What is 

methamphetamine?

M

ethamphetamine is a

powerfully addictive

stimulant that dramatically affects the central nervous 

system. The drug is made easily 

in clandestine laboratories with 

relatively inexpensive over-thecounter ingredients. These 

factors combine to make methamphetamine a drug with high

potential for widespread abuse.

The abuse of methamphetamine–a potent psychostimulant–

is an extremely serious and grow -

ing problem. Although use of

methamphetamine initially was

limited to a few urban areas in

the Southwest, several major

Western cities and Hawaii have

seen dramatic increases in its

use, and rural areas throughout

the country are becoming more

affected by the drug. In addition,

methamphetamine use among

significantly diverse populations

has been documented.

As part of our Methamphetamine Research Initiative, the

National Institute on Drug Abuse

(NIDA) has developed this publication to provide an overview of

the latest scientific findings on 

this drug. Methamphetamine is a 

powerfully addictive stimulant

associated with serious health 

conditions, including memory

loss, aggression, psychotic 

behavior, and potential heart and

brain damage; it also contributes

to increased transmission of

hepatitis and HIV/AIDS.

One of NIDA’s most important goals is to translate what 

scientists learn from research to

help the public better understand

drug abuse and addiction and

to develop more effective strategies

for their prevention and treatment. We hope this compilation 

of scientific information about 

methamphetamine will help

inform readers about the harmful

effects of methamphetamine abuse

and will assist in prevention and

treatment efforts.

Glen R.Hanson, Ph.D., D.D.S.

Acting Director

National Institute on Drug Abuse

U . S . D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s ● N a t i o n a l I n s t i t u t e s o f H e a l t h

Trends in number of emergency department 

mentions of methamphetamine, 1997-2001

Source: Drug Abuse Warning Network, SAMHSA, 2000.

Methamphetamine

Amphetamine

The Drug Abuse Warning Network tracks the number of times a

drug is mentioned in connection with emergency room visits in 

21 metropolitan areas.

METHAMPHETAMINE

Abuse and Addiction

1997 1998 1999 2000

18

15

12

9

6

3

0
Methamphetamine is commonly known as “speed,” “meth,”

and “chalk.” In its smoked form,

it is often referred to as “ice,”

“crystal,” “crank,” and “glass.” It

is a white, odorless, bitter-tasting

crystalline powder that easily 

dissolves in water or alcohol. 

The drug was developed early 

in this century from its parent

drug, amphetamine, and was used

originally in nasal decongestants

and bronchial inhalers.

Methamphetamine’s chemical

structure is similar to that of

amphetamine, but it has more

pronounced effects on the central

nervous system. Like amphetamine, it causes increased activity,

decreased appetite, and a general

sense of well-being. The effects

of methamphetamine can last 6 to

8 hours. After the initial “rush,”

there is typically a state of high

agitation that in some individuals

can lead to violent behavior. 

Methamphetamine is a

Schedule II stimulant, which

means it has a high potential 

for abuse and is available only

through a prescription that cannot be refilled. There are a few

accepted medical reasons for its

use, such as the treatment of 

narcolepsy, attention deficit 

disorder, and––for short-term

use––obesity; but these medical

uses are limited.

What is 

the scope of

methamphetamine

abuse in the 

United States?

M

ethamphetamine abuse,

long reported as the 

dominant drug problem

in the San Diego, CA, area, has

become a substantial drug problem in other sections of the West

and Southwest, as well. There are

indications that it is spreading to

other areas of the country,

including both rural and urban

sections of the South and

Midwest. Methamphetamine, 

traditionally associated with

white, male, blue-collar workers,

is being used by more diverse

population groups that change

over time and differ by geographic

area. 

According to the 2000

National Household Survey 

on Drug Abuse, an estimated 

8.8 million people (4.0 percent 

of the population) have tried

methamphetamine at some time

in their lives. 

