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| * ] | * ] | ||
| The levorotary form is an ] used in ]s for nasal decongestion. |
The levorotary form, ], is an ] used in ]s for nasal decongestion. Levomethamphetamine does not possess any significant ] activity or addictive properties. The remainder of this article deals only with the dextrorotatory form, dextromethamphetamine, or the ] form, methamphetamine. | ||
| Methamphetamine enters the ] and triggers a ] of ], ] and ]. It is highly active in the ] of the brain, inducing intense ], with risks for ]. To a lesser extent, methamphetamine acts as a ] and ] ] inhibitor with high concentrations serving as a ]. Users may become ] or obsessed with a task, thought or activity. Withdrawal is characterized by excessive sleeping, eating, and major ], often accompanied by anxiety and drug-craving.<ref>{{cite journal | author = McGregor C, Srisurapanont M, Jittiwutikarn J, Laobhripatr S, Wongtan T, White J | title = The nature, time course and severity of methamphetamine withdrawal | journal = Addiction | volume = 100 | issue = 9 | pages = 1320–9 | year = 2005 | pmid = 16128721 | doi = 10.1111/j.1360-0443.2005.01160.x}}</ref> Methamphetamine users may take ]s such as ]s as a means of easing their "]", anxiety or enable them to sleep.<ref></ref> | Methamphetamine enters the ] and triggers a ] of ], ] and ]. It is highly active in the ] of the brain, inducing intense ], with risks for ]. To a lesser extent, methamphetamine acts as a ] and ] ] inhibitor with high concentrations serving as a ]. Users may become ] or obsessed with a task, thought or activity. Withdrawal is characterized by excessive sleeping, eating, and major ], often accompanied by anxiety and drug-craving.<ref>{{cite journal | author = McGregor C, Srisurapanont M, Jittiwutikarn J, Laobhripatr S, Wongtan T, White J | title = The nature, time course and severity of methamphetamine withdrawal | journal = Addiction | volume = 100 | issue = 9 | pages = 1320–9 | year = 2005 | pmid = 16128721 | doi = 10.1111/j.1360-0443.2005.01160.x}}</ref> Methamphetamine users may take ]s such as ]s as a means of easing their "]", anxiety or enable them to sleep.<ref></ref> | ||
| Methamphetamine addiction typically occurs when a person begins to use it because of its powerful enhancing effects on mood and energy, weight loss and appetite suppression, among its other psychological and physical effects.{{Fact|April 2009|date=April 2009}} Over time effectiveness decreases, and users find that they need to take higher doses to get the same results and have far greater difficulty functioning and |
Methamphetamine addiction typically occurs when a person begins to use it because of its powerful enhancing effects on mood and energy, weight loss and appetite suppression, among its other psychological and physical effects.{{Fact|April 2009|date=April 2009}} Over time effectiveness decreases, and users find that they need to take higher doses to get the same results and have far greater difficulty functioning and expe | ||
| <!-- Anyone who wishes to add an additional nickname for methamphetamine please add it in the text between the <ref group="note"></ref> tags below, any more non-notable methamphetamine slang added to the article introduction will be move from the introduction into the <ref group="note"></ref> footote tags. --> | |||
| Nicknames for methamphetamine are numerous and vary significantly from region to region, some common nicknames for methamphetamine include "crank", "meth", "ice", "crystal", "glass", "shabu" or "syabu" (]), "tik" (]), "P" (]), "piko" (]), and "]" (]).<!-- The text contained in the ref tag is where you want to edit if you wish to add a new nickname. --><ref group="Note">Nicknames for methamphetamine are varied and differ from region to region, some less known and less notable nicknames for methamphetamine include "jib", "batu", "meth amps", "poof", "rail", "tina", and "tweak". For additional drug slang and terminology for numerous recreational drug please see the <span class="plainlinks"></span></ref> Methamphetamine is sometimes referred to as "speed", but this term is generally reserved for regular ] and ].<ref name="fade">{{cite web|title=Methamphetamine|url=http://www.fade.org.nz/alcohol-and-drug-info/methamphetamine/}} FADE Alcolohol & Drug Info: Methamphetamine</ref> | |||
| ==History== | |||
| Methamphetamine was first synthesized from ] in ] in ] by chemist ].<ref>{{cite journal|author =Nagai N.|title = Kanyaku maou seibun kenkyuu seiseki (zoku)|journal= Yakugaku | |||
| Zashi |year=1893|volume= 13|pages= 901}}</ref> In ], crystallized methamphetamine was synthesized by ] via ] of ] using red ] and ]. | |||
| ===World War II=== | |||
| One of the earliest uses of methamphetamine was during World War II when the German military dispensed it under the trade name '''Pervitin'''.<ref name=Pervitin>{{cite web | url=http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?sid=271075|title=Substance Page on Methamphetamine|work=PubChem}}</ref> It was widely distributed across rank and division, from elite forces to tank crews and aircraft personnel. Chocolates dosed with methamphetamine were known as Fliegerschokolade ("airmen's chocolate") when given to pilots, or Panzerschokolade ("tank chocolate") when given to tank crews. From 1942 until his death in 1945, ] may have been given intravenous injections of methamphetamine by his personal physician ] as a treatment for depression and fatigue. It is possible that it was used to treat Hitler's speculated ], or that his Parkinson-like symptoms which developed from 1940 onwards resulted from using methamphetamine.<ref>{{cite journal | last= Doyle | first = D | year= 2005 | title= Hitler's Medical Care | url= http://www.rcpe.ac.uk/publications/articles/journal_35_1/Hitler's_medical_care.pdf | journal = Journal of the Royal College of Physicians of Edinburgh | volume=35 | pages=75–82 | format = PDF | accessdate=2006-12-28}}</ref> | |||
| ===Post-war use=== | |||
