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KEY TAKEAWAYS

Amphetamine Detox provides up to 4 weeks of symptom-managed treatment using:

SSRIs for depression
Antipsychotics for psychosis
Antihistamines for itching
Beta-blockers for anxiety

How Is Amphetamines Detox Done For Each Amphetamine Type?

There is no medical detox for amphetamines, although medication (e.g. Diphenhydramine) is provided for up to 4 weeks to relieve withdrawal symptoms (e.g. skin itching).

	Dextroamphetamine	Lisdexamfetamine	Methamphetamine
Withdrawal Onset	Within 24 hours	24 - 36 hours, peaking during days 3 - 5	Around 48 hours after cessation
Withdrawal Length	Around 1 week	Up to 2 weeks	3 - 4 weeks
Neurotransmitter Impact	Causes a 19 - 26% downregulation of D2-receptor density for 7-14 days [2]	Reduces extracellular dopamine by 75% [4]	90% reduction of dopamine in the striatum [6]
Detox Risks	Elevated creatine kinase (e.g, 10,335 U/L), AST (856 U/L) and ALT (285 U/L) levels [3]	53% increased risk of coronary heart disease or cerebrovascular disease [5]	Users may have been awake for up to 10 days = severe hallucinations, delirium, or delusions [7] 65% increased risk of developing abscesses [8]
Symptom Management Adjustments	Fluid resuscitation + intravenous hydration to prevent rhabdomyolysis/ transaminitis within 3 - 4 days [3]	Aspirin, Atenolol or 20 - 80 mg atorvastatin once daily to restore adequate coronary blood flow	Wound assessment and care + 45mg Mirtazapine rather than 15 - 30mg for low mood and hypersensitive skin Higher doses of antipsychotics, e.g. 25 vs 12.5mg Quetiapine

Physical Symptoms Of Amphetamine Detox

Hypersomnia

Hypersomnia is a physical symptom of amphetamine detox because dopamine (DA) levels decrease by up to 90% and remain depressed by 18% for up to 1 month after withdrawal, leading to [6] [9]:

A ‘crash’ within 12 – 24 hours, including exhaustion, fatigue, and sleeping excessively for 24 – 48 hours [10] [11]
Fatigue lasting up to 4 weeks after the onset of withdrawal, as some users are awake for 10 days at a time, having ‘binged’ on amphetamines 2 -3 days prior [7] [11]
An average of 11 hours sleep per day during the first 5 days of withdrawal, followed by an average of 9 hours after 1 – 2 weeks, after sleeping for an average of 4 hours a day whilst actively using [12] [13]

Mahoney, et al (2014) found that 34% of methamphetamine users had mild excessive daytime sleepiness, and 13% had severe daytime sleepiness within 72 hours of cessation:

66% of 18 - 55-year-old users were poor sleepers (PSQI score > 5) after previously consuming around 1 gram per day for 12 years
During withdrawal, 51% had elevated daytime sleepiness (ESS score > 9) and reported falling asleep whilst sitting and talking to someone or watching TV [14]

Bruxism

Bruxism is a physical symptom of amphetamine detoxification because serotonin (5-HT) levels increase by 5-fold during active use and remain 19.7% higher in the occipital lobe for up to 90 days [15] [16].

Bruxism in 81% of chronic methamphetamine users (>1g weekly for 7 years) typically eases within 48 hours of withdrawal, although 22.3% experience teeth grinding for up to 6 years after abstaining, and 8% of cases develop into Temporomandibular Joint disorders (TMD) [17] [18].

Intravenous amphetamine use increases the risk of persistent teeth grinding by 49% compared to smoking and intranasal use due to quicker transportation into the brain (9 vs 18 minutes) and a longer elimination half-life (11.4 vs 10.7 hours) [18] [19] [20].

Uncontrollable Limb Movements

Uncontrollable arm and leg movements are physical withdrawal symptoms of amphetamines as a result of neuroexcitation and a 20 - 25% dopaminergic cell loss after chronic use, although recovery of DA terminals in the striatum begins within 7 - 30 days [21].

56% experience tremors and 44% experience Bradykinesia or Dyskinesia for up to 2 hours each episode after misusing amphetamines weekly for ≥ 1 year, resulting in muscular aches, pains, and stiffness in 35 - 60% for up to 48 hours after the onset of withdrawal [22] [23].