Data from the 2000 Drug

Abuse Warning Network

(DAWN), which collects information on drug-related episodes

from hospital emergency departments in 21 metropolitan areas,

reported that methamphetaminerelated episodes increased from

approximately 10,400 in 1999 

to 13,500 in 2000, a 30 percent

increase. However, there was a

significant decrease in methamphetamine-related episodes

reported between 1997 (17,200)

and 1998 (11,500).

NIDA’s Community

Epidemiology Work Group

(CEWG), an early warning network of researchers that provides

information about the nature and

patterns of drug use in major

cities, reported in its June 2001

publication that methamphetamine

continues to be a problem in

Hawaii and in major Western

cities, such as San Francisco,

2 NIDA RESEARCH REPORT SERIES

The preferred method of taking methamphetamine 

varies among geographical regions.

Note: Calendar year 2000 in Minneapolis/ St. Paul; July–December 2000 in San Diego,

and January–June 2001 in Texas.

Source: Community Epidemiology Work Group.

Smoking

Sniffing

60

50

40

30

20

10

0

Injecting

Other

San Diego Minneapolis-St. Paul Texas

Area
Denver, and Los Angeles.

Methamphetamine availability

and production are being reported

in more diverse areas of the 

country, particularly rural areas,

prompting concern about more

widespread use. 

Drug abuse treatment admissions reported by the CEWG in

June 2001 showed that methamphetamine remained the leading

drug of abuse among treatment

clients in the San Diego area and

Hawaii. Stimulants, including

methamphetamine, accounted for

smaller percentages of treatment

admissions in other states and

metropolitan areas of the West

(e.g., 9 percent in Los Angeles

and Seattle and 8 percent in

Texas). By comparison, stimulants were the primary drugs 

of abuse in a smaller percent 

of treatment admissions in 

most Eastern and Midwestern 

metropolitan areas, such as

Minneapolis-St. Paul and St.

Louis, where they accounted 

for approximately 3 percent of

total admissions, or Baltimore,

where no stimulant-related 

treatment admissions were

reported in the first half of 2000.

How is 

methamphetamine

used?

M

ethamphetamine comes

in many forms and can be

smoked, snorted, orally

ingested, or injected. The drug

alters moods in different ways,

depending on how it is taken. 

Immediately after smoking

the drug or injecting it intravenously, the user experiences 

an intense rush or “flash” that

lasts only a few minutes and is

described as extremely pleasurable. Snorting or oral ingestion

produces euphoria––a high but

not an intense rush. Snorting 

produces effects within 3 to 5

minutes, and oral ingestion 

produces effects within 15 to 

20 minutes. 

As with similar stimulants,

methamphetamine most often 

is used in a “binge and crash” 

pattern. Because tolerance for

methamphetamine occurs within

minutes––meaning that the pleasurable effects disappear even

before the drug concentration in

the blood falls significantly––

users try to maintain the high by

binging on the drug.

NIDA RESEARCH REPORT SERIES 3

In the brain, dopamine plays an important role in the regulation of pleasure. In addition 

to other regions, dopamine is manufactured in nerve cells within the ventral tegmental

area and is released in the nucleus accumbens and the frontal cortex.

Methamphetamine

Dopamine 

Methamphetamine stimulates the

release of excess dopamine.
In the 1980’s, “ice,” a smokable form of methamphetamine,

came into use. Ice is a large, 

usually clear crystal of high purity

that is smoked in a glass pipe 

like crack cocaine. The smoke 

is odorless, leaves a residue that

can be resmoked, and produces

effects that may continue for 

12 hours or more.

What are 

the immediate

(short-term) 

effects of 

methamphetamine

abuse?

A

s a powerful stimulant,

methamphetamine, even in 

small doses, can increase

wakefulness and physical activity

and decrease appetite. A brief,

intense sensation, or rush, is

reported by those who smoke or

inject methamphetamine. Oral

ingestion or snorting produces 

a long-lasting high instead of a

rush, which reportedly can continue for as long as half a day.

