Methamphetamine Fact Sheet

• What is methamphetamine ("meth crystal")?
• What is the history of the amphetamines?
• What are some slang names for meth?
• Who uses methamphetamine?
• How common is the use of methamphetamine among adolescents?
• What are the effects of methamphetamine?
• Meth and cocaine are both CNS stimulants. How do they compare?
• What are some common signs and symptoms of methamphetamine use and abuse?
• What dangers are involved in the use of methamphetamine?
• Glossary
• Bibliography

What is methamphetamine ("meth crystal")?

Methamphetamine is one of a group of stimulant substances within the amphetamine class. It is the most powerful of drug within this group, as well as the most common. Since pharmaceutical manufacture of the amphetamines has been sharply curtailed since the mid-1970s, virtually all methamphetamine found "on the street" is made in illicit and crude laboratories in basements and garages.

What is the history of the amphetamines?

1887	Amphetamine is first synthesized but not used medically
1919	Methamphetamine is first synthesized
1927	The medical use of amphetamines begins experimentally
1932	Amphetamine is first marketed under trade name of Benzedrine Smith Kline and French introduces the Benzedrine inhaler, sold over the counter in drugstores
1936	The first reported misuse of amphetamines occurs by student subjects in a research project at University of Minnesota testing effects of the drug. Once exposed to the drug, students were seeking and using the drug outside the research study
1937	Charles Bradley discovers the paradoxical effect of amphetamine on hyperactive children; Benzedrine is introduced in tablet form
1938	The first published report of the possible addiction to amphetamine appears Amphetamine psychosis is first reported in the medical literature.
1940's	Benzedrine is used extensively by Army Air Corp personnel stationed in England. Principle: CNS stimulants have traditionally been utilized by military forces to decrease fatigue and/or increase aggressiveness in soldiers.
1940's	Amphetamine is regularly issued to Japanese soldiers
1940's-1950's	Oral amphetamines use becomes more popular, among students, truck drivers and homemakers attempting to lose weight.
1946	The tolerant and sometimes humorous view of CNS stimulant effects is exemplified by release of the song, "Who Put the Benzedrine in Mrs. Murphy's Ovaltine".
1947	The abuse of Benzedrine inhalers is first reported.
1950's	Earliest record of intravenous amphetamine use; American soldiers in Japan and Korea report injecting heroin and amphetamine ("Speedballing") Principle: There is a historical trend toward strategic synergism: the planned combination of two or more drugs to produce an effect different than and greater than their independent effects.
1954	Amphetamines become available only by physician prescription.
Late 1950's	Some physicians in San Francisco prescribe amphetamine injections for treatment of heroin addiction; "splash", amphetamine hydrochloride, injected intravenously, emerges as a small, self-contained drug culture in California.
1959	FDA bans the use of Benzedrine inhalers except under prescription from a physician.
1960's	Amphetamines are a highly valued commodity on the illicit drug market and a large subculture of IV amphetamine users appears in many urban areas of the country.
1963	The American Medical Association (AMA) Council on Drugs states that "at this time, compulsive use of the amphetamines (appears to be) a small problem (in the United States)
1963	Illicitly manufactured methamphetamine first appears in California.
1964	A CBS investigative report reveals the ease with which amphetamines can be procured when they set up a fake import-export firm that acquires more than one million amphetamines from drug manufacturers and suppliers by simply ordering them on the bogus company's letterhead.
1966	The AMA Committee on Alcoholism and Addiction reports that enough amphetamines were available in the U.S. to supply between 25 and 50 doses to every man, woman and child in the country.
1970	The Comprehensive Drug Abuse Prevention and Control Act classifies coca, cocaine and injectable methamphetamine as Schedule II drugs having a high potential for abuse and restricted and limited use in medicine. Other amphetamines and psychostimulants are place in Schedule III.
1971	Eight billion doses of 31 different amphetamine preparations are manufactured by 15 drug companies.
1971	The amphetamines and the non-amphetamine stimulants phenmetrazine and methylphenidate are moved from Schedule III to Schedule II, in reaction to growing awareness of their abuse potential.
1972-1975	Many former IV Methamphetamine abusers, having cycled into the abuse of barbiturates and sedatives, alcohol and heroin, request admission to alcoholism and methadone programs. Principle: Periods of abuse of CNS stimulants are often followed cyclically by periods of CNS depressant abuse.
1973	Dr. Arnold Mandel, a professor of psychiatry at the University of California at San Diego, begins work with the San Diego Chargers, attempting to wean members of that team off of street "speed" by prescribing pharmaceutical amphetamines. Dr. Mandel reports his concerns regarding the issue of player drug use to the National Football League.