Involuntary muscle contractions begin within 2 – 4 days of amphetamine discontinuation and typically persist for 1 - 2 weeks, although tremors last 1 - 3 years in some cases due to DA receptor activity levels within the Parkinsonian range (up to a 97% loss) in the caudate nucleus [11] [21].

Peripheral Vasoconstriction

Peripheral vasoconstriction is a physical withdrawal symptom of amphetamine misuse due to a 110 - 210% increase of acetylcholine release, leading to restricted blood flow, tissue loss/death, and damage to the peripheral nerves and vessels [24].

15% experience numbness/tingling in the hands for around 1 hour at a time during amphetamine recovery due to elevated troponin I (2.22 ng/mL vs normal values = <0.4ng/mL) and myoglobin (467 ng/mL vs normal values = 25 – 75 ng/mL) [23] [25].

Pins and Needles typically ease within 2 days of amphetamine withdrawal, although burning and electric sensations may persist due to nerve damage or compression caused by repeated intravenous use (>4 times within 30 days) [11] [18].

Rebound Hunger

Rebound hunger is a physical withdrawal symptom of amphetamine dependence caused by a 40 - 90% reduction of dopaminergic and serotonergic activity in all brain regions, following a 5-fold increase during active use [6] [15] [26].

Increased appetite emerges during days 1 – 3 of amphetamine addiction treatment and peaks around days 3 – 5, as 5-HT no longer inhibits hunger signals from the hypothalamus and D1 and D2 receptors are unable to regulate appetite and cravings, resulting in [10]:

A 15 kg - 25 kg weight gain after ceasing methamphetamine use, as one user claims “My appetite would be very good, I could eat a lot, I ate almost everything; even the things I didn’t like to eat before were delicious to me.”
“Endless Eating”, and urges to consume high-fat/sugar foods after going 3 – 4 days at a time without eating during active use, leading to a 15kg weight loss within 10 days [27]

Cowan and Devine (2008) found that some users gain up to 80 pounds within the first 36 months of amphetamine recovery by using sweets and ‘junk’ food as a drug substitute, mood regulator, or to alleviate boredom and satisfy cravings:

1 – 6 months: “I snack more frequently, I choose more instantly gratifying foods like sugary foods, that’s sweet maybe not so healthy.”
7 – 13 months “I can eat like a whole pizza, I’m full and still eat, I could sit and eat it until I get sick.” and “All the food was comfort food, the first thing I do is go to the kitchen.”
14 – 36 months: “Mostly, I’d say my food is grease. It’s high carbs and I eat a lot of sugar.” and ‘I try and eat pretty healthy, it’s just I think I overeat at times, ‘til you feel like you’re about to burst. I eat ‘til I become miserable.’’ [28]

Regular balanced meals are provided and individualised nutrition plans are developed during amphetamine inpatient treatment to regulate food intake and prevent patients from developing a secondary addiction to food in the absence of amphetamines.

Psychological Symptoms Of Amphetamine Detox

Anhedonia

Anhedonia is a psychological symptom of amphetamine discontinuation as a result of a 50 – 61% reduction of dopaminergic activity in the caudate and putamen within 3 days of drug termination [6] [10].

Anhedonia (a loss of interest in pleasurable activities e.g. listening to music) caused by catecholamine dysregulation occurs within 24 – 72 hours of amphetamine discontinuation, peaks between days 3 – 5, and typically lasts 90 – 120 days [10] [11].

Leventhal, et al (2008) found that anhedonia lasted over 2 months in 56.9% as patients experienced diminished interest or pleasure in activities nearly every day, for at least two weeks, although this was likely to be exacerbated by co-occurring major depressive disorder in 70.6% [29].

Amphetamine Induced Psychosis

Amphetamine-induced psychotic episodes are psychological withdrawal symptoms of amphetamine discontinuation caused by cortical GABAergic dysfunction, leading to paranoid delusions and hallucinations within 24 – 72 hours [10].

Psychotic episodes are most prominent during days 3 – 5 of amphetamine withdrawal and typically subside within 1 – 3 weeks, although 10 – 28% experience symptoms for 6 months or more because [10] [30]:

Around 30% of cases develop into primary psychotic disorders after patients experience symptoms (e.g. false beliefs about being harmed) for more than 1 month after the onset of withdrawal [31]
Delusions and hallucinations are likely to be exacerbated in the 3% of patients with pre-existing psychotic disorders and the 7 – 10% of those with bipolar disorder (I and II) [29]

Patients experience confusion about whether memories (e.g. partner infidelity) were real or imagined, leading to overwhelming feelings of being unsafe, remorse or dread as psychotic symptoms subside during week 2 of amphetamine abstinence [11].

