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Meth, the Forgotten Killer, Is Back (nytimes.com)
26 points by fmihaila 6 months ago | hide | past | web | favorite | 46 comments



I'm almost glad that the meth being sold is described as "pure"... I'm tired of hearing about deaths from heroin cut with fentanyl.

Also: I would be interested to know if anyone has attempted to use a Desoxyn (pharmaceutical methamphetamine) taper to get someone out of meth addiction.

It's interesting that Desoxyn can be prescribed safely (?) to patients while crystal meth is a "killer". I'm guessing dosage and medical supervision makes a big difference in outcomes.


It's not really even clear to me that meth is that much of a killer. The article quotes 6000 deaths per year for all stimulants in the US. Alcohol related deaths per year in the US seems to be around 88,000. Obviously alcohol use is more common, but you also have confounding issues of increased risky behavior taking in general for meth users.


It's not that it's a killer, it's that it is a destroyer of lives. Produces lots of 20ish year olds with deep pockmarks, no teeth, paranoia issues, Hep C, HIV, etc. Unemployable zombies with tendencies to shoplift, drive impaired, petty theft, etc. It's in the same category as crack cocaine. Very few functional serious users. Unlike, say alcohol, mdma, ectasy, benzodiazapines, marijuana, etc.

Meth really is a nasty business.


The route of administration (ROA) has a lot to do with it. Snorting, smoking or injecting meth gives a stronger high than ingesting meth, with a correspondingly higher risk for addiction. Chasing after the high can lead to compulsive redosing, which can keep the user awake for days at a time, often without eating due to the appetite suppression. Sleep deprivation and lack of nutrition are the causes of most harms meth users experience (Stimulant psychosis seems closely linked to sleep deprivation). Medicinal dosages are also much lower than recreational ones, Desoxyn pills start at 5mg.


The problem is really bad for those who smoke meth, trying to get them on any alternative is tough. For more casual users you could steer them into something else, but a meth smoker or injector is addicted not just to the drug but also to the process of smoking or shooting on top of it. People who use IV drugs get addicted not just to the drug itself but also to the process of preparing and using the drug.


The major problem with meth is that people don't know how to use it right (e.g. you are to take much much more vitamins (A and E in particular), minerals and antioxidants, piracetam and drink much much much more water (even though this will make you pee really often) if you use meth and you should never inject it but prefer taking it orally and in as small amounts as possible while still getting the effect (magnesium and piracetam can help fighting tolerance development) and you should avoid supplementing extra tyrosine/dopa). Another serious problem for those who want to use meth to improve their productivity and relief ADHD is that legal desoxyn costs enormous amounts of money and can be rather hard to get a prescription for (and is not available outside of the USA at all - if a qualified American doctor confirms you need it you will still have to use the black market to follow his advice if you travel abroad).


I disagree, the major problem with meth is cheapness, availability, and that it is highly addictive. I live in Australia where we've been suffering under a massive meth epidemic for over a decade.

I'm chuckling about the thought of me wandering up to one of the many "walking dead" around town and informing them that they're using meth wrong. Because your definition of "wrong", whilst possibly technically correct, is completely irrelevant on the street. People want to get high, very high, as fast as possible. They're not looking to leverage meth as some sort of productivity life hack, they're using to get as high as they can for as long as possible, That's why injecting occurs, it's apparently the best bang for buck when compared to oral ingestion or smoking.


I get you point, but... IMHO a huge portion of addictivity are the withdrawal symptoms that can be made much much easier (and last just a couple of days instead of weeks) if the measures I've described above were taken in advance (another huge part is about public stigmatization, lack of understanding and support - AFAIK happy people with loving families are by orders of magnitude less prone to become addicts). And turning into the "walking dead" is all about lack of the healthcare measures I've described above (e.g. my skin went bad once I've tried using meth for about a week many ears ago to manage with a project deadline but a strong E+A vitamin supplement has turned it back healthy overnight).


From how I understand it meth floods the dopamine receptors in the brain and prolonged use effectively fries them, or at least they become dependent on the artificial dopamine rush that meth provides.

And correct me if I'm wrong, but are you advocating using meth to curb the withdrawal symptoms from meth? That seems, well, strange.

