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Crystal Meth Withdrawal & Detox

Medically Reviewed By: Benjamin Caleb Williams RN, BA, CEN

Written By: Phillippe Greenough

Article Updated: 09/25/2020

Number of References: 10 Sources

Crystal meth can be one of the most damaging drugs with regards to the long term mental and physical health of users. Furthermore, crystal meth withdrawal can be a very traumatic experience for anyone attempting to quit using. In this guide, we will detail the effects and symptoms of meth withdrawal and explore how long it takes to detox from crystal meth. Finally, we will examine crystal meth withdrawal treatments, and how they can help someone begin recovery from this crippling addiction.

In This Article:

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What Happens During Meth Withdrawal?

Even though crystal meth withdrawal does not produce physical symptoms, it can be a psychologically miserable experience. Extreme depression and anxiety are ubiquitous and paranoia or psychosis are quite common as well. While direct physical symptoms do not occur during meth withdrawal, there is a greatly increased risk of indirect physical complications such as suicide. Professional help is always recommended during meth withdrawal, and realistic expectations of the symptoms may aid someone in seeking the necessary care to make it through crystal meth withdrawal. A crystal meth detox center can provide invaluable resources to help someone make it through this process in the safest way possible.

Crystal meth works through increasing the levels of the neurotransmitters dopamine, serotonin, and norepinephrine but its strongest effect by far is on dopamine. Studies vary, but meth is thought to increase dopamine levels in the brain by between several hundred to a thousand percent. Dopamine is a crucial neurotransmitter in brain function and is responsible for feelings of reward and pleasure, motivation and mood, concentration, and a variety of motor skills. The extremely high levels produced through meth use result in the brain turning down its sensitivity to dopamine through a process called downregulation.

Downregulation initially produces tolerance to meth, and continued use will result in psychological withdrawal symptoms if and when meth use is stopped. Once downregulation has occurred and meth use is stopped, the brain has much lower levels of dopamine to work with. Join this with the fact that the brain is now much less sensitive to the dopamine which is present, and the stage is set for meth withdrawal. Serotonin and norepinephrine systems experience this same effect but to a somewhat lesser degree.

Withdrawal from meth is typically a long process, lasting weeks at best, and more commonly taking many months to completely resolve. The brain is able to perform upregulation of dopamine to reverse the changes made by chronic meth use. While meth withdrawal is a slow process overall, it is commonly divided into two general phases: acute and post-acute meth withdrawal. The acute phase is the period immediately after someone stops using meth, and is the most intense phase of withdrawal. The post-acute phase is less intense but may last much longer. Let’s take a look at the specific symptoms someone can expect during each phase:

Crystal Meth Withdrawal Symptoms

The acute phase of meth withdrawal produces the most severe symptoms by far. While it typically lasts around 10 days, this time is extremely hard for someone as the psychological symptoms are very intense. Beginning with a hard crash immediately after meth use is ceased, this phase is characterized by several common symptoms which include:

  • Psychosis (typically paranoid delusions caused from meth use, not necessarily withdrawal)
  • Extreme Cravings for Meth (obsessively thinking about meth)
  • Deep Depression (possibly with suicidal thoughts)
  • Severe Fatigue and Lethargy
  • Confusion or Clouded Thinking
  • Intense Anxiety
  • Agitation or Aggression
  • Anhedonia (inability to experience pleasure)
  • Sleep Disturbances (either insomnia or hypersomnia, commonly with very vivid dreams or nightmares)
  • Red and Irritated Eyes
  • Increased Appetite

These symptoms are due to the immense increase in dopamine levels which meth use produces, and the subsequent changes that the brain makes in response to these changes. The brain will immediately begin restoring balance after meth has left someone’s system, but this process is slow and extremely uncomfortable during the first few days. Interestingly, women appear to experience anxiety during meth withdrawal more commonly than men and the reasons for this are not currently understood. These symptoms can be overwhelming due to their intensity early on and because of this, it is highly recommended to seek medical help when attempting to quit using crystal meth.

