What Is Crystal Meth Addiction

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KEY TAKEAWAYS

Crystal meth addiction is defined as:

Chronic use of methamphetamine, a Class A drug, and physical withdrawal symptoms upon cessation
Compulsive drug-seeking behaviour for meth
Using meth despite the onset of physical and psychological side effects, such as "meth mouth" and meth-induced psychosis

Physiological Indicators Of Crystal Meth Addiction

Peptic ulcers occur in 75% of crystal methamphetamine consumers compared to non-users [1].

15% of individuals who inject methamphetamine report injection site abscesses [2].

Meth induces cell death in the dopaminergic system.

Methamphetamine consumption releases dopamine while inhibiting norepinephrine uptake, causing hypertension, cardiac arrhythmia, and tachypnea [3].

The combination of high acidity in meth and its ability to cause xerostomia leads to tooth decay, or "meth mouth" in users.

Methamphetamine consumption leads to systolic ventricular dysfunction that causes idiopathic congestive cardiomyopathy.

Having methamphetamine-associated Pulmonary Arterial Hypertension increases the chances of visiting the emergency department because of the condition by 230% compared to the idiopathic variation [4].

2mg/kg of meth alters the liver cell structure, with damage being observed 24 hours or more after the last drug use [5].

20% of crystal methamphetamine users have rhabdomyolysis [6].

Psychological Indicators Of Crystal Meth Addiction

Crystal meth induces euphoric effects that are felt for 6-12 hours [1].

21% of meth-associated hallucinations are tactile [7].

Auditory and visual hallucinations account for 85% and 46% of all reported meth-related psychosis [7].

The dose range for causing psychosis during consumption is 55–640 mg and is induced up to 34 hours post-drug use [7].

Tactile hallucinations lead to formication and skin-picking because individuals feel crawling insects that are not real [7].

2mg/kg of meth leads to a 40% decrease in GABAergic neuronal firing 24 hours after injecting the drug, reinforcing meth cravings [8].

Behavioural Indicators Of Crystal Meth Addiction

Being addicted to crystal meth leads to a 50% increase in sexual behaviour compared to non-users [9].

A 2013 case study by Mckenna evidenced that alertness and vigilance are behavioural indicators of meth substance abuse [10].

A self-report study by Newton and colleagues reported that 56% show pleasure-seeking behavior in meth use, while 27% exhibit impulsive behavior [11].

Repetitive limb movements (i.e., stereotype) are caused by acute administration of >3.0mg/kg methamphetamine [12].

Violence is a common behavioural indicator of active crystal meth addiction, caused by meth-induced psychosis in 22-33% [13].

Crystal Meth Addiction Vs Addiction To Other Drugs

Addiction Potential

	Meth	Marijuana	Heroin	Ecstasy
Half-Life	9-12 hours	1.6–59 hours	8-22 minutes	3.6 - 8 hours

	Alcohol	Oxycodone	Benzodiazepines
Half-Life	4.0–4.5 hours	3.2 - 5.6 hours	1.5 - 200 hours

Withdrawal Symptoms

	Meth	Marijuana	Heroin	Ecstasy
Fatigue	Yes	No	Yes	Yes
Memory Problems	No	No	No	Yes
Fever	No	Yes	Yes	No
Yawning	No	No	Yes	No
Tremors	Yes	No	Yes	No
Paranoia	Yes	No	No	Yes
Muscle Pain	No	No	Yes	No

	Alcohol	Oxycodone	Benzodiazepines
Fatigue	No	Yes	No
Memory Problems	Yes	No	Yes
Fever	Yes	No	No
Yawning	No	Yes	No
Tremors	Yes	No	No
Paranoia	No	No	Yes
Muscle Pain	No	Yes	Yes

Short Term Effects

	Meth	Marijuana	Heroin	Ecstasy
Increased/ Decreased Appetite	Decreased	Increased	Decreased	Decreased
Psychosis	Yes	Yes	Yes	Yes
Itching	Yes	No	Yes	No
Drowsiness	No	Yes	Yes	No
Aggression	Yes	Yes	No	Yes

	Alcohol	Oxycodone	Benzodiazepines
Increased/ Decreased Appetite	Increased	Decreased	Decreased
Psychosis	No	Yes	Yes
Itching	Yes	Yes	No
Drowsiness	Yes	Yes	Yes
Aggression	Yes	No	Yes

