguane I 131)
- Omnipaque (Iohexol)
- Isovue-M (Iopamidol)
- Marplan (Isocarboxazid)
- Fetzima (Levomilnacipran)
- Zyvox (Linezolid)
- Belviq (Lorcaserin)
- Sanorex (Mazindol)
- ProvayBlue (Methylene Blue)
- Amipaque (Metrizamide)
- Savella (Milnacipran)
- Paxil (Paroxetine)
- Adipost (Phendimetrazine)
- Nardil (Phenelzine)
- Lomaira (Phentermine)
- Dexatrim (Phenylpropanolamine)
- Orap (Pimozide)
- Matulane (Procarbazine)
- Emsam (Selegiline)
- Zoloft (Sertraline)
- Meridia (Sibutramine)
- Nucynta (Tapentadol)
- Ultram (Tramadol)
- Parnate (Tranylcypromine)
- Effexor (Venlafaxine)
- Viibryd (Vilazodone)
- Trintellix (Vortioxetine)
It is strongly advised to not use meth in tandem with any of these medications. There are significant interactions which may occur, and the clinical risks may outweigh any potential benefits¹.
Danger #4: Long Term Health Risks From Meth Abuse
Aside from the more immediate risks of meth use such as overdose, arrest, or violence there are more long term complications which may take time to develop. Some of these can be recovered from, while others appear to be permanent. That being said, even the act of doing meth produces risk. Some of the more direct effects are produced from the method a user chooses to do meth.
Some of the risks of snorting meth include:
- Loss of Sense of Smell
- Frequent Nosebleeds
- Sinus Infections¹
- Deviated or Perforated Septum (holes in the cartilage that separates the nostrils)
- Abscesses (which may become septic and lethal)¹²
- Increased Risk of Disease (when sharing a snorting utensil with someone)
Some of the risks of smoking meth are:
- Lung Damage
- Meth Mouth (extreme dental and gum line decay)
- Diminished Sense of Taste (usually temporary)
Some of the risks of shooting up Meth include:
- Endocarditis: Infection of the interior of the heart. Typically caused by strep. or staph. bacteria which are common in the mouth and can be introduced into the blood by shooting up.
- Infection: Due to repeated use of the same area or veins, there is a heightened risk of skin infection.
- Septic Embolism: An infected piece of tissue that becomes dislodged and travels through the circulatory system. Typically originate from repeatedly shooting up in the same spot. Can progress to potentially fatal abscesses or blood infections.
- Rhabdomyolysis: Caused by dead muscle tissue breaking down into the blood, causing kidney damage or failure. Can be caused by repeatedly shooting up and attendant tissue damage. Is potentially fatal and kidney damage may be permanent. Getting rhabdomyolysis once increases risk of subsequent occurrence.
- Liver Damage: Due to meth metabolism as well as adulterants/contaminants in the drug. Also due to secondary effects of shooting up such as septic embolism.
- Hepatitis B or C: Viral liver infection commonly acquired by sharing needles. Can progress to cirrhosis of the liver.
- Kidney Damage: Due to meth metabolism and adulterants/contaminants in the drug as well as secondary effects of shooting up such as rhabdomyolysis.
- HIV/AIDS: Autoimmune disorder commonly acquired by shooting up with a used needle. Particularly in a meth user it can also progress to NeuroAIDS or HIV-Associated Dementia due to compromised blood brain barrier function.
The above mentioned dangers are secondary dangers (except for Liver and Kidney damage) since they are only from the route you do Meth, and not Meth itself. Some of the more immediate effects can present within days or weeks of use and present unique risks in and of themselves. Some of the short term dangers include:
- Malnutrition through Anorexia: Since Meth has a massive impact on appetite, it is not uncommon for addicts to go many days between meals. The effects Meth has on the sympathetic nervous system, and particularly on NOR levels can suppress or even eliminate appetite entirely for extended periods of time. Many Meth users report having to “force” themselves to eat. This effect does not include the aspect of an addict having to decide between using Meth or eating.
- Dehydration: Meth use promotes hyperthermia (increased body temperature) and excessive sweating as well as decreasing the urge to drink. In this manner, it is common for many addicts to become dehydrated. Dehydration causes lowered blood pressure and thus decreased blood flow to the Kidneys, greatly increasing the risk of Kidney damage/failure.
- Tooth and Gum Decay (Meth Mouth): Due to dehydration, bruxism (teeth grinding), and the variety of chemicals in Meth itself, tooth decay is very common among Meth users. A dry mouth coupled with bruxism is enough to wear down teeth and cause gum recession over time, but add in the chemicals present in Meth and this process is accelerated greatly.
