Methamphetamine: Properties, Abuse Patterns, and Effects

Introduction to Methamphetamine

Methamphetamine, also referred to as "meth," is a powerful synthetic drug that adversely impacts the central nervous system. Common street terms used to refer to meth include glass, speed, ice, crystal, and crank. The preparation of meth involves the catalytic hydrogenation of pseudoephedrine or ephedrine and subsequent conversion to hydrochloride. Meth can also be prepared by reducing the condensation product of methylamine and benzyl methyl ketone (Dobkin & Nicosia, 2009).

Physical and Chemical Properties

Methamphetamine occurs as a white substance in a solid, crystalline state. It is odorless and has a bitter taste (Mehling & Triggle, 2008).

Meth is soluble in water, alcohol, and chloroform, and slightly soluble in absolute ether. It melts at temperatures between 171 °C and 175 °C.

Patterns of Methamphetamine Abuse

Meth abuse occurs in three patterns: low intensity, binge, and high intensity. Low-intensity abuse refers to an individual who uses meth on a casual basis by swallowing or snorting it. In this pattern, the user does not exhibit psychological addiction. The other two patterns describe users who are psychologically addicted and show a strong preference for injecting or smoking meth in order to achieve a stronger and faster high (Dean et al., 2013).

In this pattern, users snort or swallow meth in a manner similar to the use of nicotine or caffeine. Abusers in this category seek the extra stimulation that meth provides — stimulation that enables them to stay awake and active long enough to complete a particular task, or to suppress appetite as a means of losing weight. Users in this category tend to function normally because they have responsibilities such as raising families and holding jobs. Examples of individuals prone to this pattern include truck drivers who need to stay awake to reach their destinations and workers on overtime shifts (Heinzerling et al., 2013).

Users in this category are likely to transition into the binge abuse pattern. At this stage, users recognize the stimulating effect meth provides through snorting and swallowing the drug. However, low-intensity abusers do not experience the euphoric rush produced by injecting or smoking meth. Switching to injection or smoking facilitates a quick transition from the low-intensity to the binge pattern of abuse (Roussell et al., 2013).

In the binge pattern, users employ smoking and injection to introduce meth into the body. As a result, abusers experience euphoric rushes that are characteristic of psychological addiction. The binge pattern encompasses several distinct sequential stages:

Rush: The rush refers to the initial response felt by a meth user after injecting or smoking the drug. Low-intensity abusers do not experience a rush because swallowing and snorting deliver the drug more slowly. The rush causes increased metabolism, a racing heartbeat, soaring pulse, and a surge in blood pressure. A meth rush can last from five to thirty minutes (Brown, 2010).

Injecting or smoking meth triggers the adrenal glands to release epinephrine (adrenaline), placing the body in a fight-or-flight state. The explosive release of dopamine from the brain's pleasure center produces a powerful physical sensation (Dean et al., 2013).

High: The high follows the rush and causes the abuser to experience a sense of aggressive self-confidence. As a result, abusers may engage in arguments and interrupt others. The high may last between four and sixteen hours.

Binge: The binge occurs as a continuation of the high. Injecting or smoking additional meth sustains the high; however, continued use eventually eliminates the initial rush and leads to the feeling characteristic of a binge state. Physical and mental hyperactivity define this state, which can last from three to fifteen days (Mary-Lynn & Herbeck, 2013).

Tweaking: At the end of the binge, the abuser experiences dysphoria and a sense of emptiness despite continued meth intake. The resulting depression makes the abuser feel intensely uncomfortable (Dobkin & Nicosia, 2009).

Crash: The crash state involves an extraordinary need for sleep. The depletion of epinephrine causes the body to use the crash period to replenish its energy supply. This stage may last between one and three days (Roussell et al., 2013).

Normal: This stage lasts between two and fourteen days. It is characterized by a slightly deteriorated baseline compared to the user's state before meth use began. As binge episodes increase in frequency, the duration of the normal stage decreases.

Withdrawal: The withdrawal state may begin gradually, as it does not present acute or immediate physical distress. Characteristics include an inability to experience pleasure and a profound lack of energy. The abuser may become suicidal due to intense cravings for meth (Heinzerling et al., 2013).

High-Intensity Abuse and the Dangers of Tweaking

In the high-intensity pattern, users are fully addicted. Addicts seek to prevent the crash by continuously smoking or injecting meth to remain high. As a result, abusers use escalating quantities of the drug that often fail to produce the expected high. High-intensity meth abusers tend to be highly irritable and extremely unpredictable individuals (Brown, 2010).

Tweaking represents the most dangerous state associated with high-intensity meth abuse. The intense feeling of uncontrollable frustration caused by failing to achieve the desired high makes tweakers unpredictable and dangerous. In many cases, tweakers appear outwardly normal; however, subtle signs such as unusually rapid eye movements and jerky physical movements indicate overstimulation and severe paranoia (McKetin et al., 2012).

At this stage, provocation is not necessarily required to trigger a violent reaction — confrontation alone can propel violent behavior. Confrontations between law enforcement officers and tweakers frequently result in physical or verbal assaults on the officers. Tweakers exist in their own psychological world, making it nearly impossible to predict their irrational or violent behavior. Some of the hallucinations experienced by tweakers feel entirely real, triggering the actualization of paranoid delusions (Heinzerling et al., 2013).

The rise in domestic violence incidents is closely linked to meth abuse. Domestic disputes intensify due to the unpredictability of tweakers, creating dangerous situations for law enforcement. Tweakers are also involved in accidents and motor vehicle violations; hallucinations and paranoid delusions lead them to make erratic driving decisions. The delusional state causes abusers to feel threatened by moving shadows and shapes, prompting them to accelerate and drive erratically, causing accidents. This same delusional state leads many addicts to carry firearms for perceived personal safety, with most maintaining weapons in their vehicles and residences (Dean et al., 2013).

Tweakers may commit impulsive crimes such as motor vehicle theft, purse and wallet snatching, and strong-arm robberies. The binge and high-intensity patterns of meth abuse create paranoid delusions and unpredictable behavior that cut across gender and ethnic boundaries (Roussell et al., 2013).