Methamphetamine dependence (crystal meth): effects, risks and getting help in the UK

Methamphetamine is a synthetic stimulant that speeds up the nervous system. FRANK lists street names including crystal meth, ice, glass, crank, tina and yaba. Depending on its form, it can be swallowed, snorted, smoked or injected.

FRANK says that smoking the purer crystalline form produces a very intense high, similar to that of crack cocaine but much longer lasting. Because the effects can last between 4 and 12 hours, people can be awake and using for long stretches, and FRANK notes it is easy to want more and to take larger doses over many hours or even days.

Drugs sold on the street are often cut with other substances. FRANK says methamphetamine can be mixed with other amphetamines, caffeine, ephedrine, sugars, starch, laxatives, talcum powder, paracetamol and other drugs with some similar effects, and that impurities can also form during manufacture, so the contents are never certain.

FRANK describes methamphetamine as reducing appetite and making people feel exhilarated, alert, awake and aroused, but also agitated, paranoid, confused and aggressive. Inhibitions are lowered and libido may be increased, which can lead to risky activities such as unprotected sex, with the risk of sexually transmitted infections or unplanned pregnancy.

In the body it increases heart rate and blood pressure, and the higher the dose, the greater those effects and the risk of heart attack. In overdose, FRANK lists stroke, lung, kidney and gastrointestinal damage, and says coma and death can occur. Mixing methamphetamine with alcohol can have serious consequences because the stimulant and depressant effects interact unpredictably.

There is evidence that long-term use can cause brain damage, although FRANK says this gradually gets better if the user stays off the drug for a long time. Injecting carries the risks of damaged veins, abscesses and clots, and sharing needles or injecting equipment risks spreading HIV and hepatitis.

FRANK says that severe psychosis caused by methamphetamine has been reported where use is widespread. Psychosis is a serious mental state in which a person loses touch with reality and may come to believe things that are not true. The NHS describes psychosis as a mental health problem that causes people to perceive or interpret things differently from those around them.

Paranoia, agitation and confusion are among the immediate effects FRANK lists, and the risk of psychosis rises with heavy or prolonged use. Someone who seems to be losing touch with reality after using needs medical help promptly. FRANK says that if you or someone else needs urgent help after taking drugs or drinking, you should call 999 for an ambulance and tell the crew everything you know.

Dependence means that the drug has become central to how you feel and function. The features FRANK describes include cravings, a very strong drive to keep using despite evidence of accumulating harms, needing larger doses, and a severe comedown after the effects wear off.

• Using more than you intended, or for longer than planned.

• Cravings and a strong drive to carry on despite physical, mental or social harm.

• Going for days without sleep or proper food.

• Risk-taking you would not normally consider, including unsafe sex.

• Paranoia, agitation or confusion that persists.

• Trouble at work, at home or with money because of use.

The NHS says that if you need help for a drug problem you are entitled to treatment in the same way as anyone else who has a health problem. A GP can discuss your problems and help get you into treatment, usually by referring you to your local drug service, and you can also approach your local drug treatment service directly. The NHS also points to the FRANK website to find support near you and to the FRANK helpline.

The NHS explains what to expect. At your first appointment staff ask about your drug use and about your work, family and housing situation, and you may be asked for a urine or saliva sample. Staff talk you through your options and agree a treatment plan with you, and you are given a keyworker who supports you throughout treatment.

Treatment depends on your circumstances and the drug you are using. The NHS lists talking therapies such as cognitive behavioural therapy, which help you see how thoughts and feelings affect behaviour, self-help groups such as Narcotics Anonymous or SMART Recovery, and harm reduction such as testing and treatment for hepatitis or HIV. Treatment may be at home or, where intensive help is needed, as a hospital inpatient or in residential rehabilitation. The NHS notes that charities and the NHS provide most treatment and that private treatment must be paid for.

Anyone who continues to use should know the risks FRANK highlights: dose creep over many hours, mixing with alcohol or other drugs, injecting and sharing equipment, and the possibility that any street drug contains something unexpected. FRANK also notes that driving while high is dangerous and illegal.

If someone becomes seriously unwell after using, treat it as an emergency and call 999, telling the crew what was taken. Friends and family can contact FRANK, and the NHS points families and carers to Adfam for a list of useful organisations.

The NHS says charities and the NHS provide most drug treatment, and that you can be referred by a GP or approach a local drug service yourself. There are also private drug and alcohol treatment organisations, for which you pay.

Whichever you choose, the sources suggest looking for a service that agrees a written plan with you, gives you a named keyworker and addresses housing, work and mental health alongside drug use.