Both the rush and the high are

believed to result from the release

of very high levels of the neurotransmitter dopamine into areas

of the brain that regulate feelings

of pleasure.

Methamphetamine has toxic

effects. In animals, a single high

dose of the drug has been shown

to damage nerve terminals in the

dopamine-containing regions of

the brain. The large release of

dopamine produced by methamphetamine is thought to contribute to the drug’s toxic effects

on nerve terminals in the brain.

High doses can elevate body 

temperature to dangerous, 

sometimes lethal, levels, as well 

as cause convulsions. 

What are 

the long-term

effects of 

methamphetamine

abuse?

L

ong-term methamphetamine

abuse results in many damaging effects, including addiction. Addiction is a chronic,

relapsing disease, characterized by

compulsive drug-seeking and drug

use which is accompanied by

functional and molecular changes

in the brain. In addition to being

addicted to methamphetamine,

chronic methamphetamine

abusers exhibit symptoms that

can include violent behavior, 

anxiety, confusion, and insomnia.

They also can display a number 

of psychotic features, including

paranoia, auditory hallucinations,

mood disturbances, and delusions

(for example, the sensation of

insects creeping on the skin,

which is called “formication”).

The paranoia can result in homicidal as well as suicidal thoughts.

With chronic use, tolerance

for methamphetamine can develop. In an effort to intensify the

desired effects, users may take

higher doses of the drug, take it

more frequently, or change their

method of drug intake. In some

cases, abusers forego food and

sleep while indulging in a form of

binging known as a “run,” injecting as much as a gram of the drug

every 2 to 3 hours over several

days until the user runs out of 

the drug or is too disorganized to

continue. Chronic abuse can lead

to psychotic behavior, characterized by intense paranoia, visual

and auditory hallucinations, and

out-of-control rages that can be

coupled with extremely violent

behavior.

4 NIDA RESEARCH REPORT SERIES

Long-term effects 

may include:

Dependence and 

addiction psychosis

– paranoia

– hallucinations

– mood 

disturbances

– repetitive motor 

activity

Stroke

Weight loss

Short-term effects 

may include:

Increased attention 

and decreased fatigue

Increased activity

Decreased appetite

Euphoria and rush

Increased respiration

Hyperthermia
Although there are no physical

manifestations of a withdrawal

syndrome when methamphetamine use is stopped, there are

several symptoms that occur

when a chronic user stops taking

the drug. These include depression, anxiety, fatigue, paranoia,

aggression, and an intense craving

for the drug.

In scientific studies examining

the consequences of long-term

methamphetamine exposure in

animals, concern has arisen over

its toxic effects on the brain.

Researchers have reported that 

as much as 50 percent of the

dopamine-producing cells in the

brain can be damaged after prolonged exposure to relatively 

low levels of methamphetamine.

Researchers also have found that

serotonin-containing nerve cells

may be damaged even more

extensively. Whether this toxicity

is related to the psychosis seen 

in some long-term methamphetamine abusers is still an open

question.

How is 

methamphetamine

different from

other stimulants,

such as cocaine? 

M

ethamphetamine is classified as a psychostimulant, 

as are other drugs of

abuse such as amphetamine and

cocaine. We know that methamphetamine is structurally similar

to amphetamine and the neurotransmitter dopamine, but it is

quite different from cocaine.

Although these stimulants have

similar behavioral and physiological effects, there are some major

differences in the basic mechanisms of how they work at the

level of the nerve cell. However,

the bottom line is that methamphetamine, like cocaine, results in

an accumulation of the neurotransmitter dopamine, and this

excessive dopamine concentration

appears to produce the stimulation and feelings of euphoria

experienced by the user. In contrast to cocaine, which is quickly

removed and almost completely

metabolized in the body,

methamphetamine has a much

longer duration of action and a

larger percentage of the drug

remains unchanged in the body.

