Crystal Meth Detox & Rehab Guide
Symptoms, Timeline, & Effects
Crystal meth is an illicit form of methamphetamine, a powerful psychostimulant drug with effects similar to those of cocaine and prescription amphetamines.1 Crystal meth is an extremely potent substance with a powerful addiction potential. When a user has become addicted to methamphetamine, it can be extremely difficult for them to stop due to cravings and, in some cases, compulsive avoidance of unpleasant withdrawal symptoms. Fortunately, there are several detox options for those looking to begin a new life in recovery from crystal meth.
Pure methamphetamine is a white, odorless, crystalline powder; pharmaceutical methamphetamine (Desoxyn) is available as an oral tablet; illicit forms of the drug may be encountered in powder, pill, or “rock” form.1,3,4 The drug can be swallowed, smoked, injected, or snorted.1,3 Methamphetamine stimulates the activity of monoamine neurotransmitters (i.e., dopamine, norepinephrine, and serotonin) in the brain, resulting in increased energy, boosted mood, increased feelings of well-being, and wakefulness. Like other stimulant medications, the meth-associated boost in dopamine activity serves as a powerful reinforcer of repeated use.1,4
Smoking and injecting meth rapidly introduces the drug into the bloodstream, where it then quickly travels to the brain. Using meth via these fast-onset routes results in a rapid, pleasurable rush which strengthens the drug’s abuse potential as well as certain health risks.5 With snorting or oral ingestion, the onset of effects is relatively slower—a euphoric high may still be achieved but without quite the same reinforcing rush of smoking or injection.5
Usage & Impact
The 2017 National Survey on Drug Use and Health indicates a lifetime prevalence of meth use at 5.40% for those ages 12 and over.6 In 2018, according to the Monitoring the Future Study, .70% of 12th graders had tried methamphetamine at some point in their lifetime, with .50% having used it in the past year.7
Methamphetamine has powerful central nervous system stimulant properties and a very high potential for addiction development due to its effects on the motivation and reward centers of the brain.
Dopamine levels in these circuits are naturally boosted by actions important for survival, including eating, having sex, and bonding with family and friends. By artificially increasing dopamine in these brain areas, methamphetamine use gives users unnaturally intense feelings of pleasure and they are strongly motivated to repeat that action again and again.1
Although crystal meth abuse can produce intense feelings of pleasure and energy, there are also many negative effects that accompany its use. Some common side effects of crystal meth abuse include:1,2,3,4,6
- Increased body temperature.
- Increased blood pressure.
- Rapid heart rate.
- Irregular heartbeat.
- Chest pains.
- Faster breathing.
- Decreased appetite.
- Severe dental problems.
- Intense itching leading to skin sores caused by scratching.
- Anxiety and confusion.
- Mood swings.
- Violent behavior.
There is no safe way to use crystal meth. Crystal meth can be dangerous and life-threatening anytime that you use it, due to potential seizures, sudden cardiovascular events, or accidents or assaults resulting from erratic or violent behaviors. Methamphetamine abusers may soon feel that taking the drug is more important than eating or sleeping, and they are often unable to stop even when faced with overwhelmingly adverse drug-related outcomes, such as severe health issues, losing a job, or getting arrested. This compulsion to continue using a drug despite the starkly adverse consequences is a hallmark of addiction.2
Crashing and Bingeing
Methamphetamine use may result in a relative depletion of dopamine, which could explain why the intense meth high is followed by a “crash” and feelings of apathy, depression, and hopelessness. Many users attempt to avoid these symptoms by using the drug repeatedly and often in increasing amounts to maintain the high for hours or days.1,2,4
This binge pattern of use further drives the development of compulsive patterns of use, physiological dependence, and addiction.
Some methamphetamine abusers may binge for days to weeks without sleep, a pattern known as “tweaking.”8 Users in this state (“tweakers”) often become extremely paranoid, aggressive, and irritable.8 Tweakers are no longer able to achieve the desired high by taking more methamphetamine, and this pushes them into a dangerous state where the effects of sleep deprivation and overwhelming feelings of frustration set in, potentially making them mentally unstable and unpredictable.8
Risks of Long-term Abuse
Continued crystal meth use over an extended period of time can have devastating mental and physical health consequences and can greatly impair functioning in many areas of life. Some risks associated with chronic crystal meth abuse include:1,2,3,4,5
- Injection risks, such as contracting HIV and hepatitis B and C.
