Meth Withdrawals: The Onset and Symptom Timeline
You may not feel methamphetamines are a presence here in our communities, but that presence is more prevalent than you think. In 2022, the Marin County Sheriff’s Office (in conjunction with the Sonoma County Sheriff’s Office and the DEA) seized over 136 pounds of methamphetamines.
Alta Mira is committed to educating communities about substance use disorders by leveraging our clinical expertise. While methamphetamines may not be as widely recognized, they represent a growing public health concern. This article explores meth withdrawal, its symptoms, and available treatment approaches.
Understanding Methamphetamine Withdrawal
Methamphetamines (meth), a potent central nervous system stimulant, have profound effects on the brain and body. Its withdrawal process is a critical phase in recovery and significantly impacts individuals seeking to overcome methamphetamine use disorder. Withdrawal is characterized by a series of physical and psychological symptoms that manifest after the cessation of meth, following prolonged or heavy use. The severity and duration of withdrawal are influenced by various factors, including the individual’s frequency and intensity of methamphetamine use, overall health, and co-occurring disorders.
Etiology of Meth Withdrawal
The etiology of methamphetamine withdrawal is rooted in the neurochemical alterations caused by the substance. Methamphetamines primarily act by increasing the release and inhibiting the reuptake of dopamine, norepinephrine, and serotonin in the brain. Chronic use leads to significant dysregulation of neurobiological balance, resulting in hallucinations, anxiety, and seizures. Over time, the brain becomes dependent on methamphetamines to maintain normal neurotransmitter levels.
Upon cessation, this dependency leads to a sudden imbalance, manifesting as withdrawal symptoms. Additionally, prolonged methamphetamine use causes neurotoxicity, damaging dopamine and serotonin neurons, which exacerbates withdrawal symptoms and contributes to the long-term cognitive and emotional challenges experienced by individuals in recovery. Studies have shown that those who remain abstinent from methamphetamine use begin regaining cognitive function after six months. Those who continued chronic use showed a further decline.
Risks Associated with Meth Withdrawal
Methamphetamine withdrawal is poorly researched, though there are symptoms that pose risks. One of the most significant is the potential for severe psychological distress, including depression and suicidal ideation. These symptoms can be life-threatening if not adequately addressed. These psychological symptoms peak within 24 hours and diminish with few complications. However, if not properly addressed, these symptoms cause drastic results. Research has also highlighted cravings and anxiety as potential methamphetamine withdrawal symptoms, though they are much more mild. Additional risks include extreme fatigue and a drastic increase in appetite, which cause physical complications to the recovery process.
Clinical Manifestations of Methamphetamine Withdrawal
The clinical manifestations of methamphetamine withdrawal are diverse, encompassing both physical and psychological symptoms. These symptoms emerge within hours after cessation and vary in intensity and length depending on the individual’s usage history and overall health.
Psychological Manifestations of Meth Withdrawal
Psychological manifestations of methamphetamine withdrawal, while often more debilitating than physical, range from mild depression and anxiety to severe hallucinations and delusions. The mood disturbances of depression, anxiety, and irritability cause hindrances to the treatment process and must be closely monitored. Methamphetamines cause individuals to become violent even if they were not that way before. As withdrawal continues, anhedonia – the inability to feel pleasure – may persist for weeks or months, reflecting the prolonged recovery of dopaminergic pathways.
Somatic Presentations of Methamphetamine Withdrawal
Somatic manifestations of methamphetamine withdrawal primarily involve physical discomfort. Fatigue is a prominent symptom, often accompanied by hypersomnia as the body attempts to recover from prolonged periods of stimulant-induced hyperactivity. Increased appetite is another feature, reflecting the body’s need to replenish nutrients lost during periods of methamphetamine use. Headaches, muscle aches, and generalized weakness also occur and further contribute to the individual’s overall sense of malaise.
Chronology of Methamphetamine Withdrawal
The timeline of methamphetamine withdrawal unfolds in three phases: the crash, the acute withdrawal phase, and the protracted withdrawal phase. Distinct symptoms and a general timeline characterize each phase.
- The crash (24-48 hours post-cessation): The crash phase begins shortly after the last use of methamphetamine and is characterized by profound fatigue, hypersomnia, and increased appetite. Individuals often feel physically and emotionally depleted, with heightened irritability and anxiety. Cravings for the drug are low during this phase due to exhaustion.
- Acute withdrawal phase (3-14 days): During this phase, psychological symptoms are prominent but dissipate quickly. Depression and anxiety become less apparent, though cravings will begin to intensify. Sleep disturbances, such as insomnia or erratic sleep patterns, are common. Physical symptoms including headaches and muscle pain may persist, although they subside toward the end of this phase. This period is critical for intervention, as the risk of a return to use increases due to the intensity of cravings.
One study highlighted those injecting methamphetamine and withdrawal. It found that 53% of participants reported withdrawal symptoms, with 25% experiencing weekly bouts of withdrawal and 20% expressing extremely painful symptoms. It is important to consider the route of administration to address the acute withdrawal phase properly.