1974	NFL officials hold a press conference at which they announce that due to the use of controlled substances by San Diego players, it has fined and placed on probation the owner of the team, its General Manager/Coach, and eight players. Dr. Arnold Mandel, the league reveals, has been banned from further contact with players.
1974	Dr. Ben Feingold publishes Why Your Child is Hyperactive which attributes much of hyperactivity to food and beverage additives and recommends additive-free diets rather than psychostimulants for treatment of hyperactivity.
1975	Writing in Psychology Today, Dr. Mandel describes the use of amphetamines and other drugs by NFL players as "a plague" and as an "occupational disease in pro football."
1975	Of 4522 samples submitted to five U.S. street drug analysis programs between 1970 and 1974, 10.1% are alleged to be "speed", of which 33% contained no amphetamine.
1975	The National Institute on Drug Abuse begins funding of a nationwide study of drug use by high school seniors, as well as their attitudes regarding the harmfulness and availability of different drugs. 74.8% of high school seniors indicate that they disapprove of persons 18 years of age or older trying amphetamine once or twice and 92.1% say that they disapprove of regular amphetamine use.
1976	Dr. Arnold Mandel publishes The Nightmare Season, an account of his experience with the San Diego Chargers during the 1973 football season.
1977	Following a 15-day hearing before a State of California administrative board, Dr. Mandel is found guilty of overprescribing drugs. He is given a five-year probation and his right to prescribe controlled substances is suspended, but he retains his license to practice medicine.
1977	A consortium of street drug analysis programs reports that in 1976, 78% of the drug samples submitted as "speed" were misrepresented.
1978	The use of amphetamines by professional football players is satirized by Gary Trudeau in his nationally syndicated comic strip "Doonesberry." Principle: Patterns of substance abuse are reflected in, and shaped by, cultural mediums of communication. These mediums can stigmatize, glamorize, normalize or trivialize drug use.
1981	71.1% of high school seniors say that they disapprove of persons 18 years old or older trying amphetamine once or twice, and 91.7% disapprove of regular amphetamine use. This marks the lowest disapproval rating for amphetamine use since the University of Michigan study began in 1975. Although the survey is continued through 1998, disapproval will never be this low again.
1980-1990	Methamphetamine becomes part of a small underground subculture. Illicit trafficking controlled by outlaw biker gangs. Periodic outbreaks of heavy abuse reported in several states. Lab seizures concentrated in California, Oregon and Texas.
1990	The Institute for Social Research at the University of Michigan releases the NIDA funded 1990 school survey of drug use attitudes and behaviors among twelfth graders in the U.S. (Student Drug Use in America) 2.7% of U.S. high school seniors report having used methamphetamine "crystal" at some point in their lives. 0.6% indicate they have used it within the last month.
1991	8th and 10th grade students are added to the University of Michigan survey.
1991	96% of high school seniors say that they disapprove of regular amphetamine use. This is the highest level of disapproval since 1975, and although this figure will occur again in 1993, it will decline thereafter until 1998.
1992	86.9% of high school seniors indicate their disapproval of trying amphetamines once or twice. This represents the highest disapproval rating since the beginning of the survey and a figure that will never be as high again.
1991-1994	Methamphetamine-related hospital emergency room visits rise 217%. The majority of these cases involved White individuals. Less than 25% of methamphetamine emergency room visits involve persons of Black or Latino background.
1993	The University of Michigan study reveals an increase in stimulant use in 12th, 10th and 8th grade students. Of equal concern because of its predictive value related to future drug use, disapproval of occasional amphetamine use reaches its lowest rate since 1988.
1994-1995	Little change occurs in the number of methamphetamine- or amphetamine-related emergency department episodes reported.
1995	Production of illicit methamphetamine increases in the Midwest states. 35 methamphetamine labs are seized in Missouri, 19 in Arkansas, and 18 in Kansas.
1996	Methamphetamine emergency department mentions decrease by 50% from the 1995 number.
1997	5.8% of U.S. high school seniors report having used methamphetamine "crystal" at some point in their lives. 1.2% say they have used it within the last month.
1997	Methamphetamine emergency department visits increase by 56% over the number reported in 1996.
1998	Methamphetamine use by high school seniors reaches its highest level since 1975

What are some slang names for meth?