- Exacerbation of the progression of those who already have HIV/AIDS.
- Changes in the brain’s dopamine system associated with reduced coordination and impaired verbal learning.
- Extreme weight loss.
- Psychotic features, including paranoia, aggression, mood disturbances, and delusions.
- Violent behavior.
- Homicidal or suicidal thoughts.
- Meth mouth, or tooth decay, gum disease, and mouth sores.
- Skin sores due to scratching.
- Disturbed sleep patterns.
- An increase in violent behaviors.
- Respiratory risks, such as bronchitis, chronic cough, pneumonitis, and lung infections.
- Increased risk of developing Parkinson’s disease.
The longer the drug is used, the higher your risk of developing any of these long-term effects of crystal meth use. Additionally, the longer you continue to use meth, the more likely it is that you will develop an addiction.
Effects & Symptoms of Withdrawal
Methamphetamine is associated with several physical and mental symptoms that arise shortly after the effects of the drug wear off. This acutely-felt period of withdrawal is sometimes called a crash.1 If an individual has used methamphetamine long enough to develop physical dependence, they may be likely to experience intensely unpleasant and sometimes dangerous withdrawal symptoms once they stop using the drug. These symptoms include:1,2,3,5
- Strong drug cravings.
- Inability to experience pleasure (i.e., anhedonia)
- Profound depression and associated suicidality.
- Psychotic symptoms (e.g., paranoia, delusions, etc.).
- Increased appetite.
- Excessive fatigue.
Some of these symptoms may reflect a compensatory reaction to certain neglected areas of health commonly seen in chronic meth users. Abusers will often forgo eating and sleeping while under the influence of this drug because of the energizing effects of methamphetamine and its abnormal influence on motivation pathways in the brain.8 Therefore, symptoms such as increased appetite and fatigue may reflect a natural physiological attempt to return to a healthy state. These symptoms typically subside within 1 to 2 weeks of continuous abstinence, adequate nutrition, and improved sleeping behaviors.
Anxiety is a common and, in some cases, expected reaction that many drug abusers experience during withdrawal.1 For example, it could be because a person who is addicted to methamphetamine has come to rely on it as a crutch to deal with the stresses of normal life, and it may be scary for them to imagine life without it.
It is normal for individuals who are dependent on any drug to be anxious and fearful of stopping, even if drugs are actually causing them harm. Fortunately, this anxiety will also fade with time.
After someone stops taking meth, they often experience the feeling that nothing in life is pleasurable, a reaction known as anhedonia.9 This phenomenon may sometimes be a preamble to a developing depression. Abusers in withdrawal usually also feel powerful cravings for the drug that can be nearly impossible to resist by willpower alone.9
Cravings & Depression
Cravings and depression are frequently the most challenging symptoms of methamphetamine withdrawal and, because of their association with relapse and suicidal ideation, the ones that require the most attention from the treatment team.5 Because meth has such powerful and disruptive effects on the brain’s reward and motivation centers, these symptoms may be more long-lasting than other withdrawal effects and could persist for more than 5 weeks after the last use.10 This is because it takes time for these brain pathways to heal and return to normal functioning.
Detox Timeline and Protocol
The journey from methamphetamine dependence to recovery can take several months and, for many, maintaining a healthy, drug-free lifestyle is a lifelong process. This section briefly describes the steps along this journey and what to expect.
The initial phase of recovery from methamphetamine addiction is the crash that follows the high of drug use. Individuals who are crashing often feel depressed, fatigued, and irritable.2 These symptoms will pass in hours or days if a person is not yet dependent on the drug. In cases of significantly severe dependence, or if the last use was a heavy binge, they may also experience paranoia and psychosis requiring the temporary use of sedatives or antipsychotic medications.