- Protracted withdrawal phase (weeks to months): In the protracted phase, many psychological symptoms, including depression and anhedonia, persist due to the slow recovery of dopamine systems. Physical symptoms are typically resolved, though some individuals continue to have cognitive impairments, such as poor concentration and memory difficulties. Sleep disturbances are reported to continue after the acute phase, with one study noting symptoms after 4 weeks of cessation. While cravings begin during the acute phase, studies have found they have continued for 5 or more weeks.
Medical Detox for Meth Withdrawal
Medical detoxification plays a critical role in facilitating the safe and controlled elimination of methamphetamine from the body. Although no evidence-based pharmacological treatments currently exist to manage methamphetamine withdrawal effectively, certain interventions have shown preliminary promise. However, further high-quality research is necessary to establish their efficacy. At present, benzodiazepines and antipsychotic medications remain the primary approaches utilized in clinical practice.
Behavioral and supportive therapies are vital during medical detox. Cognitive behavioral therapy (CBT) and contingency management are effective in addressing the psychological aspects of withdrawal, particularly cravings and emotional distress. Peer support groups and counseling provide additional layers of emotional support and help individuals develop coping strategies for long-term recovery.
A comprehensive approach to care is essential after the medical detox is complete. This includes enrolling in an inpatient or outpatient treatment program, to address the complex needs of individuals recovering from methamphetamine use disorder. This approach ensures that both the physical and psychological dimensions of withdrawal are managed effectively, reducing the risk of a return to use and promoting sustained recovery.
Get Help For Meth Addiction in Sausalito, CA
Methamphetamine withdrawal is a multifaceted process, and if your loved one is currently trying to manage on their own with no success, help is available. Effective management through medical detox and supportive therapies is an essential part of meth rehab. Your loved one will receive the quality care they deserve surrounded by both professionals and like-minded peers. Don’t wait for further cognitive and physical decline – take the first step toward a brighter future today.
Methamphetamine withdrawal may feel like a barrier now, but there are options to begin anew. Alta Mira offers a team of multidisciplinary certified clinicians with decades of experience in addiction medicine. Our facility combines quality treatment in a comfortable and home-like setting. Call us today at 866-922-1350 to learn more or get started.
Alta Mira: Science-backed treatment, world-class care.
Sources
Edinoff AN, Kaufman SE, Green KM, Provenzano DA, Lawson J, Cornett EM, Murnane KS, Kaye AM, Kaye AD. Methamphetamine Use: A Narrative Review of Adverse Effects and Related Toxicities. Health Psychol Res. 2022 Sep 15;10(3):38161. doi: 10.52965/001c.38161. PMID: 36118981; PMCID: PMC9476235.
Lisa Proebstl, Daniela Krause, Felicia Kamp, Laura Hager, Kirsi Manz, Maik Schacht-Jablonowsky, Maximilian Straif, Marlies Riebschläger, Stefanie Neumann, Anne Schreiber, Michael Soyka, Gabi Koller, Methamphetamine withdrawal and the restoration of cognitive functions – a study over a course of 6 months abstinence, Psychiatry Research, Volume 281, 2019, 112599, ISSN 0165-1781, https://doi.org/10.1016/j.psychres.2019.112599.
McGregor, C., Srisurapanont, M., Jittiwutikarn, J., Laobhripatr, S., Wongtan, T. and White, J.M. (2005), The nature, time course and severity of methamphetamine withdrawal. Addiction, 100: 1320-1329. https://doi.org/10.1111/j.1360-0443.2005.01160.x
Fonseca R, Carvalho RA, Lemos C, Sequeira AC, Pita IR, Carvalho F, Silva CD, Prediger RD, Jarak I, Cunha RA, Fontes Ribeiro CA, Köfalvi A, Pereira FC. Methamphetamine Induces Anhedonic-Like Behavior and Impairs Frontal Cortical Energetics in Mice. CNS Neurosci Ther. 2017 Feb;23(2):119-126. doi: 10.1111/cns.12649. Epub 2016 Oct 19. PMID: 27762079; PMCID: PMC6492743.
Zorick, T., Nestor, L., Miotto, K., Sugar, C., Hellemann, G., Scanlon, G., Rawson, R. and London, E.D. (2010), Withdrawal symptoms in abstinent methamphetamine-dependent subjects. Addiction, 105: 1809-1818. https://doi.org/10.1111/j.1360-0443.2010.03066.x
Johnathan Zhao, Alex H. Kral, Kelsey A. Simpson, Rachel Carmen Ceasar, Lynn D. Wenger, Matt Kirkpatrick, Ricky N. Bluthenthal, Factors associated with methamphetamine withdrawal symptoms among people who inject drugs, Drug and Alcohol Dependence, Volume 223, 2021, 108702, ISSN 0376-8716, https://doi.org/10.1016/j.drugalcdep.2021.108702.
Mancino, M. J., Gentry, B. W., Feldman, Z., Mendelson, J., & Oliveto, A. (2011). Characterizing methamphetamine withdrawal in recently abstinent methamphetamine users: a pilot field study. The American Journal of Drug and Alcohol Abuse, 37(2), 131–136. https://doi.org/10.3109/00952990.2010.543998
