The Signs and Causes of Meth Psychosis

The Signs and Causes of Meth Psychosis

Called the “poor man’s cocaine”, meth is a popular street drug that is typically referred to as crank, ice, speed, and crystal (because of its appearance – it usually comes in the form of crystalline white powder). What makes it so popular is its accessibility and its effects. Meth, or its proper scientific name, methamphetamine hydrochloride, is a psychostimulant drug. While it is known as a prohibited drug, it actually has therapeutic properties and is prescribed by physicians, although in low doses. This is because is highly addictive.

Snorting, swallowing, smoking or injecting are common ways to ingest meth. Its onset of action is fastest – mere seconds – when it’s smoked or injected. When snorted, it usually takes five minutes, and when eaten, it takes around 20 minutes. Meth provides a quick and long-lasting “high” as well. The drug is also metabolized more slowly than other drugs (such as cocaine), thereby producing a “high” for a longer period of time.

Imagine having a drug that instantly delivers the desired effects that last longer in the body. Furthermore, imagine how it also increases pleasure and reward in the brain. It is no surprise then, that many users easily get addicted, even if it is one of the most dangerous illegal drugs, due to its treacherous properties and its unwelcome results (Covey, 2007). In order to understand what the drug does to the body, it is important that we learn about dopamine.

Dopamine and What it Does to the Brain

In an article on news-medical.net, Dr. Mandal defines dopamine as one of the neurotransmitters (chemical messengers that send information between neurons) released the brain. Some of its notable functions are in the following areas:

  • Movement
  • Memory
  • Pleasurable reward
  • Behavior and cognition
  • Attention
  • Inhibition of prolactin (hormone for producing breast milk) production
  • Sleep
  • Mood
  • Learning

To understand how psychosis works in methamphetamine addiction, we delve deep into how dopamine affects pleasure and reward.

Essentially, dopamine is a neurotransmitter implicated in pleasure. It is released during pleasurable situations and stimulates one to seek out pleasurable activity or occupation. This means that pleasurable activities such as eating, engaging sexual behaviors, and taking drugs, stimulate dopamine release in the brain.

Dopamine operates in methamphetamine addiction by having increased levels in the brain. Unlike normal dopamine release in the brain, however, it is neither recycled nor stored for later. The levels produced by drug ingestion just stay in the body, producing a high that that remains until the high is replaced with the inevitable “crash” that comes after the buzz. Because the effects of coming down from the methamphetamine high are quite unpleasant, users tend to ingest more when they feel that they Chronic use of the drug will also produce structural changes in the brain.

The severity of psychiatric symptoms associated with the drug is significantly related to how long the user has been taking it. Quitting the drug cold turkey after the person has become used to it can result in the user having cognitive problems in the areas of executive control in the brain, which is in charge of cognitive functions, such as learning and memory. It also causes severe mental health problems, such as paranoid thinking and hallucinations (Brecht et al., 2004; Srisurapanont et. al., 2003).

What are the Effects of a Methamphetamine High?

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Because it stimulates dopamine production, the user will experience intense excitement and happiness (euphoria) upon ingestion of the drug. Other effects include:

  • Decreased appetite
  • Decreased need for sleep
  • Increased energy
  • Increased attention

However, as a stimulant, when meth wears off or when the user “comes down from the high”, they are most likely to feel the opposite effects of the drug, such as weakness, lethargy, sleepiness, and depression. This is why users consume meth in a “binge-and-crash” manner: consuming the drug repeatedly once the desired effects start to wear off.

The longer usage of the drug is, the more it gets addictive, and the user feels the need to increase the dosage, due to the pleasurable effects it produces upon them. There is some evidence that people become more quickly addicted to methamphetamine and require treatment sooner than those using cocaine (Castro et. al., 2000). Addicted methamphetamine users are highly resistant to treatment, and post-treatment relapse is a common occurrence.

What will Bring About Meth Psychosis?