After the crash, a person addicted to methamphetamine will continue to experience several withdrawal symptoms, as discussed above. Fatigue, anxiety, and appetitie changes will usually subside within days or weeks. Detox program staff will provide watchful supervision throughout the withdrawal period, offering supportive medications for particularly troublesome symptoms and escalating the level of care in the event of any severe withdrawal associated developments (e.g., suicidal thoughts).
Depression and craving may last several weeks or months after withdrawal from methamphetamine and can be treated with antidepressants.4 Should withdrawal psychosis emerge, it may be managed with antipsychotics.10
There are currently no medications approved for use in the treatment of people with methamphetamine dependence or addiction, so the primary therapies employed are behavioral.1,3,5 These treatments can last between 4 weeks and a year, depending on the program chosen. Some behavioral therapies that have been shown to be effective in methamphetamine addiction include:1,3,5
- The Matrix Model: A holistic approach that combines various strategies including behavioral therapy, counseling, drug testing, 12-step support, and family education.
- Contingency Management: A strategy that rewards engagement in recovery and maintenance of abstinence with tangible rewards.
- Motivational Incentives for Enhancing Drug Abuse Recovery (MIEDAR): Another incentive-based therapy that has been shown to be effective in abusers of methamphetamine in clinical trials.
- Cognitive-behavioral therapy (CBT): An approach that helps patients recognize, avoid, and cope with situations where they are most likely to use drugs.
How Does Supervised Detox Help?
Detoxing from chronic methamphetamine abuse is an uncomfortable process that can have certain dangerous complications. Many people experience paranoid and irrational thoughts and may present a danger to themselves or others. Furthermore, depression during detox may be associated with suicidal thoughts and attempts. Additionally, cravings for methamphetamine during detox are so powerful that many abusers will eventually give in and return to drug use despite their sincere desire to stop.
Medical professionals at detox facilities are familiar with the challenges of withdrawing from methamphetamine. They provide a supportive environment that allows for:
- Administration of medication to patients, if necessary, to make them more comfortable.
- Supervision to prevent patients from harming themselves or others.
- Temporary separation of the recovering person from their normal environment and the inherent temptations and opportunities to use.
Finally, detox facilities can provide crucial support for those who are suffering from mental health issues caused or worsened by their methamphetamine use. Oftentimes, depression and psychosis are serious and ongoing consequences of abusing this drug, requiring long-term management through counseling and medication. Staff at detox centers can assist their clients by connecting them with programs and resources available to address these mental health challenges.
Finding a Treatment Program
Because of the high rate at which methamphetamine abusers return to drug use after detox, it is advisable for anyone undergoing withdrawal from methamphetamine to enter a drug treatment program immediately after completing the detox process. There are several types of drug treatment programs available depending on your specific needs.
If you or a loved one is struggling with methamphetamine addiction, you do not have to face it alone. There is help, no matter what your situation.
- National Institute on Drug Abuse. (2018). DrugFacts: Methamphetamine.
- National Institute on Drug Abuse for Teens. (2019). Methamphetamine (Meth).
- National Institute on Drug Abuse. (2018). Commonly Abused Drug Charts.
- U.S. Department of Justice Drug Enforcement Administration. (2017). Drug of Abuse: A DEA Resource Guide.
- National Institute on Drug Abuse. (2013). Methamphetamine.
- National Institute on Drug Abuse. (n.d.). Methamphetamine.
- National Institute on Drug Abuse. (2018). Monitoring the Future Study: Trends in Prevalence of Various Drugs.
- University of Maryland: Center for Substance Abuse Research (CESAR). (n.d.). Methamphetamine.
- Hatzigiakoumis, Daniele Stavros. Martinotti, Giovanni. Di Giannantonio, Massimo. Janiri, Luigi. (2011). Anhedonia and Substance Dependence: Clinical Correlates and Treatment Options. Front Psychiatry.2:10.
- Zorick, T. Nestor, L. Miotto, K. Sugar, C. Hellemann, G., Scanlon, G. London, E. D. (2010). Withdrawal symptoms in abstinent methamphetamine-dependent subjects. Addiction, 105(10), 1809-1818.