Crystal Meth Detox

What Is Detox For Crystal Meth?

A symptom-managed programme, where SSRIs, olanzapine and melatonin are prescribed to treat secondary withdrawal effects medically.

The process involves continued monitoring for depression and suicidal ideation that arise during withdrawal.

It typically lasts 7-10 days; however, this is longer in polysubstance detox.

Detox lowers dependency on crystal meth while the substance slowly leaves the body.

Detox Timeline

Symptom Management

Our admissions team will explain the process of a symptom managed crystal meth detox before admission; you will be able to communicate any concerns or fears about the detox process.

Symptom monitoring is used instead of medication because there is no regulatory-approved medication for crystal meth.

Symptom monitoring and management primarily focuses on overcoming hallucinations, depression and poor sleep, and secondary medications are prescribed as necessary.

Appetite increases due to malnourishment in active use, so more calories are consumed to compensate for this loss. 

On average, inpatients for meth addiction consume 8% more calories than those not in detox, so diets are monitored to ensure nutritional requirements are met [3].

Meth-induced psychotic episodes occur from months to years after the last use, so olanzapine is prescribed to stabilise patients in detox [4].

To manage poor cognitive functioning in meth withdrawal, modafinil is prescribed and improves memory recall scores by 59% compared to a placebo (4.5%) [2].

Detox Symptoms

At Abbeycare, our experienced clinical team are prepared for withdrawal symptoms that may occur during crystal meth detox, and treat them using symptom management methods.

Physiological Symptoms Of Detox

'Crashing' occurs due to a 38.4% reduction in dopamine transporters in the orbitofrontal cortex [1]. 

Increased appetite occurs due to reduced adrenoceptor binding 24 hours after cessation, leading to eating more [5]. 

A 0.58 ± 0.13 ng/mL reduction in orexin-A levels 1-2 months into abstinence exacerbates sleepiness and meth cravings [6]. 

Pain experienced before methamphetamine use reappears as drug levels decrease in the body - prescription painkillers are prescribed as required.

Increased interleukin levels result in an inflammatory response, leading to agitation [7].

Psychological Symptoms Of Crystal Meth Detox

Experimental evidence evidences that a 15% reduction in glutamate levels in early abstinence leads to emotional dysregulation, such as extreme anger [8].

Psychotic episodes occur because the brain recompensates for lost dopamine, resulting in overstimulation.

70% of patients report thinking about using meth and experiencing cravings at the start of treatment [9].

Depression occurs in meth withdrawal, but the prevalence of symptoms subsides by 37.8% between weeks 1 and 2 of treatment [10].

Psychological cravings begin to subside after 5 weeks of detox [9].

27% of severe meth-induced psychotic patients present with co-occurring aggression [9].

Depleted levels of dopamine and norepinephrine, neurotransmitters responsible for alertness, result in insomnia.

A 27.8% mean reduction in striatal dopamine transporters in meth withdrawal patients results in poor memory, measured by the Auditory Verbal Learning Task, and brain fog [11].

Behavioural Symptoms Of Crystal Meth Detox

Dopamine receptors are reduced by 16.1% in the caudate nucleus in meth users, resulting in compulsive hair pulling and rocking back and forward [12].

Paranoid beliefs about being watched or followed are observed in detox due to 19% higher levels of glutamate in frontal brain matter, causing overstimulation [13]. 

Formication, or "meth mites", results from constricted blood vessels and delusional beliefs [14].

Animal studies demonstrate that a 35% decrease in dopamine levels results in compulsive and drug-seeking behaviour in early abstinence [15].

A 3.67% reduction in impulse inhibition results in erratic behaviour in short-term meth abstinence <10 months - this improves with length of treatment and abstinence [16].

Crystal Meth Detox Recovery Markers 

Improving Cognitive Function

Attention improves by ~18% following 6 days of crystal meth detox compared to controls [17].

Improvements (~12.5%) in attention and psychomotor speed are maintained for 12 months following detox compared to no treatment [18].

Motor impulsivity improves by ~17% following 2 weeks of crystal meth detox, increasing to ~19% in 1 month of abstinence [19].

