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What ismethamphetamine?

ethamphetamine is ahighly addictive stimu-lant that affects thecentral nervous system. Althoughmost of the methamphetamineused in this country comes fromforeign or domestic superlabs,the drug is also easily made insmall clandestine laboratories, with relatively inexpensive over-the-

counter ingredients. Thesefactors

combine to make meth-

f r o m th edi r e ct o r

The abuse of methamphetamine—a potent and highly addictive psycho- stimulant—is a very serious problemin the United States. Initially limited to Hawaii and western parts of the country, methamphetamine abuse continues to spread eastward, withrural and urban areas everywhere increasingly affected. According toone national survey, approximately 10 million people in the United States have tried methamphetamine at least once. Methamphetamine abuse leads todevastating medical, psychological,and social consequences. Adverse health effects include memory loss,aggression, psychotic behavior, heart damage, malnutrition, and severe dental problems. Methamphetamine abuse also contributes to increased transmission of infectious diseases, such as hepatitis and HIV/AIDS, and can infuse whole communities withnew waves of crime, unemployment,child neglect or abuse, and other social ills.The good news is that methamphetamine abuse can be prevented and methamphetamine addictioncan be treated. People do recover,but only when effective treatments

that address the multitude of problems

resulting from methamphetamine abuse are readily available. Primary goals of the National Institute on Drug Abuse (NIDA) are to apply what our scientists learn fromdrug abuse research to develop new and enhance existing treatment approaches and to bring these effec-tive treatments to the communities that need them. In this report, we provide an over-view of the latest scientific findings on methamphetamine. Our intent is to enlighten readers about the dam-aging effects of methamphetamine abuse and to inform prevention and treatment efforts.

Nora D.Volkow,M.D.

Director National Institute on Drug Abuse

U.S. Department of Health and Human Services

•

National Institutes of Health

ResearchReport

NATIONAL INSTITUTE ON DRUG ABUSESERIES

METHAMPHETAMINE

Abuse and Addiction

amphetamine a drug with highpotential for widespread abuse.

Methamphetamine is commonly

known as “speed,” “meth,” and“chalk.” In its smoked form, itis often referred to as “ice,”“crystal,” “crank,” and “glass.” Itis a white, odorless, bitter-tastingcrystalline powder that easily dissolves in water or alcohol.The drug was developed early last century from its parent drug,

Methamphetamine



amphetamine, and was usedoriginally in nasal decongestantsand bronchial inhalers. Likeamphetamine, methamphetaminecauses increased activity andtalkativeness, decreased appetite,

and a general sense of well-being.

However, methamphetaminediffers from amphetamine inthat at comparable doses, muchhigher levels of methampheta-mine get into the brain, makingit a more potent stimulant drug.It also has longer lasting andmore harmful effects on thecentral nervous system.Methamphetamine is aSchedule II stimulant, whichmeans it has a high potentialfor abuse and is available only through a prescription. It isindicated for the treatment of narcolepsy (a sleep disorder)and attention deficit hyperactivity disorder; but these medical usesare limited, and the doses aremuch lower than those typically abused.

What is thescope ofmethamphetamineabuse in theUnited States?

IDA’s Community Epidemiology WorkGroup (CEWG), an early warning network of researchersthat provides information aboutthe nature and patterns of drugabuse in 21 major areas of theU.S., reported in January 2006that methamphetamine continuesto be a problem in the West, with indicators persisting at highlevels in Honolulu, San Diego,Seattle, San Francisco, and Los Angeles; and that it continuesto spread to other areas of thecountry, including both ruraland urban sections of the Southand Midwest. In fact, metham-phetamine was reported to bethe fastest growing problem inmetropolitan Atlanta. According to the 2005 NationalSurvey on Drug Use and Health(NSDUH), an estimated 10.4 mil-lion people age 12 or older (4.3percent of the population) havetried methamphetamine at sometime in their lives. Approximately 1.3 million reported past-yearmethamphetamine use, and512,000 reported current (past-month) use. Moreover, the 2005Monitoring the Future (MTF)survey of student drug use andattitudes reported 4.5 percent of high school seniors had usedmethamphetamine within theirlifetimes, while 8th-graders and10th-graders reported lifetimeuse at 3.1 and 4.1 percent,respectively. However, neitherof these surveys has documentedan overall increase in the abuseof methamphetamine over thepast few years. In fact, bothsurveys showed recent declinesin methamphetamine abuseamong the Nation’s youth.In contrast, evidence fromemergency departments andtreatment programs attest to

