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Speed (methamphetamine)

Medically reviewed on Apr 24, 2018 by L. Anderson, PharmD.

Common or street names: Crystal meth, Crank, Meth, Ice, Glass, Fire, Crypto, Chalk

What is methamphetamine (speed)?

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 (DEA), which means it has a high potential for abuse and is available legally only by prescription. Methamphetamine, when abused, is commonly referred to as “speed”, “meth”, or “chalk” and has been in use since the early 1960s. When abused, methamphetamine is usually smoked, snorted, injected, or taken orally.

Medically, methamphetamine 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 illegally. In the U.S., methamphetamine is available by prescription as the brand name product Desoxyn or generically.

Methamphetamine is cheap and easy to make from common ingredients. 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”, often using the cold decongestant pseudoephedrine. Pseudoephedrine can only be purchased from behind the pharmacy counter now in the U.S., and in limited quantities. This law is enforced to help curb abuse and keep a record of the purchaser.

How is speed abused?

Methamphetamine (speed) may be abused by inhaling or smoking, swallowing, snorting through the nose, or by injection. Another common form of the drug is crystal methamphetamine, or “crystal meth”, which is 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”.

What are the effects of speed?

Immediately after smoking or intravenous (IV) 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 within 3 to 5 minutes, whereas oral ingestion takes 15 to 20 minutes.

Common, immediate effects of methamphetamine abuse include:

  • increased activity and body temperature
  • wakefulness
  • talkativeness
  • faster breathing
  • increased concentration
  • decreased appetite
  • elevated blood pressure
  • rapid heart rate
  • increased libido (sex drive)
  • a sense of well-being.

Some users become addicted quickly, and abuse it with increasing frequency and 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”.

Is speed addicting?

Yes, methamphetamine (speed) is extremely addicting. Withdrawal from methamphetamine produces:

  • severe depression
  • anxiety
  • fatigue
  • psychosis
  • intense cravings for 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 neuro-imaging studies after roughly 2 years. Motor skills and verbal memory tests showed some recovery, but not all changes have been shown to reverse over time.

How do you treat a speed addiction?

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

There are no specific medications approved for use in methamphetamine addiction. The National Institute of Drug Abuse (NIDA) reports that clinical studies are ongoing looking at medications or vaccine use for treatment of methamphetamine addiction. In addition, bupropion (Wellbutrin), approved for use in depression, has been shown to reduce low-to-moderate methamphetamine cravings, in combination with behavioral group therapy. Bupropion's proposed mechanism in methamphetamine dependence by inhibiting the re-uptake of norepinephrine and dopamine.

What are the side effects with speed?

Methamphetamine is a stimulant. Methamphetamine use:

  • increases heart rate
  • increases blood pressure
  • elevates body temperature
  • quickens the breathing rate
  • dilates the pupils.

Other side 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, all typical side effects expected from a high-dose stimulant.

Methamphetamine can cause irreversible damage to blood vessels in the brain, leading to a  stroke. Death can result from hyperthermia (elevated body temperature), 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/AIDS, and hepatitis B or C if needles or other injection equipment are shared.

Can you overdose on speed?

Yes, an overdose is possible with methamphetamine abuse. An overdose can occur due to high doses or a serious reaction that leads to death.

Death due to a methamphetamine overdose can be caused by:

  • stroke
  • heart attack
  • organ problems, such as with the kidney

How does methamphetamine affect the brain?

Similar to cocaine, methamphetamine blocks the re-uptake of dopamine. Methamphetamine releases high levels of the brain chemical dopamine, which stimulates brain cells, enhancing mood and body movement. Dopamine is an important neurotransmitter used for body movement, motivation, pleasure, and reward. A "rush" of dopamine release in the brain due to methamphetamine abuse leads to the intense high and continued reuse of "speed" that can lead to addiction.

Methamphetamine also increases levels of serotonin (5-HT) and norepinephrine, other brain chemicals. Methamphetamine can easily cross into the brain. 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. Metabolism occurs in the liver, and excretion occurs primarily in the urine and is pH dependent. 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.

Is speed use in pregnancy dangerous?

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, low birth weight, placental abruption, fetal growth retardation, heart and brain abnormalities, and withdrawal symptoms. Research is continuing to assess the effect of methamphetamine use on social interactions, cognition and medical health in children exposed to methamphetamine in utero. Animal studies have shown birth defects and embryo death when high doses.

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

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