Antipsychotic medications (e.g. 12.5 - 25mg Quetiapine) are administered and environmental overstimulation (e.g. bright lights, loud noises) is minimised to manage hallucinations and delusions during the amphetamine withdrawal period.

Compulsive Skin Scratching

Compulsive picking/scratching of the skin is a psychological symptom of amphetamine cleansing caused by overstimulated D1 and D2 receptors in the striatum, exacerbated by skin disorders and infections (e.g. lesions, hives) in up to 46% of users [8].

Compulsive skin scratching occurs for around 2 – 3 hours at a time during withdrawal from amphetamines, as up to 25% experience tactile hallucinations with feelings of bugs crawling under the skin [32].

Fisher and Stanciu (2017) documented a 55-year-old man who had abused drugs for 26 years, began to feel worms under his skin within 24 hours of smoking 2mg methamphetamine:

The patient was agitated, had excoriations on the dorsum of the hands, and picked off pieces of skin and scabs whilst screaming at medical staff “See these are the worms, this isn’t skin, I know skin!”
Compulsive skin scratching eased by day 2 as no tactile or visual hallucinations were present after a single dose of 400mg albendazole and 2mg risperidone was administered twice daily [33]

Intrusive Obsessive Thoughts

Intrusive obsessive thoughts are a psychological amphetamine withdrawal symptom caused by a 5.2% decrease of cerebral blood flow in the right anterior cingulate cortex within 6 months of discontinuation [34].

Amphetamine users experience a 25% increase in perseverative responses (uncontrollable repetition of a particular thought or action e.g. a previous car crash or asking the same question multiple times) after 16 years of drug use [35]:

Intrusive obsessive thoughts emerge during days 1 – 3 of detox, and typically ease within 1 week, although 6.9% of cases result in a diagnosis of amphetamine-induced OCD [10] [36]
Perseverative responses decrease by 20% after 1 year of abstinence, although symptoms may be exacerbated in the 3.3% of patients with OCD before substance abuse [35] [36]

Social Interaction Overwhelm

Social interaction overwhelm is a psychological symptom of amphetamine discontinuation as a result of a 90% reduction in dopaminergic activity, causing anxiety, sweating, palpitations, and shortness of breath during social situations for over 2 months after the onset of withdrawal [6].

34% feel anxious/nervous and 9% feel as though people are watching or talking about them within 24 hours of methamphetamine withdrawal, following 11 years of drug abuse [37]
Social overwhelm is likely to be exacerbated in 70.3% of patients with co-occurring social anxiety disorder after misusing methamphetamines for around 10 years, as 56.4% initially take drugs aged 18 to relieve social anxiety that developed 5 - 6 years before [38] [39]

Williams (2000) documented a 26-year-old woman who became overwhelmed with social interactions within 8 weeks of withdrawal after consuming 1.5g of amphetamines daily for 6 years:

The first episode involved an anxiety attack, feeling embarrassed, and like people were staring, resulting in social avoidance out of fear of reexperiencing similar feelings
Anxiety attacks only occurred during social situations and the patient had no psychiatric history, claiming to be confident and extroverted before substance abuse [40]

Positive Markers Of Amphetamines Detox

Stabilising Heart Rate And Blood Pressure

Methamphetamine detox reduces heart rate by 2 beats per minute, systolic blood pressure by 3 mmHg, and diastolic blood pressure by 6 mmHg within 1 week because beta-blockers (e.g. propranolol, atenolol) are administered to control irregular heart rhythms and encourage steady blood flow [41].

Within 7 days of methamphetamine rehabilitation, standing blood pressure measurements are reduced from 123/85 mmHg to 120/79 mmHg (normal values = <120/80 mm/Hg) in patients previously consuming 1g per day, 5 – 6 days a week for 11 – 13 years [41].

Vital signs are monitored regularly for up to 2 weeks during amphetamine addiction treatment, and quiet, cool environments are provided to diminish agitation/hypersensitivity to external stimuli for patients with persisting hypertension (>140/90 mmHg) or tachycardia (> 100 beats/min) [11].