Long Term Effects

	Meth	Marijuana	Heroin	Ecstasy
Bronchitis	Yes	Yes	Yes	No
Executive Dysfunction	Yes	Yes	Yes	Yes
Constipation	No	No	Yes	No
Liver Damage	Yes	No	No	Yes

	Alcohol	Oxycodone	Benzodiazepines
Bronchitis	No	No	No
Executive Dysfunction	Yes	No	Yes
Constipation	No	Yes	Yes
Liver Damage	Yes	No	No

Neurological And Brain Changes

	Meth	Marijuana
Neurotransmitter Behaviour	Blocks dopamine re-uptake	Activates CB1 receptors
Changes In Brain Regions	Increased neuronal death in the striatum, prefrontal cortex, and hippocampus	Reduced grey matter in: Medial temporal cortex Orbitofrontal cortex
Neurobiological Changes	Decreased gliogenesis and damage to oligodendrocytes and Schwann cells Decreased white matter	Induces CB1 receptor downregulation Synaptic pruning in GABAergic pathways Desynchronization of PFC neuronal networks

	Heroin	Ecstasy
Neurotransmitter Behaviour	Mu opioid activation	Increased SERT transmission
Changes In Brain Regions	Reduced white matter in the Nucleus Accumbens	Serotonergic system Dopaminergic system GABAergic system
Neurobiological Changes	Changes to the locus ceruleus Suppressed release of noradrenaline	Reduced serotonin levels Degeneration of serotonin terminals Reduced serotonin transporters

	Alcohol	Oxycodone	Benzodiazepines
Neurotransmitter Behaviour	Increased inhibitory transmission (GABA, adenosine)	Increased dopamine levels during use	Enhanced GABA at GABA-A receptor
Changes In Brain Regions	Frontal lobe damage Widespread cerebral atrophy	Frontal lobe damage Decreased amygdala transmission	Reduced white matter Reduced prefrontal cortex functioning
Neurobiological Changes	Widespread neural degeneration Reduced limbic system function	Reduced medial orbitofrontal cortex transmission Reduced striatal dopamine transmission	GABA-A uncoupling after short-term and long-term

When Crystal Meth Use Becomes Crystal Meth Addiction

Usage

	Crystal Meth Use	Crystal Meth Addiction
Effects From Low Doses	Yes	No
Frequent Use	No	Yes
Method	Smoking and snorting	Injecting

Dependence

	Crystal Meth Use	Crystal Meth Addiction
Type Of Dependence	Psychological	Physical and psychological
Needs Meth To Function?	No	Yes

Withdrawal

	Crystal Meth Use	Crystal Meth Addiction
Attempts To Stop	Easier to stop Does not require detox	More difficult to stop Requires detox
Cravings	Immediate psychological craving	Physical and psychological cravings
Withdrawal Symptoms	Acute symptoms 1 - 2 days	Chronic symptoms Up to 7 days
Relapse	Triggers are unknown	Greater awareness of triggers

What Factors Change Crystal Meth Addiction?

Method Of Usage

68.1% of first-time meth consumers choose smoking, with an absorption rate of 37.4%, leading to physical addiction and symptoms of withdrawal [14] [15].

When users begin to snort meth, there is a 79% bioavailability rate leading to physical dependence more quickly [16].

62% of injection-related overdoses are caused by unknown meth potencies, becoming a warning for dependent individuals to get help and support for meth addiction [17]

Crystal meth addiction changes with transrectal use, as this causes fatal concentrations of crystal meth to accumulate in the femoral vein [18].

Potency Of Batch

Low-potency (<93%) crystal meth does not elicit immediate severe addiction, though users become psychologically addicted to the euphoria.

A new variation of crystal meth, called P2P meth, is over 93% potent, making it more addictive than standard crystal meth [19].

First-time users who consume very potent doses (~97%) of crystal meth become addicted more quickly than someone who uses less potent doses.

Meth potency and purity of ~97% also lead to impulsive behavior, where sporadic use escalates into compulsive addiction.

The average potency of meth has increased from 95.1% to over 97% between 2012 and 2019 since 2015, making crystal meth more addictive [20].

Crystal meth addiction becomes unpredictable when it is cut with fentanyl, as this substance is 100 times stronger than morphine and not always declared by distributers.

(Read about fentanyl detoxification.)