| After World War II, a large supply of amphetamine stockpiled by the Japanese military became available in Japan under the street name ''shabu'' (also Philopon, pronounced ''Hiropon'', a tradename)<ref name=Philopon>{{cite web | url = http://www.yama-arashi.com/medical/antidepressants.htm | title = 抗うつ薬いろいろ (Various Antidepressants) | accessdate = 2006-07-14 | author = Digital Creators Studio Yama-Arashi | date= 2006-04-16 | work = 医療情報提供サービス | language = Japanese}}</ref>. The Japanese Ministry of Health banned it in 1951; since then it has been increasingly produced by the ] criminal organization.<ref name=banning_in_1951>{{cite web | url = http://www.unodc.org/unodc/en/data-and-analysis/bulletin/bulletin_1989-01-01_1_page007.html | title = Japan: stimulant epidemics past and present | dateformat = mdy | accessdate = ] 2006 | author = M. Tamura | date= 1989-01-01 | work = Bulletin on Narcotics | publisher = United Nations Office on Drugs and Crime | pages = 83–93}}</ref> Today methamphetamine is still associated with the Japanese underworld, and its use is discouraged by strong social taboos.{{Fact|April 2009|date=April 2009}} | |||
| In the 1950s there was a rise in the legal prescription of methamphetamine to the American public. According to the 1951 edition of ''Pharmacology and Therapeutics'' by Arthur Grollman, it was to be prescribed for "], post-] ], ], ... in certain depressive states... and in the treatment of ]."{{Fact|April 2009|date=April 2009}} | |||
| The 1960s saw the start of significant use of clandestinely manufactured methamphetamine as well as methamphetamine created in users' own homes for personal use. The recreational use of methamphetamine peaked in the 1980s. The December 2, 1989 edition of '']'' described ] as the "methamphetamine capital of North America."{{Fact|April 2009|date=April 2009}} | |||
| In 2000, '']'' again described ] as the methamphetamine capital of North America, and ] as the second capital city.{{Fact|April 2009|date=April 2009}} | |||
| ===Legal restrictions=== | |||
| In 1983 laws were passed in the United States prohibiting possession of precursors and equipment for methamphetamine production; this was followed a month later by a bill passed in Canada enacting similar laws. In 1986 the U.S. government passed the Federal Controlled Substance Analogue Enforcement Act in an attempt to curb the growing use of ]s. Despite this, use of methamphetamine expanded throughout rural United States, especially through the Midwest and South.{{Fact|April 2009|date=April 2009}} | |||
| Since 1989 five U.S. federal laws and dozens of state laws have been imposed in an attempt to curb the production of methamphetamine. Methamphetamine can be produced in home laboratories using pseudoephedrine or ephedrine, the active ingredients in over-the-counter drugs such as ] and ]. Preventative legal strategies of the past 17 years have steadily increased restrictions to the distribution of pseudoephedrine/ephedrine-containing products.{{Fact|April 2009|date=April 2009}} | |||
| As a result of the U.S. ], a subsection of the ], there are restrictions on the amount of pseudoephedrine and ephedrine one may purchase in a specified time period, and further requirements that these products must be stored in order to prevent theft.<ref>Cunningham JK, Liu LM. (2003) Impacts of Federal ephedrine and pseudoephedrine regulations on methamphetamine-related hospital admissions. Addiction, 98, 1229–1237.</ref> | |||
| ==Pharmacology== | |||
| Methamphetamine is a potent ] ] which affects neurochemical mechanisms responsible for regulating heart rate, body temperature, blood pressure, appetite, attention, mood and responses associated with alertness or alarm conditions. | |||
| The acute physical effects of the drug closely resemble the physiological and psychological effects of an ]-provoked ], including increased heart rate and blood pressure, ] (constriction of the arterial walls), ], and ] (increased blood sugar). Users experience an increase in focus, increased mental alertness, and the elimination of fatigue, as well as a decrease in appetite. | |||
| The ] is responsible for the potentiation of effects as compared to the related compound ], rendering the substance on the one hand more lipid soluble and easing transport across the ], and on the other hand more stable against enzymatic degradation by ]. | |||
| Methamphetamine causes the ], ] and ] (5HT) transporters to reverse their direction of flow. This inversion leads to a release of these transmitters from the vesicles to the cytoplasm and from the cytoplasm to the synapse (releasing monoamines in rats with ratios of about ]:] = 1:2, NE:]= 1:60), causing increased stimulation of post-synaptic receptors. Methamphetamine also indirectly prevents the reuptake of these neurotransmitters, causing them to remain in the synaptic cleft for a prolonged period (inhibiting monoamine reuptake in rats with ratios of about: NE:DA = 1:2.35, NE:5HT = 1:44.5<ref>Rothman, et al. "Amphetamine-Type Central Nervous System Potently than they Release Dopamine and Serotonin." (2001): Synapse ''39'', 32-41 (Table V. on page 37)</ref>). | |||
| Methamphetamine is a potent neurotoxin, shown to cause dopaminergic degeneration.<ref>{{cite journal | author = Itzhak Y, Martin J, Ali S | title = Methamphetamine-induced dopaminergic neurotoxicity in mice: long-lasting sensitization to the locomotor stimulation and desensitization to the rewarding effects of methamphetamine | journal = Prog Neuropsychopharmacol Biol Psychiatry | volume = 26 | issue = 6 | pages = 1177–83 | year = 2002 | pmid = 12452543 | doi = 10.1016/S0278-5846(02)00257-9}}</ref><!-- This corresponds to a human equivalent dose of at least 100 mg! Even higher on a simple mg/kg basis, which is probably a better measure for acute toxicity. --><ref>{{cite journal | author = C. Davidson, A. J. Gow, T. H. Lee, E. H. Ellinwood | title = Methamphetamine neurotoxicity: necrotic and apoptotic mechanisms and relevance to human abuse and treatment | journal = Brain Research Reviews | volume = 36 | issue = 1 | pages = 1–22 | year = 2001 | doi = 10.1016/S0165-0173(01)00054-6}}</ref> High doses of methamphetamine produce losses in several markers of brain dopamine and serotonin neurons. Dopamine and serotonin concentrations, dopamine and 5HT uptake sites, and tyrosine and tryptophan hydroxylase activities are reduced after the administration of methamphetamine. It has been proposed that dopamine plays a role in methamphetamine induced neurotoxicity because experiments which reduce dopamine production or block the release of dopamine decrease the toxic effects of methamphetamine administration. When dopamine breaks down it produces ] such as hydrogen peroxide. It is likely that the approximate 1200% increase in dopamine levels and subsequent ] that occurs after taking methamphetamine mediates its ].<ref>{{cite journal | url = http://jpet.aspetjournals.org/cgi/content/full/287/1/107 | author = Yamamoto, B. and Zhu, W. | title = The Effects of Methamphetamine on the Production of Free Radicals and Oxidative Stress | journal = The Journal of Pharmacology and Experimental Therapeutics | volume = 287 | issue = 1 | pages = 107–114 | month= October | year= 1998 | accessdate=2007-11-19 | pmid = 9765328 | day = 01}}</ref> It has been demonstrated that a high ambient temperature increases the neurotoxic effects of methamphetamine.<ref>{{cite journal | url = http://jpet.aspetjournals.org/cgi/content/abstract/jpet.105.096503v1 | journal = The Journal of Pharmacology and Experimental Therapeutics | title = Relationship between Temperature, Dopaminergic Neurotoxicity, and Plasma Drug Concentrations in Methamphetamine-Treated Squirrel Monkeys | volume = 316 | issue = 3 | year= 2006 | pages = 1210–1218 | accessdate = 2007-11-20 | pmid = 16293712 | doi = 10.1124/jpet.105.096503 | author = Yuan, J. }}</ref> | |||
