Street Names, Common Forms and Paraphernalia

Methamphetamine is known by more than 200 street names. The purest forms are commonly referred to as ice, or crystal, while glass generally refers to its crystalline chunk form. In Thailand, a combination of methamphetamine and caffeine is known as yaba, meaning "crazy medicine." Today, yaba remains widely used throughout parts of Southeast Asia.^20,33 Individuals who chronically use methamphetamine may be referred to as tweakers, reflecting the severe behavioral changes that can occur during prolonged stimulant use, including agitation, paranoia, and violent behavior. Users are also sometimes called speed freaks, while those who manufacture illicit methamphetamine are commonly referred to as cookers.^20,34

Because of the variety of manufacturing methods and precursor chemicals used, methamphetamine can appear in many different forms and colors, making visual identification unreliable. Powdered methamphetamine may be white, pink, gray, brown, orange, or yellow. Tablet formulations vary widely in color, while crystalline methamphetamine ("ice") typically appears as off-white or clear rock-like crystals.^3,20 Liquid methamphetamine continues to be encountered in drug trafficking because it can be concealed in common containers such as fuel tanks, windshield washer reservoirs, liquor bottles, detergent containers, antifreeze bottles, and other commercially packaged liquids. After transport, the solvent is evaporated, leaving crystalline methamphetamine. Because methamphetamine readily dissolves in liquids, accidental ingestion of liquid methamphetamine can result in life-threatening toxicity.^2,30,34 Methamphetamine may be administered by multiple routes, including oral ingestion, smoking, intranasal insufflation (“snorting”), intravenous injection, rectal administration, and vaginal administration. Preferred routes of administration vary according to geographic region, drug availability, purity, and user preference.^3,20

Various items of drug paraphernalia may indicate methamphetamine use, depending on the route of administration. Oral use may be associated with tablets or capsules. Injection may involve syringes and other injection equipment. Smoking is commonly associated with glass pipes, modified light bulbs, aluminum foil, or altered beverage cans. Intranasal use may involve hollowed pens or drinking straws. The presence of numerous beverage bottles or unusual chemical containers, particularly those found in inappropriate locations, may also warrant further attention because they can be associated with methamphetamine trafficking or production.^34,35

According to recent National Drug Threat Assessments, seizures of methamphetamine adulterated with or co-distributed alongside illicit fentanyl continue to increase throughout the United States. Because users are often unaware that fentanyl is present, this combination substantially increases the risk of fatal overdose.^2,30