Safer Using – Methamphetamine

About Meth

Methamphetamine (also called methylamphetamine or meth among other names) is a powerful stimulant drug which is chemically related to amphetamine.¹ Meth is most commonly snorted, ingested, injected, or smoked (vaporised) in an oil burner pipe (a.k.a. pizzo or pilo pipe).² When smoked or injected, meth quickly produces a high which is characterised by intense stimulation and euphoria.^1,2 Meth is primarily found in three forms: crystal (commonly called ice, glass, or shard), powder (commonly called speed), or freebase (a.k.a. base).³ Crystal meth is typically purer than powdered meth (although not always), and freebase meth exists as an oil which is rarely sold on the street.³

Meth puts a lot of strain on the heart, so avoid meth if you have a pre-existing heart condition.⁴

Like amphetamine, meth works by triggering the release of dopamine, norepinephrine and (to a lesser extent) serotonin in the brain.² Compared to amphetamine, meth is better able to cross from the bloodstream into the brain and, once inside, can cause the release of more dopamine.^5-7 This means meth generally produces similar but more potent and long-lasting stimulant effects than amphetamine.⁷

Chemically, methamphetamine refers to two molecules which are mirror images of each other (called enantiomers): dextro-methamphetamine (a.k.a. d-meth or dextro-meth) and levo-methamphetamine (a.k.a. l-meth or levmetamfetamine). D-methamphetamine is the psychoactive molecule, whereas l-methamphetamine has no psychoactive effects and is sold in the US as a nasal decongestant.⁸ Meth sold on the street is often either a 50:50 mixture of d-methamphetamine and l- methamphetamine (called a racemic mixture or racemate), or pure d-methamphetamine.⁹ In theory, d-methamphetamine is more potent than racemic meth, but there is unfortunately no practical way for users to tell whether their meth is pure d-methamphetamine or racemic. Data from the DEA suggests that most of the meth circulating in the US in 2010 was d-methamphetamine.¹⁰

Meth sold on the street can vary greatly in purity, leading to accidental overdoses. It’s always best to start with a low dose and wait before redosing (start low and go slow) to avoid an accidental overdose. CanTEST, Canberra’s health and drug checking service, can provide estimates of meth purity. At CanTEST, meth has also been detected in samples expected to be ketamine, MDMA and a counterfeit Duromine diet pill.^11-14 If you suspect your drugs contain adulterants or other drugs, consider testing them using a reagent kit or by taking them to a drug checking service like CanTEST.

Meth Effects

The exact effects of drugs can vary from person to person. Generally, the effects people experience when taking meth can include:^1,9

Stimulation.
Euphoria, elevated mood.
Increased sex drive.
Wakefulness.
Dry mouth.
Reduced appetite.
Increased body temperature.
Increased heart rate (tachycardia).
Increased blood pressure (hypertension).
Dilated pupils (mydriasis).
Teeth grinding (bruxism).
Irritability.
Insomnia.
Anxiety.

The effects of smoked or injected meth typically come on in a few seconds and last 1-4 hours (smoked) or 4-8 hours (injected).^1,9 When snorted, it can take up to 10 minutes to kick in and the effects typically last 2-4 hours.⁹ When ingested orally, it can take over an hour to kick in and the effects typically last 8-10 hours.^1,9

Dosing Meth

People can react differently to drugs due to differences in bodyweight, metabolism, and other factors. Additionally, it is very difficult to verify the potency of drugs sold on the street. It is always better to start with a low dose and wait before redosing drugs (start low and go slow).

The following is a rough dosage guide for smoked or ingested meth:

LOW DOSE – 5-10 mg

MODERATE DOSE – 10-20 mg

STRONG DOSE – 20-50 mg

HEAVY, POSSIBLE OVERDOSE – 50+ mg

Meth Overdose

The symptoms of a meth overdose can include:⁴

Nausea.
Vomiting.
Shaking and tremors.
Increased body temperature (hyperthermia).
Increased heart rate (tachycardia).
Anxiety.
Panic.
Agitation.
Paranoia.
Hallucinations.

If someone is experiencing these symptoms, wait with them until they recover and seek medical attention if you are concerned or if they deteriorate.

Severe meth overdoses come with a risk of heart attack and other life-threatening heart complications.⁴ Seek emergency medical attention immediately if someone experiences the following symptoms:⁴

Chest pain.
Irregular breathing.
Seizures.
Delusions and inability to tell what is real with what is not (psychosis).

Mixing meth with other drugs can increase the risk of side effects and overdose:¹

Mixing meth with depressants (such as alcohol, GHB and opioids) can reduce the effects of the depressant, causing someone to takemore than they otherwise would. When the meth wears off, the depressant effects can cause life-threatening respiratory depression.
Mixing meth with other stimulants (such as cocaine and MDMA) can put excessive strain on the heart and increase the risk of heart damage.
Mixing meth with tramadol carries a high risk of seizures.
Mixing meth with cannabis, psychedelics (such as LSD and psilocybin) or dissociatives (such as ketamine) can increase the risk of anxiety, paranoia, and drug-induced psychosis.

Meth Withdrawal

If you stop using meth, particularly after frequent or long-term use, you may experience symptoms of withdrawal. These symptoms can include:^4,15,16

Fatigue.
Poor sleep or insomnia.
Poor concentration.
Appetite changes.
Depression.
Mood swings.
Irritability.
Agitation.
Unpleasant dreams.
Strong cravings for meth.

The severity of symptoms and how long they last depend on the frequency and length of use and can vary from person to person.¹⁶ Symptoms can last as little as one day or as long as several weeks.¹⁶ Most symptoms clear up after 7 days, but some (such as poor sleep and mood swings) can persist for two weeks to a month.^15,16

If you are experiencing symptoms of meth withdrawal and you are concerned, consider seeing a non-judgmental health professional, for example at the CAHMA clinic.

If you experience persistent symptoms after stopping meth use such as:^17,18

Difficulty telling what is real with what is not.
Delusions.
Hearing or seeing things that aren’t there.
Disordered thinking.
Suicidal thoughts.

This may suggest something more serious, and you should strongly consider seeing a non-judgmental health professional, for example at the CAHMA clinic.