Psychosis means exhibiting behavior in such a way that it is not congruent to the present reality. In part due to the structural changes brought about by meth use, bizarre, outlandish thoughts are concocted by the brain. The person suddenly believes thoughts and experiences things that have no basis in reality. In other words, psychosis is being “out of touch with reality”.

The Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, (the definitive manual for mental illness as of this writing), defines psychosis (called psychotic disorder in this particular reference, although some practitioners tend to use both terms interchangeably) as abnormalities in one or more of the following five domains:

  • Delusions
  • Hallucinations
  • Disorganized thinking and speech
  • Grossly disorganized or abnormal behavior (including catatonia)
  • Negative symptoms

Meth psychosis mainly features TWO symptoms that are considered the hallmark of psychosis, and which will be the only ones discussed in this article: delusions and hallucinations.

Delusions are fixed beliefs that do not change in spite of conflicting evidence that renders the user’s beliefs to be unreal. The content varies. The most common types of delusions are the following:

  • In persecutory delusions, the user believes that they are about to be harmed and/or harassed by an individual, organization, or other group.
  • In referential delusions, the user believes that certain gestures, comments, environmental cues, and so forth are directed at oneself; (ex. A TV personality making a peace sign means that he/she is directly communicating to the user, albeit subtly).
  • In grandiose delusions, the user believes they have exceptional abilities, wealth and/or fame
  • In erotomaniac delusions, the user believes falsely that another person is in love with them
  • In nihilistic delusions, the user is convinced that a major catastrophe will occur.

Delusions can also be bizarre or non-bizarre in terms of thought content.

  • Bizarre – An example of this is when the user believes that an outside force has removed his or her internal organs and replaced them with someone else’s organs without leaving any wounds or scars.
  • Non-bizarre – An example of this is when the user believes he or she is under constant surveillance by the government’s intelligence agency, despite lack of convincing evidence.

The most common type of delusion in meth psychosis is bizarre persecutory delusions.

Meanwhile, hallucinations are sensory experiences that occur without an external stimulus. These are vivid and clear in quality, with full force and impact of normal perceptions. While they may occur in any sensory modality, the most common types of hallucination in meth psychosis is auditory and tactile hallucinations. Auditory hallucinations are partivu

Auditory hallucinations are usually experienced as voices, which could be familiar or unfamiliar. They are also perceived as distinct from the individual’s own thoughts, and can be command or non-command in content.

On the other hand, tactile hallucinations are false sensations of touch perceived by the body.

Signs and Symptoms of Meth Psychosis

Psychotic woman with a chainsaw covered in blood

The onset of meth psychosis can be brought about by intoxication or withdrawal. As previously discussed, the most prominent features are delusions and/or hallucinations that are brought about by the physiological effects of meth.

It can arise soon or after exposure after exposure to meth, or after substance intoxication or withdrawal, but it can also persist for weeks. Once it occurs, the psychotic symptoms may continue as long as substance/medication use continues.

The initiation varies considerably with the substance. Because meth has an almost instantaneous effect, smoking it may produce psychosis within minutes. Persecutory delusions may develop shortly after use of amphetamine. Sometimes, the user also experiences tactile hallucinations during intoxication. Users commonly report that they feel as if insects are crawling on their skin, despite evidence suggesting the contrary.

In concordance to knowing these symptoms, because it occurs either upon meth intoxication or withdrawal, the symptoms of the aforementioned in the context of meth psychosis must also be noted.

Meth intoxication

The following physiological symptoms typically indicate meth intoxication:

  • Restlessness to severe muscle spasms (tremors) – this may result to sweating to an unusual degree (diaphoresis)
  • Seizures
  • Hyperactivity
  • Confusion
  • Body temperature elevated beyond normal (hyperthermia)
  • Increased blood pressure (hypertension)
  • Abnormal activity in the heart (dysrhythmias), such as increased heart rate (tachycardia), which is most common in meth intoxication
  • Increased respiration (tachypnea)
  • Loss of consciousness
  • Nausea and vomiting
  • Diarrhea
  • For pregnant users, there may be placental abruption, and, in some cases, even fetal death

Meanwhile, these psychological symptoms typically accompany meth intoxication:

  • Hallucinations
  • Delusions
  • Manic behavior

Note that both hallucinations and delusions could be the cause of aggressive, anxious, angry or paranoid behavior exhibited by the user.

