What is 

methamphetamine?

Methamphetamine is a

highly addictive stimulant that affects the 

central nervous system. Although

most of the methamphetamine

used in this country comes from

foreign or domestic superlabs,

the drug is also easily made in

small clandestine laboratories,

with relatively inexpensive overthe-counter ingredients. These

factors combine to make methf

r

o

m

t

h

e

dir

e

c

t

o

r

The abuse of methamphetamine—

a potent and highly addictive psychostimulant—is a very serious problem

in the United States. Initially limited

to Hawaii and western parts of the

country, methamphetamine abuse

continues to spread eastward, with

rural and urban areas everywhere

increasingly affected. According to

one national survey, approximately

10 million people in the United States

have tried methamphetamine at

least once.

Methamphetamine abuse leads to

devastating medical, psychological,

and social consequences. Adverse

health effects include memory loss,

aggression, psychotic behavior, heart

damage, malnutrition, and severe

dental problems. Methamphetamine

abuse also contributes to increased

transmission of infectious diseases,

such as hepatitis and HIV/AIDS, and

can infuse whole communities with

new waves of crime, unemployment,

child neglect or abuse, and other

social ills. 

The good news is that methamphetamine abuse can be prevented

and methamphetamine addiction

can be treated. People do recover,

but only when effective treatments

that address the multitude of problems

resulting from methamphetamine

abuse are readily available. Primary

goals of the National Institute on

Drug Abuse (NIDA) are to apply

what our scientists learn from 

drug abuse research to develop new

and enhance existing treatment

approaches and to bring these effective treatments to the communities

that need them. 

In this report, we provide an overview of the latest scientific findings

on methamphetamine. Our intent is

to enlighten readers about the damaging effects of methamphetamine

abuse and to inform prevention and

treatment efforts.

Nora D.Volkow, M.D.

Director

National Institute on Drug Abuse

U.S. Department of Health and Human Services • National Institutes of Health

ResearchReport NATIONAL INSTITUTE ON DRUG ABUSE

SERIES

METHAMPHETAMINE

Abuse and Addiction

amphetamine a drug with high

potential for widespread abuse.

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

last century from its parent drug,

Methamphetamine
amphetamine, and was used

originally in nasal decongestants

and bronchial inhalers. Like

amphetamine, methamphetamine

causes increased activity and

talkativeness, decreased appetite,

and a general sense of well-being.

However, methamphetamine 

differs from amphetamine in 

that at comparable doses, much

higher levels of methamphetamine get into the brain, making

it a more potent stimulant drug.

It also has longer lasting and

more harmful effects on the 

central nervous system. 

Methamphetamine is a

Schedule II stimulant, which

means it has a high potential 

for abuse and is available only

through a prescription. It is 

indicated for the treatment of

narcolepsy (a sleep disorder) 

and attention deficit hyperactivity

disorder; but these medical uses

are limited, and the doses are

much lower than those typically

abused.

What is the 

scope of 

methamphetamine

abuse in the

United States?

NIDA’s Community

Epidemiology Work

Group (CEWG), an early

warning network of researchers

that provides information about

the nature and patterns of drug

abuse in 21 major areas of the

U.S., reported in January 2006

that methamphetamine continues

to be a problem in the West,

with indicators persisting at high

levels in Honolulu, San Diego,

Seattle, San Francisco, and Los

Angeles; and that it continues 

to spread to other areas of the

country, including both rural 

and urban sections of the South

and Midwest. In fact, methamphetamine was reported to be

the fastest growing problem in

metropolitan Atlanta. 

According to the 2005 National

Survey on Drug Use and Health

(NSDUH), an estimated 10.4 million people age 12 or older (4.3

percent of the population) have

tried methamphetamine at some

time in their lives. Approximately

1.3 million reported past-year

methamphetamine use, and

512,000 reported current (pastmonth) use. Moreover, the 2005

Monitoring the Future (MTF) 

survey of student drug use and

attitudes reported 4.5 percent of

high school seniors had used

methamphetamine within their

lifetimes, while 8th-graders and

10th-graders reported lifetime

use at 3.1 and 4.1 percent,

respectively. However, neither 

of these surveys has documented

an overall increase in the abuse

of methamphetamine over the

past few years. In fact, both 

surveys showed recent declines

in methamphetamine abuse

among the Nation’s youth. 