| Recent research published in the Journal of Pharmacology And Experimental Therapeutics (2007),<ref></ref> indicates that methamphetamine binds to a group of receptors called ]. TAAR is a newly discovered receptor system which seems to be affected by a range of amphetamine-like substances called ]. | |||
| ==Effects== | |||
| Retrieved on April 16, 2009</ref>]] | |||
| ===Physical effects=== | |||
| Physical effects can include ]<ref name="Erowid">http://www.erowid.org/chemicals/meth/meth_effects.shtml Erowid Methamphetamines Vault : Effects</ref>, ]<ref name="Erowid"/>, ]<ref>http://www.iir.com/centf/guide.htm#What%20are%20the%20signs%20that%20a%20person%20may%20be%20using%20methamphetamine</ref>, ]<ref name="kci">http://www.kci.org/meth_info/sites/meth_facts2.htm</ref>, ]<ref name="Drugs.com">http://www.drugs.com/mtm/methamphetamine.html</ref>, ]<ref name="kci"/>, ]<ref name="Drugs.com"/>, ]<ref name="kci"/>, ]{{Fact|May 2009|date=May 2009}}, ]<ref name="kci"/>, ]<ref name="kci"/>, ]{{Fact|May 2009|date=May 2009}}, ]<ref name="cesar.umd.edu">http://www.cesar.umd.edu/cesar/drugs/meth.asp</ref>, ]<ref name="Erowid"/>, ]<ref name="Erowid"/>, ]<ref name="Drugs.com"/>, ]<ref name="Drugs.com"/>, ]{{Fact|May 2009|date=May 2009}}, ]<ref name="Drugs.com"/>, muscle twitches<ref name="Drugs.com"/>, ]<ref name="Drugs.com"/>, ]<ref name="Drugs.com"/>, ]<ref name="CenTF"/>, ]{{Fact|May 2009|date=May 2009}}, ]<ref name="Drugs.com"/>, dry and/or itchy skin<ref name="Erowid"/>, ]<ref name="cesar.umd.edu"/>, ]<ref name="kci"/>, and with chronic and/or high dosages, ]<ref>http://www.iir.com/centf/guide.htm#Are%20there%20any%20effective%20treatments%20for%20methamphetamine%20abusers</ref>, ]<ref>http://www.montana.edu/wwwai/imsd/rezmeth/effmethod.htm</ref>, ]<ref name="Erowid"/> and ] can occur<ref name="cesar.umd.edu"/>. | |||
| ===Psychological effects=== | |||
| Psychological effects can include ]<ref name="Erowid"/>, ]<ref name="Erowid"/>, increased ]<ref name="Erowid"/>, increased ]<ref name="Erowid"/>, increased ], increased ]<ref name="Erowid"/>, increased ]<ref name="Erowid"/>, increased ]<ref name="Erowid"/>, increased ]<ref name="Erowid"/>, increased ]ic intensity{{Fact|May 2009|date=May 2009}}, increased ]<ref name="Erowid"/>, increased ]<ref name="Erowid"/>, increased ]<ref name="Erowid"/>, ]<ref name="Erowid"/>, ]<ref name="Erowid"/>, excessive feelings of ] and/or ]<ref name="Erowid"/>, repetitive and/or obsessive behaviors<ref name="Erowid"/>, ]<ref name="Erowid"/>, and with chronic and/or high doses, ] can occur<ref name="Erowid"/>. | |||
| ===Withdrawal effects=== | |||
| Withdrawal is characterized by excessive sleeping<ref name="Erowid"/>, excessive eating<ref name="Erowid"/>, and ]<ref name="Erowid"/>, often accompanied by anxiety and drug-craving<ref name="Erowid"/>. | |||
| ==Pharmacokinetics== | |||
| The half life of methamphetamine is 9–15 hours. It is excreted by the kidneys and its half life depends on urinary pH. Main metabolites of methamphetamine are amphetamine<ref name="ncbi.nlm.nih.gov"></ref>, 4-hydroxymethamphetamine, 4-hydroxyamphetamine and some of the methamphetamine remains unchanged until excretion.<ref name="meth_metabolites_quant"></ref> | |||
| ==Tolerance== | |||
| As with other amphetamines, tolerance to methamphetamine is not completely understood, but known to be sufficiently complex that it cannot be explained by any single mechanism. The extent of tolerance and the rate at which it develops varies widely between individuals, and even within one person it is highly dependent on dosage, duration of use and frequency of administration. Many cases of ] were treated with methamphetamine for years without escalating doses or any apparent loss of effect. | |||
| Short term tolerance can be caused by depleted levels of ] within the ] available for release into the ] following subsequent reuse (]). Short term tolerance typically lasts until neurotransmitter levels are fully replenished, because of the toxic effects on dopaminergic neurons, this can be greater than 2–3 days. Prolonged overstimulation of ] caused by methamphetamine may eventually cause the receptors to ] in order to compensate for increased levels of ] within the synaptic cleft.<ref>{{cite journal | author = Bennett B, Hollingsworth C, Martin R, Harp J | title = Methamphetamine-induced alterations in dopamine transporter function | journal = Brain Res | volume = 782 | issue = 1-2 | pages = 219–27 | year = 1998 | pmid = 9519266 | doi = 10.1016/S0006-8993(97)01281-X}}</ref> To compensate, larger quantities of the drug are needed in order to achieve the same level of effects. | |||
| ==Addiction== | |||
| Methamphetamine is ],<ref>. Centre for Addiction and Mental Health.</ref> especially when ] or smoked.<ref>{{cite web|url=http://www.methamphetamineaddiction.com/treatment_admissions.html|title=Methamphetamine/Amphetamine Treatment Admissions, by Route of Administration}}</ref> While not life-threatening, ] is often intense and, as with all addictions, ] is common. ] meetings, such as ] are available to combat relapse. | |||
| Methamphetamine-induced hyperstimulation of pleasure pathways leads to ]. It is possible that daily administration of the amino acids L-] and ]/] can aid in the recovery process by making it easier for the body to reverse the depletion of ], ], and ]. Although studies involving the use of these amino acids have shown some success, this method of recovery has not been shown to be consistently effective. {{Fact|date=November 2008}} | |||
