Methamphetamine is a highly addictive stimulant drug that originates from the amphetamine class of drugs and causes effects similar to cocaine. Like amphetamine and cocaine, methamphetamine causes increased alertness, feelings of empowerment, excessive talkativeness, decreased appetite, and euphoria, but, unlike either of those drugs, greater amounts of meth are able to enter the brain and produce longer-lasting acute effects.
As a controlled substance, methamphetamine is classified as a Schedule II stimulant by the DEA, which makes it legally available only by prescription, although rarely, is methamphetamine used in medical practices today. Most methamphetamine is processed in foreign or domestic labs using a variety of unique chemicals and processes for recreational abuse and resulting in unpredictable and inconsistent levels of purities, toxicity, and hazardous effects. As a result, methamphetamine detox must take into consideration a number of extra factors to keep the person safe during the process. The following is how methamphetamine detox works.
The Initial Assessment
Methamphetamine detox can be provided in a variety of settings including outpatient or inpatient. Assessing the levels of care needed in methamphetamine detox is the very first step and can be challenging because individuals seeking treatment for methamphetamine detox present a wide range of withdrawal symptoms. Safety is a major concern and supervised withdrawal in an inpatient setting is recommended especially, when the person shows signs of withdrawal complications which can be determined by a medical and psychiatric evaluation.
During the assessment, the counselor will need to know certain things beyond the intoxication levels and currently presented withdrawal symptoms. Most people seeking methamphetamine detox have tried to quit on their own a few times and have been unsuccessful. The history and patterns of methamphetamine use are important to determine the necessary support levels needed to keep the person comfortable so this time, they can finish the detox process.
Factors Determining Higher Levels of Care Needed
Methamphetamine has a profound effect on the brain and central nervous system. According to the National Institute on Drug Abuse, “In studies of chronic methamphetamine users, severe structural and functional changes have been found in areas of the brain associated with emotion and memory, which may account for many of the emotional and cognitive problems observed in these individuals.”
Factors that help to determine higher levels of care needed are:
- Physical health status including co-existing medical conditions that would require close observation and access to medical equipment and resources, signs of malnutrition or dehydration, injuries, pregnancy, or signs of IV use. A medical evaluation can help determine the need for referrals and treatment of infections or communicable diseases such as hepatitis, tuberculosis, AIDs, or HIV.
- Mental health status including psychotic symptoms of hallucinations, psychosis, delirium, or schizophrenic-like behaviors, the co-existence of anxiety, depression, violent or suicidal tendencies, or bi-polar and other mental health disorders, and the risk of harm to the patient or others.
- Lack of social support, stability, safety, or abstinence encouragement in home environment such as being homeless or victim of domestic violence.
- Co-existing substance abuse
- Willingness to succeed
Methamphetamine withdrawal symptoms can become increasingly serious over the acute phase of 2-10 days with protracted withdrawals lasting for weeks or months. Methamphetamine withdrawals can be more severe than the withdrawals associated with other stimulant drugs because of the unpredictable neurotoxicity and accumulated effects in the person. Methamphetamine also produces longer effects that impact the severity of withdrawals and the damages to the central nervous system can become extremely complex and affect every organ and physiological process in the body.
Common withdrawal symptoms include:
- Intense cravings
- Physical aches and pains
- Severe anxiety
- Sleep disturbances
More disturbing symptoms include:
- Violent or harmful tendencies
- Suicidal tendencies
- Psychotic behaviors
Managing Methamphetamine Withdrawals
Methamphetamine detox provides close monitoring and assistance for the safety, comfort, and stabilization of the individual as they eliminate the drugs from their system. According to the NIDA, “there are currently no medications that counteract the specific effects of methamphetamine or that prolong abstinence from and reduce the abuse of methamphetamine by an individual addicted to the drug.” Medications can be used to minimize the distressing symptoms of methamphetamine withdrawals under medical supervision, however, during the detox period.
Medications used in methamphetamine detox may include:
- Anxiolytics or Sedatives such as benzodiazepines to reduce the severity of overstimulation of the central nervous system and help to alleviate anxiety, hypertension, nervousness, insomnia, and agitation.
- Antidepressants may be prescribed to help ease depression which is a major concern due to elevated risk of suicidal tendencies even through the protracted phases of withdrawal.
- Antipsychotics help manage symptoms of psychosis such as schizophrenic like behaviors that can be harmful to the patient or others.
- Adjunct Medications to reduce pain and digestive disorders or lower levels of anxiety and insomnia
A successful detox is one that can safely ensure the completion of the process in comfort and with adequate support to keep the person engaged through the process. It also involves, according to the SAMHSA “preparing the patient for entry into substance abuse treatment by stressing the importance of following through with the complete substance abuse treatment continuum of care.”
Unfortunately many methamphetamine abusers relapse during the protracted withdrawal phase and may be more at risk of ongoing depression with suicidal tendencies developing and therefore, having the right amount of support, guidance, and resources is critical to ensuring success both during the acute phase of detox and in follow-up treatment afterwards.