Methamphetamine

Basic Data

(Description) "Methamphetamine is a central nervous system stimulant drug that is similar in structure to amphetamine. Due to its high potential for abuse, methamphetamine is classified as a Schedule II drug and is available only through a prescription that cannot be refilled. Although methamphetamine can be prescribed by a doctor, its medical uses are limited, and the doses that are prescribed are much lower than those typically abused. Most of the methamphetamine abused in this country comes from foreign or domestic superlabs, although it can also be made in small, illegal laboratories, where its production endangers the people in the labs, neighbors, and the environment.
"How Is Methamphetamine Abused?
"Methamphetamine is a white, odorless, bitter-tasting crystalline powder that easily dissolves in water or alcohol and is taken orally, intranasally (snorting the powder), by needle injection, or by smoking."

(Prevalence)
"• The number and percentage of persons aged 12 or older who were current nonmedical users of stimulants in 2011 (970,000 or 0.4 percent) were similar to those in 2010 (1.1 million or 0.4 percent), but lower than those in 2009 (1.3 million or 0.5 percent).
"• The number and percentage of persons aged 12 or older who were current users of methamphetamine in 2011 (439,000 or 0.2 percent) were similar to those from 2007 through 2010, but lower than those from 2002 through 2006. The previous numbers and percentages were 353,000 (0.1 percent) in 2010, 502,000 (0.2 percent) in 2009, 314,000 (0.1 percent) in 2008, 530,000 (0.2 percent) in 2007, 731,000 (0.3 percent) in 2006, 628,000 (0.3 percent) in 2005, 706,000 (0.3 percent) in 2004, 726,000 (0.3 percent) in 2003, and 683,000 (0.3 percent) in 2002."

(Youth Methamphetamine Use) "A general measure of methamphetamine (as opposed to crystal methamphetamine) use was introduced later, in 1999, at which time an annual prevalence of 4.7% was observed. Use has declined considerably since then; reaching 3.4% in 2004, and 1.4% by 2011 (see Figure 5-4j). In sum, methamphetamine use among 12th graders has fallen by about two thirds since its use was first measured in 1999—quite an important development."

(Prevalence Among Youth) "In 1990, a full set of prevalence questions was added about 12th graders’ use of crystal methamphetamine (ice)—which can be smoked, much like crack—because of growing concern about the development of an epidemic in crystal methamphetamine use (see Tables 5-1 through 5-4). Despite this concern, crystal methamphetamine did not make much of an inroad into the national population of 12th graders, quite possibly because the dangerous reputation of crack, with which it has so many similarities, “rubbed off” on it. Annual prevalence of use held at about 1.3% from 1990, the first measurement point, through 1992, and then use began to rise gradually during the incline phase in general illicit drug use, reaching 2.8% by 1996. This more than twofold increase gave crystal methamphetamine a slightly higher prevalence rate than crack had that year (2.1%). From 1996 through 2002, crystal methamphetamine use changed rather little, and stood at 3.0% in 2002. In 2003, however, a significant decline to 2.0% was observed; annual prevalence fell further to 1.2% by 2011 (see Figure 5-4j). So, by including this drug in the MTF study starting in 1990, we have been able to show that the great sense of alarm has not been justified, at least not for secondary school students. As noted below, the rates of crystal methamphetamine use were even lower among college students and young adult high school graduates generally."

(Initiation of Use) "The number of recent new users of methamphetamine among persons aged 12 or older was 133,000 in 2011 (Figure 5.6), which was similar to the 2010 estimate (107,000), but lower than the 2002 to 2006 estimates (ranging from 192,000 to 318,000). The average age of new methamphetamine users aged 12 to 49 in 2011 was 17.8 years, which was not significantly different from the corresponding estimates for 2002 and 2003 and from 2005 to 2010, but was lower than the 2004 estimate (20.6 years)."

(Law Enforcement Perception) "In fact, according to National Drug Threat Survey (NDTS) 2006 data, 38.8 percent of state and local law enforcement officials nationwide report methamphetamine as the greatest drug threat to their areas, a higher percentage than that for any other drug."