Post-Acute Withdrawal Symptoms

Post-acute withdrawal from meth can be a drawn-out process. While the worst of the symptoms may be over after about 2 weeks, others will linger for many more weeks or even months. These symptoms can wear away at a person’s mental wellbeing during this time, and suicide during meth withdrawal is a very real possibility. Some of the most common PAWS symptoms of meth withdrawal  are:

  • Depression
  • Cravings for Meth
  • Fatigue and Lethargy
  • Anxiety

Post-acute withdrawal from meth can last for different lengths depending on the individual. Due to the intense changes produced in the brain from meth use, this phase may last months, years, and some of these symptoms may even be permanent. Fatigue, lethargy, and depression are frequently the most long-lived of these symptoms. Some factors which affect the duration of meth withdrawal, both acute and post-acute, include the amounts of meth someone used as well as the length of time some used. Studies show that the amounts are directly correlated to the withdrawal symptom duration; with more or longer meth use leading to more long-lasting symptoms.

Crystal Meth Withdrawal Timeline

The psychological symptoms of meth withdrawal and the timeline involved are the biggest hurdles in meth addiction recovery. Since these symptoms are exclusively psychological in nature, it is hard to detail them in a quantitative way. While the timeline as well as the intensity of symptoms will vary between individuals, here is a rough outline that we can use to illustrate the general timeline someone could expect.

First Week

The first few days are often the most difficult, as someone will experience a brutal comedown that takes them from feeling “on top of the world” to an empty shell within a dozen hours or so. Psychosis is a common result of chronic meth use, and these symptoms can often persist into the first 24 to 48 hours of withdrawal. Meth users commonly describe people talking about them or watching them, and are very suspicious of others. This commonly resolves very quickly and can be accelerated through the use of medications. In the absence of psychosis, meth users almost unanimously report feelings of confusion, difficulty thinking, and extreme cravings for meth being much worse in the first few days and gradually reducing over the first week. Depression, fatigue, lethargy, and anxiety are rampant as well, appearing and commonly remaining at a constant level for the first week and into the second.

Second Week

The second week of meth withdrawal may bring some comfort as the symptoms may begin to diminish somewhat. Sleep disturbances may change from hypersomnia to insomnia with a reduction in the severity of nightmares or dreams. Anxiety and cravings may diminish somewhat between days 7 and 14 as well as appetite returning to a somewhat normal level. Depression, lethargy, fatigue, and anhedonia will still be present and intense, although possibly somewhat reduced since the first week.

Third Week

Sleep and appetite should be returning to normal levels during week three with a reduction in sleep disturbances. Cravings and anxiety may be lessened somewhat as well, with anxiety typically making more progress towards normalcy. Depression may begin to lighten as well but will still be strong. Fatigue and lethargy may begin to revolve around the third week but should be expected to persist in some capacity for many more weeks. Anhedonia commonly resolves almost entirely after about 3 weeks, and this may be the first glimmer of hope that someone experiences during post-acute meth withdrawal.

Fourth Week and Onwards

Depression and cravings may persist for quite a long time, with cravings eventually coming and going intermittently. Fatigue and lethargy usually resolve within the first month of ceasing meth use and anxiety and anhedonia may linger in some form for several more weeks. Keep in mind that the intensity and duration of all of these symptoms will vary from person to person. Some forms of these symptoms may be expected to last for many weeks or months after ceasing meth use, and appropriate medical and psychiatric care is highly recommended to anyone undergoing withdrawal from crystal meth.

The Importance Of Crystal Meth Detox

Due to the severity of symptoms during crystal meth withdrawal, it is highly recommended that someone enter a crystal meth detox center. These programs can greatly reduce the discomfort of the detox process and provide treatment and care during this difficult time. In addition, they can provide a wealth of resources for continuing treatment after withdrawal and detox have been completed, giving someone a better chance of attaining long term sobriety.

