Common or street names: crystal meth, crank, meth, ice, glass, fire, crypto, chalk

Speed (methamphetamine, C10H15N) is a potent and addictive central nervous system stimulant, chemically related to amphetamine, but with greater central nervous system side effects. It is a white, odorless, bitter-tasting powder that easily dissolves in water or alcohol.

Methamphetamine is classified as a Schedule II stimulant by the U.S. Drug Enforcement Agency, which means it has a high potential for abuse and is available by prescription only. Medically it has been used for the treatment of attention deficit hyperactivity disorder (ADHD) and obesity, but these uses are limited in the U.S. due to the high potential for abuse and diversion. Prescription doses are typically much lower than those used illicitly. In the U.S., methamphetamine is available by prescription as the brand name product Desoxyn or generically.

Most of the illegal methamphetamine in the U.S. comes from foreign or domestic superlabs, although small batches may be made in residencies or other clandestine buildings called “meth labs”.1 Methamphetamine is cheap and easy to make from common ingredients. Ilicit meth labs often explode and may cause a fire in the building or surrounding buildings. Children of meth users are at a great risk, possibly being exposed to the meth lab dangers (explosion, fire, chemicals and criminal activity) and parental neglect. Twenty percent of the meth labs raided in 2002 had children present.

Methods of Speed (methamphetamine) Abuse

Methamphetamine may be smoked, snorted, injected, or taken orally. Methamphetamine is commonly referred to as “speed”, “meth”, or “chalk” and has been in use since the early 1960s. Another common form of the drug is crystal methamphetamine, or “crystal meth”, which are clear, chunky crystals resembling ice. Crystal math is smoked in a manner similar to crack cocaine, and became popular in the 1980s. Street names for this form of methamphetamine include “ice”, “crystal”, “crank”, and “glass”.

Immediately after smoking or intravenous injection, the user experiences an intense sensation, often called a “rush”, which lasts only a few minutes and is described as extremely pleasurable. Oral or intranasal use produces euphoria or high, but not a rush. Snorting methamphetamine will lead to effects with 3 to 5 minutes, whereas oral ingestion takes 15 to 20 minutes.

Increased activity, wakefulness, talkativeness, increased concentration, decreased appetite, increased libido, and a sense of well-being are common, immediate effects of methamphetamine abuse. Some users become addicted quickly, and abuse it with increasing frequency and in increasing doses. As the pleasurable effects of methamphetamine disappear, abusers may use more and more drug to get the same effect. Using methamphetamine many times over a period of several days, usually without food or sleep, is often called a “run”.

Pharmacology of Speed (methamphetamine)

Methamphetamine releases high levels of the neurotransmitter dopamine, which stimulates brain cells, enhancing mood and body movement. Similar to cocaine, methamphetamine also blocks the re-uptake of dopamine. The release of dopamine at high levels in the synapse can lead to toxicity at the nerve terminals.1 Methamphetamine also increases synaptic levels of serotonin (5-HT) and the sympathomimetic norepinephrine. Methamphetamine use results in effects similar to cocaine; however, it has a slower onset and a longer duration of action.

Methamphetamine has high lipophilicity and can easily cross the blood-brain barrier. Methamphetamine is able to penetrate the central nervous system more readily than amphetamine, making it a more potent and longer-lasting stimulant. However, amphetamine is also an active metabolite of methamphetamine, peaking in blood levels in roughly 12 hours.

Oral methamphetamine has a half-life of roughly 4 to 5 hours. Methamphetamine is metabolized in the liver. Excretion occurs primarily in the urine and is dependent on urine pH. Approximately 62% of an oral dose is eliminated in the urine within the first 24 hours with about one-third as intact drug and the remainder as metabolites.