Improving Appetite And Causing Weight Gain

Detoxing from amphetamines improves appetite in 63% and leads to an average 8% increase in BMI within 2 - 3 weeks of treatment by addressing the 5% loss of D2 and D3 receptors in the striatum and the 40 – 67% reduction of 5-HT to [37] [26] [42]:

Regulate appetite following the inhibition of hunger signals from the hypothalamus during active use, by providing access to controlled high-calorie and nutritious foods to encourage weight gain and restore electrolyte imbalances
Minimise disordered (e.g. suppressing appetite), infrequent, and impulsive eating behaviours by providing guidance on eating a healthy, balanced diet, and arranging consultations with nutrition or dietary specialists [11]

Reducing Temperature Fluctuations

Amphetamine addiction treatment reduces temperature fluctuations by 8.2% (an average of -3◦C) by [43] :

Providing a cool environment, encouraging 2 – 3L of water daily, and frequently observing physiological homeostasis for 3 - 10 days during treatment [10] [11]
Using physical cooling (e.g. air fans, ice packs, or baths) and intravenous isotonic fluids (e.g. 0.9% NaCl solution) for users with a temperature >40 ◦C, to restore core body temperature within 1 hour [43]

Temperature fluctuations occur during amphetamine recovery because noradrenaline is no longer increased by 400 - 450%, resulting in 16% feeling sweaty or clammy for up to 14 days due to impaired thermoregulation [1] [37].

How Does Amphetamines Detox Change For Women?

Amenorrhea caused by methamphetamine abuse changes detox because up to 73.3% of women experience abnormal uterine bleeding and deregulated sex hormone (e.g. estrogen, progesterone) signalling within the first 10 months of abstinence, leading to [44]:

The consumption of 2500 or more calories per day during treatment, rather than the recommended intake of 2000, to attain a healthy weight (e.g. BMI - 18.5 - 24.9), balance hormone levels, and restore the menstrual cycle [45]
A pregnancy test and evaluation to assess whether unprotected sex occurred within the past 21 days, followed by the administration of desogestrel or levonorgestrel progestogen-only pills (POP) within 5 days to regulate bleeding [46]
Checks of serum follicle-stimulating hormone (FSH) levels at least twice within 6 weeks or arrangements for speculum and pelvic examinations if persistent bleeding occurs within the first 3 months of taking POP [46]

Amphetamines Detox At Abbeycare

Abbeycare's inpatient detox for amphetamines is symptom-managed and adapted to meet patients' individual needs by:

Assessing the type of stimulant used, as dextroamphetamine withdrawal lasts around 1 week, whereas methamphetamine withdrawal lasts up to 4 weeks and typically requires wound assessment and abscess care
Regularly monitoring vital signs (e.g. pulse, blood pressure)
Prescribing beta-blockers, antipsychotics, or SSRIs as required, based on anhedonia, anxiety, and delusions/hallucinations

