What Medications are Used for Meth Withdrawal

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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What Medications Get Used for Methamphetamine Withdrawal?

Methamphetamine, better known as meth, is a central nervous system stimulant. It increases the production of dopamine in the brain, which leads to a euphoric, pleasurable state. Unfortunately, the high is short-lived, and users build tolerance quickly. That necessitates the use of more and more of the drug to achieve the same level of euphoria, and users sometimes go days on end without food or drink so that they can stay in the euphoric state.

Are There Any Side Effects of Taking Meth?

As can be seen in the aforementioned National Institute on Drug Abuse reference, the short-term side effects are, paradoxically, quite mild. In fact, one or two of them are actually beneficial in the short run. That makes this particular drug that much more dangerous. Some of those side effects include:

  • Increased wakefulness
  • Increased focus
  • Stronger need for physical activity
  • Increased blood pressure
  • Rapid and/or irregular heartbeat

The last two short-term side effects are dangerous enough to counteract the possible benefits. The long-term side effects of meth use are devastating, and they include:

  • Memory loss
  • Paranoia
  • Extreme weight loss
  • Hallucinations
  • Severe addiction
  • Rotting teeth
  • Permanent changes in brain chemistry

The last one is the most important. Permanent means just that. The terrible changes, which include loss of problem-solving capability, memory functions, and even just the ability to think clearly, never go away. Due to the permanent damage caused in the brain, memory loss is typically irreversible.

The cruel truth also includes the fact that people who have substance use disorder with meth lose the ability to feel pleasure without the drug. Most of the time, this is also a permanent loss. So, even though users get a short-term dopamine boost that gives them great pleasure, it is ephemeral, resulting in even more use to recapture that feeling.

What Are the Numbers Regarding Meth Addiction?

From 2009 until 2021, the number of people who used meth climbed steadily. In 2021, the number was more than 2.5 million, which means that roughly one in every 130 people used meth. The average person interacts with 12 people a day, meaning that you’ll meet at least three-dozen meth users in any given year. Most people we meet are family and friends, so that means that many of those three dozen people who use meth are people we love in one way or another.

Only one in 20 meth users kicks the habit completely the first time they try to get help, which is a sobering thought. According to the Pew Charitable Trusts, the latest verifiable data regarding deaths from meth use is from 2019. Pew notes that the death rates from 2015 until 2019 doubled. The organization also noted that it wasn’t just more people using that was a contributing factor. Street meth is often mixed with fentanyl, unbeknownst to the people with a meth substance use disorder. In 2015, deaths from a meth and fentanyl mixture occurred once every 14 deaths. In 2019, the number was closer to one in three.

Is There Hope?

Meth is clearly both seductive and destructive, yet there is hope. A strong support network is crucial, and that starts with the person with the substance use disorder listening to family and friends. Eventually, rehab at an appropriate center with extensive experience in treating meth substance use disorder will be a necessary component of recovery. Cold turkey doesn’t work, and withdrawal symptoms can be dangerous. This is especially true in cases of long-term use where the addict’s brain chemistry has been altered.

First Steps: Admitting the Problem and Detox

The old expression is 100% true: To treat an addiction successfully, addicts have to admit that they have a problem. Once the person crosses that step, the rest of the recovery procedure can begin. With stimulants like meth, there are two phases of withdrawal: acute withdrawal and protracted withdrawal. 

During acute withdrawal, the effects are unpleasant but not usually dangerous. The person will become irritable and agitated. The person might sleep for prolonged periods because of the lack of stimulants. The person’s muscles will ache. Sometimes, particularly when substance use began because of a trauma, the person will exhibit signs of depression. Acute withdrawal lasts roughly five days, but it may also last for a shorter period.

Protracted withdrawal can last up to two months. The feelings of anxiety, agitation, and irritability continue. The person’s sleep patterns could be changed, sometimes irrevocably. Many people also experience lethargy and listlessness. Throughout the entire two months, there will be nearly irresistible cravings for meth or some other stimulant.

With co-morbid conditions, such as mental illness or chronic insomnia, medical professionals who are monitoring the person may need to use other medications to control their conditions. In almost all cases, the person in recovery will need to see a psychiatrist or other mental health professional for therapy in addition to medication.

Medical professionals must take care not to create additional substance use disorders while helping the person in question recover. Also, they must be vigilant in assessing the person’s mental state. Because meth changes a person’s brain chemistry, it’s possible for an individual to develop psychoses. In rare cases, individuals might experience a psychotic break with unknown consequences.