As for the walking dead, here in Australia we have free socialised healthcare which meth addicts can access whenever they want. And yet they're still undernourished, missing most teeth, and engaging in what could easily be described as risky behaviour. I don't think you worry too much about all of your damaged or missing teeth when your primary concern is finding enough money to buy your next fix.


> And correct me if I'm wrong, but are you advocating using meth to curb the withdrawal symptoms from meth?

I am absolutely absolutely not, this is ridiculous. But I believe this is what many people do: they feel bad after the meth wears off so the take more of it. What I am saying is they should take big amounts of vitamins, piracetam and water instead (before, under and after meth) so they won't need more meth to go back to what feels normal. But I think at least 80% of meth users don't know about this (I had to educate some of them personally and this, together with support from people they loved helped them quit) and this is a huge portion of the problem.

> From how I understand it meth floods the dopamine receptors in the brain and prolonged use effectively fries them, or at least they become dependent on the artificial dopamine rush that meth provides.

This is true but slightly exaggerated. This problem is not really hard to resist and mitigate if you want (sad thing many people don't want as they have no other feel-good things in their lives, there also are some people that are dopamine-addicts by nature genetically - e.g. these are also prone to gambling).

> As for the walking dead, here in Australia we have free socialised healthcare which meth addicts can access whenever they want. And yet they're still undernourished, missing most teeth, and engaging in what could easily be described as risky behaviour. I don't think you worry too much about all of your damaged or missing teeth when your primary concern is finding enough money to buy your next fix.

Indeed deeply addicted people usually have no will, let alone knowledge to cure. By the way what things do you give away there at the centres? I would say piracetam is the most important thing but this is not confirmed scientifically by any accredited institutions so it would hardly appear in government-sponsored cnentres. It is also important to educate people about all the substances that tey should take together with the meth so it won't feel this bad after it wears off.


> This is true but slightly exaggerated. This problem is not really hard to resist and mitigate if you want (sad thing many people don't want as they have no other feel-good things in their lives. there also are some people that are dopamine-addicts by nature genetically - e.g. these are also prone to gambling).

How it was described to me is that the dopamine receptors in the brain become "re-calibrated" for lack of a better term to the high levels of dopamine that are dumped when they reup on their high. And IF they try and quit the dopamine receptors never come back to normal. So for heavy addicts the only way their brain registers a dopamine dump (for lack of a better term) is if it's artificially triggered by meth.

> By the way what things do you give away there at the centres?

I live in Western Australia and I'm pretty sure we don't operate any meth focused centres or clean needle exchanges. IIRC those services are in Sydney (Kings Cross).

All that said I find there are some people who can be "weekend warriors" and smoke meth for pleasure without being swallowed up by it. That said I've also seen good people hollowed out by meth. I suspect it's gene based but that's suspicion alone.


> How it was described to me is that the dopamine receptors in the brain become "re-calibrated"

This is true, but...

> never come back to normal

Never say never. They get back to normal rather quickly if you actually stop taking meth and start taking magnesium, piracetam and St. John's Wort and sleep well regularly. But I can't really tell for heavy addicts that inject meth instead of just snorting it and do it for years. I worry speaking this openly as it can happen to inspire some to try meth but I feel the knowledge must be shared to help those who are in the trouble already. If you know a meth addict that shows at least a minor sign of will to quit - don't blame him or tell him "just stop!", invite him to spend a meth-free weekend at your house, promise it won't hurt as bad as he thinks and feed him reasonably big amounts of the supplements I've mentioned. Another very helpful supplement is phenibut but it causes real physical addiction+tolerance itself so no more than 7 pills a month. Emoxypine and carphedon can also help a lot (safe, not addictive).

> All that said I find there are some people who can be "weekend warriors" and smoke meth for pleasure without being swallowed up by it. That said I've also seen good people hollowed out by meth. I suspect it's gene based but that's suspicion alone.

This is a very important thing to mention. People are different and should not be treated as perfectly equal. People that have the capacity for using substances consciously for good should not be denied the right to and stigmatized for doing this while people who can't should not be given the drug (e.g. I am pro 100% legalization of marijuana but against legalization of meth as only a minor portion of the people can manage with it constructively) and left alone without active participation of people actually understanding them.


