Methamphetamines, commonly known as meth, are potent stimulants that affect the brain and body by increasing the concentration of dopamine, a neurotransmitter associated with pleasure, movement, and attention. This leads to high levels of dopamine in the brain, causing intense euphoria and increased energy. However, these effects come at a cost: meth use can result in severe dental problems ("meth mouth"), skin sores, weight loss, and cardiovascular issues. Chronic use can lead to addiction, characterized by compulsive drug-seeking behavior, and can cause long-term cognitive and emotional deficits, including memory loss, aggressive behavior, and psychotic symptoms such as paranoia and hallucinations.
In recent years, there has been a notable increase in methamphetamine use across the United States. The National Survey on Drug Use and Health (NSDUH) released a report estimating the number of people 12 years or older reporting past-year use of methamphetamine in 2019 was 2.0 million, up from 1.4 million in 2016. Likewise, the number of deaths from stimulant overdoses tripled between 2013 and 2019. This rise in usage has been attributed to several factors, including increased production and availability of the drug, changes in drug trafficking patterns, and a decrease in the price of methamphetamine.
The issue has garnered more attention as more patients are diagnosed with psychosis induced by methamphetamine use. Methamphetamine-induced psychosis is a diagnosis that has been known for several decades now but has seen a rise in recent years. Patients present as disconnected from reality and can experience episodes hallucinations and/or delusions - often affecting their ability to care for themselves.
In addition, this substance-induced psychosis is not always limited to a single episode of methamphetamine use. Chronic use of methamphetamines can cause long-lasting changes in the brain’s dopamine system, which is critically involved in psychosis and schizophrenia. Studies have shown that individuals who use methamphetamines are at an increased risk of developing psychotic symptoms, which can persist even after they stop using the drug. This suggests that methamphetamine use can both trigger and exacerbate the underlying vulnerability to psychotic disorders such as schizophrenia.
Overall, while surveys show that methamphetamine use and induced psychosis are on the rise, understanding the compexity of socioeconomic and physiologic factors affecting the rise in methamphetamine-induced psychosis is crucial for developing effective prevention and treatment strategies. There are many clinical and societal implications of this uptrending diagnosis that are critical to quality of life and safety for individuals everywhere.
References
Jones CM, Houry D, Han B, Baldwin G, Vivolo-Kantor A, Compton WM. Methamphetamine use in the United States: epidemiological update and implic
ations for prevention, treatment, and harm reduction. Ann N Y Acad Sci. 2022 Feb;1508(1):3-22. doi: 10.1111/nyas.14688. Epub 2021 Sep 24. PMID: 34561865; PMCID: PMC9097961.
Seeman MV. History of the dopamine hypothesis of antipsychotic action. World J Psychiatry. 2021 Jul 19;11(7):355-364. doi: 10.5498/wjp.v11.i7.355. PMID: 34327128; PMCID: PMC8311512.
Glasner-Edwards S, Mooney LJ. Methamphetamine psychosis: epidemiology and management. CNS Drugs. 2014 Dec;28(12):1115-26. doi: 10.1007/s40263-014-0209-8. PMID: 25373627; PMCID: PMC5027896.
Hany M, Rehman B, Rizvi A, et al. Schizophrenia. [Updated 2024 Feb 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.
Akiyama K, Kanzaki A, Tsuchida K, Ujike H. Methamphetamine-induced behavioral sensitization and its implications for relapse of schizophrenia. Schizophr Res. 1994 Jun;12(3):251-7. doi: 10.1016/0920-9964(94)90035-3. PMID: 8054317.
Rognli EB, Heiberg IH, Jacobsen BK, Høye A, Bramness JG. Transition From Substance-Induced Psychosis to Schizophrenia Spectrum Disorder or Bipolar Disorder. Am J Psychiatry. 2023 Jun 1;180(6):437-444. doi: 10.1176/appi.ajp.22010076. Epub 2023 May 3. PMID: 37132221. Assessed and Endorsed by the MedReport Medical Review Board