References

[1] Heal, David J., et al. “Amphetamine, Past and Present – a Pharmacological and Clinical Perspective.” Journal of Psychopharmacology, vol. 27, no. 6, Mar. 2013, pp. 479–96. Accessed 6 March. 2025.“A fast onset of action with peak increases of noradrenaline and dopamine efflux occurring at 30–45 min, large effects (400–450% of baseline for noradrenaline and 700–1500% of baseline for dopamine).”
[2] Ginovart, Nathalie, et al. “Changes in Striatal D2-Receptor Density Following Chronic Treatment with Amphetamine as Assessed with Pet in Nonhuman Primates.” Synapse, vol. 31, no. 2, Wiley, Feb. 1999, pp. 154–62. Accessed 6 Mar. 2025.“At 7 and 14 days after withdrawal, there was a 19–26% decrease in Bmax but no change in K<0K;D;app> as compared to baseline.”
[3] Swisher, Austin R., et al. “Rhabdomyolysis and the Use of Low-Dose Amphetamine.” Cureus, July 2022. Accessed 6 Mar. 2025.“Table 1.”
[4] Rowley, Helen L., et al. “Differences in the Neurochemical and Behavioural Profiles of Lisdexamfetamine Methylphenidate and Modafinil Revealed by Simultaneous Dual-Probe Microdialysis and Locomotor Activity Measurements in Freely-Moving Rats.” Journal of Psychopharmacology, vol. 28, no. 3, Dec. 2013, pp. 254–69. Accessed 6 Mar. 2025.“Lisdexamfetamine (4.5 mg/kg, po) produced a gradual, sustained reduction in extracellular DOPAC with a 75±10%.”
[5] Forns, Joan, et al. “Risk of Major Cardiovascular and Cerebrovascular Events in Users of Lisdexamfetamine and Other Medications for Attention-Deficit/Hyperactivity Disorder in Denmark and Sweden: A Population-Based Cohort Study.” Neurology and Therapy, vol. 11, no. 4, Aug. 2022, pp. 1659–76. Accessed 6 Mar. 2025.“Among patients with no history of cardiovascular disease, we found an increased, although imprecise, risk of MACE in LDX users compared with previous users (pooled adjusted IRR, 1.53; 95% CI 0.97–2.40).”
[6] Boileau, Isabelle, et al. “Rapid Recovery of Vesicular Dopamine Levels in Methamphetamine Users in Early Abstinence.” Neuropsychopharmacology, vol. 41, no. 4, Aug. 2015, pp. 1179–87. Accessed 6 Mar. 2025." In two post-mortem brain investigations, we reported very low (up to 90% depletion) levels of dopamine in the striatum (caudate, putamen) of the brain of some recreational MA users who all tested positive for the drug at autopsy."
[7] Buxton, J. A., and N. A. Dove. “The Burden and Management of Crystal Meth Use.” Canadian Medical Association Journal, vol. 178, no. 12, June 2008, pp. 1537–39. Accessed 6 Mar. 2025.“Users binging on crystal meth (on a ‘run’) may stay awake for 10 days, often with little food or drink, ... extreme paranoia and violence may occur and the psychosis may become permanent.”
[8] Pollini, Robin A., et al. “High Prevalence of Abscesses and Self-Treatment among Injection Drug Users in Tijuana, Mexico.” International Journal of Infectious Diseases, vol. 14, Elsevier BV, Sept. 2010, pp. 117–22. Accessed 6 March. 2025.. “Table 2.”
[9] Jenner, P., et al. “The Effect of Chronic Administration and Withdrawal of Amphetamine on Cerebral Dopamine Receptor Sensitivity.” Psychopharmacology, vol. 58, no. 2, 1978, pp. 131–36. Accessed 6 Mar. 2025.“The dopamine content of the intact forebrain was reduced by 43% during amphetamine administration and remained 18% depressed 1 month following drug withdrawal.”
[10] NSW Health. “Management of Withdrawal from Alcohol and Other Drugs Clinical Guidance.” NSW Health, Aug. 2022. Accessed 6 March. 2025.“Table 7.1”
[11] SAMHSA. Treatment for Stimulant Use Disorders TREATMENT IMPROVEMENT PROTOCOL TIP 33. 2021. Accessed 6 March . 2025.“People who use stimulants who have binged for 2 to 3 days are dysphoric and exhausted, and they sleep excessively for 24 to 48 hours”.
[12] McGregor, Catherine, et al. “The Nature, Time Course and Severity of Methamphetamine Withdrawal.” Addiction, vol. 100, no. 9, Sept. 2005, pp. 1320–29. Accessed 6 Mar. 2025.“Peak at day 5 when participants slept for around 11 hours, ... hours of sleep gradually declined from their peak until the ninth day, after which total hours of sleep remained stable at around 9 hours for the rest of the monitoring period.”
