Medically Reviewed By: Benjamin Caleb Williams RN, BA, CEN
Written By: Phillippe Greenough
Article Updated: 01/25/2021
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.
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Even though crystal meth withdrawal does not produce physical symptoms, it can be a psychologically painful experience. Extreme depression and anxiety are common and paranoia or psychosis are not unheard of. 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.
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.
A general overview of the crystal meth withdrawal timeline may look something like this:
The initial 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. 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 recovery 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.
Some of the symptoms of crystal meth withdrawal that someone may experience in the first or second week could include:
These symptoms will emerge, intensify, and plateau within the first week or so before beginning a slow resolution. The second week of meth withdrawal may bring some comfort as the symptoms may begin to diminish somewhat.
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. Keep in mind that the intensity and duration of all of these symptoms will vary from person to person.
Some symptoms commonly experienced during the third or fourth week of crystal meth withdrawal may include:
These symptoms may be greatly improved, but there is often some time to go before they will be gone. 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.
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:
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.
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 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 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:
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 CentersThere are several other stimulant drugs that can produce uncomfortable or even dangerous withdrawal symptoms. We have more in-depth withdrawal guides for drugs such as:
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