Thank you. This has been a great interaction from my perspective, I really appreciate your comments about the issue. Obviously there's much more I need to learn but your comments have given me some excellent info to pull apart further.

Seriously, thanks again. It's great having a Internet based conversation that doesn't end up a shouting match!


I just really hope the information I share can help somebody to save their health and set them free. And I am very grateful to you for the kind words of appreciation - that's a kind of dopamine and serotonin boost those poor people we are talking about don't receive often if ever!

Let me also give credits: portions of this information (e.g about need in big doses of vitamins A&E, about supplementing dopa/tyrosine while on meth being a bad idea (though good during the abstinence, together with tryptophan) and that you really must drink a huge lot of water on meth, e.g. 1-2 full glasses every time you pee - this will actually save your kidneys, not overload them) come from Quora and Reddit, others from Adam at PsychedSubstance on YouTube (see https://www.youtube.com/watch?v=FlMxTpONKT0 - every advice from this video on MDMA applies to meth too), others from Wikipedia (e.g. about magnesium and emoxypine), some from my own reasoning and experimentation and the whole journey to understanding addictions has began with this extremely true video https://www.youtube.com/watch?v=ao8L-0nSYzg I have also tried everything on myself (many years ago, I have only met the person who given me the substance once while dead drunk at a club, can't remember his face, I don't have his number and I don't know where to get meth at all, believe it or not this is true) as well as just meth without the supplements so I could compare and confirm everything (that's not nearly as credible as a good double-blind placebo-controlled test could be but I personally have no doubts, especially in piracetam which is not FDA-approved unfortunately yet extremely effective and safe in big doses as my experience suggests). I am not a doctor, however, and can be wrong in some parts yet I believe no of my advises can harm more than just taking meth without following them (unless the patient happens to be allergic to a particular supplement or something like that).

BTW, regarding the "invite him to spend a meth-free weekend at your house" part - be really careful doing this with people you don't know well, some real junkies (I haven't met any but have heard scary rumors, these were more about crack an heroine addicts, not meth, but people are different and some can be more madness-prone than others) can happen to be really dangerous, especially when they go crazy on the drug/withdrawal-induced paranoia. Make sure to keep your wife and children away, knives, guns, jewelry and windows well-locked and have a beefy buddy by your side for just a case - "better safe than sorry".

And an addition about magnesium: don't use mg lactate with meth, I don't know the details but I've heard they don't fit together, prefer a chelate, oxide or citrate.

Another might-be-important thing I've forgotten to mention is supplementing pro&pre-biotics: meth-induced diarrhea can harm intestinal ecology seriously and a recent study I've read about in New Scientist says the major portion of all body serotonin (which is crucial for emotional well-being and also affected by meth) is produced in the intestines, not in the brain.

PS: I'm not on meth writing this much :-) Just too much coffee, "the stairs effect", urge to procrastinate and enthusiasm to help people by sharing understanding :-)


My understanding was that Addrall and the like, while kinda similar chemically to meth, ends up having pretty different effects on the brain?

I've also heard that ADHD meds end up being counterproductive for people without ADHD too, though.


> My understanding was that Addrall and the like, while kinda similar chemically to meth

Adderall is similar to amphetamine, not metamphetamine. If adderall/amphetamine doesn't help you sufficiently you need desoxyn/metamphetamine.

> I've also heard that ADHD meds end up being counterproductive for people without ADHD too, though.

This is true... approximately. In fact small amounts of amphetamine/adderall can boost concentration/memory/productivity in healthy people (not all of them though) too.


> people don't know how to use it right

IMHO you should not even suggest there is a "right" way to use meth. If you do you're basically advocating for drug use.

There is no right way to do drugs. Don't do drugs kids, period.


There certainly are right ways to use drugs and doctors are generally supposed to know them. And some people without a medical degree/license happen to know too though they're quite rare to meet. I don't advocate mindless illegal abuse of any substances but I don't advocate mindless falsely-moralist medical purism and all the nonsensical "war on drugs" policy either.