NIDA

RESEARCH REPORT SERIES

1992199419992002

Source: Treatment Episode Data Set (TEDS), SAMHSA.

Primary Methamphetamine

Amphetamine AdmissionRates per 100,000 Population Aged 12 and Over

Incomplete Data<33-910-2324 or moreKEY YEAR: 1992

the growing impact of metham-phetamine abuse in the country.The Drug Abuse WarningNetwork (DAWN), which collectsinformation on drug-related

episodes from hospital emergency

departments (EDs) throughoutthe Nation, has reported agreater than 50 percent increase

in the number of ED visits related

to methamphetamine abusebetween 1995 and 2002, reachingapproximately 73,000 ED visits,or 4 percent of all drug-related visits in 2004.Treatment admissions formethamphetamine abuse havealso increased substantially. In1992, there were approximately 21,000 treatment admissions in which methamphetamine

amphetamine was identifiedas the primary drug of abuse,representing more than 1 percent

of all treatment admissions during

the year. By 2004,

the numberof methamphetamine

treatmentadmissions increased to greaterthan 150,000, representing 8percent of all admissions.Moreover, this increased

involvement of methamphetamine

in drug treatment admissions hasalso been spreading across thecountry. In 1992, only 5 statesreported high rates of treatmentadmissions (i.e., >24 per 100,000population) for primary meth-amphetamine/amphetamineproblems; by 2002, this numberincreased to 21, more than a

third of the states.

How ismethamphetamineabused?

ethamphetamine comesin many forms and canbe smoked, snorted,injected, or orally ingested.The preferred method of methamphetamine abuse variesby geographical region and haschanged over time. Smokingmethamphetamine, which leadsto very fast uptake of the drugin the brain, has become morecommon in recent years,amplifying methamphetamine’saddiction potential and adversehealth consequences.The drug also alters mood indifferent ways, depending onhow it is taken. Immediately after smoking the drug or inject-ing it intravenously, the userexperiences an intense rushor “flash” that lasts only a fewminutes and is described asextremely pleasurable. Snortingor oral ingestion produceseuphoria—a high but not anintense rush. Snorting produceseffects within 3 to 5 minutes, andoral ingestion produces effects within 15 to 20 minutes. As with similar stimulants,methamphetamine most oftenis used in a “binge and crash”pattern. Because the pleasurableeffects of methamphetaminedisappear even before the drugconcentration in the blood fallssignificantly—users try to main-tain the high by taking more of the drug. In some cases, abusersindulge in a form of bingingknown as a “run,” foregoingfood and sleep while continuingabuse for up to several days.

How ismethamphetaminedifferent fromother stimulants,such as cocaine?

ethamphetamine isstructurally similar toamphetamine and theneurotransmitter dopamine, but

NIDA

RESEARCH REPORT SERIES

Cocaine

Stimulant and local anestheticPlant-derivedSmoking produces a brief high50% of the drug is removed fromthe body in 1 hourBlocks dopamine re-uptakeLimited use as a local anesthetic insome surgical procedures

Methamphetamine

StimulantMan-madeSmoking produces a long-lasting high50% of the drug is removed fromthe body in 12 hoursIncreases dopamine release and blocksdopamine re-uptakeLimited medical use

vs.