Early Exposure To Crystal Meth

Meth exposure in utero causes a 3.9% reduction in white matter connections in the left orbital-frontal cortex, leading to poor future decision-making and drug-seeking behaviour [21].

Prenatal exposure to meth causes smaller subcortical volumes, resulting in poor education and negative health habits relating to meth use [22].

55% of children exposed to crystal meth in home-based meth labs test positive for toxic levels of chemicals used in production, causing delayed neurological development and desensitization to meth [23].

Children who are exposed to meth from an early age are more likely to exhibit intergenerational patterns of meth abuse and neglectful parenting compared to unexposed children [24].

Combined With Other Drugs

Combining meth with other drugs leads to habituation of the combined effects; users no longer take meth by itself due to being physically addicted to more than one drug.

Mixing meth with other stimulants, such as MDMA, increases tolerance to meth, so individuals consume more meth to feel the same effects as before polydrug use.

(Read about detox from ecstasy here, or about ecstasy rehab here.)

Polydrug use in meth addiction further complicates the onset of withdrawal symptoms and subsequent detox from the drug, as not all substances are known or declared to healthcare professionals.

Cocaine use during active meth addiction enhances the stimulant effects of both drugs, leading to enhanced euphoria and addictive potential.

59% of active meth consumers use marijuana to overcome meth's side effects, resulting in a higher risk of depression compared to non-users [25].

52% of combined meth and marijuana users experience psychotic symptoms, but users continue using meth to self-medicate [26].

Violence

25% of meth users break entry to properties to steal money for drugs, but this limits family support, causing addiction to persist without intervention [27].

53% of meth users exhibit violent behaviour, leading to disengagement with social support, enabling addiction to escalate [28].

Incarceration for meth-related violence leads to a 37.8% increased risk of meth relapse to occur when leaving prison [29].

Cases with a violent criminal history are not permitted in meth rehab facilities; this is a barrier to receiving addiction support, where health deteriorates when help is not sought quickly enough.

A 2015 study by Hobkirk and colleagues showed that all cases of meth-related violence are associated with symptoms of PTSD, further reducing the ability to seek drug addiction support [30].