By the way I am about 99% sure that the main reason behind drug abuse epidemics, drug-induced degradation and deaths is lack of relevant education (the real kind, not just the scary "don't use drugs" stuff), lack of understanding and support. NO SUBJECT EVER should be made unspeakable. The more serious a problem is - the harder we are to try to actually understand it and everything relevant to it thoroughly and educate everybody to understand that. Imagine we would just teach kids not to use electricity / not to friend with those who use it and scare them about electrical shocks instead of telling them they should use it with their hands dry.


I presume you get your FDA-approved meth from a licensed pharmacist?


I don't take any though I have given it a try many ears ago. I personally prefer alprazolam (aka xanax) now - it helps great with my ADHD too (especially in combination with piracetam and sunifiram) and is much safer as long a you don't abuse it (by taking high doses or mixing it with alcohol). Anyway, it is important to mention that FDA-approved meth from a licensed pharmacist costs are insane, street meth of the same or better purity is more affordable by orders of magnitude. There is also no such thing as "approved meth from a licensed pharmacist" outside the USA unfortunately so if you need it and go abroad that's a problem (I wouldn't even risk having it in my luggage).


Even if there are, you should not publicly talk about them. Otherwise, what's to stop me from thinking you're a meth dealer who's advertising its product?


> Otherwise, what's to stop me from thinking you're a meth dealer who's advertising its product? reply

Common sense, perhaps?


By citing the hundreds of academic articles about the benefits of them?

By showing the countless cases of success of drugs like Penicillin?


Keep quiet about condoms too, otherwise people might think you're suggesting they have sex!


(This is an ignorant comment but it doesn't deserve to be flagkilled, I think.)

In regards to ignorance, if your view of drug use comes from the popular media then it looks irredeemable. If you have no personal experience of people you know who have tried or recreationally used different drugs you will be seduced by the notion that "there's no right way to do drugs". Indeed, not long ago it might have even be easy to hold the same opinion about marijuana.

The reality is that while some drugs hold the potential to wreck lives, few drugs are worse than those we already grapple with and accept into mainstream culture: tobacco and alcohol. Just as with alcohol it is possible for other drugs to ruin lives, but just as with alcohol many drugs can be used without doing so.


It didn't particularly ever leave. The Midwestern US is hit particularly hard with it, and has been for decades.


Dosage is the critical factor for any drug and everyone is absolutely unique (and, more so, in unique life circumstances at a given point) as it pertains to mind altering substances and the actual outcome of their lives. Set and setting matter. If you’re depressed and doing nothing but getting stoned, you’re using weed to keep yourself busy. It offers potential for “wasting” away, by staying stoned.

Marijuana is commonly abused and does ruin lives. Washed up marijuana addicts are common, yielding lost potential for the addict and a loss for society. The unproductive stoner has long been an American cliche, but true. (file_id.diz)

Meth, on the other hand, leaves little room for responsible recreational use. I’d be shocked if more than 1% of people who’ve ever tried meth would call themselves “responsible casual users”.



Is meth high different from other drugs. And if other comparably safer drugs were available legally would it decrease the usage of meth. I do believe if drugs were legalised it is a huge industry so billions would be spent of finding a safe way to get high.


It seems different because it has the addiction proclivities of heroin coupled with crazy cheap and ubiquitous availability. Any semi educated person can cook it locally.

Plus it's devastating physically. The welts, scratching, paranoia, food avoidance, tooth eating qualities, etc, are pretty unique. It wrecks your body pretty fast. Serious meth addicts seem to age at a 10x+ factor compared to other addicts. Twentyish old people look 40+ after just a year or so after getting hooked.

I'm pretty liberal, but I would fight against legalization of meth. It's really terrible. Meet a girl in her 20's that's been on it a year or two and you might see the issue. Not yet 30, but no teeth left, massive skin issues on their face/arms/upper torso from the welts/scratching, emaciated, and infertile. Also often HIV and/or Hep-C from trading sex for drugs. That shit is pure poison.


I think the effects you're describing are mostly all the result of developed behaviors / personal neglect from taking large does regularly. Taking high doses of, ex. Adderall for two years would likely have similar effects.


Maybe. I recall uppers/amphetamines (phenphen/etc) being popular in the 90's with college kids, bored/depressed housewives and high stress occupations. Bad effects for sure, but I don't recall toothless pockmarked emaciated zombies carrying serious STDs.

