Which of the following psychoactive drugs produces the quickest and most powerful rush of euphoria?

Methamphetamine is a highly addictive and illegal psychostimulant drug that is similar to amphetamine. It is used for its powerful euphoric effects, which are similar to those of cocaine.

It increases the levels of naturally occurring dopamine and norepinephrine in the brain.

The effect lasts longer than with cocaine, it is cheaper, and it is easy to make with commonly available ingredients.

Street names for this drug include chalk, crank, ice, crystal, meth, and speed.

Discovered in the late 19th century, amphetamine was first used as a nasal decongestant and a respiratory stimulator.

During World War 2, methamphetamine — similar in structure to amphetamine — was used to keep military personnel alert and to improve endurance and mood.

In time, it became clear that methamphetamine was dangerously addictive. In the 1970s, the drug was added to the schedule II list of controlled substances. Methamphetamine is illegal except when it is prescribed by a physician for a very limited number of medical conditions.

Methamphetamine is easy to produce and it is a potent drug, so it remains a serious drug of abuse. Long-term use is associated with devastating effects on the user and society.

Methamphetamine is a white, odorless, bitter-tasting crystalline powder that easily dissolves in water or alcohol.

Amphetamine is prescribed to treat some medical conditions, including:

• obesity
• ADHD
• narcolepsy as (off-label)

Methamphetamine, a drug with a similar substance, is used illegally for its pleasurable effects. Misuse can be hazardous and even deadly.

Illegal forms of the drug can be smoked, snorted, injected, or ingested orally.

Smoking or injecting methamphetamine causes an immediate, intense “rush” or bliss that lasts for a few minutes.

Snorting does not produce the intense rush, but a euphoric high within 3 to 5 minutes of ingestion. The oral effects can be felt within 20 minutes.

Depending on how the drug is ingested, the effects can last for 6 to 24 hours.

Effects

People take methamphetamine for its pleasurable effects.

These include:

• increased attention
• higher levels of activity and talkativeness
• decreased appetite
• reduced fatigue
• a feeling of power and self-control
• a pleasurable sense of well-being or euphoria

There may also be:

• faster breathing
• a fast or irregular heartbeat
• higher blood pressure
• raised body temperature

How it works

The pleasurable effects of methamphetamine happen when the body releases very high levels of the neurotransmitter dopamine. This is the brain chemical involved in motivation, pleasure, and motor function.

As with many stimulants, methamphetamine is most often abused in a “binge and crash” pattern. Users try to maintain the high by taking more of the drug before the first dose wears off.

The drug acts on parts of the brain involved in reward, and this makes taking another dose tempting.

Some people binge for several days, avoiding food and sleep while continually using the drug until it is finished.

However, these high levels of dopamine are also thought to help make the drug more toxic to nerve terminals in the brain.

Methamphetamine is different from and more dangerous than other stimulants because a larger percentage of the drug remains unchanged in the body. This allows the drug to be present in the brain longer, extending the stimulant effects.

When amphetamine is prescribed legally, doses normally range from 2.5 to 10 mg daily, to a maximum 60 mg a day.

Since illegal drugs are not regulated, there is no way to know how much methamphetamine is in each illicit dose.

A high body temperature, heart attack, and seizures can occur with overdose. If not treated immediately, an overdose can result in organ failure and death.

People use methamphetamine because they enjoy the effects. However, it can have some dangerous side effects.

These include:

• increased distractibility
• nausea
• dry mouth and bad breath
• dilated pupils
• tremors
• muscle twitching
• memory loss
• aggressive or violent behavior
• mood disturbances
• severe dental problems
• weight loss
• skin sores from intense itching
• rapid or irregular heart rate
• increased blood pressure

Long-term methamphetamine use can lead to:

• feelings of aggressiveness and anxiety
• confusion
• insomnia

The following symptoms of methamphetamine psychosis are also possible:

• paranoia
• aggression
• visual and auditory hallucinations
• mood disturbances
• delusions, such as the sensation of insects creeping on or under the skin

Paranoia can result in thoughts of homicide or suicide.