Crystal Meth Detox Centers

Physical Effects of Crystal Meth Withdrawal

Crystal meth addiction does not produce physical symptoms during withdrawal. That being said, there have been reports of elevated heart rate at the onset of meth withdrawal. This typically reduces very quickly and is most likely a secondary effect produced by anxiety and/or psychosis as a result of meth use and not as a direct result of meth withdrawal itself. The extreme fatigue and lethargy may also appear physical at first, but these are probably psychological in nature even though they do produce externally observable effects.

Psychological Effects of Crystal Meth Withdrawal

The brunt of crystal meth withdrawal is experienced mentally, and there are many different psychological symptoms. The profound neurotransmitter imbalances produced through crystal meth use can result in crippling depression, a very bleak outlook and sense of hopelessness, and severe anxiety and cravings for meth. Low levels of dopamine result in fatigue and lethargy, clouded or disorganized thinking, and sleep issues. Low serotonin levels can result in mood swings, depression, and anxiety while low levels of norepinephrine can worsen the symptoms of dopamine and serotonin imbalances.

Some very common and specific psychological symptoms that someone may experience during withdrawal from crystal meth include:

-Psychosis and Paranoia

Methamphetamine induced psychosis is surprisingly common in active meth users. This is a direct result of chronic meth use and not a result of meth withdrawal. Although psychotic symptoms may be present when someone enters a meth detox center, they usually resolve within a day or two and possibly sooner with effective treatments. Estimates from 2014 claim that about 40% of meth users experience meth-induced psychosis at some point during their use. During meth withdrawal, this can manifest in a more destructive manner, as the heavy crash of ceasing meth use can result in violent, irrational outbursts.

The symptoms of meth-induced psychosis can be indistinguishable from paranoid schizophrenia and include symptoms such as hallucinations and/or paranoid delusions. The hallucinations are often auditory, but may also be visual or tactile. The paranoid delusions most often take the form of perception of persecution by others. This includes someone thinking that others are plotting against them, talking about them, poisoning them, or stealing from them. This can either result in someone isolating from others or, conversely, lashing out violently at those that they think are out to get them.

For most meth users psychosis will be transient, appearing and resolving as meth use ceases. In a small percentage of meth users, these psychotic states may re-emerge and persist for long periods, even after meth use has ceased. These symptoms are treated with antipsychotic medications in addition to therapy and resocialization techniques. Someone’s susceptibility to meth-induced psychotic states is increased if they have a history of psychosis, or if it runs in their family.

-Intense Cravings For Meth

While many drugs produce cravings during withdrawal, the cravings produced by chronic meth use seem to be of an altogether greater magnitude than those produced by most other drugs. The first few weeks of meth withdrawal can be described as having a mental fixation on thoughts of crystal meth. These cravings are so intense as to dominate someone’s thoughts for every waking hour.

The extreme increases in neurotransmitter levels, particularly dopamine, during meth use leave a lasting impression in the psyche of a recovering user. Since dopamine plays such a large role in learning, motivation, and memory the mental connections between feeling good and meth are extremely strong and heavily enforced. These connections will take time and effort to change, and in the interim period cravings for meth will be strong and frequent.

The brain is capable of undoing the damage done by meth use in most cases, but this process takes time. Strong cravings can typically last for several months after quitting meth. These may eventually come and go before disappearing altogether, but this will normally be a years-long process.

-Depression, Fatigue, and Lethargy

Almost everyone who is attempting to recover from crystal meth addiction will experience some form of depression during withdrawal. This is the most common symptom reported during meth withdrawal other than cravings and is also one of the longest-lasting. The depleted levels of the neurotransmitters dopamine, norepinephrine, and serotonin all contribute to these symptoms, but the largest factor by far is lowered dopamine levels. In addition, the brain may undergo further neurological changes in the consistent presence of meth and the stimulation it produces. Once meth is removed, these neurological changes will take time to return to normal, and these symptoms of reduced energy and motivation may be experienced while this process is taking place.