[13] Herrmann, Evan S., et al. “Morning Administration of Oral Methamphetamine Dose-Dependently Disrupts Nighttime Sleep in Recreational Stimulant Users.” Drug and Alcohol Dependence, vol. 178, Sept. 2017, pp. 291–95. Accessed 3 June 2025.“Table 2.”
[14] Mahoney, James J., et al. “The Relationship between Sleep and Drug Use Characteristics in Participants with Cocaine or Methamphetamine Use Disorders.” Psychiatry Research, vol. 219, no. 2, Oct. 2014, pp. 367–71. Accessed 6 Mar. 2026.“Of those individuals with a METH use disorder, 34% had mild excessive daytime sleepiness while 13% demonstrated severe daytime sleepiness, ... 66% of participants with a METH use disorder were defined as poor sleepers and 51% had elevated daytime sleepiness.”
[15] Dorota Zolkowska, et al. “Amphetamine Analogs Increase Plasma Serotonin: Implications for Cardiac and Pulmonary Disease.” Journal of Pharmacology and Experimental Therapeutics, vol. 318, no. 2, American Society for Pharmacology & Experimental Therapeutics (ASPET), Sept. 2006, pp. 604–10. Accessed 6 March. 2025.“Amphetamine had weak effects on 5-HT levels [F(2,120) 3.64; p 0.03], and only the 1 mg/kg dose caused a significant 5-fold rise.”
[16] Watkins, Tristan J. “Evidence for Chronically Altered Serotonin Function in the Cerebral Cortex of Female 3,4-Methylenedioxymethamphetamine Polydrug Users.” Archives of General Psychiatry, vol. 69, no. 4, Apr. 2012, p. 399. Accessed 6 March. 2025..“Users had increased serotonin in occipital-parietal (19.7%), temporal (20.5%), occipitotemporal-parietal (18.3%), frontal (16.6%), and frontoparietal (18.5%) regions.”
[17] Rommel, Niklas, et al. “Sympathomimetic Effects of Chronic Methamphetamine Abuse on Oral Health: A Cross-Sectional Study.” BMC Oral Health, vol. 16, no. 1, BioMed Central, May 2016, p. 59. Accessed 6 Mar. 2025.“Bruxism criteria were fulfilled among 81 % of MA consumers, ... almost half of all abusers indicated pain in the TMJ from the beginning of MA abuse.”
[18] Shetty, Vivek, et al. “The Relationship between Methamphetamine Use and Increased Dental Disease.” Journal of the American Dental Association (1939), vol. 141, no. 3, Mar. 2010, pp. 307–18. Accessed 6 Mar. 2025.“Table 2.”
[19] Fowler, Joanna S., et al. “Fast Uptake and Long-Lasting Binding of Methamphetamine in the Human Brain: Comparison with Cocaine.” NeuroImage, vol. 43, no. 4, Dec. 2008, pp. 756–63. Accessed 6 Mar. 2025.“Peak concentration of METH in putamen at ∼ 9 minutes after its intravenous administration, ... this tracks the onset of peak behavioral effects produced by smoked which occurs within 9-18 min.”
[20] Harris, D. “The Bioavailability of Intranasal and Smoked Methamphetamine.” Clinical Pharmacology & Therapeutics, vol. 74, no. 5, Nov. 2003, pp. 475–86. Accessed 6 Mar. 2025.“The elimination half-life was similar for intravenous (11.4 hours), intranasal (10.7 hours), and smoked (10.7 hours) methamphetamine.”
[21] Granado, Noelia, et al. “Methamphetamine and Parkinson’s Disease.” Parkinson’s Disease, vol. 2013, 2013, pp. 1–10. Accessed 7 March. 2025.“These counts show 20 to 25% dopaminergic cell loss, measured at different time points after methamphetamine exposure”
[22] Christine, Chadwick W., et al. “Parkinsonism in Patients with a History of Amphetamine Exposure.” Movement Disorders, vol. 25, no. 2, Wiley, Jan. 2010, pp. 228–31. Accessed 7 Mar. 2025.“Table 1.”
[23] Topp, Libby, et al. “Ecstasy Use in Australia: Patterns of Use and Associated Harm.” Drug and Alcohol Dependence, vol. 55, no. 1-2, June 1999, pp. 105–15. Accessed 7 March. 2025..“Table 2.”
[24] Imperato, Assunta, et al. “Effects of Cocaine and Amphetamine on Acetylcholine Release in the Hippocampus and Caudate Nucleus.” European Journal of Pharmacology, vol. 238, no. 2-3, July 1993, pp. 377–81. Accessed 7 March. 2025..“After the injection of d-amphetamine (1 and 2 mg/kg i.p.) the enhancement of acetylcholine release was 110 and 210% in the hippocampus whereas it was 35 and 54%, respectively, in the caudate nucleus.”