Crystal, crystal meth, meth, crank, ice, go-fast, zip, speed. Note: Some of these terms (e.g., "speed") also refer to non-prescription tablets and capsules that contain caffeine, ephedrine and/or the antihistamine phenylpropanolamine.

Who uses methamphetamine?

There is a clear racial and ethnic pattern associated with methamphetamine use. Table 1 shows that white (European-American) persons are much more likely than blacks (African-Americans) to be involved in the use of this drug.

RACE	NUMBER
White	4,254
Latino	1,089
African-American	587

How common is the use of methamphetamine among adolescents?

Since the early 1990s, the use of methamphetamine by students has increased sharply. The best indication of this fact is provided by the University of Michigan’s Student Drug Use in America survey, which has been conducted each year since 1975 under the auspices of the National Institute in Drug Abuse. As shown in Table 2, although 1990 was the year of lowest use of methamphetamine, by 1998 use of this drug had reached it’s highest level since the beginning of the survey. The use of methamphetamine has been highest in the western and southwestern states, but has been moving steadily north and east. At present (late-1999), the incidence of methamphetamine use in Iowa and Missouri has reached epidemic proportions, but has only recently been detected in Central and Northern Illinois.

Year of Highest Use (%)	Year of Lowest Use (%)	1997 (%)	1998 (%)	1997-98 Change (%)
1998 ( 5.3)	1990 (2.7)	4.4	5.3	+0.9

What are the effects of methamphetamine?

All CNS stimulants produce certain characteristic changes in the physiology of the user. Major actions include:

• Overall stimulation of the central nervous system
• Psychomotor arousal causing increased physical activity
• Reversal of fatigue
• Suppression of sleep
• Anorexia (reduction or blocking of appetite)
• Paradoxical suppression of attention deficit-hyperactivity disorder.
• Sympathomimetic effects: Stimulation of the sympathetic nervous system, and activation of the body's "fight or flight" reaction
• Hypertension (Elevated blood pressure)
• Tachycardia (Increased pulse rate)
• Hyperthermia/hyperpyrexia (Increased Body Temperature)

Meth and cocaine are both CNS stimulants. How do they compare?

Methamphetamine and cocaine belong to the broad class of drugs called psychostimulants that also includes amphetamine and methylphenidate (Ritalin). Methamphetamine and cocaine often are compared to each other because they produce similar mood-altering effects and both have a high potential for abuse and dependence. Methamphetamine and cocaine also share other similarities. However, the two drugs also exhibit significant differences. Here are some of these similarities and differences:

