History has shown that stimulant epidemics follow opioid epidemics. In recent years…Methamphetamine poses its own set of risks: addiction, damage to the body and brain, overdose, and increasing contamination with fentanyl and other toxic adulterants. Like cocaine, methamphetamine is highly reinforcing. Administration fuels binge use and often leads to major health problems in addition to craving and substance use disorder. The treatment for methamphetamine overdose has not advanced very much in the last 50 years and life-saving options remain limited. Because of these factors, prevention is the more important intervention while more effective treatments are developed for those with methamphetamine use disorder.
Methamphetamine use has both short- and long-term effects on the brain and body. Methamphetamine is toxic to the brain — studies have found that methamphetamine can cause similar damage to brain tissue as traumatic brain injuries. Acute use can cause short-term psychiatric symptoms, such as anxiety, hyper ability, disturbed speech patterns, and aggression. For some people these symptoms are not temporary. Long-term use can cause methamphetamine-induced psychosis, which includes hallucinations, delusions, and paranoia that can persist after long periods of abstinence. This methamphetamine-induced psychosis has similar symptoms to naturally occurring psychosis but does not respond as well to standard treatments.
In terms of its effects on the body, methamphetamine is rapidly absorbed by many organs and chronic use can harm the heart, lungs, and kidneys, among other organs. Intravenously injecting methamphetamine increases one’s risk of contracting infections such as Hepatitis C and HIV which are spread through shared injection supplies like needles.
Researchers have begun testing drugs approved for other substance use disorders to treat people with methamphetamine addiction. Examples include naltrexone—which is used for the treatment of opioid use disorder—and bupropion, which helps people quit smoking.
Both treatments have shown some effectiveness when used alone to treat methamphetamine addiction. A research team led by Dr. Madhukar Trivedi at the University of Texas Southwestern Medical Center launched a clinical trial to see if a combination of the two might help more people quit.
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In prior work, it’s been noted how psychosis can follow methamphetamine use and last into abstinence. Varying levels of methamphetamine use can induce psychosis, depending in part on an individual’s background, and it can develop quickly or after 20 years of use. This psychosis can be quite similar to Schizophrenia - in some cases, violent behaviors have been connected to methamphetamine psychosis as well. A study of Japanese prisoners found that a subgroup of methamphetamine users experienced chronic psychosis. Lingering cognitive problems may cause other health complications, difficulty thinking or concentrating at work, and increasingly risky behavior, in addition to higher relapse rates. Furthermore, later-in-life stress can also revive psychotic symptoms. More research on methamphetamine and cognitive problems can help treatment providers understand these hidden tripwires for patients.
Some of the strategies currently used to treat traumatic brain injuries may be helpful, as may use of exercise, dance, and transcranial magnetic stimulation. Post drug abstinence psychoses may not be as reversible by medications used for naturally-occurring psychoses.
With methamphetamine this is even more important as medication assisted therapies do not exist. Time of abstinence, rehabilitation with healthy thinking, eating, sleeping, and diet are easier to prescribe or advise than find. Time of abstinence is of the essence as it appears that methamphetamine induces a drug use disorder with binges, relapses and cravings but also with loss of brain function and evidence of something that looks like a traumatic brain injury. Treating it like a neurological injury in addition to traditional addiction treatment, may be an idea worth looking at too.