During detox, individuals going through meth withdrawal will also need supportive care, such as vitamins, nutritional food, encouragement, and understanding.

Which Medications Are Most Useful in Treating Meth Withdrawal?

Unfortunately, there are no FDA-approved medications for the treatment of meth withdrawal itself. According to the National Center for Biotechnology Information, which is associated with the National Library of Medicine, between 2000 and 2020, “No medication provided sufficient evidence to promote its use in the routine clinical management of MUD.” MUD stands for meth use disorder.

However, there has been interesting research in Australia using ADHD medicine as a possible treatment for MUD. Additionally, according again to the National Library of medicine article referenced above, Trivedi has begun research with injectable naltrexone and oral bupropion, and preliminary results of double-blind trials are encouraging.

Currently, the medications used in the field to treat meth withdrawal are limited to alleviating the symptoms of co-morbid conditions while leveraging therapy as the primary treatment for meth withdrawal and MUD. Examples include pain relievers for headaches, antidepressants for new or continuing depression, and nitrazepam for insomnia.

Therapy as Part of Recovery

More than with any other kind of drug, recovery from stimulants like meth requires diligence and fortitude for the rest of the individual’s life. This can make therapy a necessity. Therapists can teach people skills and coping mechanisms to stave off the cravings, deal with the changes in their minds and bodies, and accept their changed lives. Renowned addiction specialist Nora Volkow, M.D., spoke out against the stigma associated with addiction. She emphasized that addicts need the same kind of support that people with other illnesses receive from friends, family, and support personnel. Addiction is an illness, and as such, it needs treatment and not derision. Therapy is an integral part of that treatment.

Kinds of Therapy Used in Addiction Treatment

The most common therapy used in support of recovering addicts is cognitive behavioral therapy. This is where the therapist asks questions about the person’s feelings, moods, and inner thoughts regarding meth use, addiction, and their cravings. Once the therapist identifies the problems, the person learns coping strategies to avoid these negative thoughts and emotions. The idea is to get the person to focus instead on helpful and useful ideas, feelings, and emotions. A common strategy is for the person in recovery to take up a new hobby and to channel energy into that hobby.

As stated, acceptance of the situation is a key part of controlling it. In dialectical behavior therapy, the focus is on change as well as the necessary acceptance. This method of therapy began in the early 1970s as a treatment for people contemplating suicide. Rather than focusing on the underlying causes of the addiction, the therapist will focus instead on preventing a relapse. This treatment method also incorporates developing positive outside influences.

Contingency management therapy is all about creating incentives to avoid relapse. Examples might include activities outside the treatment center, extra visits with loved ones, or even the client’s favorite food being on the menu. It can be paired with motivational interviewing. The therapist becomes a cheerleader, celebrating successes and sharpening focus after relapse. Such a focus might be, “You won’t be able to go back to the job you love if you relapse. We know that you can keep your focus, so do it! Here are a few strategies to accomplish that.”

Eye movement desensitization and reprocessing, or EMDR, is a therapy that mental health professionals use to alleviate trauma. While it’s not psychotherapy, it can be an effective method of dealing with post-traumatic stress disorder or other traumas. PTSD and other traumas are often intertwined with substance use disorder. Therefore, it stands to reason that controlling and treating the trauma successfully can lead to greater success in recovery. 

As many as nine in 10 people with PTSD exhibit signs of complete recovery from the condition after EMDR treatments. The number of treatments varied from three to 12. If a client’s meth use stems from a traumatic event, such as seeing a buddy killed while serving in the military, then using EMDR to treat the PTSD from that event will remove the chief motivation for the client’s meth use. With the main mental health issue dealt with, recovery becomes mostly a matter of dealing with the physical cravings. EMDR is not a panacea, but it can be effective. EMDR must only be attempted when individuals are sober, which is why it’s an integral part of recovery and not detox.

Defining Wellness Centers

At Defining Wellness Centers, we’re a family-owned and -operated rehabilitation clinic. We focus on evidence-based methods of treating addiction. Even the newest technology that we use has been thoroughly vetted for effectiveness and safety. We’ve been helping people with substance use disorders since founding Defining Wellness Centers in 2019. While meth is one of our main foci, we help people with all manner of addictions. We adopt a comprehensive approach, too, and provide help with nutrition, physical fitness, and treatment options that include the participation of clients’ families. By highlighting the support of our client’s families, we help our clients feel calmer than if they were separated from their families. We’d be honored if you’d let us help you in your recovery. Contact us today when you’re ready to begin your journey.

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