What is methamphetamine toxicity?

Updated: Oct 29, 2020
  • Author: John R Richards, MD, FAAEM; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Methamphetamine is a highly addictive psychostimulant drug that is chemically related to amphetamine. Methamphetamine can produce euphoria and stimulant effects like those from other stimulants such as cocaine. In addition, methamphetamine is easily synthesized from inexpensive and readily obtainable chemicals. Those qualities have led to the widespread and rampant abuse of this dangerous drug. [1]

Methamphetamine use has increased rapidly throughout the world, with more than 30 million users worldwide. East and Southeast Asia and North America remain the two main subregions for methamphetamine trafficking worldwide. In North America, the availability of methamphetamine was reported to have increased between 2013 and 2016, and, in 2016, the drug was reported to be the second greatest drug threat in the United States, after heroin. [2] In the US, the National Institute on Drug Abuse reported that although lifetime methamphetamine use by those 12 years of age and older remained stable at 5.4% of the population, use in the past year increased from 0.5% to 0.7% of the population between 2016 and 2018. [3]  

Methamphetamine is available in powder and crystalline forms. It may be taken orally or intravenously, or be snorted or smoked. The smokable form of methamphetamine (“ice”) produces an immediate euphoria similar to that of crack cocaine, but the effects may last much longer. [4, 5]

Inadvertent absorption of methamphetamine may occur in “body packers”, who swallow packages of the drug for transportation purposes, or “body stuffers”, who insert bags of methamphetamine rectally or vaginally in an attempt to elude drug enforcement. There are also users who indulge in "parachuting", in which the drug is loosely wrapped to delay absorption and prolong effect. These persons, and body stuffers, are at high risk for toxicity as the drug wrapping may be compromised and allow complete drug absorption. [6]

North American methamphetamine abusers are predominantly white men in their 30s and 40s. [7, 8] However, epidemic abuse has been described in adolescents; they cite availability, low cost, and a longer duration of action than cocaine as reasons for their drug preference. [9]

Most cases of methamphetamine toxicity can be managed supportively. In severe overdoses, termination of methamphetamine-induced seizure activity and arrhythmias are of immediate importance. Correction of hypertension, hypotension, hyperthermia, metabolic and electrolyte abnormalities, and control of severe psychiatric agitation are indicated. See Treatment and Medication.

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