In contrast, evidence from

emergency departments and

treatment programs attest to 

2NIDA RESEARCH REPORT SERIES

1992 1994

1999 2002

Source: Treatment Episode Data Set (TEDS), SAMHSA.

Primary Methamphetamine/Amphetamine Admission

Rates per 100,000 Population Aged 12 and Over

Incomplete Data <3

3-9

10-23

24 or more

KEY YEAR: 1992
the growing impact of methamphetamine abuse in the country.

The Drug Abuse Warning

Network (DAWN), which collects

information on drug-related

episodes from hospital emergency

departments (EDs) throughout

the Nation, has reported a

greater than 50 percent increase

in the number of ED visits related

to methamphetamine abuse

between 1995 and 2002, reaching

approximately 73,000 ED visits,

or 4 percent of all drug-related

visits in 2004.

Treatment admissions for

methamphetamine abuse have

also increased substantially. In

1992, there were approximately

21,000 treatment admissions in

which methamphetamine/

amphetamine was identified 

as the primary drug of abuse,

representing more than 1 percent

of all treatment admissions during

the year. By 2004, the number 

of methamphetamine treatment

admissions increased to greater

than 150,000, representing 8 

percent of all admissions.

Moreover, this increased

involvement of methamphetamine

in drug treatment admissions has

also been spreading across the

country. In 1992, only 5 states

reported high rates of treatment

admissions (i.e., >24 per 100,000

population) for primary methamphetamine/amphetamine

problems; by 2002, this number

increased to 21, more than a

third of the states.

How is 

methamphetamine

abused?

Methamphetamine comes

in many forms and can

be smoked, snorted,

injected, or orally ingested. 

The preferred method of

methamphetamine abuse varies

by geographical region and has

changed over time. Smoking

methamphetamine, which leads

to very fast uptake of the drug 

in the brain, has become more

common in recent years, 

amplifying methamphetamine’s

addiction potential and adverse

health consequences. 

The drug also alters mood 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 the pleasurable

effects of methamphetamine 

disappear even before the drug

concentration in the blood falls

significantly—users try to maintain the high by taking more of

the drug. In some cases, abusers

indulge in a form of binging

known as a “run,” foregoing

food and sleep while continuing

abuse for up to several days.

How is 

methamphetamine

different from

other stimulants,

such as cocaine?

Methamphetamine is

structurally similar to

amphetamine and the

neurotransmitter dopamine, but

NIDA RESEARCH REPORT SERIES3

Cocaine

Stimulant and local anesthetic

Plant-derived

Smoking produces a brief high 

50% of the drug is removed from 

the body in 1 hour

Blocks dopamine re-uptake

Limited use as a local anesthetic in

some surgical procedures

Methamphetamine

Stimulant

Man-made

Smoking produces a long-lasting high

50% of the drug is removed from 

the body in 12 hours

Increases dopamine release and blocks

dopamine re-uptake

Limited medical use

vs.
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. 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. And

although both methamphetamine 

and cocaine increase levels of

the brain chemical dopamine,

animal studies reveal much 

higher levels of dopamine 

following administration of

methamphetamine due to the

different mechanisms of action

within nerve cells in response to

these drugs. Cocaine prolongs

dopamine actions in the brain 

by blocking dopamine re-uptake.

While at low doses, methamphetamine blocks dopamine 

re-uptake, methamphetamine

also increases the release of

dopamine, leading to much 

higher concentrations in the

synapse, which can be toxic to

nerve terminals. 

What are the

immediate 

(short-term)

effects of 

methamphetamine

abuse?

As a powerful stimulant,

methamphetamine, even

in small doses, can

increase wakefulness and 

physical activity and decrease

appetite. Methamphetamine can

also cause a variety of cardiovascular problems, including rapid

heart rate, irregular heartbeat,

and increased blood pressure.

