Methamphetamine, an N-methyl analog of amphetamine, is a highly psychoactive stimulant that is currently FDA-approved to treat attention-deficit hyperactivity disorder (ADHD) and narcolepsy, a debilitating sleep disorder.
Methamphetamine and the Brain
Methamphetamine binds with and activates the release of monoamines, primarily dopamine in the midbrain region where the rewarding effects of food, hydration and coitus originate. Methamphetamine use initially produces a prolonged euphoria but also hyperactivity and disturbed and/or disoriented patterns of speech, sleep and behavior.
Users commonly experience acute anxiety, agitation, irritability, aggressiveness, impulsive hyper-sexuality and thus increased risk for sexually transmitted infections. It is not uncommon for meth abusers/addicts to binge and consume large quantities of the drug over a period of several days.
Chronic methamphetamine use causes neuroadaptive/pathological changes in the brain, including numerous cognitive deficits plus mood, thought and behavioral disorders, the worst of which is psychosis. Research by Wang et al, (2015) found similar patterns of delusions common in patients with schizophrenia among those with methamphetamine-induced psychoses. Moreover, when compared with schizophrenic patients, those with methamphetamine-induced psychosis present a higher prevalence of visual and tactile hallucinations but less cognitive disorganization, blunted affect and motor retardation.
Additional investigations are needed to identify biological differences between schizophrenia and methamphetamine-induced psychosis in order to develop therapeutic targets and potential medications for methamphetamine addiction and co-occurring mental illness.
Why Does This Matter?
Because of the high toxicity of meth, the debilitating effects often persist after extended periods of abstinence. As a result, the cognitive deficits (which are not easy to detect in abstinence) affect how individuals respond to treatment, which is a highly didactic and educational experience. Therefore, treatment modalities and interventions must be tailored to address the individuals’ unique cognitive and emotional deficits and co-occurring psychiatric and medical disorders.