[25] Sinha, Archana, et al. “Amphetamine Abuse Related Acute Myocardial Infarction.” Case Reports in Cardiology, Feb. 2016. Accessed 7 Mar. 2025.“Table 1.”
[26] Trulson, M., and B. Jacobs. “Long-Term Amphetamine Treatment Decreases Brain Serotonin Metabolism: Implications for Theories of Schizophrenia.” Science, vol. 205, no. 4412, Sept. 1979, pp. 1295–97. Accessed 10 Mar. 2025.“8.75 milligrams per kilogram twice daily for 10 days) produced large decreases (40 to 67 percent in serotonin and its major metabolite, 5-hydroxyindoleacetic acid, in all brain regions.”
[27] Liu, Liu, et al. “Using Illicit Drugs to Lose Weight among Recovering Female Drug Users in China: An Exploratory Qualitative Study.” International Journal of Environmental Research and Public Health, vol. 19, no. 5, Feb. 2022, p. 26. Accessed 10 March. 2025. " Most reported that they had gained 15 kg to 25 kg, ... In the absence of drugs, “endless eating and sleeping” (Ling, 40 years old) was believed to be the reason for an increased weight.”
[28] Cowan, Jennifer, and Carol Devine. “Food, Eating, and Weight Concerns of Men in Recovery from Substance Addiction.” Appetite, vol. 50, no. 1, Jan. 2008, pp. 33–42. Accessed 10 March. 2025.“Total weight gain in recovery between 15 and 80 lb, I might snack more frequently, I might choose more instantly gratifying foods like sugary foods, that’s sweet maybe not so healthy.”
[29] Leventhal, Adam M., et al. “Anhedonia and Amotivation in Psychiatric Outpatients with Fully Remitted Stimulant Use Disorder.” American Journal on Addictions, vol. 17, no. 3, Jan. 2008, pp. 218–23. Accessed 10 Mar. 2025.“Table 1 - 2.”
[30] Hsieh, Jennifer H., et al. “The Neurobiology of Methamphetamine Induced Psychosis.” Frontiers in Human Neuroscience, vol. 8, July 2014. Accessed 11 Mar. 2025.“Symptoms of MAP were originally thought to dissipate within a week of methamphetamine withdrawal, ... although 30% of those with MAP had symptoms persist for up to 6 months and 10–28% reported persisting symptoms for more than 6 months.”
[31] Mullen, Jeff M., et al. “Amphetamine Related Psychiatric Disorders.” PubMed, StatPearls Publishing, 8 June 2023. Accessed 11 Mar. 2025.“Some studies have suggested about 30% of patients with amphetamine-induced psychosis end up with a primary psychosis over time.”
[32] The National Drug and Alcohol Research Centre, University of New South Wales. Methamphetamine Psychosis. 2006. Accessed 11 March. 2025.“Almost one-quarter of regular methamphetamine users will suffer from a symptom of psychosis in a given year.”
[33] Fisher, Alec H., and Cornel N. Stanciu. “Amphetamine-Induced Delusional Infestation.” American Journal of Psychiatry Residents’ Journal, vol. 12, no. 12, Dec. 2017, pp. 12–13. Accessed 11 Mar. 2025."He reported smoking, on average, 2 grams of methamphetamine every other day, ... He picked off pieces of skin and scabs and screamed, “See these are the worms, this isn’t skin, I know skin!”
[34] Hwang, Jaeuk, et al. “Decreased Cerebral Blood Flow of the Right Anterior Cingulate Cortex in Long-Term and Short-Term Abstinent Methamphetamine Users.” Drug and Alcohol Dependence, vol. 82, no. 2, Apr. 2006, pp. 177–81. Accessed 11 Mar. 2025.“There were significant decreases in relative rCBF in the right anterior cingulate cortex (Talairach coordinates [x, y, z]: 6, 36, 24; Brodmann area 32, 5.2% decrease) in MA users relative to healthy comparison subjects.”
[35] Ersche, Karen D., et al. “Chronic Cocaine but Not Chronic Amphetamine Use Is Associated with Perseverative Responding in Humans.” Psychopharmacology, vol. 197, no. 3, Jan. 2008, pp. 421–31. Accessed 11 Mar. 2025.“Table 3.”
[36] Shakeri, Jalal, et al. “The Prevalence and Clinical Features of Amphetamine-Induced Obsessive Compulsive Disorder.” Drug and Alcohol Dependence, vol. 160, Mar. 2016, pp. 157–62. Accessed 11 Mar. 2025.“Amphetamine-induced OCD (AI-OCD) was observed in 6.9% of a large sample of amphetamine abusers, while in 3.3% of participants, OCD was diagnosed as a pre-existing though previously undiagnosed psychiatric disorder.”