The experience of the deep depression felt during meth withdrawal has been described as being down a deep emotional well whose walls are coated in thick black oil. The world may appear hollow and empty with no hope of ever-changing or getting better. When you add mental fatigue and lethargy, there is a total lack of enthusiasm, motivation, desire, and most importantly hope.

Dopamine and norepinephrine both contribute to attention, focus, energy levels, motivation, and mood to a certain degree. The profound absence of energy, drive, enthusiasm, and motivation is a result of imbalances in these 2 neurotransmitters. Serotonin is a mood elevator and regulator and serotonin deficiency and dysregulation are the largest contributors to depression and mood swings. These symptoms typically take some time to resolve completely with depression lasting months, sometimes years, and more rarely being a permanent condition.

-Confusion and Clouded Thinking

Confused or disoriented thoughts or difficulty thinking things through is a common symptom experienced during meth withdrawal. Memory is also commonly affected and often contributes to the disorganized thought patterns during the early days of meth withdrawal. These cognitive issues typically resolve fairly quickly; usually within the first 2 weeks after ceasing meth use.

A recovering meth user may have difficulty holding a conversation, as they lose track of what is being talked about. Their thoughts may move slowly compared to others and this can worsen any cognitive instability, making it difficult to connect with others around them. This in turn can worsen the depressive symptoms and lead to further isolation and social withdrawal.

These cognitive issues during meth withdrawal are the result, again, of reduced levels of dopamine and norepinephrine. Dopamine has an effect on learning and memory while norepinephrine has effects on attention, alertness, and memory. Lowered levels of both of these neurotransmitters produce a variety of psychological issues until balance and proper function is restored. The brain will begin upregulating all of these neurotransmitters very soon after meth use has ceased, and subsequently, these symptoms will reduce in severity until they are gone.

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What Factors Influence the Intensity of Crystal Meth Withdrawal?

The severity of crystal meth withdrawal symptoms varies a great deal between individuals, the reasons for this include the use habits of each individual, as well as factors that are beyond their control. Depending on the person, withdrawal symptoms may resolve in a handful of weeks, while others may experience symptoms for many years. Likewise, some people experience very mild symptoms while others will suffer intense and psychologically brutal withdrawals.

Some of the factors which affect the experience of meth withdrawal between individuals include:

  • Genetic Predisposition for Addictive Behavior
  • Co-Occurring Mental Health Conditions (depression, schizophrenia, bipolar disorder, etc.)
  • The amounts of crystal meth someone used
  • The length of time that someone used crystal meth
  • Age at time of meth use

Genetic susceptibility for addictive behavior largely remains a mystery to modern medicine. What is known for certain is that addiction does tend to run in families. Those who have ancestors or relatives who exhibit addictive behaviors are much more prone to fall prey to these same behaviors themselves. There is certainly a genetic component that affects the ease with which someone may become psychologically addicted to substances, although the exact mechanisms for this remain elusive and unclear.

There is a marked trend for those who have co-occurring mental health issues such as depression to be more prone to addiction than the general population. While drug abuse rates are fairly equivalent, there is a much larger percentage of those who suffer from depression to be physically dependent upon drugs compared to those who do not suffer from depression. This indicates that depression, or a multitude of other mental health conditions, may accelerate and strengthen addict-like behaviors and aid someone’s slide into a full-blown addiction.

The amount of crystal meth that someone used is maybe the single largest contributing factor with regards to the intensity of the meth withdrawal symptoms that someone could expect to face. The extent to which meth use increases dopamine levels has a direct effect on the process of dopamine downregulation with larger amounts of meth producing a larger degree of downregulation. This has the result of increasing the reward threshold in the brain and subsequently requiring more stimulation to produce any feeling of reward or pleasure. During meth withdrawal, this translates to feeling extremely depressed and down and being temporarily unable to experience good or positive feelings that aren’t drug-induced. This is known as anhedonia and it will heal, but this is a slow process and takes time.