| It is shown that taking ] prior to using methamphetamine may help reduce acute toxicity to the brain, as rats given the human equivalent of 5-10 grams of ascorbic acid 30 minutes prior to methamphetamine dosage had toxicity mediated<ref>Wagner GC, Carelli RM, Jarvis MF. "Pretreatment with ascorbic acid attenuates the neurotoxic effects of methamphetamine in rats." ''Research Communications in Chemical Pathology and Pharmacology''. 1985 Feb;'''47'''(2):221-8. PMID 3992009</ref><ref>Wagner GC, Carelli RM, Jarvis MF. "Ascorbic acid reduces the dopamine depletion induced by methamphetamine and the 1-methyl-4-phenyl pyridinium ion." ''Neuropharmacology''. 1986 May;'''25'''(5):559-61. PMID 3488515</ref>, yet this will likely be of little avail in solving the other serious behavioral problems associated with methamphetamine use and addiction that many users experience. Large doses of ascorbic acid also lower urinary ], reducing methamphetamine's elimination ] and thus decreasing the duration of its actions.<ref>Oyler JM, Cone EJ, Joseph RE Jr, Moolchan ET, Huestis MA. ''Clinical Chemistry''. 2002 Oct;'''48'''(10):1703-14. PMID 12324487.</ref> | |||
| To combat addiction, doctors are beginning to use other forms of amphetamine such as ] to break the addiction cycle in a method similar to the use of ] in the treatment of ] addicts. There are no publicly available drugs comparable to ], which blocks opiate receptors and is therefore used in treating ] dependence, for use with methamphetamine problems.<ref>The Ice Age (See Below)</ref> However, experiments with some monoamine reuptake inhibitors such as ] have been successful in blocking the action of methamphetamine.<ref>Rothman RB, Partilla JS, Baumann MH, Dersch CM, Carroll FI, Rice KC. "Neurochemical Neutralization of Methamphetamine With High-Affinity Nonselective Inhibitors of Biogenic Amine Transporters: A Pharmacological Strategy for Treating Stimulant Abuse." ''Synapse'' 2000 Mar 1;'''35'''(3):222-7. PMID 10657029</ref> There are studies indicating that fluoxetine, bupropion and imipramine may reduce craving and improve adherence to treatment.<ref name="pmid17990840">{{cite journal |author=Winslow BT, Voorhees KI, Pehl KA |title=Methamphetamine abuse |journal=American family physician |volume=76 |issue=8 |pages=1169–74 |year=2007 |pmid=17990840 |doi=}}</ref> Research has also suggested that ] can help addicts quit methamphetamine use.<ref>{{cite journal | author = Grabowski, J. et al. | title = Agonist-like, replacement pharmacotherapy for stimulant abuse and dependence | journal = Addictive Behaviors | volume = 29 | issue = 7 | pages = 1439–1464 | year = 2004 | url = http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VC9-4D7C8G6-4&_user=10&_coverDate=09%2F01%2F2004&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=7bc6e2c0a338da052c8ac605628cdfb7 |accessdate = 2007-12-02 | doi = 10.1016/j.addbeh.2004.06.018}}</ref><ref>{{cite web | title = Sleep medicine 'can help ice addicts quit' | url = http://www.abc.net.au/news/stories/2007/12/01/2107027.htm | accessdate = 2007-12-02}}</ref> | |||
| Methamphetamine addiction is one of the most difficult forms of addictions to treat. Although ], ], and Baclofen have been employed to treat post-withdrawal cravings the success rate is low. ] is somewhat more successful, but this is a Class IV scheduled drug. ] has been used with success in Europe, but is a Class I drug and available only for research use. ] has been reported useful in some small-population studies.<ref>AJ Giannini. ''Drugs of Abuse--Second Edition''. Los Angeles, Practice Management Information Company, 1997.</ref> | |||
| Since the ] ] is a constitutional isomer of methamphetamine, it has been speculated that it may be effective in treating methamphetamine addiction. Although phentermine is a central nervous stimulant that acts on ] and ], it has not been reported to cause the same degree of euphoria that is associated with other amphetamines. | |||
| Abrupt interruption of chronic methamphetamine use results in the withdrawal syndrome in almost 90% of the cases. Withdrawal of amphetamine often causes a depression which is longer and deeper than even the depression from cocaine withdrawal.<ref name="pmid17990840" /> | |||
| ==Natural occurrence== | |||
| ] | |||
| Methamphetamine has been reported to occur naturally in '']'' and possibly '']'', trees which grow in west ]. Acacia trees contain numerous other psychoactive compounds (ex. ], ], ], ], ...<ref>BA Clement, CM Goff, TDA Forbes, Phytochemistry Vol.49, No 5, pp1377–1380 (1998) | |||
| "Toxic amines and alkaloids from Acacia rigidula"</ref>), but scientific papers specifically mentioning the presence of methamphetamine did not exist until 1997 and 1998.<ref></ref> | |||
| ==Medical use== | |||
| {{main|Desoxyn}} | |||
| d-Methamphetamine is used medically under the brand name ] for the following conditions: | |||
| * ]<ref>{{cite journal |author= |title=NTP-CERHR monograph on the potential human reproductive and developmental effects of amphetamines |journal=NTP CERHR MON |volume= |issue=16 |pages=vii–III1 |year=2005 |month=July |pmid=16130031 |doi= |url=}}</ref>; | |||
| * Extreme ]; | |||
| * ] | |||
| ] | |||
| Because of its social stigma and toxicity, Desoxyn is not generally prescribed for ADHD unless other stimulants, such as ] (Ritalin), ] (Dexedrine), ] (Vyvanse) or mixed amphetamines (]) have failed.{{Fact|date=November 2008}} | |||
| ===Other uses=== | |||
| A new study by a group of ] scientists showed that methamphetamine appears to lessen damage to the brains of rats and gerbils that have suffered strokes. The researchers found that small amounts of methamphetamine created a protective effect, while higher doses increased damage. The work is preliminary, and more research is needed to confirm and expand the findings; however, U.M. research assistant professor Dave Poulsen said someday humans may use methamphetamine to lessen stroke damage.<ref>{{cite news |url=http://www.boston.com/news/education/higher/articles/2006/10/12/um_study_meth_may_lessen_stroke_damage/ |title=UM study: Meth may lessen stroke damage |publisher=AP |date=2006-10-12 |archiveurl=http://www.webcitation.org/5drWLLkEb |archivedate=2009-01-15 |accessdate=2008-06-29 }}</ref> | |||
| ==Health issues== | |||
| ===Meth mouth=== | |||
| ] | |||
| {{main|Meth mouth}} | |||