This results in methamphetamine

being present in the brain longer,

which ultimately leads to prolonged stimulant effects.

What are 

the medical 

complications of

methamphetamine

abuse? 

M

ethamphetamine can

cause a variety of cardiovascular problems. 

These include rapid heart rate,

irregular heartbeat, increased

blood pressure, and irreversible,

stroke-producing damage to

small blood vessels in the brain.

Hyperthermia (elevated body

temperature) and convulsions

occur with methamphetamine

overdoses, and if not treated

immediately, can result in death.

Chronic methamphetamine

abuse can result in inflammation

of the heart lining, and among

users who inject the drug, 

damaged blood vessels and skin

abscesses. Methamphetamine

abusers also can have episodes 

of violent behavior, paranoia,

anxiety, confusion, and insomnia.

Heavy users also show progressive social and occupational 

deterioration. Psychotic symptoms

NIDA RESEARCH REPORT SERIES 5

Although both methamphetamine and cocaine are 

psychostimulants, there are differences between them.

Methamphetamine vs. 

Man-made

Smoking produces a high

that lasts 8-24 hours

50% of the drug is removed 

from the body in 12 hours

Limited medical use

Cocaine 

Plant-derived

Smoking produces a high

that lasts 20-30 minutes 

50% of the drug is removed

from the body in 1 hour

Used as a local anesthetic in

some surgical procedures
can sometimes persist for months

or years after use has ceased.

Acute lead poisoning is

another potential risk for

methamphetamine abusers. A

common method of illegal

methamphetamine production

uses lead acetate as a reagent.

Production errors therefore may

result in methamphetamine 

contaminated with lead. There

have been documented cases of

acute lead poisoning in intravenous methamphetamine

abusers.

Fetal exposure to methamphetamine also is a significant

problem in the United States. At

present, research indicates that

methamphetamine abuse during

pregnancy may result in prenatal

complications, increased rates of

premature delivery, and altered

neonatal behavioral patterns, such

as abnormal reflexes and extreme

irritability. Methamphetamine

abuse during pregnancy may 

be linked also to congenital

deformities.

Are methamphetamine abusers at

risk for contracting

HIV/AIDS and

hepatitis B and C? 

I

ncreased HIV and hepatitis B

and C transmission are likely

consequences of increased

methamphetamine abuse, particularly in individuals who inject the

drug and share injection equipment. Infection with HIV and

other infectious diseases is spread

among injection drug users 

primarily through the re-use of

contaminated syringes, needles,

or other paraphernalia by more

than one person. In nearly onethird of Americans infected with

HIV, injection drug use is a risk

factor, making drug abuse the

fastest growing vector for the

spread of HIV in the nation.

Research also indicates that

methamphetamine and related

psychomotor stimulants can

increase the libido in users, in

contrast to opiates which actually

decrease the libido. However,

long-term methamphetamine use

may be associated with decreased

sexual functioning, at least in

men. Additionally, methamphetamine seems to be associated

with rougher sex, which may lead

to bleeding and abrasions. The

combination of injection and 

sexual risks may result in HIV

becoming a greater problem

among methamphetamine abusers

than among opiate and other

drug abusers, something that

already seems to be occurring in

California.

NIDA-funded research 

has found that, through drug

abuse treatment, prevention, 

and community-based outreach 

programs, drug abusers can

change their HIV risk behaviors.

Drug use can be eliminated and

drug-related risk behaviors, such

as needle-sharing and unsafe 

sexual practices, can be reduced

significantly thus decreasing the

risk of exposure. Therefore, 

drug abuse treatment is also 

highly effective in preventing 

the spread of HIV, hepatitis B,

and hepatitis C.

What treatments

are effective for

methamphetamine

abusers?

A

t this time the most 

effective treatments for

methamphetamine addiction are cognitive behavioral

interventions. These approaches

are designed to help modify the

patient’s thinking, expectancies,

and behaviors and to increase

skills in coping with various life

stressors. Methamphetamine

recovery support groups also

appear to be effective adjuncts 

to behavioral interventions that

can lead to long-term drug-free

recovery.