The length of time that someone used meth has a similarly strong impact on the intensity of meth withdrawal symptoms as well as the duration of withdrawal. The longer that someone used meth, the more complete the process of downregulation becomes. The longer these neurotransmitter receptors remain downregulated, the longer it takes for them to be restored through upregulation. The phrase “5 miles into the woods, 5 miles out” comes to mind and is very appropriate in this scenario. It is impossible to put an exact figure on the timeline between individuals, but it is certainly the case, with all other factors being equal, that if someone used meth for 1 year they will recover sooner than if someone used meth for 2 years.

Someone’s age at the time of meth use and addiction also plays a role in the intensity and possibly the duration of withdrawal symptoms from meth. Meth use, through mechanisms not fully understood, has been shown to accelerate the neurological symptoms of aging. This effect may be compounded by advanced age at the time of initiating meth use. While the exact way that meth produces this effect is unclear, it is known that meth increases oxidative stress due to byproducts of the metabolism of meth. This results in greatly reduced cellular efficiency, particularly in the brain, with regards to healing and cell division. Subsequently, the normal healing and recovery processes of the body will take longer while simultaneously being less thorough. The end result is that meth withdrawal will be harsher, last longer, and a full recovery may be increasingly unlikely depending on the age of the user.

Finally, due to the massive impact meth has on normal brain function, if someone were to use meth while they were still in their teens to mid-twenties, they could potentially permanently alter the normal brain development which is commonly ongoing until ~25 years of age. This not only poses challenges to someone’s mental health, but it also correlates to negative treatment outcomes for the rest of their life and a higher chance to have recurring and persistent substance abuse issues.

Crystal Meth Withdrawal Treatment

Withdrawal from crystal meth can be an agonizing process without help. Completing withdrawal and continuing on the journey of recovery is very difficult if someone were to attempt it on their own. The option that provides the greatest chance of success as well as the least discomfort is entering a crystal meth detox program. These programs are often the first step towards a new life and they specialize in helping users to recover from crystal meth addiction.

These programs commonly use a combined treatment regime which includes medications, therapies, and social support to help meth users change their lives. There is no single “silver bullet” treatment for crystal meth addiction and the more tools that are available to someone in recovery, the better chances they have to achieve long term recovery.

-Medications

While there is currently no FDA approved medications for treating crystal meth withdrawal, there are many medications that are quite effective in this application. These medications are used to treat a variety of disparate conditions but have shown great promise towards helping crystal meth users successfully complete withdrawal through minimizing the uncomfortable symptoms.

Some of the medications most commonly used to treat crystal meth withdrawal include:

  • Antidepressants
  • Anti Anxiety Medications
  • Anti Psychotics
  • Dopamine Agents
  • GABA Agents

These medications are frequently used to treat the psychological symptoms of meth withdrawal in the acute as well as post-acute phases. There are also a variety of medications that have only recently been applied to treat crystal meth withdrawal but have proven quite promising. These would be considered investigational medications for the purpose of meth withdrawal, but have been safely used to treat other conditions for many years.

-Therapies

There are many therapeutic techniques which are used in the treatment of crystal meth addiction. Some people may find some therapies more helpful than others, and luckily there is a wealth of choice in this regard. Many crystal meth detox centers offer therapy or counseling during the detox process as well as referrals to continuing care programs after detox has been completed. It is highly recommended to continue treatment after detox, as this provides a greater chance of achieving long term recovery.

Some of the most commonly used therapies provided at detox centers include:

  • Group Therapy
  • Individual Counseling
  • Addiction Education
  • Coping Skills Development

These are just a few of the most common therapies used early on in recovery from crystal meth addiction. Detox is only the beginning and there is a multitude of options for further treatment and care after detox completion. Further treatment opens the door for someone to find a treatment center and program which is suited to their particular needs, views, and desires. This includes treatment programs that are psychiatric, holistic, or religiously focused, or possibly a combination of several.

There is life after crystal meth addiction and help is available to help someone make it to that point. There are also options in the type of help that someone chooses to reach for. Pick up the phone, ask a friend, or begin right here. Recovery is possible, but it can’t be achieved alone. It requires help, and help is available if someone is willing to ask for it.

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