| Methamphetamine addicts may lose their teeth abnormally quickly, a condition known as "]". This effect is not caused by any corrosive effects of the drug itself, which is a common myth. According to the ], meth mouth "is probably caused by a combination of drug-induced psychological and physiological changes resulting in ] (dry mouth), extended periods of poor ], frequent consumption of high calorie, carbonated beverages and ] (teeth grinding and clenching)."<ref name="ADA">{{cite web |url=http://www.ada.org/prof/resources/topics/methmouth.asp |title=Methamphetamine Use (Meth Mouth) |accessdate=2006-12-16 |publisher=American Dental Association }}</ref> Similar, though far less severe symptoms have been reported in clinical use of other amphetamines, where effects are not exacerbated by a lack of oral hygiene for extended periods.<ref></ref> | |||
| Like other substances which stimulate the ], methamphetamine causes decreased production of acid-fighting saliva and increased thirst, resulting in increased risk for tooth decay, especially when thirst is quenched by high-sugar drinks.<ref></ref> | |||
| ===Hygiene=== | |||
| Serious health and appearance problems can be caused by unsterilized needles, lack or ignoring of hygiene needs (more typical on chronic use), increase in acne on high doses, and obsessive skin-picking which may lead to ]es.<ref name="pmid17990840"/> | |||
| ===Sexual behaviour{{anchor|Sexual behaviour}}=== <!-- anchor referred to by Methamphetamine and sex --> | |||
| {{seealso|sex and drugs}} | |||
| Users may exhibit ] behaviour while under the influence.{{Fact|date=January 2009}} This disregard for the potential dangers of unprotected sex or other reckless sexual behavior may contribute to the spread of sexually transmitted infections (STIs) (]s (STDs)). | |||
| Among the effects reported by methamphetamine users are increased libido and sexual pleasure, the ability to have sex for extended periods of time, and an inability to ] or reach ] or physical release. In addition to increasing the need for sex and enabling the user to engage in prolonged sexual activity, methamphetamine lowers inhibitions and may cause users to behave recklessly or to become forgetful. Users may even report negative experiences after prolonged use, which contradict reported feelings, thoughts, and attitudes achieved at similar dosages under similar circumstances but at earlier periods of an extended or prolonged cycle.<ref></ref> | |||
| According to a recent San Diego study {{Fact|date=June 2007}}, methamphetamine users often engage in ] activities, and forget to or choose not to use ]s. The study found that methamphetamine users were six times less likely to use condoms. The urgency for sex combined with the inability to achieve release (ejaculation) can result in tearing, chafing, and trauma (such as rawness and friction sores) to the ]s, the ] and mouth, dramatically increasing the risk of transmission of ] and other ]. Methamphetamine also causes ] due to vasoconstriction. | |||
| ''See also: ]'' | |||
| ===Use in pregnancy and breastfeeding=== | |||
| Methamphetamine passes through the placenta and is secreted in the breast milk. Half of the newborns whose mothers used methamphetamine during pregnancy experience ]; this syndrome is relatively mild and required medication in only 4% of the cases.<ref name="pmid17990840"/> | |||
| ==Routes of administration== | |||
| Studies have shown that the subjective pleasure of drug use (the reinforcing component of addiction) is proportional to the rate at which the blood level of the drug increases. In general, intravenous injection is the fastest mechanism (i.e., it causes blood concentrations to rise the most quickly), followed by smoking, anal insertion (]), ], and ] (swallowing). Ingestion does not produce a "rush", which is the most transcendent state of euphoria experienced with the use of methamphetamine and is the most prominent with intravenous use. While the onset of the "rush" produced by injection or smoking can occur in as little as two minutes, the oral route of administration usually requires approximately half an hour before the "high" kicks in. Thus, oral routes of administration are generally used by recreational or medicinal consumers of the drug, while other more fast-acting routes of administration are used by addicts. | |||
| ===Smoking=== | |||
| "Smoking" amphetamines actually refers to vaporizing it to inhale fumes, rather than burning and inhaling the resulting smoke, as with tobacco. It is commonly smoked in glass pipes made from ] ] tubes, light bulbs, or on aluminium foil heated underneath by a flame. This method is also known as "chasing the ''white'' dragon" (derived from heroin, known as "]"). There is little evidence that methamphetamine inhalation results in greater toxicity than any other route of administration. Lung damage has been reported with long-term use, but manifests in forms independent of route (pulmonary hypertension and associated complications), or limited to injection users (pulmonary emboli). | |||
| ===Injection=== | |||
| ] is a popular method for use, also known as slamming, but carries quite serious risks. The hydrochloride salt of methamphetamine is soluble in water; injection users may use any dose from 125 ]s to over one ] using a ] needle (Although it should be noted that typically street methamphetamine is "cut" with a water-soluble cutting material which constitutes a significant portion of that street methamphetamine dose). Injection users often experience skin rashes (sometimes called "speed bumps") and infections at the site of injection. As with any injected drug, if a group of users ] or any type of injecting equipment without sterilization procedures, blood-borne diseases such as ] or ] can be transmitted as well. | |||
| ===Insufflation=== | |||
| Another popular method for recreational use of methamphetamine is to insufflate (sometimes called snorting). This is done by crushing the methamphetamine crystals up into a fine powder and then sharply inhaling it (sometimes with a straw or a rolled up ]) into the nose where the methamphetamine is absorbed through the soft tissue in the ] of the ] straight into the bloodstream. This method bypasses first pass metabolism and has a faster onset with a higher ], although duration is shorter than oral administration. This method is sometimes preferred by users who do not want to use needles for injection or do not want to have to smoke the methamphetamine. | |||
| ===Other methods=== | |||
| ] | |||
