Methamphetamine

Methamphetamine is a common, illegal, drug sold on the streets. It may be called meth, crystal meth, crank, speed, glass, tweak, chalk, Tina, or ice.

A much weaker form of methamphetamine is sold as a prescription with the brand name Desoxyn. It is sometimes used to treat narcolepsy. Adderall, a brand name drug containing amphetamine, is used to treat ADHD.

Methamphetamine most often causes a general feeling of wellness (euphoria) that is most often called a "rush." Other symptoms are increased heart rate, increased blood pressure, sweating, restlessness, dry mouth, elevated body temperature, and large, wide pupils.

If you take a large amount of the drug, you will be at higher risk for more dangerous side effects, including:

• Agitation
• Chest pain
• Coma or unresponsiveness (in extreme cases)
• Heart attack
• Irregular or stopped heartbeat
• Difficulty breathing
• Very high body temperature
• Kidney damage and possibly kidney failure
• Paranoia
• Seizures
• Severe stomach pain
• Stroke

Long-term use of methamphetamine can lead to significant psychological problems, including:

• Delusions
• Delusional behavior
• Extreme paranoia
• Major mood swings
• Insomnia (severe inability to sleep)

Other symptoms may include:

• Missing and rotted teeth (called "meth mouth")
• Repeated infections
• Severe weight loss
• Skin sores (abscesses or boils)

The length of time methamphetamines stay active can be much longer than for cocaine and other stimulants. Some paranoid delusions can last for 15 hours.

If you believe someone has taken methamphetamine and they are having bad symptoms, get them medical help right away. Take extreme caution around them, especially if they appear to be extremely excited or paranoid.

If they are having a seizure, gently hold the back of their head to prevent injury. If possible, turn their head or body to the side in case they vomit. DO NOT try to stop their arms and legs from shaking, or put anything in their mouth.

Before you call for emergency help, have this information ready, if possible:

• Person's approximate age and weight.
• How much of the drug was taken?
• How was the drug taken? (For example, was it smoked or snorted?)
• How long has it been since the person took the drug?

If the patient is actively having a seizure, becoming violent, or having difficulty breathing, do not delay. Call your local emergency number (such as 911).

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The person may receive:

• Activated charcoal and laxative, if the drug was recently taken by mouth.
• Blood and urine tests.
• Breathing support, including oxygen. If needed, the person may be placed on a breathing machine with a tube through the mouth into the throat.
• Chest x-ray if the person had vomiting or abnormal breathing.
• CT (computerized tomography) scan of the head, if head injury is suspected.
• ECG (electrocardiogram, or heart tracing).
• Intravenous fluids (through a vein) medicines to treat symptoms such as pain, anxiety, agitation, nausea, seizures, and high blood pressure.
• Poison and drug (toxicology) screening.
• Other medicines or treatments for heart, brain, muscle, and kidney complications.

How well a person does depends on the amount of drug they took and how quickly they were treated. The faster a person gets medical help, the better the chance for recovery.

Psychosis and paranoia may last up to 1 year, even with aggressive medical treatment. Memory loss and difficulty sleeping may be permanent. Skin changes and tooth loss are permanent unless the person has cosmetic surgery or dentistry to correct the problems. Further disability may occur if the person had a heart attack or a stroke. These can happen if the drug caused very high blood pressure and body temperatures. Infections and other complications in organs such as the heart, brain, kidneys, liver, and spine, may occur as a result of injection. There may be permanent damage to the organs even if the person receives treatment. The antibiotics used to treat these infections may also result in complications.

The long-term outlook depends on what organs are affected. Permanent damage may occur, which may cause:

• Seizures, stroke, and paralysis
• Chronic anxiety and psychosis (severe mental disorders)
• Decreased mental functioning
• Heart problems
• Kidney failure that requires dialysis (kidney machine)
• Destruction of muscles, which can lead to amputation

A large methamphetamine overdose can cause death.

Intoxication - amphetamines; Intoxication - uppers; Amphetamine intoxication; Uppers overdose; Overdose - methamphetamine; Crank overdose; Meth overdose; Crystal meth overdose; Speed overdose; Ice overdose

Aronson JK. Amphetamines. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier B.V.; 2016:308-323.

Brust JCM. Effects of drug abuse on the nervous system. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 87.

Jamshidi N, Dawson AH. Toxidromes. In: Cameron P, Little M, Mitra B, Deasy C, eds. Textbook of Adult Emergency Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 25.21.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.