I do feel differently about marijuana, ecstasy, benzodiazepines, mdma, etc. They don't seem much different from alcohol, which we openly condone, despite the obvious issues. At least none of them (mostly) destroy lives in the span of a few years.

Opiates are somewhere in the middle for me. Legalization seems dangerous, but not as obviously stupid as for meth. It's in the same category as crack for me. No real casual/functioning users, really, just almost inevitable misery.


Actually MDMA is probably the most dangerous drug that people are trying to get legalized. If I had a teenager, I wouldn't be concerned at all if xanax or weed were legal. Plenty of people take these every day and get by just fine. I could totally see a stupid teenager taking MDMA 1-2 times a week for a good time, and then totally frying out their brain as a consequence. Look at what it does: https://en.wikipedia.org/wiki/MDMA#Long-term

That said, I would still support its legalization as long as it could only be administered in controlled environments.


> Look at what it does:

> As of 2015, the long-term effects of MDMA on human brain structure and function have not been fully determined.

MDMA in itself isn't as bad as other drugs, as has been mentioned. It's the compounds that it's cut/mixed with that poses most of the immediate dangers. In fact, the therapeutic potential of MDMA is reason enough for it's rescheduling.

http://www.maps.org/research/mdma


That's true in aggregate, but there is still obvious evidence that when taken over long periods, MDMA results in neurodegeneration, and that this is only partially reversible. Serotonergic pathways are especially effected, which is why acute MDMA use causes short-term depressive symptoms (tolerance), and long-term MDMA causes long-term depressive symptoms (neurotoxicity).

I'm not saying MDMA is as bad as other drugs, nor that it should be illegal. My cousin's uncle's daughter's brother has taken it several times, and he thinks it definitely has a lot of potential for therapy - can't attest to PTSD, but he can absolutely see it working for couple's counseling.

What I'm saying is that it shouldn't be something you can pick up for $5 at the gas station. If MDMA were legal, I would want there to be some pseudofed-like limit to how often you could purchase it (one dose every 3 months is generally considered safe), and I would also want it to be required to take the drug immediately after purchase.


I see cocaine as a higher risk, due to the long term permanent damage it causes to the heart and the brain. MDMA abuse causes a fairly rapid onset of negative symptoms and a reduction of positive effects that gets most people to stop before they can do too much damage to themselves (the long term impact of heavy MDMA abuse is still uncertain but anecdotal evidence suggests that recovery is possible).


That's fair. I have no real personal exposure to MDMA users. I have, though, lots of personal exposure to crack cocaine, opiate, and meth users. There's very few functional addicts. All three are life ruining, if not life ending.


I actually have met a few functional opiate addicts in my days, and I know very functional people that take meth on occasion, but which are not addicted to it. That said, I think it's more important to protect the 90% of people that can't use these drugs responsibly than for the remaining 10% of responsible users to be able to enjoy their favorite high.


But wouldn't the physician prescribing them notice the neglect and take appropriate action? Whereas a meth addict only has the self to decide whether to make some get dome or not? In other words it's less likely you will see those effects on an Adderall users since they are under some medical supervision.


Great observation. I personally know opiate users that resort to meth when the opiates aren't available. The need for any kind of "high" overrules everything else. There's no check/balance at all. They are free to over indulge with all the obvious downsides. The suppliers only care about sales.


I agree - taking drugs is not to my taste, but if people want to get high then it should be legal for them to get clean and prescribed doses of LSD or Cocaine or Ecstasy.

But since we've done such a great job of making those things illegal and impossible to get, our children end up on meth.

I blame meth on government policy.

People would never have reason to try meth in the first place if they could easily, legally and cheaply smoke pot or take one of the above mentioned drugs.


I think the issue is moderation. People aren't all that good at moderation --which is why you don't get doctors encouraging people to have "a moderate amount of red wine" because people will make up their own minds what "moderate" means even if you say 4oz... that definition will be stretched.

I knew [past tense] some coke addicts, not pretty.

Alcohol is not "good" on the other hand its effects usually take a decade or more of heavy use to show up in most adults-whereas heavy use of other drugs ravage people quicker.