There are currently no particular pharmacological treatments

for dependence on amphetamine

or amphetamine-like drugs 

such as methamphetamine. The

current pharmacological approach

is borrowed from experience with

treatment of cocaine dependence.

Unfortunately, this approach 

has not met with much success

since no single agent has proven

efficacious in controlled clinical

studies. Antidepressant medications are helpful in combating 

the depressive symptoms frequently seen in methamphetamine

users who recently have become

abstinent. 

There are some established

protocols that emergency room

physicians use to treat individuals

who have had a methamphetamine

overdose. Because hyperthermia

and convulsions are common and

often fatal complications of such

6 NIDA RESEARCH REPORT SERIES
overdoses, emergency room

treatment focuses on the immediate physical symptoms. Overdose

patients are cooled off in ice

baths, and anticonvulsant drugs

may be administered also.

Acute methamphetamine

intoxication can often be handled

by observation in a safe, quiet

environment. In cases of extreme

excitement or panic, treatment

with antianxiety agents such as

benzodiazepines has been helpful,

and in cases of methamphetamineinduced psychoses, short-term

use of neuroleptics has proven

successful.

Where can I get

further scientific

information about

methamphetamine

abuse?

T

o learn more about methamphetamine and other drugs

of abuse, contact the

National Clearinghouse for

Alcohol and Drug Information

(NCADI) at 1-800-729-6686.

Information specialists are 

available to assist you in locating

needed information and resources.

Information can be accessed

through the NIDA Web 

site (www.drugabuse.gov) or 

the NCADI Web site

(www.health.org).

Fact sheets on health effects

of drug abuse and other topics

can be ordered free of charge, in

English and Spanish, by calling

NIDA INFOFAX at 1-800-

NIH-NIDA (1-800-644-6432) 

or 1-888-TTY-NIDA (1-888-889-

6432)for the hearing impaired.

A list of fact sheet topics follows:

Health Effects of Specific Drugs

•Cigarettes and other 

tobacco products

•Crack and cocaine

•Ecstasy

• Heroin

• Inhalants

•LSD

•Marijuana

•Methamphetamine

•Pain medications

•PCP

•Ritalin

•Rohypnol and GHB

• Steroids (anabolic)

Drug Abuse and AIDS, Lessons

from Prevention Research, and

Treatment Research

•Treatment methods

•Treatment medications

•Treatment methods for 

women

•Behavior change through 

treatment

Trends and Surveys

•Costs to society from 

drug abuse

• High school and youth 

trends

• Hospital visits and deaths

• Nationwide trends

•Pregnancy and drug abuse 

trends

•Treatment trends

•Workplace trends

News Releases on Research 

Findings and Information 

about NIDA

•Web page

•Mission and structure

• Opportunities for special 

populations

•Funding opportunities

• Upcoming events and 

conferences

Access information 

on the Internet

• What’s new on the 

NIDA Web site

• Information on 

drugs of abuse

• Publications and 

communications 

(including N I D A N O T E S)

• Calendar of events

• Links to NIDA 

organizational units

• Funding information 

(including program 

announcements and 

d e a d l i n e s )

• International activities

• Links to related 

Web sites (access to 

Web sites of many 

other organizations 

in the field)

NIDA RESEARCH REPORT SERIES 7

NIDA Web Sites

www.drugabuse.gov

www.steroidabuse.org

www.clubdrugs.org

National Clearinghouse

for Alcohol and Drug

Information (NCADI)

Web Site: www.health.org

Phone No.: 1-800-729-6686
8NIDA RESEARCH REPORT SERIES

Glossary

Addiction: a chronic, relapsing

disease, characterized by compulsive drug-seeking and drug use

and by neurochemical and molecular changes in the brain.

Analog: a chemical compound

that is similar to another drug in

its effects but differs slightly in its

chemical structure.