Hyperthermia (elevated body

temperature) and convulsions

may occur with methamphetamine overdose, and if not treated

immediately, can result in death.

Most of the pleasurable effects

of methamphetamine are believed

to result from the release of 

very high levels of the neurotransmitter dopamine. Dopamine

is involved in motivation, the

experience of pleasure, and

motor function, and is a common

mechanism of action for most

drugs of abuse. The elevated

release of dopamine produced

by methamphetamine is also

thought to contribute to the

drug’s deleterious effects on

nerve terminals in the brain.

4NIDA RESEARCH REPORT SERIES

Dopamine Pathways

In the brain, dopamine plays an important role in the regulation of reward and movement. As part 

of the reward pathway, dopamine is manufactured in nerve cell bodies located within the ventral

tegmental area (VTA) and is released in the nucleus accumbens and the prefrontal cortex. Its motor

functions are linked to a separate pathway, with cell bodies in the substantia nigra that manufacture

and release dopamine into the striatum.
What are the 

long-term 

effects of 

methamphetamine

abuse?

L

ong-term methamphetamine

abuse has many negative

consequences, including

addiction. Addiction is a chronic,

relapsing disease, characterized

by compulsive drug seeking and

use, accompanied by functional

and molecular changes in the

brain. In addition to being

addicted to methamphetamine,

chronic abusers exhibit symptoms

that can include anxiety, confusion, insomnia, mood disturbances, and violent behavior.

They also can display a number

of psychotic features, including

paranoia, visual and auditory 

hallucinations, and delusions 

(for example, the sensation of

insects creeping under the skin).

Psychotic symptoms can sometimes last for months or years

after methamphetamine abuse

has ceased, and stress has been

shown to precipitate spontaneous

recurrence of methamphetamine

psychosis in formerly psychotic

methamphetamine abusers. 

With chronic abuse, tolerance

to methamphetamine’s pleasurable effects can develop. In an

effort to intensify the desired

effects, abusers may take higher

doses of the drug, take it more

frequently, or change their

method of drug intake. Withdrawal from methamphetamine

occurs when a chronic abuser

stops taking the drug; symptoms

of withdrawal include depression, anxiety, fatigue, and an

intense craving for the drug.

Chronic methamphetamine

abuse also significantly changes

the brain. Specifically, brain

imaging studies have demonstrated alterations in the activity

of the dopamine system that are

associated with reduced motor

speed and impaired verbal 

learning. Recent studies in 

chronic methamphetamine

NIDA RESEARCH REPORT SERIES5

Short-Term Effects 

May Include: 

■ Increased attention and

decreased fatigue

■ Increased activity and 

wakefulness

■ Decreased appetite

■ Euphoria and rush

■ Increased respiration

■ Rapid/irregular 

heartbeat

■ Hyperthermia

Long-Term Effects 

May Include: 

■ Addiction

■ Psychosis, including:

• paranoia

• hallucinations

• repetitive motor 

activity

■ Changes in brain 

structure and function

■ Memory loss

■ Aggressive or violent 

behavior

■ Mood disturbances

■ Severe dental 

problems

■ Weight loss

Recovery of Brain Dopamine Transporters 

in Chronic Methamphetamine (METH) Abusers

Source: Volkow ND et al., Journal of Neuroscience 21:9414–9418, 2001.

Normal Control METH Abuser

(1 month abstinence)

METH Abuser

(24 month abstinence)
abusers have also revealed

severe structural and functional

changes in areas of the brain

associated with emotion and

memory, which may account 

for many of the emotional and

cognitive problems observed in

chronic methamphetamine

abusers.

Fortunately, some of the

effects of chronic methamphetamine abuse appear to be, at 

least partially, reversible. A

recent neuroimaging study

showed recovery in some brain

regions following prolonged

abstinence (2 years, but not 6

months). This was associated

with improved performance on 

motor and verbal memory tests.

However, function in other 

brain regions did not display

recovery even after 2 years of

abstinence, indicating that some

methamphetamine-induced

changes are very long-lasting.