References

[1] Turan, Bilal, et al. “Methamphetamine-Related Peptic Ulcer Perforation: A Growing Medical Concern.” Turkish Journal of Trauma & Emergency Surgery, Turkish Association of Trauma and Emergency Surgery, Jan. 2023, pp. 1357–63. "12 (75.0%) had peptic ulcer."
[2] 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. e117–22. Accessed 7 Jan. 2024. “Table 1.”
[3] De-Carolis, C., et al. “Methamphetamine Abuse and Meth Mouth in Europe.” Medicina Oral Patología Oral Y Cirugia Bucal, vol. 20, no. 2, 2015, pp. e205–10. “The abuse of methamphetamine is associated with several negative effects on health, because MA is a neurotoxin and a dangerous central nervous system stimulant. It changes levels of neurotransmitters in the brain, releasing dopamine and inhibiting nor epinephrine uptake which increases sympathetic nervous system activity and can lead to cardiac arrhythmia, hypertension and tachypnea.”
[4] Kolaitis, Nicholas A., et al. “Clinical Differences and Outcomes between Methamphetamine-Associated and Idiopathic Pulmonary Arterial Hypertension in the Pulmonary Hypertension Association Registry.” Annals of the American Thoracic Society, vol. 18, no. 4, Apr. 2021, pp. 613–22. Accessed 17 Nov. 2021. “Participants with Meth-APAH were more likely to seek care in the emergency department (incidence rate ratio, 2.30; 95% CI, 1.71 to 3.11).”
[5] Halpin, Laura E., et al. “Methamphetamine Causes Acute Hyperthermia‐Dependent Liver Damage.” Pharmacology Research & Perspectives, vol. 1, no. 1, Oct. 2013. “These findings support that methamphetamine produces changes in hepatocellular morphology and damage persisting for at least 24 h after drug exposure.”
[6] Richards, John R., et al. “Rhabdomyolysis, Methamphetamine, Amphetamine and MDMA Use: Associated Factors and Risks.” Journal of Dual Diagnosis, July 2020, pp. 1–9. Accessed 19 Aug. 2020. “The frequency of rhabdomyolysis in patients screening positive for MA was 20%.”
[7] Tas, Ibrahim, et al. "Drug-induced skin picking associated with tactile hallucination due to methamphetamine." Psychiatry and Clinical Psychopharmacology; Istanbul Vol. 28, 2018, pp 141-142. "Methamphetamine-induced hallucinations are ... tactile (21%)."
[8] Padgett, Claire L., et al. “Methamphetamine-Evoked Depression of GABAB Receptor Signaling in GABA Neurons of the VTA.” Neuron, vol. 73, no. 5, Mar. 2012, pp. 978–89. Accessed 19 May 2022. "There was a ~40% decrease in the GABABR-GIRK currents of DA neurons 24h following a METH injection."
[9] Semple, Shirley J., et al. “Impulsivity and Methamphetamine Use.” Journal of Substance Abuse Treatment, vol. 29, no. 2, Sept. 2005, pp. 85–93. Accessed 14 Nov. 2020. “Table 2.”
[10] McKenna, Stacey A. “‘We’re Supposed to Be Asleep?’ Vigilance, Paranoia, and the Alert Methamphetamine User.” Anthropology of Consciousness, vol. 24, no. 2, 2013, pp. 172–90. Accessed 24 Nov. 2019. “The increased alertness that is a key outcome of meth use is exploited by users to avoid sleep and to remain vigilant while doing so.”
[11] Newton, Thomas F., et al. “Theories of Addiction: Methamphetamine Users’ Explanations for Continuing Drug Use and Relapse.” The American Journal on Addictions, vol. 18, no. 4, 2009, pp. 294–300. “The greatest number of respondents (56%) affirmed that they used drugs due to ‘pleasure seeking.’ The next highest categories selected were ‘impulsivity’ (27%).”
[12] Rauhut, Anthony Sean, and Victoria Bialecki. “Development and Persistence of Methamphetamine-Conditioned Hyperactivity in Swiss-Webster Mice.” Behavioural Pharmacology, vol. 22, no. 3, Lippincott Williams & Wilkins, Mar. 2011, pp. 228–38. Accessed 23 Jan. 2025. “Methamphetamine (> 3.0 mg/kg) produce stereotypy (e.g., repetitive head and limb movement.”
[13] McKetin, Rebecca, et al. “Does Methamphetamine Use Increase Violent Behaviour? Evidence from a Prospective Longitudinal Study.” Addiction, vol. 109, no. 5, Feb. 2014, pp. 798–806. “The odds of violent behaviour were further increased by psychotic symptoms (OR = 2.0, 95% CI = 1.1-3.6), which accounted for 22-30% of violent behaviour related to methamphetamine use.”
[14] WOOD, EVAN, et al. “Circumstances of First Crystal Methamphetamine Use and Initiation of Injection Drug Use among High-Risk Youth.” Drug and Alcohol Review, vol. 27, no. 3, May 2008, pp. 270–76. Accessed 22 Apr. 2021. "Among those who had used CM, route of first administration included: ... (68.1%) smoked."
[15] Harris, D. “The Bioavailability of Intranasal and Smoked Methamphetamine.” Clinical Pharmacology & Therapeutics, vol. 74, no. 5, Nov. 2003, pp. 475–86. "Methamphetamine was well absorbed after smoking or intranasal administration, with bioavailabilities of ... 37.4% of the absolute (pipe) dose after smoking."