B e n z o d i a z e p i n e s : drugs that

relieve anxiety or are prescribed

as sedatives; among the most

widely prescribed medications,

including valium and librium. 

Central nervous system (CNS):

the brain and spinal cord.

Craving: a powerful, often

uncontrollable desire for drugs.

Designer drug: an analog of a

restricted drug that has psychoactive properties.

D e t o x i f i c a t i o n : a process of

allowing the body to rid itself of a

drug while managing the symptoms of withdrawal; often the first

step in a drug treatment program.

Dopamine: a neurotransmitter

present in regions of the brain

that regulate movement, emotion,

motivation, and feelings of pleas u r e .

Narcolepsy: a disorder characterized by uncontrollable attacks of

deep sleep.

Physical dependence: an adaptive physiological state that occurs

with regular drug use and results

in a withdrawal syndrome when

drug use stops.

Psychosis: a mental disorder

characterized by symptoms such

as delusions or hallucinations that

indicate an impaired conception

of reality.

Rush: a surge of euphoric pleasure that rapidly follows administration of a drug.

Serotonin: a neurotransmitter that

has been implicated in states of

consciousness, mood, depression,

and anxiety.

Tolerance: a condition in which

higher doses of a drug are

required to produce the same

effect as experienced initially;

often leads to physical depend e n c e .

Toxic: temporary or permanent

drug effects that are detrimental

to the functioning of an organ or

group of organs.

W i t h d r a w a l : a variety of symptoms that occur after use of an

addictive drug is reduced or

s t o p p e d .

Resources

“Blood Level of Intravenous Drug Users,” by R.L. 

Norton, B.T. Burton, and J. McGirr. Journal of 

Clinical Toxicology 34(4):425-30, 1996.

Epidemiologic Trends in Drug Abuse: Vol. I. 

Highlights and Executive Summary of the 

Community Epidemiology Work Group, June 2001. 

NIH Pub. No. 01-4916A. National Institute on 

Drug Abuse, 2001.

Epidemiologic Trends in Drug Abuse: Vol. II. 

Proceedings of the Community Epidemiology Work 

Group, June 2001. NIH Pub. No. 01-4917A. 

National Institute on Drug Abuse, 2001.

“Integrating Treatments for Methamphetamine Abuse:

A Psychosocial Perspective,” by A. Huber, W. Ling, 

S. Shoptaw, V. Gulati, P. Brethen, and R. Rawson. 

Journal of Addictive Diseases, 16(4):41-50, 1997.

“Like Methamphetamine, Ecstacy May Cause LongTerm Brain Damage,” by R. Mathias. NIDA Notes 

11:7, 1996.

Methamphetamine Abuse (NIDA Capsules). National 

Institute on Drug Abuse, September 1997.

National Methamphetamine Strategy. U.S. 

Department of Justice, 1996.

National Survey Results on Drug Use From the 

Monitoring the Future Study, 1975-1994, Vol. I: 

Secondary School Students. NIH Pub. No. 93-

3498. National Institute on Drug Abuse, 1995.

National Survey Results on Drug Use From the 

Monitoring the Future Study, 1975-1994, Vol. II: 

College Students and Young Adults. NIH Pub. No. 

96-4027. National Institute on Drug Abuse, 1995.

“NIDA Survey Provides First National Data on Drug 

Abuse During Pregnancy,” by R. Mathias. NIDA 

Notes 10:6-7, 1995.

Summary of Findings from the 2000 National 

Household Survey on Drug Abuse. Substance 

Abuse and Mental Health Services Administration, 

2000.

Detailed Emergency Department Tables 2000, Drug 

Abuse Warning Network. Substance Abuse and 

Mental Health Services Administration, available 

online at www.samhsa.gov/oas/dawn.htm.

NIH Publication Number 02-4210.

Printed April 1998, Reprinted 

January 2002.

Feel free to reprint this publication.