Pardon my curiosity but how does Meth differ from Adderall in terms of side effects? My understanding is they are very similar but meth is stronger?

Being in tech I know many people with Adderall perscriptions but none of the side effects typically reported for meth.

At low dose is it similar to Adderall? Is it only huge doses that result in scary sides?


The key difference between methamphetamine and adderall is that meth is neurotoxic at clinical doses, while adderall is actually neuroprotective. Meth use also causes negative side effects like dry mouth, dizziness, etc much more frequently and powerfully than amphetamine. Users also report that meth tends to hit much "harder" compared to amphetamine, increasing its addiction potential. It mostly is the high doses that cause the side effects, but because of the impurities in street meth, it's nearly impossible to properly weigh the amounts required for adderall-like usage(5-10mg), and even then, it's still neurotoxic. This means that most street users use large doses that cause those effects.


I'm not special in any way. But I've been pretty liberal with drugs despite their stigma.

Before I talk about myself, I'd like to point out a sore spot in our classification of drug culture -- Being a "nerd" / intellectual does not include being a square / prude. Though they go hand and hand often, because up-tight people tend to keep to themselves, and avoid any risk-taking behavior. These people tend to be well-learned because reading and learning is an extremely low-risk endeavor.

But I think the truly smart people take evidence in a bayesian way, they become aware of risks, yet know to reason from first principles. The only way to yield new knowledge is to veer from the well-trodden paths.

And so, with that preamble out of the way, I take certain drugs often for medical reasons. I've done pretty much every drug under the sun in my college days, and every one of those drugs changed me in a positive way, despite the prude and straight-edged grandmas protesting that I would become addicted or go bonkers, or kill myself somehow. The psychadelics in my opinion, are the most worthwhile drugs, that only really need to be tried ONCE to have an immense effect on someones' life. I don't think someone should do acid every day -- I'm not that guy. But trying it once is definitely worthwhile. And any more than the first time, even a few times, is not even all that profound.

I take amphetamines orally, a few times a week to help me with my focus issues, when studying. I have insufflated them before, back in college, and it's not good for the noses' capillaries, the sinuses, etc.. It's just dumb, a party thing, what immediacy could be gained through faster administration is lost in the mal health effects.

I have chronic pain from multiple herniated discs from an accident. I take opiates daily to help with focus, because pain is extremely exhausting, and will wear you down. You will literally feel mentally tired from the body having to had processed pain -- you'll even need to eat more.

I disagree with synthetic opiates being prescribed. Oxycodone is stronger than heroin in receptor affinity. Addicts will even prefer it, in even oral formulations, versus heroin. Morphine on the other hand, is less pleasurable, and is the gold standard for pain. The synthetics like Oxycodone, Oxymorphone, Hydrocodone, were created because the side effects of morphine were deemed too numerous. When I first took morphine, I hated it. It made me nauseous, made my poops hard, and well, it just made me dizzy and disoriented. But once I gave it another chance, it worked really well. Morphine and codeine are the poppy plants natural alkaloids. Why go with a synthetic opiate designed to have a stronger affinity than the natural one?? That is just asking for addictions.

If insurance in the United States were better, Tapentadol would actually be the drug of choice for pain relief that all doctors should prescribe. Tramadol works great for minor pain, and Tapentadol is the second revision of Tramadol, designed for moderate to strong pain, by the same drug company that discovered Tramadol. But unfortunately, it costs $1500 a bottle for the innovation. I used to take it until I lost my good insurance. It is both an opiate and a norepinephrine agonist, like Tramadol, but has stronger opioid agonism. Souped up Tramadol. Less physically addictive than pure opioids like morphine, yet stronger pain relief, drug science is amazing.

Both of these drugs, amphetamines, morphine, can be abused. But they have so much utility for people who can benefit from them. Amphetamine abuse is high in rural communities that utilize a lot of manual labor. And that naturally follows from amphetamines enabling a higher capacity to do both physical and mental work.

So when I see the blind opinion that drugs are bad..mmkay -- that they will instantly addict even open-minded rational, logical people -- I have to provide the other perspective. Responsible use. Drugs improving someones' life who would otherwise be severely tired and inefficient.


I wonder how much of the cartels switching to meth is the fact that legalization is sapping their profits from marijuana.




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