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Methamphetamine: Implications for the Dental Team

Course Number: 332

Stages of Meth Use

The Rush (or Flash) – the initial response the abuser feels when smoking or injecting methamphetamine. The methamphetamine rush can continue for up to thirty minutes whereas the initial response to cocaine lasts only 5 minutes. Snorting or oral ingestion produces euphoria – a high – but not the intense rush.

The High – the rush is followed by a high, sometimes called “the shoulder.” During the high, the abuser often feels aggressively smarter and becomes argumentative, often interrupting other people and finishing their sentences. The delusional effects can result in a user becoming intensely focused on an insignificant item, such as repeatedly cleaning the same window for several hours. The high can last four to sixteen hours.

The Binge – is uncontrolled use of methamphetamine. The abuser tries to maintain the high by smoking or injecting more methamphetamine. The binge can last three to fifteen days. During the binge, the abuser becomes hyperactive both mentally and physically. Each time the abuser smokes or injects more of the drug, he experiences another but smaller rush until, finally, there is no rush and no high.

Tweaking – this is the most dangerous phase of meth addiction. This is the end of a drug binge when methamphetamine no longer provides a rush or a high. Unable to relieve the feelings of emptiness and craving, an abuser loses his sense of identity. Intense itching is common and a user can become convinced that bugs are crawling under his skin. Unable to sleep for days at a time, the abuser is often in a completely psychotic state, and he exists in his own world, seeing and hearing things that no one else can perceive. The hallucinations are so vivid that they seem real and, disconnected from reality, the user can become hostile and dangerous to himself and others. The potential for self-mutilation is high.

The Crash – occurs when the body shuts down, unable to cope with the overwhelming effects of the drug resulting in a long period of sleep. Even violent abusers can become almost lifeless during the crash, which can last one to three days.

Meth Hangover – after the crash, the abuser is in a deteriorated state: starved, dehydrated and exhausted physically, mentally and emotionally. This stage ordinarily lasts from two to fourteen days. This leads to enforced addiction, as the “solution” to these feelings is to take more meth.

Withdrawal – often thirty to ninety days can pass after the last drug use before the abuser realizes that he is in withdrawal. First, he becomes depressed, loses his energy and the ability to experience pleasure. Then the craving for more methamphetamine hits, and the abuser often becomes suicidal. Meth withdrawal is painful and difficult, and most users continue to use meth.