Researchers have reported that up to 50 percent of the dopamine-producing cells in the brain can be damaged after prolonged exposure to relatively low levels of methamphetamine.

Psychotic symptoms can last for months or years after discontinuing methamphetamine use. They can spontaneously recur.

Methamphetamine use can lead to a number of other health problems, including dependence, heart problems, and other physical and mental health issues.

Addiction and dependence

The drug has a high potential for abuse and dependence. Tolerance develops quickly, and psychological addiction can develop within a relatively short space of time.

Methamphetamine is very addictive. This is because a large amount of dopamine remains in the brain cells synapses for long periods of time after use. The dopamine keeps the cells activated, allowing the user to experience the powerful feelings of euphoria.

After a while, the user is unable to produce dopamine naturally and requires the drug to feel normal, needing larger doses to experience feelings of pleasure.

Stopping suddenly does not cause a physical withdrawal, as with heroin. Instead, the person may feel extreme fatigue, mental depression, irritability, apathy, and disorientation.

Heart problems and stroke

Methamphetamine use increases the risk of heart problems, such as chest pain, abnormal heart rhythm, and high blood pressure. This can lead to a heart attack, acute aortic dissection, or sudden cardiac death, even after using the drug for the first time.

These risks are higher when using the drug with alcohol, cocaine, or opioids.

There is a higher risk of stroke, possibly due to elevated blood pressure or faster rate of atherosclerosis.

Tooth decay

Methamphetamine abuse can also cause tooth decay so severe that most of the teeth either rot, known as “meth mouth,” or need extracting.

Causes are thought to include:

• having a dry mouth
• increased consumption of sugary drinks
• teeth clenching and grinding
• a lack of dental hygiene

Parkinson’s disease

Methamphetamine may have neurological effects that do not go away if a person stops using the drug.

Researchers have linked amphetamine use to a higher risk of Parkinson’s disease, for example, a condition that affects the nerves of movement.

Toxicity risks for producers

Illicit drug manufacturers are called “cooks.” They are at risk of numerous injuries related to the production of methamphetamine.

Anyone in the area of a methamphetamine laboratory is also at risk of exposure to chemicals, including children.

Other risks

Other health risks include a higher chance of getting a blood-borne disease, such as hepatitis, among those who inject the drug.

Since the drug is illegally produced and sold, there are no controls over its contents. There is a risk of toxicity from unknown substances that may be present.

The individual’s overall health may deteriorate due to a lack of food or a poor diet. Severe weight loss may occur.

It can also affect a person’s ability to think, learn, understand, and remember. They may feel confused and anxious.

Social consequences of long-term use include financial pressures, problems with work, and challenges with family relationships.

Some of these changes may be permanent.

Withdrawal syndrome can occur within 24 hours of the last dose of methamphetamine.

Symptoms include:

• depression and anxiety
• drug craving
• restlessness
• poor concentration
• irritability
• psychosis
• unpleasant dreams
• fatigue
• sleep problems and vivid dreams
• increased appetite
• slow movement

Symptoms vary considerably in intensity and duration. They typically last between 7 and 10 days.

There are currently no available medications for methamphetamine addiction.

Possible strategies include behavioral approaches such as cognitive behavioral therapy (CBT), family education, individual counseling, and motivational strategies, such as vouchers for those who do not use the drug for some time.

According to the National Institute on Drug Abuse (NIDA), in 2016, 6.5 percent of adults aged 26 years or over had used it at some time in their lives, and 5.4 percent of those aged 12 years and above.

Most methamphetamine is made in “superlabs” in California or Mexico, but it can also be made in small home laboratories, using relatively inexpensive over-the-counter ingredients such as pseudoephedrine.

It is often mixed with other substances, including caffeine, talc, and other toxic additives.

By law, pharmacies and retail stores must keep pseudoephedrine and ephedrine products behind the counter. They also need to keep a log of consumer identification and the amount of product purchased.

Commercially, methamphetamine is available under the brand name Desoxyn, in 5-mg tablets. It has a very limited use in the treatment of obesity, and attention deficit hyperactivity disorder (ADHD). It is used off-label to treat narcolepsy.