In 2007 I had my wallet stolen. I was also battling a cold and needed medication. I knew I would need photo ID to purchase the “good” cold medicine, so I went into Walgreens with my passport since I had not replaced my Texas driver license. Denied. My passport, that magical little booklet that opens the door to almost every country in the world was insufficient to obtain cold medicine containing ephedrine or pseudoephedrine.
Monitoring and restricting the sale of medications with these ingredients was meant to slow the influx of methamphetamine into communities. Surprising probably no one, except the people who changed the legislation, methamphetamine use did not only persist, but has made a bigger comeback in the past few years.
Methamphetamine use on the rise
In 2019, methamphetamine was considered the number one drug threat in Texas. This is partially due to its relative cheap cost and widespread availability. And meth got more potent. Rather than relying on ephedrine and pseudoephedrine, meth is now often made across the border with phenyl-2-propanone (P2P). With this method, it is usually made into a liquid solution and then transported to Texas to "dry houses" where the drugs are prepared to be sold. Meth made with P2P often has potency levels of over 97%. Note: for pop culture enthusiasts, this is also the method used in later seasons of Breaking Bad.
In 2008, the number of people admitted to treatment facilities where methamphetamine was the primary drug of choice was 8%. In 2018, that number increased to 18%.
Methamphetamine effects on the body
People are often drawn to meth because of the euphoria it produces. Other perceived benefits are increased energy and enhanced sexual experiences. Stimulants increase the amount of the “fight or flight” neurotransmitter, norepinephrine. Chronic activation of the fight or flight response can have deleterious effects on the body’s immune response, something especially relevant during Covid-19.
Norepinephrine causes our sympathetic nervous system to increase our heart rate and respiration, constricts our blood vessels, increases our blood pressure and causes a rise in our body temperature. Stimulants also dilate our bronchioles which allows for more oxygen to enter the lungs, thus the medical benefits of cold medications with ephedrine or pseudoephedrine.
Since meth restricts blood flow to capillaries, dental problems and gum deterioration can be problematic. Stimulants can also cause psychotic symptoms during prolonged use or in vulnerable people due to the dopamine release. Repetitive movements, which are often self-destructive (such as skin picking), often accompany frequent use.
A major difference between methamphetamine and cocaine is the duration of effects. Cocaine effects typically last between a few minutes to an hour; methamphetamines may last for up to 12 hours.
Overamping and overdose
In some circles, these terms are used interchangeably. With other groups, these are two distinct events. Some people describe overamping as bad feelings, either physically or psychologically, and could occur with even a small amount of methamphetamines. Some possible reasons overamping may occur is dehydration, using for too many days in a row, lack of sleep, using in an unfamiliar environment, or using with people you are not comfortable with.
Some recommendations for managing overamping include drinking water or something with electrolytes, taking a warm shower, doing breathing exercises, eating some food, getting some sleep or taking a walk in fresh air.
Physical Signs and Symptoms of Overamping
Falling asleep/passing out
High temperature/sweating profusely/chills
Fast heart rate, racing pulse
Irregular breathing or shortness of breath
Limb jerking or rigidity
Feeling paralyzed while awake
Elevated blood pressure
Insomnia or decreased need for sleep
Psychological Signs of Overamping
Restlessness or irritability
Hypervigilance (increased awareness of your environment, sounds, people, etc.)
Enhanced sensory awareness
Overdose can occur due to an increased heart rate. This in turn can cause an irregular heart rhythm and highly elevated blood pressure, leading to a stroke or heart attack. It is also possible to accumulate toxic levels of the drug by using at closely spaced intervals. However, it is possible to overdose on a single dose.
If any of the following occur, contact 911 immediately:
Unconscious or showing signs of confusion
Body temperature reaches 104 degrees F
They are having breathing difficulties
Harm reduction and methamphetamine use
Although there is no way to guarantee safety in methamphetamine use (or any drug for that matter), there are some simple steps that people can take to reduce risk of harm and overdose.
Avoid dosing on the high
Avoid combining meth with other stimulants or depressants
Take care of your skin; keep first aid kits and moisturizer on hand
Keep your mouth moist; drink plenty of water, chew gum or use dental products designed to combat dry mouth
Use test strips to check for fentanyl
Household bleach can be used to test and make your sure your drug is really meth
If using with others, stagger your use.
Use safe, recommended practices whether you shoot, smoke, snort, ingest, plug or hot rail
Getting support for meth use
There is no reversal drug that works in the event of an amphetamine overdose. Unfortunately, unlike with opioids, there is not currently a replacement medication to assist with getting off meth.
If you would like to examine your meth use, get support in implementing harm reduction or are ready to work toward quitting altogether, Substance Use Therapy is here for you. Whatever you are facing, you don't have to face it alone.
Denning, P., & Little, J. (2017). Over the Influence: The Harm Reduction Guide to Controlling Your Drug and Alcohol Use. The Guilford Press.
About the Author: Kimberly May, LPC-S, LMFT is a therapist at Substance Use Therapy in Austin, TX. Kimberly works with individuals, couples and families whose lives have been affected by drug and alcohol use. By utilizing a harm reduction framework, Kimberly works effectively with people in any stage of use. In addition to substance use, she works with other issues such as anger, burn-out, anxiety and grief. Contact today to schedule a no-charge, 30 minute, in-person consultation. *Note: telephone and telehealth sessions are currently available.