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Methamphetamine Dependence

Methamphetamine is a type of amphetamine (“speed”) which has effects that are similar to cocaine. It has grown in popularity, particularly in the western, southern, and central regions of the United States. People have learned to build home laboratories and manufacture it from over the counter pseudoephedrine (which now has restrictions)

People abuse it by snorting, smoking, inhaling, or injecting it. The effects include rapid onset of euphoria (feeling “high”), behavioral activation, anxiety, insomnia, and lack of appetite. These effects can last up to 8-10 hours in some individuals.

In addition, methamphetamine can create much more severe psychological/psychiatric effects including paranoia, delusions, agitation, aggression, and irritability. This can look like other psychiatric syndromes like Bipolar Disorder or Schizophrenia.

Methamphetamine can also cause many different medical problems. Since it constricts blood vessels, it may lead to increased blood pressure, chest pain, seizures, muscle breakdown, kidney failure, and other complications. A common finding is so-called “meth mouth”, in which one develops severe dental disease, probably due to a decreased production of saliva.

Treatment can be effective but it must be comprehensive and should almost always begin in a residential setting. The craving to continue to use methamphetamine is so strong, the individual is highly unlikely to remain abstinent while attempting outpatient treatment. In a treatment center, the individual will be protected from giving in to these impulses. There is no need for a medical detoxification, but the individual may experience withdrawal symptoms such as fatigue, depressed mood, decreased interest, and severe craving.

Group and individual psychotherapy help the person to learn how he/she has come to experience methamphetamine dependence, learn ways of preventing relapse, as well as to address other psychiatric issues which may be underlying or coexisting.

Although there are no FDA-approved medicines for methamphetamine dependence, some studies have shown potential benefit from baclofen, bupropion, slow-release methylphenidate, and possibly modafinil. These options could be considered for an individual in treatment.

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