[37] Zorick, Todd, et al. “Withdrawal Symptoms in Abstinent Methamphetamine-Dependent Subjects.” Addiction, vol. 105, no. 10, Sept. 2010, pp. 1809–18. Accessed 11 Mar. 2025.“Table 2.”
[38] Cetin Turan et al. “The Relationship between Social Anxiety and Anxiety Sensitivity in Young Adults with Methamphetamine Use Disorder.” Genel Tıp Derg, vol. 33, no. 5, Aug. 2023, pp. 569–75. Accessed 11 Mar. 2025.“It was determined that 70.3% of the participants were diagnosed as social anxiety disorder, ... 56.4% of the sample group stated that the reason for substance use was to relieve anxiety and boredom, 11.9% stated that it was to increase self-confidence.”
[39] Sareen, Jitender, et al. “Illicit Drug Use and Anxiety Disorders: Findings from Two Community Surveys.” Psychiatry Research, vol. 142, no. 1, May 2006, pp. 11–17. Accessed 11 Mar. 2025.“Table 2.”
[40] WILLIAMS, K. “Amphetamine Misuse and Social Phobia.” American Journal of Psychiatry, vol. 157, no. 5, May 2000, pp. 834--835. Accessed 11 Mar. 2025.“Ms. A, a 26-year-old woman, was seen after 2 months of flushing, sweating, palpitations, and shortness of breath, which occurred in a range of social situations, ... She had been taking 1.5 g of street amphetamine orally almost daily for 6 years.”
[41] Thompson, Ronald G., et al. “Utility of a Controlled Amphetamine Withdrawal Paradigm among Adults Who Use Methamphetamine: A Pilot Clinical Trial.” Journal of Psychopharmacology, vol. 35, no. 11, Oct. 2021, pp. 1420–30. Accessed 12 Mar. 2025.“Table 3.”
[42] Zorick, Todd, et al. “Low Striatal Dopamine Receptor Availability Linked to Caloric Intake during Abstinence from Chronic Methamphetamine Abuse.” Molecular Psychiatry, vol. 17, no. 6, Springer Nature, Oct. 2011, pp. 569–71. Accessed 11 Mar. 2025.“Loss of striatal D2/3 receptors, D2/3 receptor availability was normalized to a common age, using a published estimate (4.9% loss/decade for nucleus accumbens and putamen, 5.5% loss/decade for caudate.”
[43] Parrott, A. C. “MDMA and Temperature: A Review of the Thermal Effects of ‘Ecstasy’ in Humans.” Drug and Alcohol Dependence, vol. 121, no. 1-2, Feb. 2012, pp. 1–9. Accessed 12 March. 2025.“Temperature on admission was 40.7 ◦C, but this was reduced to 38 ◦C by cooling blankets, ice baths and isotonic intravenous liquids; symptomatic improvement soon followed.”
[44] Shen, Wen, et al. “Long-Term Use of Methamphetamine Disrupts the Menstrual Cycles and Hypothalamic-Pituitary-Ovarian Axis.” Journal of Addiction Medicine, vol. 8, no. 3, May 2014, pp. 183–88. Accessed 12 Mar. 2025.“Long-term use of MA significantly altered the menstrual cycle, and 33.6% of women suffered from abnormal uterine bleeding while using MA. Deregulation of sex hormones was observed in 73.3% of participants during abstinence.”
[45] Western, Shannon. Hypothalamic Amenorrhea: 3 Starter Nutrition Tips. Nutritionist Resource, 8 May 2023. Accessed 12 Mar. 2025.“If your period is missing, you’re very likely to experience energy loss. This means you will need to eat at least 2500 calories minimum per day to regain your period.”
[46] NICE. Scenario: Progestogen-Only Pill. Nov. 2024. Accessed 12 Mar. 2025.“Check serum follicle-stimulating hormone (FSH) levels on two occasions, with an interval of 6 weeks between tests, ... Start the POP immediately (or after 5 days if ulipristal acetate EC was given).”
[47] Mukherjee, Amrita, et al. “Methamphetamine Use and Oral Health-Related Quality of Life.” Quality of Life Research, vol. 27, no. 12, Aug. 2018, pp. 3179–90. Accessed 12 March. 2025. “Moderate/heavy MA users were more likely to report an affected sense of taste [OR = 1.58, 95% CI (1.10–2.27)] and avoidance of particular foods [OR = 1.45, 95% CI (1.02–2.01)] than light users.”

About the author

Mischa Ezekpo

Mischa Ezekpo has a Bachelors degree in Psychology from Northumbria
University, and a Masters degree in Childhood Development and
Wellbeing, from Manchester Metropolitan University. Since 2018, Mischa
has written and published work on Addiction, Mental Health, Depression, and Eating Disorders. Content reviewed by Laura Morris (Clinical Lead).

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Last Updated: June 3, 2025