| Very little research has focused on ] or anal insertion as a method, and anecdotal evidence of its effects is infrequently discussed, possibly due to social taboos in many cultures regarding the anus. This method is often known within methamphetamine communities as a "butt rocket", "potato thumping", "turkey basting", a "booty bump", "keistering", "plugging", "shafting", "shelving" (vaginal), or "bumming" and is anecdotally reported to increase sexual pleasure while the effects of the drug last longer.<ref></ref> The rectum is where the majority of the drug would likely be taken up, through the membranes lining its walls. | |||
| ==Illicit production== | |||
| ] | |||
| ===Synthesis=== | |||
| Methamphetamine is most structurally similar to ] and ]. When illicitly produced, it is commonly made by the ] of ] or ]. Most of the necessary chemicals are readily available in household products or ] cold or allergy medicines. Synthesis is relatively simple, but entails risk with flammable and corrosive chemicals, particularly the solvents used in extraction and purification. Clandestine production is therefore often discovered by fires and explosions caused by the improper handling of volatile or flammable solvents. | |||
| Most methods of illicit production involve ] of the ] group on the ] or ] molecule. The most common method for small-scale methamphetamine labs in the United States is primarily called the "Red, White, and Blue Process", which involves red ], ] or ] (white), and blue ] (which is technically a purple color in elemental form), from which ] is formed. In Australia, criminal groups have been known to substitute "red" phosphorus with either hypophosphorus acid or phosphorus acid.<ref></ref> | |||
| This is a fairly dangerous process for amateur chemists, because ] gas, a side-product from ] hydroiodic acid production, is extremely toxic to inhale. An increasingly common method uses the process of ], in which metallic ], commonly extracted from non-rechargeable ], is substituted for difficult-to-find metallic ]. | |||
| However, the Birch reduction is dangerous because the alkali metal and liquid ] are both extremely reactive, and the temperature of liquid ammonia makes it susceptible to explosive boiling when reactants are added. Anhydrous ammonia and lithium or sodium (Birch reduction) may be surpassing hydroiodic acid (])<!-- huh? --> as the most common method of manufacturing methamphetamine in the U.S. and possibly in Mexico. Hydroiodic acid "super lab" busts receive more media attention because the equipment employed is much more complex and visible than the glass jars or coffee carafes commonly used to produce methamphetamine with Birch reduction. | |||
| ].]] | |||
| A completely different procedure of synthesis uses the ] of ] with ],<ref></ref> both of which are currently ] ] chemicals (as are pseudoephedrine and ephedrine). The reaction requires a catalyst that acts as a reducing agent, such as ] or platinum dioxide, also known as ]. This was once the preferred method of production by ] in ],<ref>{{cite book |url=http://books.google.com/books?id=8lWBixJv0QAC |title=No Speed Limit: The Highs and Lows of Meth |first=Frank |last=Owen |publisher=Macmillan |year=2007 |isbn=9780312356163 |chapter=Chapter 1: The Rise of Nazi Dope |pages=17–18}}</ref> until DEA restrictions on the chemicals made the process difficult. Other less common methods use other means of hydrogenation, such as ] ] in the presence of a ]. | |||
| Methamphetamine labs can give off noxious fumes, such as ] gas, ] gas, solvent vapors; such as ] or ], ] vapors, white ], anhydrous ], ]/], ], ]/] metal, ], or methamphetamine vapors. If performed by amateurs, manufacturing methamphetamine can be extremely dangerous. If the red ] overheats, because of a lack of ventilation, phosphine gas can be produced. This gas, if present in large quantities, is likely to explode upon autoignition from diphosphine, which is formed by overheating ]. | |||
| ===Production and distribution=== | |||
| Until the early 1990s, methamphetamine for the US market was made mostly in labs run by drug traffickers in ] and ]. Since then, authorities<!-- which ones? --> have discovered increasing numbers of small-scale methamphetamine labs all over the United States, mostly in rural, suburban, or low-income areas. ] ] found 1,260 labs in 2003, compared to just 6 in 1995, although this may be partly a result of increased police activity.<ref></ref> As of 2007, drug and lab seizure data suggests that approximately 80 percent of the methamphetamine used in the United States originates from larger laboratories operated by Mexican-based syndicates on both sides of the border, and that approximately 20 percent comes from small toxic labs (STLs) in the United States.<ref>{{Citation | |||
| |url=http://www.usdoj.gov/dea/pubs/cngrtest/ct032207attach.html | |||
| |title=DEA Congressional Testimony, "Drug Threats And Enforcement Challenges" | |||
| |publisher=U.S. Drug Enforcement Administration | |||
| |date=], ] | |||
| |accessdate=]}}</ref> | |||
| Mobile and motel-based methamphetamine labs have caught the attention of both the US news media and the police. Such labs can cause explosions and fires, and expose the public to hazardous chemicals. Those who manufacture methamphetamine are often harmed by toxic gases. Many police departments have specialized task forces with training to respond to cases of methamphetamine production. The National Drug Threat Assessment 2006, produced by the ], found "decreased domestic methamphetamine production in both small and large-scale laboratories", but also that "decreases in domestic methamphetamine production have been offset by increased production in Mexico." They concluded that "methamphetamine availability is not likely to decline in the near term."<ref>. National Drug Intelligence Center. National Drug Threat Assessment 2006. January 2006.</ref> | |||
| In July 2007, a ship was caught by Mexican officials at the port of ], originating in ], after traveling through the port of ] with 19 tons of ], a raw material needed for meth.<ref>{{cite web|url=http://www.signonsandiego.com/news/mexico/20070726-1352-mexico-millionsseized.html|title=Mexico says pseudoephedrine case signals breakdown in port security in U.S., China | author = Olga R. Rodriguez | publisher=Sign On San Diego}}</ref> The ] owner ] was found to have $206 million at his ] mansion. The load went undetected at Long Beach. | |||
| Methamphetamine is distributed by prison gangs, ], street gangs, traditional ] operations, and impromptu small networks.{{Fact|May 2009|date=May 2009}} In the U.S. illicit methamphetamine comes in a variety of forms, at an average price of $150 per gram for pure substance.<ref></ref> Most commonly it is found as a colorless ] solid. Impurities may result in a brownish or tan color. Colourful flavored pills containing methamphetamine and ] are known as ] (Thai for "crazy medicine"). | |||