• Sources: Methamphetamine is man-made. Cocaine is plant-derived.
• Common Methods of Use: Both methamphetamine and cocaine are commonly smoked, injected intravenously or snorted. Methamphetamine can also be ingested orally.
• Geographic Patterns of Use: Methamphetamine use is highest in Honolulu, Hawaii, and western areas of the continental United States, particularly urban areas of California, Washington, Oregon, Colorado, and Arizona. In recent years, methamphetamine use has increased in both rural and urban areas of the South and Midwest, particularly Iowa and Missouri. (Source: Epidemiologic Trends in Drug Abuse: Advance Report, 1997, NIDA.) Cocaine use shows no clear geographic pattern; regional rates of use vary from year to year. Cocaine use also is significantly higher in large metropolitan areas than in nonmetropolitan areas. (Source: Preliminary Results from the 1996 National Household Survey on Drug Abuse, Substance Abuse and Mental Health Services Administration.)
• Euphoric Effects: When they are smoked or injected intravenously, both methamphetamine and cocaine produce an intense, extremely pleasurable "rush" almost immediately, followed by euphoria, referred to as a "high." When snorted, both methamphetamine and cocaine produce no intense rush and take longer to produce a high; orally ingested methamphetamine produces a similar effect.
• Length of action: Methamphetamine's high lasts anywhere from 4 to 12 hours, and 50 percent of the drug is removed from the body in 12 hours. Cocaine's high lasts anywhere from 10 to 60 minutes, and 50 percent of the drug is removed from the body in 1 hour.
• Mechanism of Action: Both methamphetamine and cocaine stimulate the brain’s reward pathways, producing euphoria, self-confidence and other psychological effects that are sought by users. The neurotransmitter dopamine appears to be the primary "key" which "unlocks" these reward pathways, although other brain chemicals are also affected. As brain levels of dopamine increase, however, stimulant users often begin to develop a paranoid psychosis that can lead to violence in some individuals. Clinical evidence suggests that violent behavior may be more common among chronic methamphetamine users than it is among chronic cocaine users. Following the "high," dopamine levels plummet, resulting in a rebound effect know as the "crash." During this period of time, common effects include depression (sometimes severe), weakness (from lack of food and sleep), anxiety, irritability, and insomnia. In addition, the stimulant psychosis can persist into the "crash" period.

What are some common signs and symptoms of methamphetamine use and abuse?

• Lack of appetite
• Unexplained weight loss
• Insomnia
• Mood shifts from euphoria to depression
• Dilated pupils
• Hand tremor
• Person unusually talkative
• Dry mouth
• Inexplicable paranoia or delusions of grandeur
• Hallucinations linked to paranoid thinking

What dangers are involved in the use of methamphetamine?

• Increased body temperature, heart rate, and blood pressure
• "Heart attack" or other acute cardiovascular problem
• Cerebrovascular accident ("stroke")
• Stimulant psychosis
• Addiction
• Neurotoxicity: Methamphetamine is neurotoxic in animal species ranging from mice to monkeys; the drug damages the neurons that produce the neurotransmitters dopamine and serotonin. The usual doses taken by high-dose methamphetamine abusers are comparable to the doses that produce neurotoxicity in animals.
• Transmission of HIV/AIDS: Methamphetamine use contributes to transmission of HIV/AIDS through intravenous injection. Methamphetamine use in conjunction with high-risk sexual behaviors and "sex-for-drugs" exchanges also contribute to transmission of HIV/AIDS.

Adrenaline:

Community Epidemiology Work Group (1996). Epidemiologic Trends in Drug Abuse. Rockville, MD, National Institute on Drug Abuse, Vol. 1. NIH, Publication No. 96-4126; Vol. 2, NIH Publication No. 96-4127, June.

Huber, A., Ling, W, Shoptaw, S, Gulati, V, Brethen, P. , Rawson, R. "Integrating Treatments for Methamphetamine Abuse: A Psychosocial Perspective", Journal of Addictive Diseases, (16) 4,

McCann U & Ricaurte G (1993). Strategies for detecting subclinical monoamine depletion in humans. In L Erinoff (ed.) Assessing Neurotoxicity of Drugs of Abuse. NIDA Research Monograph 136. Rockville, MD: NIH Publication No. 93-3644.

Richards JB, Baggot MJ, Sabol KE & Seiden LS (1993). A high-dose methamphetamine regimen results in long-lasting deficits on performance of a reaction-time task. Brain Research 627:254-260.

Shoptaw, S., Reback, CJ, Frosch, DL, Rawson, RA (199_). Stimulant Abuse Treatment as HIV Prevention, Journal of Addictive Diseases, (17) 4,

Smith, M.D, Galloway, GP, Seymour, R.B. (1996). Methamphetamine: An Old Problem Returns, ASAM News: (11) 1, January / February / March.

Swan, N. (1997). "Methamphetamine Use Spreading Across U.S., New Federal Studies Show", ASAM News, July/ August/ September 1997 Volume 12, Number 4

Wagstaff JD, Gibb JW & Hanson GR (1996). Microdialysis assessment of methamphetamine-induced changes in extracellular neurotensin in the striatum and nucleus accumbens. Journal of Pharmacology and Experimental Therapeutics 278(2):1-8.