- Amphetamine Psychosis (Acute)¹²³: A common result from psychostimulant abuse, but much more widespread with Meth use. Symptoms can be indistinguishable from Acute Paranoid Schizophrenia and can include a variety of symptoms such as visual/auditory/tactile hallucinations, paranoid delusions, disorganized thoughts, erratic behavior, and violent outbursts.
- Stroke: Due to the rapid rise in blood pressure through Meth use, the risk for Stroke is greatly elevated. A Stroke is when blood flow to a part of the brain is interrupted either by arterial blockage or rupture (Ischemic or Hemorrhagic respectively). Using Meth in general will increase risk of a Hemorrhagic Stroke, while shooting up Meth adds the additional risk of an Ischemic Stroke. Can be fatal.
Some of the more long lasting consequences of meth use are neurological in nature and may take many years to resolve, if they resolve at all. These typically result from long term use, but genetic factors may make certain people more easily susceptible. Some of these risks include:
- Dementia-Like Symptoms: Some of the ways this can present is as a slowing of mental functions such as comprehension, reaction time, memory, and an greatly increased susceptibility to Parkinsonism. The exact cause is unclear but involves damage to dopamine terminals in the brain. This particular type of brain damage has been shown to improve with prolonged abstinence, however a return to pre-meth function is unlikely. The effects meth has on the brain appear to resemble a roughly 4x acceleration of age related neural degradation¹².
- Increase in Aggression: This is an acute symptom of meth use, but can also be a permanent change to a users personality. The exact mechanism is unknown, but damage to serotonin terminals is somehow involved. Studies using PET scans have shown that meth use is directly correlated to decreased serotonin terminal density, and further, that decreased serotonin terminal density is an indicator for the amount of aggression someone displays. It is currently unknown if, or to what degree, this is reversible¹.
- General Brain Damage: Through a variety of mechanisms, meth is known to negatively impact the brain through acute or chronic use. The results resemble other neurodegenerative diseases and the exact mechanisms are not fully understood. Some of the ways meth negatively affects the brain are through neuroinflammation, excitotoxicity, hyperthermia, and damage to neurotransmitter transporters and terminals. These effects can be worsened by chronic malnutrition, dehydration, and insomnia.
Danger #5: Legal Consequences of Meth Abuse
The legal repercussions of meth possession, manufacture, or trafficking can be very severe as the social costs of meth use are so widely damaging. In 2018 there were 18,964 cases of drug trafficking in the US. Of these, 39.8% involved the trafficking of meth. Between 2014 and 2018, there was a 19.6% increase in the number of meth trafficking cases in the US¹. Additionally, the districts with the highest rates were found in the southwestern US including Texas, Arizona, and California. As far as meth trafficking in 2018, the average offense was Level 32, which translates to between 1.5 to 5 kilograms of meth mixture (less than 80% pure), or 150 to 500 grams of methamphetamine “actual” (meth that is 80% or more pure)¹. The average sentence in these cases was 96 months and this is including the fact that 51.7% received some type of sentence reduction due to either Substantial Assistance or Early Disposition Program.
There have been several studies investigating the link of violent crime to meth use. One study published in 2006 found that of the cases investigated, 34.9% of perpetrators committed violent crimes while under the influence of meth and of these, 45.9% claimed that they had never committed an act of violence prior to meth use¹. While there is evidence which points towards meth use fueling violent crimes such as robbery, burglary, and assault, there are also suggestions that emphasize the fact that people who commit violent crimes before meth use may be more prone to using meth as their drug of choice if and when they do begin using drugs. That being said, there is also a growing body of evidence suggesting that chronic meth use can degrade executive functions such as impulse control and the ability empathize with other people, leading to more violent interactions with others. The exact dynamic of the relationship between meth addict behavior and violence is unclear at present, although meth users do exhibit more violent tendencies than other drug users on average¹². Compared to heroin users, meth users are almost twice as likely (1.94x more on average) to commit violent crimes¹. This is due to multiple factors including the extreme boost in energy and confidence as well as the acute promotion of psychosis and paranoia through chronic meth use¹².
- DEA: 2018 National Drug Threat Assessment
- Griffith University School of Psychology: Impulsivity and Positive Psychotic Symptoms Influence Hostility In Methamphetamine Users
- Zanjan University of Medical Sciences: A New Approach on Methamphetamine-Induced Hepatotoxicity: Involvement of Mitochondrial Dysfunction