What to Know About Today's Meth

New York Times

16-04-2025

Fentanyl overdoses have finally begun to decline over the past year, but that good news has obscured a troubling shift in illicit drug use: a nationwide surge in methamphetamine, a powerful, highly addictive stimulant.
This isn't the '90s club drug or even the blue-white tinged crystals cooked up in 'Breaking Bad.' As cartels keep revising lab formulas to make their product more addictive and potent, often using hazardous chemicals, many experts on addiction think that today's meth is more dangerous than older versions. Here is what to know.
What is meth?
Meth, short for methemphetamine, is a stimulant, a category of drugs that includes cocaine. Meth is far stronger than coke, with effects that last many hours longer. It comes in pill, powder or paste form and is smoked, snorted, swallowed or injected.
Meth jolts the central nervous system and prompts the brain to release exorbitant amounts of reinforcing, feel-good neurotransmitters such as dopamine, which help people experience euphoria and drive them to keep seeking it.
Meth is an amphetamine, a category of stimulant drugs perhaps best known to the public as the A.D.H.D. prescription medications Adderall and Vyvanse. Those stimulants are milder and shorter-lasting than meth but, if misused, they too can be addictive.
What are meth's negative side effects?
They vary, depending on the tolerance of the person taking it and the means of ingestion.
After the drug's rush has abated, many users keep bingeing it. They forget to drink water and are usually unable to sleep or eat for days. In this phase, known as 'tweaking,' users can become hyper-focused on activities such as taking apart bicycles — which they forget to reassemble — or spending hours collecting things like pebbles and shiny gum wrappers. They may become agitated and aggressive. Paranoia, hallucinations and psychosis can set in.
Some people incessantly scratch or pick their skin to root out 'meth bugs,' often leaving scars or open wounds.
Long-term side effects include cognitive decline, memory loss, severe depression, heart-valve damage, and gum disease and tooth decay, known as 'meth mouth.'
Can meth kill?
Unless the meth dose is adulterated with fentanyl — which is increasingly common — it is usually not immediately lethal. But people can overdose on meth alone, and those deaths are rising.
In 2023, the most recent year for which statistics are available, nearly 35,000 overdose deaths in the United States involved meth or other stimulants, with or without fentanyl contributing. That amounted to a rise of about 870 percent from about 3,600 such deaths in 2013, according to researchers at the Centers for Disease Control and Prevention.
The true measure of meth's lethality cannot be captured by overdoses. People die from meth-related causes, including strokes and brain bleeds, as well as accidents while on a meth binge, such as wandering in traffic and being hit by a vehicle. Meth can cause chronic users to overheat and go into convulsions.
How does meth get into the country?
Traffickers hide it in numerous ways. Law enforcement officers have seized shipments of meth in bottles of mineral water ('conversion labs' in the United States then extract the drug from the liquid); in a tractor-trailer that listed its cargo as 'tomatillos;' stuffed in rolls of toilet paper; disguised as watermelons; and mailed inside bags of Cheetos.
How can people quit meth?
Although there are medications that suppress cravings for opioids, there are no approved medicines to treat meth addiction. Moreover, overdose reversal medications like naloxone do not work on a person overdosing on meth (unless the drug was adulterated with fentanyl).
One behavioral treatment for meth addiction is called 'contingency management.' It rewards clients with modest gift cards when their urine screens are negative and has long been featured in addiction treatment at Veterans Affairs programs.
Are there other names for meth?
It's known as ice, Tina, crystal, glass and speed. The nickname 'crank' was a nod to bikers who smuggled it in the crankcase of their engines.
How long has meth been around?
It has been around over 100 years, but has changed considerably and become much more potent.
In 1887, a German chemist synthesized the chemical compound ephedrine, found in the ephedra plant. By 1893, Japanese scientists were developing methamphetamine. During World War II, German, British and American military distributed meth tablets to keep troops awake and to suppress appetites. In Japan, the tablets were given to kamikaze pilots and also sold over the counter.
In 1944, the Food and Drug Administration approved a methamphetamine medication, Desoxyn, which has been used to treat narcolepsy, obesity and A.D.H.D., but it is infrequently prescribed.
According to researchers, by the late 1960s, the warning 'Speed Kills'— referring to drugs as well as driving — was being promoted in the United States.
In the 1990s, meth became known as a dance club drug. Home 'cooks' made batches of it, often using pseudoephedrine, an ingredient in over-the-counter cold medications.
In 2005, alarmed at the rising use of meth, Congress passed the Combat Methamphetamine Epidemic Act, requiring retailers to move cold medicines containing pseudoephedrine behind the counter. Meth production began to drop, while the opioid crisis gathered force.
Then, as reported in The Atlantic, chemists discovered a powerful formulation that sidestepped pseudoephedrine. This formula was adapted by Mexican cartels, who began mass-producing meth in labs and distributing it along the West Coast and throughout the Southwest.
In its 2024 annual report on national drug threats, the Drug Enforcement Administration said that cartels had been exploiting the American demand for counterfeit pills by producing meth in tablets that mimic A.D.H.D. medications.