(Mexican Methamphetamine Production) "Law enforcement pressure and strong precursor chemical sales restrictions have achieved marked success in decreasing domestic methamphetamine production. Mexican DTOs, however, have exploited the vacuum created by rapidly expanding their control over methamphetamine distribution -- even to eastern states -- as users and distributors who previously produced the drug have sought new, consistent sources. These Mexican methamphetamine distribution groups (supported by increased methamphetamine production in Mexico) are often more difficult for local law enforcement agencies to identify, investigate, and dismantle because they typically are much more organized and experienced than local independent producers and distributors. Moreover, these Mexican criminal groups typically produce and distribute ice methamphetamine that usually is smoked, potentially resulting in a more rapid onset of addiction to the drug."

(Military Use) "During Vietnam both the Air Force and Navy made amphetamines available to aviators. Intermittently since Vietnam up through Desert Storm the Air Force has used both amphetamines and sedatives in selected aircraft for specific missions."

"A paranoid psychosis may result from long-term use; rarely, the psychosis is precipitated by a single high dose or by repeated moderate doses. Typical features include delusions of persecution, ideas of reference (notions that everyday occurrences have special meaning or significance personally meant for or directed to the patient), and feelings of omnipotence. Some users experience a prolonged depression, during which suicide is possible. Recovery from even prolonged amphetamine psychosis is usual but is slow. The more florid symptoms fade within a few days or weeks, but some confusion, memory loss, and delusional ideas commonly persist for months."

(Source of Supply) "Preliminary 2008 availability and seizure data indicate a strengthening in domestic methamphetamine availability and domestic methamphetamine production, and an increase in the flow of methamphetamine into the United States from Mexico—most likely attributable to the efforts of methamphetamine producers in both countries to reestablish the methamphetamine supply chain in the face of disruptions and shortages that began occurring in early 2007. Throughout 2007 methamphetamine availability decreased in U.S. drug markets, causing instability in the methamphetamine supply chain. Prior to 2007, U.S. drug markets relied on the strong flow of methamphetamine produced in Mexico, a supply system established in 2005 and strengthened in 2006. However, ephedrine and pseudoephedrine restrictions in Mexico resulted in a decrease in methamphetamine production in Mexico and reduced the flow of the drug from Mexico to the United States in 2007 and from January through June 2008."

(Medical Uses) "Some amphetamines, including dextroamphetamine, methamphetamine, and the related methylphenidate, are widely used medically to treat attention-deficit hyperactivity disorder, obesity, and narcolepsy, thus creating a supply subject to diversion for illicit use. Methamphetamine is easily manufactured illicitly."

(HIV and Hepatitis Transmission) "Transmission of HIV and hepatitis B and C can be consequences of methamphetamine abuse. The intoxicating effects of methamphetamine, regardless of how it is taken, can also alter judgment and inhibition and lead people to engage in unsafe behaviors, including risky sexual behavior. Among abusers who inject the drug, HIV and other infectious diseases can be spread through contaminated needles, syringes, and other injection equipment that is used by more than one person."

(Incidence of Use in 1990s) "The number of new users of stimulants generally increased during the 1990s, but there has been little change since 2000. Incidence of methamphetamine use generally rose between 1992 and 1998. Since then, there have been no statistically significant changes."

(Military Stimulant Use) "Following Desert Storm an anonymous survey of deployed fighter pilots was completed. 464 surveys were returned (43%). For Desert Storm: 57% used stimulants at some time (17% routinely, 58% occasionally, 25% only once). Within individual units, usage varied from 3% to 96%, with higher usage in units tasked for sustained combat patrol (CAP) missions. Sixty one percent of those who used stimulants reported them essential to mission accomplishment."

Effects

"Pathophysiology
"Amphetamines enhance release of catecholamines, increasing intrasynaptic levels of norepinephrine, dopamine, and serotonin. The resulting marked α- and β-receptor stimulation and general CNS excitation account for the “desired” effects of increased alertness, euphoria, and anorexia, as well as the adverse effects of delirium, hypertension, hyperthermia, and seizures. Effects of amphetamines are similar, varying in intensity and duration of psychoactive effects; MDMA and its relatives have more mood-enhancing properties, perhaps related to a greater effect on serotonin. Amphetamines can be taken orally as pills or capsules, nasally by inhaling or smoking, or by injection.
"Chronic effects: Repeated use of amphetamines induces dependence. Tolerance develops slowly, but amounts several 100-fold greater than the amount originally used may eventually be ingested or injected. Tolerance to various effects develops unequally. Tachycardia and increased alertness diminish, but hallucinations and delusions may occur.
"Amphetamines typically cause erectile dysfunction in men but enhance sexual desire. Use is associated with unsafe sex practices, and users are at increased risk of sexually transmitted infections, including HIV infection. Amphetamine abusers are prone to injury because the drug produces excitation and grandiosity followed by excess fatigue and sleepiness."