| At its most impure, it is sold as a crumbly brown or off-white rock commonly referred to as "peanut butter crank."<ref></ref> | |||
| Methamphetamine found on the street is rarely pure, but adulterated with chemicals that were used to synthesize it. It may be diluted or "]" with non-psychoactive substances like ], ] or ]. Another popular method is to combine methamphetamine with other stimulant substances such as ] or ] into a pill known as a "Kamikaze", which is particularly dangerous due to the synergistic effects of multiple stimulants on the heart. It may also be flavored with high-sugar candies, drinks, or drink mixes to mask the bitter taste of the drug. Coloring may be added to the meth, as is the case with "Strawberry Quick."<ref> <!-- Needs date and title: requires registration--></ref><ref>. ]</ref> | |||
| ==Legality== | |||
| ===Australia=== | |||
| Strictly speaking, as a Schedule 9 drug, the medical use of methamphetamine is recognized in ], however in practice this is not the case. | |||
| Some forms of Methamphetamine are known or ''Ice'' and has become the focus of a nation-wide crackdown. | |||
| ===Canada=== | |||
| Methamphetamine is not approved for medical use in ]. As of 2005, methamphetamine has been moved to Schedule I of the Controlled Drugs and Substances Act, which provides access to the highest maximum penalties. The maximum penalty for production and distribution of methamphetamine has increased from 10 years to ].<ref>{{cite web | |||
| |url=http://www.kcd.gc.ca/ev.php?ID=6493_201&ID2=DO_TOPIC | |||
| |title=Government of Canada increases maximum penalties for Methamphetamine offences | |||
| |work=Health Canada News Release | |||
| |publisher=Health Canada | |||
| |date=2005-08-11 | |||
| |accessdate=2008-09-01 }}</ref> | |||
| ===Hong Kong=== | |||
| Methamphetamine is regulated under Schedule 1 of ] Chapter 134 ''Dangerous Drugs Ordinance''. It can only be used legally by health professionals and for university research purposes. The substance can be given by pharmacists under a prescription. Anyone who supplies the substance without prescription can be fined $10000(HKD). The penalty for trafficking or manufacturing the substance is a $5,000,000 (]) fine and life imprisonment. Possession of the substance for consumption without license from the Department of Health is illegal with a $1,000,000 (HKD) fine and/or 7 years of jail time. | |||
| ===Italy=== | |||
| Methamphetamine is not approved for medical use in ], except for an extremely small number of case-approved, strictly controlled experimental therapies, and it is inscribed in the ''Tabella 1'' ("Schedule One") of the Psychotropic Substances List of the Italian Ministry of Health, which lists all illegal drugs (while the ''Tabella 2'', or "Schedule Two", lists psychotropic substances that can be used as prescription drugs). Methamphetamine is thus regulated like any other "heavy drug" (Italian law makes distinction between "Light Drugs", such as ], and "heavy drugs", such as ], ] or ]). Production, traffic and/or sale of methamphetamine can be punished with a sentence of imprisonment ranging from six to twenty years, and with a fine ranging from 26.000 to 260.000 ]s, according to the severity of the felony. As for any other drugs, the consumption of methamphetamine and the possession of the substance for "personal use" (under a certain quantity) is not illegal in Italy, although law enforcement and health authorities keep files on known users and addicts, which are often forced to undergo treatment.<ref>http://www.ministerosalute.it/medicinaliSostanze/paginaInternaMedicinaliSostanze.jsp?id=7&menu=strumentieservizi Italian Ministry of Health — Psychotropic substances List (in Italian)</ref><ref>http://www.altalex.com/index.php?idnot=33849 ''Testo Unico sulla Droga'' Italian drugs law</ref> However, methamphetamine is not a particularly common or popular substance in Italy, surclassed by the above-mentioned ], ], and by ]. | |||
| ===The Netherlands=== | |||
| Methamphetamine is not approved for medical use in ]. It falls under Schedule I of the Opium Act. Although production and distribution of this drug are prohibited, few people who were caught with a small amount for personal use have been prosecuted. | |||
| ===New Zealand=== | |||
| Methamphetamine is a Class "A" controlled drug under the ]. The maximum penalty for production and distribution is imprisonment for life. While in theory a doctor could prescribe it for an appropriate indication, this would require case-by-case approval by the director-general of public health. In ], Methamphetamine is most commonly referred to by the unique street name '''P'''.<ref name="fade" /> | |||
| ===Singapore=== | |||
| Under the ] in Singapore, methamphetamine is a Class A — Schedule I controlled drug. Under the Section 17 of the Misuse of Drugs Act, any person who carries 25 or more grammes of the drug shall be presumed to possess them for the purpose of drug trafficking, which is punishable by death. Unless authorized by the government, the possession, consumption, manufacturing, import, export, or trafficking of methamphetamine in any amount are illegal.<ref></ref> | |||
| ===South Africa=== | |||
| In ], methamphetamine is classified as a Schedule 5 drug, and is listed as Undesirable Dependence-Producing Substances in Part III of Schedule 2 of the Drugs and Drug Trafficking Act, 1992 (Act No 140 of 1992).<ref>.</ref> Commonly called '''Tik''', it is mostly abused by youths under the age of 20 in the ] areas.<ref> - ]</ref> | |||
| ===United Kingdom=== | |||
| As of 18 January 2007,<ref>Misuse of Drugs Act 1971 (Amendment Order) SI 2006/3331</ref> methamphetamine is classified as a Class A drug in the ] under the ] following a recommendation made by the ] in June 2006.<ref>, BBC News, 14 June 2006</ref> It had previously been classified as a Class B drug, except when prepared for injection. | |||
| ===United States=== | |||
| {| class="wikitable" style="text-align:center" align="right" | |||
| |+ Methamphetamine Lab Seizures in the US | |||
| |- | |||
| ! Year !! Seizures | |||
| |- | |||
| |1999 || 7,438 | |||
| |- | |||
| |2000 || 9,902 | |||
| |- | |||
| |2001 || 13,357 | |||
| |- | |||
| |2002 || 16,212 | |||
| |- | |||
| |2003 || 17,356 | |||
| |- | |||
| |2004 || 17,710 | |||