Recovering from meth intoxication takes tremendous time and energy, as well as a strong support system and solid treatment program. In fact, abruptly withdrawing from chronic and excessive meth use may result in the following:

  • Physiological symptoms: cramping, nausea, diarrhea, convulsions
  • Psychological symptoms: feelings of weariness; impaired ability to concentrate, learn, and remember; social, economic, and personality deterioration; depression (which usually peaks in 48 to 72 hours, often remaining intense for a day or two. Then it tends to lessen gradually over a period of several days. However, mild feelings of depression and lassitude may persist for weeks or even months.)

Withdrawal from amphetamines is usually safe, although there is some evidence that suggests that physiological dependence on the drug should be considered as one of the main factors when planning for treatment.

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What to Do When You Observe These Signs and Symptoms

Seeing your loved one exhibit the aforementioned symptoms can be tough, and while you may feel helpless, here is what you should do when you see the tell-tale signs of meth psychosis:

Seek immediate help if the following signs and symptoms have been observed:

  • Changes in breathing
  • High blood pressure
  • Increased heart rate
  • Seizures and tremors
  • Perceptual disturbances (hallucinations and delusions)
  • Agitated and anxious behavior that is unusually high

It is understandable that, even if immediate medical help is sought, it may not arrive quickly. Here are some things you, as the loved one and support system of the meth user, can do in case he or she exhibits seizures:

  • First, remove anything within the vicinity that can harm the user while they are experiencing an episode.
  • After the episode, gently turn their head to the side in case they vomit. This is to prevent them from choking on their own vomit. By doing this, you are helping them clear their airways and giving them an avenue for breathing.
  • Note that there is still a common misconception that people experiencing seizures are at risk for swallowing their own tongues. It is physically impossible to do this. Do not place any object in the user’s mouth during an episode. This will only cause further injuries, particularly in the jaw.

Meanwhile, if you observe changes in the meth user’s breathing, try to make them as comfortable as possible while waiting for medical help to arrive.

Psychotic Symptoms: Hallucinations, Delusions, and Agitation/Paranoia

Psycho lurking in the dark. Visible noise and harshness for scary atmosphere.

Remember that in psychosis, the user’s reality is distorted. Negating their version of reality may only aggravate their already disturbed psyche, so it is best to do the following:

Note that these suggestions are only until medical help has been rendered. It is strongly advised to seek medical help for meth psychosis, as it is a medical emergency due to the physiological symptoms, and the psychological symptoms as well, because the user may be in danger of harming themselves or other people.

Particularly in psychotic symptoms with paranoid content, they may accuse you of doing things to them, such as trying to poison them or kill them. In their psychotic state of mind, they firmly believe this. It will be difficult trying to talk sense into them, and trying to convince them that you are only trying to help. Affirm and acknowledge that this is what they are feeling at the moment.

Specifically, this is how you should deal when your loved one is suffering from signs and symptoms of meth psychosis:

  • First, acknowledge their version of reality; as much as possible do not try to argue and convince, as this may only further aggravate them and lead them to exhibit harmful behavior.
  • Avoid direct eye contact. They may feel threatened by this.
  • If they threaten to kill themselves, take any object within their vicinity that they may use for suicide, and never leave them out of your sight.
  • If you must leave them out of your sight, ask a trusted loved one to keep an eye on them.

Although methamphetamine psychosis is usually a problem for chronic users, it can also pose as a problem for those that are starting to take the drug as well, especially if the dose ingested is higher than what the body can tolerate.

