Methamphetamine psychosis: symptoms, risks and getting help in the UK

Methamphetamine is part of the amphetamine family of stimulant drugs. FRANK says it comes as tablets (sometimes called yaba), powder or crystals, known as crystal meth or ice, and that it can be swallowed, snorted, smoked or injected. It is a Class A drug in the UK.

The NHS defines psychosis as a state where people lose some contact with reality. FRANK describes psychosis as a serious mental state in which you lose touch with reality and may come to believe things that are not true, and says methamphetamine can cause it. When psychosis is triggered by a drug it is often described as drug-induced or substance-induced psychosis.

The NHS lists three main symptoms of psychosis, and FRANK lists feelings associated with methamphetamine such as agitation, paranoia, confusion and aggression.

• Hallucinations: hearing, seeing or sometimes feeling, smelling or tasting things that are not there, such as hearing voices.

• Delusions: strong beliefs that other people do not share, such as believing there is a conspiracy to harm them.

• Disordered thinking and speech: thoughts that come very quickly, making speech fast and confusing.

• Agitation, paranoia, confusion or aggression (FRANK lists these among the feelings methamphetamine can cause).

• Marked changes in behaviour and severe distress.

The NHS advises seeing a GP immediately if you are experiencing symptoms of psychosis. If you are worried about someone else, you can contact a GP on their behalf, or their mental health worker if they have one. If their symptoms are severe enough to need urgent treatment and could place them at risk, the NHS says you can take them to the nearest A&E if they agree, call their GP or out-of-hours GP, or call 999 and ask for an ambulance.

FRANK says that if someone needs urgent help after taking drugs you should call 999 for an ambulance and tell the crew everything you know. The NHS also warns that people with psychosis have a higher than average risk of self-harm and suicide; the Samaritans can be called free on 116 123, and NHS 111 or A&E are options if someone is feeling suicidal.

The sources reviewed explain the risk in general terms rather than describing a precise mechanism. FRANK says the drug increases heart rate and blood pressure, can lead to severe psychosis, and that taking larger doses over many hours or even days is easy to do. It adds that there is evidence long-term use can cause brain damage, although this gradually gets better if the user stays off the drug for a long time.

The NHS lists other triggers for psychosis, including stress, a traumatic experience, alcohol use disorder, prescribed medicine side effects and physical conditions such as a brain tumour or head injury. This is why a clinician will usually ask about everything that could be contributing, not just drug use.

The NHS says a GP may ask questions to find out what is causing psychosis and should refer you to a mental health specialist for assessment and treatment. Treatment depends on the cause, but usually involves antipsychotic medicine to relieve symptoms, talking therapies such as CBT and family interventions, and social support with needs such as education, employment or accommodation. Severe episodes may need admission to a psychiatric hospital.

When psychosis is linked to drug use, the NHS says drug or alcohol use can make psychotic symptoms worse. Support for drug use can therefore matter alongside mental health treatment. The NHS says not to stop prescribed medicines suddenly, because that could trigger a relapse.

FRANK says methamphetamine can lead to very strong psychological and physical dependence, especially if injected or smoked, with cravings and a strong drive to keep using. The NHS says people with a drug problem are entitled to treatment in the same way as anyone else with a health problem, and that a GP is a good place to start, with referral to a local drug service. At a first appointment staff talk through treatment options and agree a plan, and you will be given a keyworker.

The NHS notes that talking therapies such as CBT are among the options, that self-help groups such as UKNA and SMART Recovery help some people, and that services can offer testing and treatment for hepatitis or HIV. Treatment can be at home or, if intensive help is needed, in hospital or residential rehabilitation.

How long drug-induced psychosis lasts and whether it returns depends on the person and on continuing drug use. The NHS says how often a psychotic episode occurs and how long it lasts can depend on the underlying cause. FRANK says brain effects of long-term methamphetamine use gradually get better if the user stays off the drug for a long time. People who have had psychosis are more likely than others to have drug or alcohol problems, according to the NHS, so ongoing support matters.