Impulse inhibition improves by ~4% from short-term (4-9 days) to long-term (1 month+) crystal meth abstinence [20].

Natural Dopamine Production

Crystal meth detox causes natural dopamine production as a result of the brain's regulatory response to the absence of crystal meth during abstinence [21].

Research suggests that most dopamine restoration occurs in days 1-3 of detox, as dopamine binding increases by 41% compared to 15% in days 7-21 [22].

Dopamine activity increases by 19% in the caudate and 16% in the putamen, brain areas responsible for motivation, following long-term abstinence (12 months) [23].

Neurological Stabilisation

Crystal meth detox leads to neurological stabilisation as a result of neurotransmitter regulation, leading to the resolution of psychotic symptoms within 10 days of detox [24].

Thalamic activity increases by 12% compared to before detox, indicating increases in brain metabolism during early abstinence [25].

In widespread dopaminergic damage, some patients experience hallucinations a few months after detox, though this can be managed appropriately with anti-psychotic medication and talking therapy.

It takes up to 35 months for neural restoration to be evident, though most patients see improvements in 2 weeks [26].

Crystal Meth Detox In Different Settings

What Factors Change Crystal Meth Detox

Meth Mouth

Severe pain felt during meth mouth changes treatment programmes to include strong pain medication, such as gabapentin until dental care is sought.

Severe cases of meth mouth report inability to chew food, so programmes changes to suit the individual's needs with a soft and nutritional diet.

Professional advice on nutrition and safe alternatives (e.g., switching from sugar to sweetener) helps patients manage dental complications.

Meth mouth is known to affect treatment compliance and attendance to appointments, necessitating the need for inpatient care [27].

Immunocompromised cases of meth mouth require treatment in a hospital, as a weakened immune system is a risk factor for septicaemia. 

Patients who injected meth are 2.47 times more likely to have dental disease than those who smoked, shifting the focus to nutritional care to prevent the spreading of the disease [28].

For patients who have recently become abstinent but used meth in the last 6 hours, dental treatment is deferred for 24 hours due to the use of local anaesthetic being contraindicated in this group [29].

Self Medicating Crystal Meth For Chronic Pain

Self-medicating meth for HIV-related pain causes a 2-fold increased risk of immunosuppression and further viral replication, requiring hospitalised treatment [30].

3 weeks of acupuncture reduces anxiety scores by 15%, reducing the need for diazepam for chronic pain patients in crystal meth withdrawal [31].

A 36% reduction in overall meth withdrawal symptoms through 3 weeks of acupuncture reduces the need for gabapentin for chronic pain patients [32].

Using acupuncture instead of pain medication in meth withdrawal eliminates side effects from analgesics, such as drowsiness, therefore making it easier to manage.

HIV patients need more information when using herbal remedies for depression during meth withdrawal, as St John's Wort reduces the blood plasma concentrations of Lopinavir [33].

Crystal Meth Induced Psychosis

25 mg intramuscular risperidone reduces the weekly average meth use by 75%, reducing the need for inpatient care when psychotic tendencies are present but addiction is mild [34].

The use of 8mg/day Perphenazine increases negative meth tests by 57% and enables those experiencing psychotic episodes to finish treatment as an outpatient if inpatient treatment becomes unsuitable [35].

Those experiencing psychotic episodes combined with violence in an inpatient facility require frequent clinical observations.

Co-occurring psychotic episodes with suicidal ideation require risk assessments to remove any ligature points or tools that could cause harm in a psychotic episode.

When Crystal Meth Detox Is Appropriate

Detoxification is appropriate when:

When Crystal Meth Detox Is NOT Appropriate

Detoxification is not appropriate when:

Crystal Meth Detox At Abbeycare

The Abbeycare detoxification programme lasts for 28 days and is offered as part of rehab.

At Abbeycare, each client is assessed individually before admission to gauge whether detox is appropriate or another programme is more suitable.

Comprehensive care plans consider triggers, physical symptoms and appropriate treatment options accordingly.

Please speak with our admissions team for further advice, on 01603 513 091.