Moreover, the increased risk of

stroke from the abuse of

methamphetamine can lead to

irreversible damage to the brain.

What are 

the risks of 

methamphetamine

abuse during 

pregnancy?

Prenatal exposure to

methamphetamine may

also be a problem in the

United States. Although according

to the NSDUH, less than 1 percent of pregnant women aged

15–44 had used methamphetamine in the past year, any use

among this population is of 

concern. Unfortunately, our

knowledge of the effects of

methamphetamine during pregnancy is limited. The few human

studies that exist have shown

increased rates of premature

delivery, placental abruption,

fetal growth retardation, and

heart and brain abnormalities.

However, these studies are 

difficult to interpret due to

methodological issues, such as

small sample size and maternal

use of other drugs. Ongoing

research is continuing to study

developmental outcomes such 

as cognition, social relationships,

motor skills, and medical 

status of children exposed to

methamphetamine before birth.

Are 

methamphetamine

abusers at risk 

for contracting

HIV/AIDS and 

hepatitis B and C?

I

ncreased HIV and hepatitis B

and C transmission are 

consequences of increased

methamphetamine abuse, not

only in individuals who inject the

drug, but also in noninjecting

methamphetamine abusers.

Among injection drug users,

infection with HIV and other

infectious diseases is spread 

primarily through the re-use of

contaminated syringes, needles,

or other paraphernalia by more

than one person. However,

regardless of how it is taken, the

intoxicating effects of methamphetamine can alter judgment

and inhibition and lead people

to engage in unsafe behaviors. 

Methamphetamine has become

associated with a culture of risky

sexual behavior, both among

men who have sex with men

(MSM) and heterosexual populations. This link may be due to

the fact that methamphetamine

and related psychomotor 

stimulants can increase libido.

Paradoxically, long-term

methamphetamine abuse may be

associated with decreased sexual

functioning, at least in men. 

The combination of injection and

sexual risk-taking 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, according to some epidemiologic reports. For example,

while the link between HIV

infection and methamphetamine

abuse has not yet been established for heterosexuals, data

show an association between

methamphetamine abuse and the

spread of HIV among MSM.

Methamphetamine abuse may

also worsen the progression of

6NIDA RESEARCH REPORT SERIES
HIV and its consequences. In

animal studies, methamphetamine

increased viral replication; in

human methamphetamine

abusers, HIV caused greater 

neuronal injury and cognitive

impairment compared with 

nondrug abusers.

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 abuse 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

to HIV and other infectious 

diseases. Therefore, drug abuse

treatment is HIV prevention.

What treatments

are effective for

methamphetamine

abusers?

At this time, the most 

effective treatments for

methamphetamine addiction are behavioral therapies

such as cognitive behavioral 

and contingency management

interventions. For example, the

Matrix Model, a comprehensive

behavioral treatment approach

that combines behavioral therapy,

family education, individual

counseling, 12-Step support,

drug testing, and encouragement

for nondrug-related activities, 

has been shown to be effective

in reducing methamphetamine

abuse. Contingency management

interventions, which provide 

tangible incentives in exchange

for engaging in treatment and

maintaining abstinence, have

also been shown to be effective. 

There are currently no specific

medications that counteract the

effects of methamphetamine or

that prolong abstinence from and

reduce the abuse of methamphetamine by an individual

addicted to the drug. However,

there are a number of medications that are FDA-approved for

other illnesses that might also be

useful in treating methamphetamine addiction. Recent study

findings reveal that bupropion,

the anti-depressant marketed 

as Wellbutrin, reduced the

methamphetamine-induced

“high” as well as drug cravings

elicited by drug-related cues.

This medication and others are

currently in clinical trials, while

new compounds are being

developed and studied in 

preclinical models. 

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

800–729–6686. Information 

specialists are available to help

you locate information and

resources.

Fact sheets, including

InfoFacts, on the health effects of

methamphetamine, other drugs

of abuse, and other drug abuse

topics are available on the NIDA

Web site (www.drugabuse.gov),

and can be ordered free of

charge in English and Spanish

from NCADI at www.health.org.