(Acute effects) "Many psychologic effects of amphetamines are similar to those of cocaine; they include increased alertness and concentration, euphoria, and feelings of well-being and grandiosity. Palpitations, tremor, diaphoresis, and mydriasis may also occur during intoxication.
"Binges (perhaps over several days) lead to an exhaustion syndrome, involving intense fatigue and need for sleep after the stimulation phase.

"Amphetamines are CNS stimulants and are used both medicinally and as drugs of abuse. Amphetamines are generally taken recreationally and to enhance performance (e.g., truck drivers staying awake). Ecstasy falls within this category, and as a methylated amphetamine derivative it also has hallucinogenic properties. Amphetamines have been associated with crash occurrence and could logically be associated with driving impairment both in the stimulation and withdrawal stages; in the latter case especially as the drug interacts with fatigue."

(Chronic Effects) " A paranoid psychosis may result from long-term use; rarely, the psychosis is precipitated by a single high dose or by repeated moderate doses. Typical features include delusions of persecution, ideas of reference (notions that everyday occurrences have special meaning or significance personally meant for or directed to the patient), and feelings of omnipotence. Some users experience a prolonged depression, during which suicide is possible. Recovery from even prolonged amphetamine psychosis is usual but is slow. The more florid symptoms fade within a few days or weeks, but some confusion, memory loss, and delusional ideas commonly persist for months.
"Users have a high rate of severe tooth decay affecting multiple teeth; causes include decreased salivation, acidic combustion products, and poor oral hygiene."

(Withdrawal) "Although no stereotypical withdrawal syndrome occurs when amphetamines are stopped, EEG changes occur, considered by some experts to fulfill the physical criteria for dependence. Abruptly stopping use may uncover or exacerbate underlying depression or precipitate a serious depressive reaction. Withdrawal is often followed by 2 or 3 days of intense fatigue or sleepiness and depression."

(Dopamine) "Methamphetamine increases the release and blocks the reuptake of the brain chemical (or neurotransmitter) dopamine, leading to high levels of the chemical in the brain, a common mechanism of action for most drugs of abuse. Dopamine is involved in reward, motivation, the experience of pleasure, and motor function. Methamphetamine’s ability to rapidly release dopamine in reward regions of the brain produces the intense euphoria, or 'rush,' that many users feel after snorting, smoking, or injecting the drug."

Environmental Hazards from Methamphetamine Production

(Dangers) "Illicit production of methamphetamine may involve hazardous materials that are toxic, corrosive, flammable, or explosive. Such materials include anhydrous ammonia, sulfuric acid, hydrochloric acid, red phosphorous, lithium metal, sodium metal, iodine, and toluene. Upon discovery, the hazardous materials contained at clandestine drug laboratory locations are classified and managed as hazardous wastes."

(Lab Clean-up Costs) "Toxic chemicals used to produce methamphetamine often are discarded in rivers, fields, and forests, causing environmental damage that results in high cleanup costs. For example, DEA's annual cost for cleanup of clandestine laboratories (almost entirely methamphetamine laboratories) in the United States has increased steadily from FY1995 ($2 million), to FY1999 ($12.2 million), to FY 2002 ($23.8 million). Moreover, the Los Angeles County Regional Criminal Information Clearinghouse, a component of the Los Angeles HIDTA, reports that in 2002 methamphetamine laboratory cleanup costs in the combined Central Valley and Los Angeles HIDTA areas alone reached $3,909,809. Statewide, California spent $4,974,517 to remediate methamphetamine laboratories and dumpsites in 2002."

(Lab Fires and Explosions) "Further contributing to the threat posed by the trafficking and abuse of methamphetamine, some chemicals used to produce methamphetamine are flammable, and improper storage, use, or disposal of such chemicals often leads to clandestine laboratory fires and explosions. National Clandestine Laboratory Seizure System (NCLSS) 2003 data show that there were 529 reported methamphetamine laboratory fires or explosions nationwide, a slight decrease from 654 reported fires or explosions in 2002."

(Growth of Clandestine Labs) "The incidence of clandestine drug laboratories has grown dramatically in the past 10 years. For example, in Fiscal Year 1992, the DEA's National Clandestine Laboratory Cleanup Program funded approximately 400 removal actions and by fiscal year 2001, the DEA Program funded more than 6,400 removal actions."