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  • Dr. D

Methamphetamine - hard to quit

Today I’d like to go into a bit more detail about the effects of methamphetamine (referred to as “speed” for the rest of this post) use.


Every now and then I read people saying that one drug is worse than another in terms of the problems it causes. In my mind, though, most drugs may have some up side to them.


Low dose alcohol may help with circulation. Stimulants can help with attention. One part of marijuana and cousins of heroin can help with pain.


But all of them in excessive amounts, cause an incredible amount of trouble.


And everything I said above is also true about methamphetamine. At low doses it can treat attention deficit disorder.


But speed seems to cause trouble early and often when it’s used just for fun. So let’s look at some of the issues.


Your brain on speed

In my last post (https://www.sjdpsych.com/post/methamphetamine-speed-what-and-why) I talked just very briefly about some of the neurological, psychiatric, and physical conditions it can cause or make worse.


Now I’d like to go into more detail about the psychiatric problems – my area - that speed causes.


Again, it depends on how you use it and how much you take. At low doses methamphetamine has been used to treat obesity and attention deficit disorder (ADD).


But at high doses, I’ve seen some pretty scary results. One of our in-patient psychiatric hospitals is usually filled with speed users.


When someone is heavily on speed and getting psychiatric problems from it, it’s really hard to tell if they have paranoid schizophrenia or not. It looks just like it. (It also looks like it’s about as much fun as having schizophrenia – NOT!)


When people get paranoid and have hallucinations we call it, no matter if it’s from schizophrenia or drugs, “psychosis.” And speed psychosis can be frightening both for the person who has it and for the people around them.


People who have a speed psychosis are extremely suspicious of everything and everybody. They may be convinced that everyone around them wants to hurt them.


And somebody like that can be violent. In fact, violent behavior is common in speed

psychosis. This is one of the reasons that we see so much of it in the psych hospitals. These

people are really scary.


Unfortunately, the effects of speed can continue for a number of days. And while most people will stop hallucinating and return to a little more normal state, nearly a quarter of them continue to be psychotic.


There is also the fact that many speed users have a lot of compulsive behaviors. I talked about “automatic” behaviors like scratching yourself until you bleed.


Another problem that people on speed may show is repeated or compulsive behaviors. When we say “compulsive” we’re talking about this feeling that you have to do something. That you have no choice. It’s not unusual for people on speed to have repeated high risk sex, a compulsion to gamble, or other actions that they just don’t seem able to control.


Brain changes with speed use


After using methamphetamine, it takes a long time for the brain to get back to normal levels of the brain chemicals, especially dopamine (DA).


DA is the chemical that lets us feel good. Without DA working on us, we wouldn’t enjoy orgasm as much as we do. If DA didn’t surge in the brain and give us pleasure when we use drugs, we wouldn’t use them. It just wouldn’t be fun.


And DA is the chemical that is active in enormous amounts when we use speed. Speed uses it up faster and more completely than almost anything else we do, even to the point of practically running us out of the supply.


When that happens, it’s just really hard to feel like doing anything.


Plus, we think of stimulants as treating attention problems. But it turns out that long term, heavy use of speed results in bad memory, difficulty learning new things and being able to focus. Just the opposite of what we say it’s supposed to help us with.


And those problems may go on to last for a very long time.


Maybe even permanently.


Effects of speed on pregnancy


I especially worry about females when it comes to speed’s effects. Many women on speed have uterine bleeding even though they may not have normal periods.


There may be have huge shifts in their female hormones. It isn’t uncommon for fertility to be affected.

Despite this, babies do happen. And what happens to fetuses exposed to speed while in the womb can cause permanent changes.


Plus, the complications due to speed use in pregnancy don’t just happen to the fetus. The mother is more likely to suffer from severe increases in blood pressure, maybe even strokes and heart attacks. They tend to go into labor way before the baby is due.


There is a huge increase in the number of miscarriages even late in pregnancy.


And the babies that do survive tend to be smaller at birth. They have trouble learning to drink milk. They don’t grow and develop like babies of non-using mothers.


And the problems these infants have at birth continue. As children, speed babies have trouble learning to speak, to read. They don’t develop the skills of walking and running at the same rate as more normal babies.


In other words, the bad effects of exposure to speed in the womb may be lifelong.


So what do we do about speed?


One of the things we need to do is get the word out. People have been so focused on opioid drugs that they’re missing the fact that we have an enormous other problem facing us. Speed.


Beyond that, though, is trying to get the person to agree to at least try to not use anymore.

If you understand what the drug does to you, like I described above, it’s also easy to understand why someone addicted to speed might be really unsure about doing that.


Maybe they know that they’re going to be absolutely miserable, to lack energy to do almost anything, no matter how simple; to feel suicidal, to never feel good. It’s easy to understand why they might not even try.


If you can get them to a professional to help with speed addiction, great. Do it.


That person should give them reassurance that people can and do get better after being addicted to meth. As of right now, though, there aren’t any medications that help people

who are hooked on speed the way buprenorphine and methadone help people on heroin and opioid drugs.


Many of us have tried any number of medications, usually antidepressants, to help get the user’s brain chemistry back to normal faster. So far, we haven’t been successful.


Some people have tried giving users long lasting medications that mimic meth, like concerta,® but the results haven’t been great there either.


Some of the things that I’ve talked about before, like getting a list of people you can talk to immediately if you’re feeling like you’re going to fail, and starting to go to 12 step meetings even if you’re using, are good moves toward stopping.


Encourage the person to eat.

When someone is heavily into meth, they typically lose weight because they just stop eating. Slowly getting into a healthy pattern of eating on a regular basis can be of benefit.


I see that I’m almost out of room here, so I can’t go into recovery steps right now. However, some readers pointed out to me that I hadn't really gone into enough depth about what speed does and thought that was important.


I agree. There is so much more I could say about the effects. But I also want to tell you some things you can do to help the speed user, so you know it can be done.


So next time, in a couple of weeks, I’ll have a checklist for how to approach the person on methamphetamine.


Image of Shadowy figure by @CanStockPhoto/ABCDK

Image of person's brain by @CanStockPhoto/Pikovit

Image of pregnancy by @CanSTockPhoto/Insognolucido

Image of hand and pills by @CanStockPhoto/Zinkevych

Image of person with knife and fork by @CanStockPhoto/AnatolyM

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