How Meth Has Changed in 20 Years

Medscape Staff

October 18, 2021

The rise of P2P methamphetamine is fueling mental health problems and homelessness across the United States, according to a new book.

What to know:

  • In the early 2000s, most methamphetamine available in the United States was produced from ephedrine, extracted from ephedra plants. However, most meth is now made from phenyl-2-propanone (P2P), which can be extracted from a wide array of chemicals and produced in larger quantities.

  • In the 2010s, P2P meth spread across the country, causing the price to plummet significantly increasing access to the drug.

  • P2P meth appears to cause much more pronounced deterioration in mental health. Some persons experience hallucinations and delusions within hours instead of only after long-term use, as seen with ephedrine-based meth.

  • Although there is not consensus on why P2P meth causes worse mental health symptoms, they may be due to toxic chemicals used in production or to the greater potency of the drug in conjunction with increased accessibility, which allows more people to use it continually.

  • The recent impact of methamphetamine use on mental health and homelessness is the subject of Sam Quinones's new book, The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth.

This is a summary of the article "'I Don't Know That I Would Even Call It Meth Anymore," published by The Atlantic on October 18. The full article can be found on

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