| |- | |||
| |2005 || 12,484 | |||
| |- | |||
| |2006 || 6,435 | |||
| |} | |||
| Methamphetamine is classified as a ] substance by the ] under the ].<ref>. International Narcotics Control Board.</ref> It is available by prescription under the trade name ], manufactured by ]. While there is technically no difference between the laws regarding methamphetamine and other controlled stimulants, most medical professionals are averse to prescribing it due to its notoriety. | |||
| Illicit methamphetamine has become a major focus of the ']' in the ] in recent years. In addition to federal laws, some states have placed additional restrictions on the sale of precursor chemicals commonly used to synthesize methamphetamine, particularly ], a common over-the-counter ]. In 2005, the ] seized 2,148.6 kg of methamphetamine.<ref></ref> In 2005, the ] was passed as part of the ], putting restrictions on the sale of methamphetamine precursors. | |||
| On November 7, 2006, the US Department of Justice declared that November 30, 2006 be Methamphetamine Awareness Day.<ref>{{cite web|url=http://www.usdoj.gov/dea/pubs/states/methawareness_news_releases.html|title=Meth Awareness News Releases|author=DEA|date=2007-01-01}}</ref> | |||
| ] El Paso Intelligence Center data is showing a distinct downward trend in the seizure of clandestine drug labs for the illicit manufacture of methampetamine from a high of 17,710 in 2004. Lab seizure data for the United States is available from EPIC beginning in 1999 when 7,438 labs were reported to have been seized during that calendar year. | |||
| ===Legality of similar chemicals=== | |||
| See ] and ] for legal restrictions in place as a result of their use as precursors in the ] of methamphetamine. | |||
| ==See also== | |||
| * ] | |||
| * '']'', TV series about a chemistry teacher who starts cooking meth after he is diagnosed with terminal lung cancer | |||
| * ] | |||
| * ] | |||
| * ] | |||
| * ] | |||
| * ] | |||
| * ] | |||
| * ]s | |||
| * ] | |||
| * ] | |||
| * ] | |||
| ==References== | |||
| {{reflist|2}} | |||
| ==Footnotes== | |||
| <references group="Note" /> | |||
| ==Further reading== | |||
| * (PIM 334: Methamphetamine) | |||
| * - a thorough review on the effects of chronic use (American College of Neuropsychopharmacology) | |||
| * ''Methamphetamine Use: Clinical and Forensic Aspects'', by Errol Yudko, Harold V. Hall, and Sandra B. McPherson. CRC Press, Boca Raton, Fl, 2003. | |||
| ==Documentaries== | |||
| * - ABC Australia - 4 Corners — Australian methamphetamine use. | |||
| * - PBS United States — Frontline. | |||
| * - National Geographic. | |||
| ==External links== | |||
| * - Entry for d-methamphetamine | |||
| * | |||
| * | |||
| * - A comprehensive thematic index of methamphetamine research published in academic and scientific journals with links from citations to the PubMed abstracts. | |||
| ** - More detailed synthesis and synthesis from other sources. | |||
| * | |||
| {{Methamphetamine}} | |||
| {{Stimulants}} | |||
| {{Phenethylamines}} | |||
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Revision as of 14:48, 2 June 2009
This article is about the psychostimulant drug, methamphetamine, in both racemic and dextrorotatory forms. For the CNS inactive OTC nasal decongestant, see levomethamphetamine.
 | Editing of this article by new or unregistered users is currently disabled due to vandalism. See the protection policy and protection log for more details. If you cannot edit this article and you wish to make a change, you can submit an edit request, discuss changes on the talk page, request unprotection, log in, or create an account. |
 | |
 | |
| Clinical data | |
|---|---|
| Other names | Desoxyephedrine Pervitin Anadrex Methedrine Methylamphetamine Syndrox Desoxyn |
| Routes of administration | Medical: Oral Recreational: Oral, I.V., I.M., Insufflation, Inhalation, Suppository |
| ATC code | |
| Legal status | |
| Legal status |
|
| Pharmacokinetic data | |
| Bioavailability | 62.7% oral; 79% nasal; 90.3% smoked; 99% rectally; 100% IV |
| Metabolism | Hepatic |
| Elimination half-life | 9–15 hours |
| Excretion | Renal |
| Identifiers | |
IUPAC name
| |
| CAS Number | |
| PubChem CID | |
| ChemSpider | |
| CompTox Dashboard (EPA) | |
| ECHA InfoCard | 100.007.882  |
| Chemical and physical data | |
| Formula | C10H15N |
| Molar mass | 149.233 g/mol g·mol |
| 3D model (JSmol) | |
SMILES
| |
Methamphetamine (/mɛθæm'fɛtəmiːn/, also known as, methylamphetamine, N-methylamphetamine, and desoxyephedrine) is a psychostimulant and sympathomimetic drug.
A member of the family of phenylethylamines, methamphetamine is chiral, with two isomers:
The levorotary form, levomethamphetamine, is an over-the-counter drug used in inhalers for nasal decongestion. Levomethamphetamine does not possess any significant central nervous system activity or addictive properties. The remainder of this article deals only with the dextrorotatory form, dextromethamphetamine, or the racemic form, methamphetamine.
Methamphetamine enters the brain and triggers a cascading release of dopamine, serotonin and norepinephrine. It is highly active in the mesolimbic reward pathways of the brain, inducing intense euphoria, with risks for addiction. To a lesser extent, methamphetamine acts as a dopaminergic and adrenergic reuptake inhibitor with high concentrations serving as a monoamine oxidase inhibitor. Users may become hypersexual or obsessed with a task, thought or activity. Withdrawal is characterized by excessive sleeping, eating, and major depression, often accompanied by anxiety and drug-craving. Methamphetamine users may take sedatives such as benzodiazepines as a means of easing their "come down", anxiety or enable them to sleep.
Methamphetamine addiction typically occurs when a person begins to use it because of its powerful enhancing effects on mood and energy, weight loss and appetite suppression, among its other psychological and physical effects. Over time effectiveness decreases, and users find that they need to take higher doses to get the same results and have far greater difficulty functioning and expe
- Cite error: The named reference
ncbi.nlm.nih.govwas invoked but never defined (see the help page). - McGregor C, Srisurapanont M, Jittiwutikarn J, Laobhripatr S, Wongtan T, White J (2005). "The nature, time course and severity of methamphetamine withdrawal". Addiction. 100 (9): 1320–9. doi:10.1111/j.1360-0443.2005.01160.x. PMID 16128721.
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