ABC Health & Wellbeing

Fact File

Methamphetamines: speed and ice

by Peter Lavelle

Highly addictive, methamphetamines such as speed and ice can cause long-term physical and mental health problems.

Published 01/11/2007

[Image source: NDARC]

• Types
• Effects
• Treatment
• More info

It's cheaper than heroin and cocaine, and easier to get – it can be made locally in backyard labs and doesn't have to be grown or depend exclusively on being imported.

Methamphetamine is now the second most commonly used illicit drug in Australia after cannabis. Its use has skyrocketed over the past 15 years, as it's become increasingly refined, potent and dangerous.

Like heroin and cocaine, methamphetamine (in the form of its chemical precursor, amphetamine) began life about a hundred years ago as pharmaceuticals – stimulants and appetite suppressants. Doctors still prescribe similar drugs, like dexamphetamine and methylphenidate, for disorders such as narcolepsy or attention deficit hyperactivity disorder (ADHD).

But over the past 15 years or so, advances in refining techniques have allowed backyard lab operators run by criminal gangs to make and distribute a range of methamphetamine products from easily obtainable substances such as pseudophedrine (found in cold and flu tablets) and household chemicals. Increasingly, these drugs, especially the more potent crystallised form known as ice, are being imported from overseas labs, particularly from southeast Asia.

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Types

At the street level there's an enormous variety of forms of methamphetamine with different purities, prices, places of origin and routes of administration – all of which vary around Australia. Hence, there's no consistent classification of the various forms; the following descriptions draw on information from the Illicit Drugs Unit Methamphetamine Program of the Australian Customs Service, and from the National Drug and Alcohol Research Centre.

Speed – also known as goey or whiz, is the most widely used. It's the cheapest and least pure form, at about 10 per cent purity. It's manufactured in Australia and comes as a powder, ranging in colour from white to yellow, orange, brown or pink. It's usually snorted but can be injected.

Pills are methamphetamine tablets mostly manufactured in Australia and are generally sold as 'ecstasy' (though real ecstasy is actually methylenedioxymethamphetamine or MDMA). Sometimes these 'fake ecstasy' tablets are mixed with drugs like ketamine to try to mimic the effects of real ecstasy. Real MDMA is almost always imported.

Base – also called paste, wax, point and pure. This is an oily, gluggy or pasty type of damp, sticky powder that often has a brownish tinge and is difficult to dissolve for injection without heat. It's manufactured in Australia and is higher purity than speed. It's injected or smoked (using a glass pipe, or by heating it on aluminium foil and inhaling the vapours) or snorted.

Ice (crystal methamphetamine hydrochloride), also called shabu, crystal and crystal meth, is much more potent (about 80 per cent purity) and so is more expensive. True 'ice' is manufactured in Asia and imported into Australia. It comes in the form of crystals or coarse powder that range in colour from translucent to white, but may have a green, blue or pink tinge. It's snorted, injected or smoked.

Speed and base users are usually young adults (under 30) on lower incomes, who can't afford heroin or cocaine. Ice users are often partygoers, nightclubbers, or people in the gay scene. Only about three per cent of methamphetamine users are regular users; most use occasionally only in a social setting. Regular users also usually take other drugs, like cannabis, alcohol and ecstasy, at the same time.

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Effects

Methamphetamine triggers the release of powerful neurotransmitter hormones – norepinephrine, dopamine and serotonin – into the bloodstream. This acts on nerve pathways in the brain, producing feelings of euphoria, excitement, alertness, confidence, increased libido, energy and strength.

In the body, methamphetamine causes:

• increased heart rate and breathing rate
• raised blood pressure
• sweating
• suppressed appetite
• difficulty sleeping
• teeth grinding and clenching
• dilated pupils
• dry mouth
• stomach cramps
• nausea
• dizziness
• blurred vision
• severe headaches.

Someone taking methamphetamines can become very nervous, anxious and paranoid and can experience panic attacks.

About a quarter of people who regularly use methamphetamines have symptoms of psychosis. They can become irritable, aggressive and hostile and suffer hallucinations, paranoid delusions and bizarre behaviour. They can become violent and a risk to themselves and bystanders.

As the effects of the drug wears off, methamphetamine users can become depressed, moody and exhausted. Often they'll use other drugs, such as benzodiazepines, to 'bring themselves down' from the high of amphetamines and to sleep.

It's rare for metahamphetamines to actually cause sudden death (unlike heroin). But using methamphetamines regularly (that is, several times week or more) over months or years causes serious health problems such as:

• high blood pressure and increased risk of heart attack and heart failure
• malnutrition and weight loss from reduced appetite
• chronic sleeping problems
• depression, anxiety, and paranoia (two-thirds of regular users experience some degree of mental health disability)
• brain damage (poor memory and other cognitive impairments)
• dental problems (from clenching and grinding teeth).

As well, there are health problems related to the way it's taken. Smoking methamphetamine can damage the lungs; snorting it can damage the nasal passages; and injecting it can lead to scarring and abscesses. If syringes are shared, there is a risk of hepatitis B and C, and HIV.

Problems with family, finances, work, legal problems and school problems can arise from the mental health and behavioural problems. Methamphetamine users are often involved in criminal behaviour. In one study of regular users, almost half had committed an offence in the past month, one quarter had been arrested in the past year, and one third had served a prison sentence during their lifetime, mostly for drug dealing and property crime.

Women who are pregnant and who use methamphetamines have an increased risk of uterine bleeding, early labour, and foetal abnormalities. Babies born to mothers who use regularly may experience withdrawal symptoms after birth.

Methamphetamines are both tolerance forming and addictive, especially when injected and when purer forms like ice are used. Addicts quickly develop a tolerance to the drug so that more and more is needed to achieve the desired effects. They can become physically addicted to it, so if they suddenly stop they experience withdrawal symptoms such as fatigue, decreased energy, anxiety, irritability and depression. These symptoms may last for weeks.

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Treatment

In Australia, there are far fewer treatment programs for methamphetamine users than there are for other drugs like heroin and alcohol.

Methamphetamine users experiencing psychosis can turn up in hospital emergency departments. They may be agitated and aggressive and need to be restrained and sedated. General psychiatric units find it difficult to manage patients who are withdrawing from the drug. Meanwhile, detox centres that normally manage heroin or alcohol users are often unwilling to take methamphetamine users because these centres aren't able to mange methamphetamine withdrawal with psychosis.

Even after the psychosis is brought under control, treatment options are few. GPs, community health centres and drug and alcohol treatment centres don't generally have programs in place for methamphetamine users (being more experienced with treating heroin and alcohol dependence).

There are no proven effective substitute drugs (like methadone for heroin addicts) that can be used to manage addiction to methamphetamines. Also, methamphetamine users may be reluctant to seek treatment because they know there are not many services available.

But this situation is starting to change as methamphetamine becomes more widespread.

Treatment from those centres that do specialise in methamphetamine involves managing the whole range of psychotic symptoms and physical health problems, as well as dependence to the drugs.

Drug dependency can be managed with counselling techniques such as cognitive behavioural therapy, available through private psychology and outpatient services. About half of all people with a methamphetamine addiction who are motivated to sign up for counselling successfully finish the program and many remain drug free. But most methamphetamine users are ordered to rehabilitation centres by a court order and in these cases treatment is less successful. In many cases, stopping the drug altogether may not be possible in which case the goal is to minimise the drug's harm as much as practicable.

While methamphetamine remains a serious health issue, anecdotal reports from clinics suggest the use of ice may be dropping, particularly among casual users, following widespread publicity in the media of its dangers.