NIDA RESEARCH REPORT SERIES7

Access information 

on the Internet

• What’s new on the NIDA Web site

• Information on drugs of abuse

• Publications and communications

(including NIDA Notes)

• Calendar of events

• Links to NIDA organizational units

• Funding information 

(including program announcements 

and deadlines)

• International activities

• Links to related Web sites 

(access to Web sites of many other

organizations in the field)

NIDA Web Sites

www.drugabuse.gov

www.steroidabuse.gov

www.clubdrugs.gov

www.hiv.drugabuse.gov

www.inhalant.drugabuse.gov

NCADI

Web Site: www.health.org

Phone No.: 800-729-6686
References

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HIV and chronic methamphetamine use on brain

metabolite abnormalities. Am J Psychiatry

162:361–369, 2005.

Gavrilin MA, Mathes LE, Podell M. Methamphetamine

enhances cell-associated feline immunodeficiency virus

replication in astrocytes. J Neurovirol 8:240–249,

2002.

Huber A, Ling W, Shoptaw S, Gulati V, Brethen P, Rawson

R. Integrating treatments for methamphetamine

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Future: National Results on Adolescent Drug Use,

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5506, Bethesda, MD: NIDA, NIH, DHHS, 2005. 

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Lichtman AM, Bramen J, Shinn AK, Miotto K, Learn J,

Dong Y, Matochik JA, Kurian V, Newton T, Woods R,

Rawson R, Ling W. Mood disturbances and regional

cerebral metabolic abnormalities in recently abstinent

methamphetamine abusers. Arch Gen Psychiatry

61:73–84, 2004.

National Institute on Drug Abuse. Epidemiologic Trends 

in Drug Abuse: Advance Report, Community

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Bethesda, MD: NIH, DHHS, 2006. 

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Macdonald M, Liebert M, Rader L, Burns R, DiMaria J,

Copersino M, Stabile PQ, Kolodner K, Li R. Effect of

prize-based incentives on outcomes in stimulant

abusers in outpatient psychosocial treatment 

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trials network study. Arch Gen Psychiatry

62(10):1148–1156, 2005. 

Rawson RA, Marinelli-Casey P, Anglin MD, Dickow A,

Frazier Y, Gallagher C, Galloway GP, Herrell J, Huber

A, McCann MJ, Obert J, Pennell S, Reiber C,

Vandersloot D, Zweben J. A multi-site comparison 

of psychosocial approaches for the treatment of

methamphetamine dependence. Addiction

99:708–717, 2003.

Rippeth JD, Heaton RK, Carey CL, Marcotte TD, Moore DJ,

Gonzalez R, Wolfson T, Grant I. Methamphetamine

dependence increases risk of neuropsychological

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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.

Attention deficit hyperactivity 

disorder: A disorder that often presents in

early childhood, characterized by inattention,

hyperactivity, and impulsivity.

Central nervous system (CNS): The brain

and spinal cord.

Craving: A powerful, often uncontrollable

desire for drugs.

Dopamine: A neurotransmitter present in

regions of the brain that regulate movement,

emotion, motivation, and feelings of 

pleasure.

Narcolepsy: A disorder characterized by

uncontrollable attacks of deep sleep.

Psychomotor stimulants (psychostimulants): Drugs that increase or enhance the

activity of monoamines (such as dopamine

and norepinephrine) in the brain.

Psychostimulants increase arousal and 

activity, as well as heart rate, blood pressure,

and respiration.

Psychosis: A mental disorder characterized

by symptoms such as delusions or 

hallucinations and disordered thinking.

Rush: A surge of euphoric pleasure that 

rapidly follows administration of a drug.

Tolerance: A condition in which higher 

doses of a drug are required to produce the

same effect as experienced initially.

Toxic: Damage to an organ or group of

organs.

Withdrawal: A variety of symptoms that

occur after chronic abuse of an addictive 

drug is reduced or stopped.

NIH Publication Number 06-4210

Printed April 1998, Reprinted January 2002. 

Revised September 2006.

Feel free to reprint this publication.