Health Hazards Due to Speed (methamphetamine) Use

Methamphetamine use increases heart rate, blood pressure, body temperature, breathing rate and dilates the pupils. Other effects include temporary hyperactivity, insomnia, anorexia and tremors. High doses or chronic use have been associated with increased nervousness, irritability, paranoia, confusion, anxiety and aggressiveness.

Methamphetamine can cause irreversible damage to blood vessels in the brain, producing strokes. Death can result from hyperthermia, convulsions and cardiovascular collapse.

Chronic, high-dose methamphetamine abusers are susceptible to violent and erratic behavior, hallucinations, and a psychosis similar to schizophrenia. Psychotic episodes may recur for months or years after methamphetamine abuse has stopped. The neurotoxic effect of methamphetamine causes damage to brain cells that contain dopamine. Over time, reduced levels of dopamine can result in symptoms like those of Parkinson’s disease, a severe movement disorder.

Other adverse health effects that may occur due to speed abuse include memory loss, severe dental problems (often called “meth mouth”, where the users’ teeth rot from the inside out), weight loss, and malnutrition.

The injecting drug user is at risk for transmitting or acquiring HIV infection/AIDS, and hepatitis B or C if needles or other injection equipment are shared.

Extent of Speed (methamphetamine) Use

The 2010 National Household Survey on Drug Abuse estimated that the number of recent new users of methamphetamine among persons aged 12 or older was 105,000 in 2010, which was similar to the 2009 estimate (154,000), but lower than the 2002 to 2007 estimates (ranging from 157,000 to 318,000). The average age of new methamphetamine users aged 12 to 49 in 2010 was 18.8 years, which was not significantly different from corresponding 2002 to 2009 estimates. The number of past month methamphetamine users decreased between 2006 and 2010, from 731,000 (0.3 percent) to 353,000 (0.1 percent).

The 2010 Monitoring the Future Survey found that annual use of methamphetamine is down in 8th, 10th and 12th grades by 60% to 80% since 1999, when its use was first measured in all three grades. Annual prevalence rates in 2010 were 1.2%, 1.6%, and 1.0% for 8th, 10th, and 12th graders, respectively. All of these levels are down considerably from the first measurement taken in 1999, when they were 3.2%, 4.6%, and 4.7%.

Despite growing public concern about the methamphetamine problem in the United States, use actually has shown a fairly steady decline over the past seven years, at least among secondary school students. Secondary school students perceive a strong risk with the use of methamphetamine, and this may partly explain declining use.

Speed (methamphetamine) Use in Pregnancy

Methamphetamine use in pregnancy is of concern. There is limited knowledge of the fetal effects of methamphetamine abuse. Limited human studies have shown increased rates of premature delivery, placental abruption, fetal growth retardation, and heart and brain abnormalities. Research is continuing to assess the effect of methamphetamine use on social interactions, cognition and medical health in children exposed to methamphetamine in utero.

Infants born to mothers who are addicted to methamphetamine may experience symptoms of withdrawal as demonstrated by dysphoria, including agitation and significant lassitude. Additionally, amphetamines are excreted in human milk, and mothers who taking amphetamines should be advised to refrain from nursing.

Treatment Options for Speed (methamphetamine) Abuse

Withdrawal from methamphetamine produces severe depression, anxiety, fatigue, and an intense craving for more of the drug. The health hazards from chronic use of methamphetamine appear to be at least partially reversible. Recovery of dopamine transporter activity has been shown on brain neuroimaging studies after roughly 2 years. Motor skills and verbal memory tests showed some recovery, but not all changes have been shown to reverse.1

Behavioral therapy remains the most effective treatment for methamphetamine abuse and addiction, at this time. According to the National Institute of Drug Abuse, the Matrix Model, which combines behavioral therapy and family education, counseling and 12-step support, drug testing and positive reinforcement for nondrug-related activities has been shown to be effective.

There are no specific medications in use for methamphetamine addiction. However, other agents that are approved for other illnesses, such as bupropion (used for depression), have been shown to reduce methamphetamine cravings.

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