Treatment of Meth Psychosis

There are three main goals of treatment for meth psychosis. First is to decrease the reward value of meth and increasing the reward value of nondrug reinforcers. As previously discussed, the neurochemical dopamine, which is implicated in drug addiction, is increased during ingestion of meth. Dopamine is the neurochemical implicated in feelings of reward and pleasure, so this is particularly difficult for those who have developed an addiction to the drug, as they will tend to use and use in higher amounts, to give them the euphoric effect.

The second goal is to weaken conditioned drug behaviors (as dopamine is also implicated in learning). The neurochemical dopamine is also implicated in learning, so medical intervention, along with following a rehabilitation program provided by a qualified facility, can help the client in recovering from meth addiction. Included in the treatment program should be the discovery of the root cause of what made the patient take the drug in the first place. Upon addressing this issue (with therapy specifically tailored according to the client’s needs), not only will they be able to learn skills to go back to an optimum level of functioning, they will also be aware of their issues and do something about it.

Lastly, meth psychosis treatment aims to strengthen frontal inhibitory and executive control. Effective treatment will help re-orient patients into reality, allowing them to start being able to think rationally and make sound decisions on their own. The facility encourages clients to learn skills that will make them stand at their own two feet.

Lanna Rehab Can Help You or Your Loved One Conquer Meth Addiction and Prevent or Treat Meth Psychosis

Situated in the quiet and peaceful confines of the mountainous Chiang Mai, Thailand, Lanna Rehab is a facility that is well-equipped to treat clients with various mental illnesses. Lanna Rehab continuously develops programs that are specifically tailored to their clients’ needs. It employs a holistic approach in developing programs that not only directly treat their clients’ symptoms but also help them develop healthy habits and behaviors that help their clients live better lives.

Lanna Rehab’s thorough physical and psychological assessment services and intervention programs are curated and implemented by highly trained and empathetic staff, who empower not only the patients, but their supportive loved ones as well, as they strive toward recovery and a better life together. Allow Lanna Rehab to hold your hand on your journey to recovery. Know more about Lanna Rehab programs for meth addiction or meth psychosis by calling their 24/7 hotline today.

Martin Peters

Martin Peters has a BA (Hons) Dip HE Dip RN CSAT III and is the Group Program Director Lanna Healthcare. He is a Registered Nurse and Certified Substance Abuse Therapist working in the mental health field since 1994; Martin has had a wide range of experience in management and supervisory roles within established healthcare systems, and has provided consultancy services to a number of private and public sector organizations in the UK and Asia in terms of management, policy writing, accreditation and recruitment. Martin’s addictions experience has been in developing inpatient services in Thailand since 2009, both clinical and operational. He has been instrumental in expanding and developing a non 12 step inpatient treatment centre and opening a further inpatient centre with a 12 step approach, implementing KIPU Electronic Records, strengthening hospital partnerships, introducing a Scholarship for students under the Masters in Addiction Studies Program at The ASEAN Institute for Health Development and working with an international accreditation body. Martin has also been a speaker at several international conferences on addiction, including ASEAN conferences and has also guest lectured at Mahidol University (Thailand), University of Sarghoda (Pakistan) Institute of Medical Sciences (Pakistan) and has been a representative on the CARF Standards Advisory Committee for 2016.In 2015. Martin became a Co-Founder of Lanna Healthcare, launching Lanna Rehab in March 2016 and opening Jintra in January 2018. In June of 2018, Martin was involved in the merger of Lanna and DARA, becoming Thailand's biggest private licensed operator. Martin is currently a Joint and Asia Health Co Ltd Owner Operator of Lanna Healthcare Co Ltd, which under its umbrella manages Lanna Rehab in Chiang Mai, Jintra Rehab in Chiang Mai and DARA Rehab in Koh Chang - all Thailand MoPH Licensed Addiction Facilities providing world-class treatment in Thailand.



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