[16] Harris, D. “The Bioavailability of Intranasal and Smoked Methamphetamine.” Clinical Pharmacology & Therapeutics, vol. 74, no. 5, Nov. 2003, pp. 475–86. "Methamphetamine was well absorbed after smoking or intranasal administration, with bioavailabilities of 79% after intranasal administration."
[17] Fairbairn, Nadia, et al. “Crystal Methamphetamine Use Associated with Non-Fatal Overdose among a Cohort of Injection Drug Users in Vancouver.” Public Health, vol. 122, no. 1, Jan. 2008, pp. 70–78. Accessed 16 Mar. 2021. “Sixty-two percent of individuals were unaware of drug potency.”
[18] Takasu, Shojiro, et al. “Fatal Intoxication due to Transrectal Methamphetamine Overdose: A Case Report.” Legal Medicine, vol. 52, Sept. 2021, p. 101904. Accessed 5 Feb. 2022. “MA was believed to have been absorbed transrectally through the lower part of the rectum, bypassed the liver, and was transported directly to the systemic circulation.”
[19] Statista. “Purity of Methamphetamine U.S. By Half-Year 2012-2019 | Statista.” Statista, 2019. Accessed 23 Jan. 2025. “Table 1.”
[20] PharmChem, Inc. “The Rise of Super Meth: The Destructive Effects of P2P….” PharmChek, 19 Nov. 2023. “Potency and purity (up to 97% pure with matching potency.”
[21] Warton, Fleur L., et al. “Prenatal Methamphetamine Exposure Is Associated with Corticostriatal White Matter Changes in Neonates.” Metabolic Brain Disease, vol. 33, no. 2, Oct. 2017, pp. 507–22. Accessed 29 Sept. 2022. “Table 1.”
[22] Li, Jia-Hao, et al. “The Adverse Effects of Prenatal METH Exposure on the Offspring: A Review.” Frontiers in Pharmacology, vol. 12, July 2021, p. 715176. “Increased efforts are needed to strengthen the publicity and education in pregnant women and provide psychosocial support to combat prenatal METH exposure and its effect on the newborn and the pregnant mother itself.”
[23] Messina, Nena, et al. “Children Exposed to Methamphetamine Use and Manufacture.” Child Abuse & Neglect, vol. 38, no. 11, Nov. 2014, pp. 1872–83. “In fact, approximately 55% of children removed from home-based methamphetamine labs test positive for toxic levels of chemicals in their bodies.”
[24] Messina, Nena, et al. “Children Exposed to Methamphetamine Use and Manufacture.” Child Abuse & Neglect, vol. 38, no. 11, Nov. 2014, pp. 1872–83. “In fact, approximately 55% of children removed fr "Moreover, children of drug-dependent parents are at high-risk to continue intergenerational patterns of drug abuse, criminal behaviors, and neglectful parenting."
[25] Timko, Christine, et al. “Polysubstance Use by Stimulant Users: Health Outcomes over Three Years.” Journal of Studies on Alcohol and Drugs, vol. 79, no. 5, Sept. 2018, pp. 799–807. Accessed 27 Apr. 2022. “Among 1,016 methamphetamine-dependent outpatients, concurrent use of other substances was ... 59% for marijuana.”
[26] Hetherington, K., and R. Mcketin. "The Contribution of Cannabis Use to Psychotic Symptoms among Ethamphetamine Treatment Entrants M." Sydney: National Drug and Alcohol Research Centre, 2008. “Table 3.”
[27] Tyner, Elizabeth A., and William J. Fremouw. “The Relation of Methamphetamine Use and Violence: A Critical Review.” Aggression and Violent Behavior, vol. 13, no. 4, Aug. 2008, pp. 285–97. Accessed 3 Dec. 2019. “In 2002, of all jail convictions for engaging in criminal activity to obtain money for drugs, approximately 25% were crimes against property.”
[28] Sommers, Ira, and Deborah Baskin. “Methamphetamine Use and Violence.” Journal of Drug Issues, vol. 36, no. 1, Jan. 2006, pp. 77–96. "Overall, the 55 respondents reported 80 separate violent events while using methamphetamine."
[29] Huang, Ming-Chyi, et al. “Risk Factors for Relapse among Methamphetamine Users Receiving a Joint Legal–Medical Treatment Program as a Diversion Intervention: A One-Year Follow-up Study.” Journal of Substance Use and Addiction Treatment, vol. 151, Elsevier BV, Aug. 2023, pp. 208955–55. Accessed 24 Sept. 2024. “Of all participants, 37.8 % relapsed to use METH.”
[30] Hobkirk, Andréa L., et al. “Mediators of Interpersonal Violence and Drug Addiction Severity among Methamphetamine Users in Cape Town, South Africa.” Addictive Behaviors, vol. 42, Mar. 2015, pp. 167–71. Accessed 11 Jan. 2022. “The findings point to the need for integrated treatments that address drug use and PTSD for methamphetamine users.”

About the author

Philippa Scammell

Philippa Scammell MSci holds an integrated Master's degree in Psychology
from the University of York and has completed undergraduate statistical studies at Harvard University. Philippa has substantial experience in inpatient psychiatric care (Foss Park Hospital York), Research in Psychology at University of York, and group therapy facilitation (Kyra Women's Project). Philippa writes on clinical psychology and addiction recovery. Content reviewed by Laura Morris (Clinical Lead).

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Last Updated: May 27, 2025