Comment by edgyquant
5 years ago
I saw a similar post that claimed the new meth caused psychosis and hallucinations, etc. I don’t know much about meth itself but I do know about Adderall. When you take the normal dose (10-30mg) it can cause some euphoria but for the most part it helps you focus, gives energy (makes you more happy, talkative.) But when it is abused (60+mg) it can cause serious psychosis with all kinds of mental side effects. I image than the new meth is just extremely strong and so for people who are used to doing (or seeing others do) a weaker type it would seem to be a completely different drug. At least this is my theory, since as you said there isn’t any evidence there is a new type of meth, just a stronger type.
Yeah it's all very straightforward when you look at usage patterns. Often meth abusers will smoke multiple points across a day (a point = 100mg). As a result they stay awake for days straight, don't eat, and often will engage in enormously risky sexual behavior (this is the dirty secret of AIDS btw...it arose in the context of the "party and play" gay subculture where people would smoke meth or other drugs and have sex for hours and hours and hours straight with many, many different partners...but I digress)
The infamous "meth mouth"? That's caused by not sleeping and by just overall letting one's life go to shit. Amphetamines do suppress saliva production, so they aren't great for teeth, but it's 95% the lack of sleep and other associated behavior patterns.
I've taken pharmaceutical adderall (which is 75% d-amp and 25% l-amp btw), and pharmaceutical dextroamphetamine (100% d-amp), and illicit, presumably cartel-sourced, and presumably very pure d-methamphetamine. When taken orally, d-meth is, in my opinion, simply a superior ADHD drug (it is much more dopaminergic than amphetamine, yet causes less peripheral stimulation, so you get a much more favorable ratio of positive cognitive effects to negative peripheral effects).
However, the moment someone starts taking (especially smoking, since the RoA of any drug makes a massive difference in addiction, doubly so for meth) hundreds of milligrams, it becomes a completely different drug. It becomes super deleterious to health through the sleep deprivation and risky behaviors alone. Furthermore meth has a unique property that amphetamine apparently doesn't, which is that it can become directly neurotoxic in large doses (meth has some serotonin release, like a much, much weaker form of MDMA, whereas amphetamine has virtually none, so it's possible that that's the mechanism). This is why in the research literature there's a lot about methamphetamine "neurotoxicity", but the papers conveniently omit that if taking oral doses comparable to what's given for ADHD, it's not neurotoxic whatsoever (and frankly may be neuroprotective, especially against traumatic brain injury).
So yeah, your analogy to Adderall is spot on. I've often seen people derisively refer to Adderall or other amphetamines by saying "we're basically giving kids meth!". Which is true in a sense, except it's really the other way around: meth is really not very different from Adderall. If someone were to smoke 100mg+ of amphetamine, their body would break down the same way it does in a meth user, except possibly for the direct neurotoxicity effect I mentioned.
Great writeup!
Just adding on: Other key differentiator between recreational and therapeutic amphetamine usage is the pharmacokinetics: Vyvanse is the best in this regard - it’s actually an amphetamine prodrug that gets converted to amphetamine in the bloodstream over the course of ~2 hours, giving a very smooth release. Adderall achieves a similar end (to a lesser degree) by combining equal ratios of four different amphetamine salts with various absorption rates to smooth out the serum concentration curve. Dexedrine and Desoxyn I believe are both single salt compounds, and thus have a slightly higher risk of dependency due to their sharper peaks. Of course, other RoAs like smoking or injecting amphetamines recreationally take the effect to a whole new level with even sharper curves, dramatically raising the chances of addiction and negative side effects.
Totally agreed. Expanding a bit on some of the stuff you mentioned:
Vyvanse hits C_max around 3 to 3.5 hours. But you'll hit the maximum "acceleration" (as opposed to "velocity") around 1-2 hours like you said.
Fun fact: Vyvanse was basically designed to have more meth-like pharmacokinetics, since meth also takes about 3-3.5 hours to peak in the blood. Having done both lisdexamfetamine and d-methamphetamine orally, the C_max numbers in the literature are definitely correct because those numbers line up perfectly with when I subjectively peak.
> Adderall achieves a similar end (to a lesser degree) by combining equal ratios of four different amphetamine salts with various absorption rates to smooth out the serum concentration curve.
Yup, and I forget the exact mechanism but I have seen a paper arguing that the 75:25 ratio actually does improve the efficacy. Although I can't remember what the mechanism actually was...
> Dexedrine and Desoxyn I believe are both single salt compounds, and thus have a slightly higher risk of dependency due to their sharper peaks
Correct, both are 100% d-enantiomer, and both due have somewhat sharper peaks as a result. Although to elaborate AFAIK Vyvanse is really the only super unique one. Adderral does/should have a slightly smoother peak but largely the levoamphetamine seems to serve to up the norepinephrine-y effects (that is to say, the "I need to be doing something right now" effects, whereas dopamine is moreso the "once I start something I can keep doing it" effects).
Also methamphetamine in particular when taken orally is very vyvanse-like, as I mentioned above. So it's really exclusively with the fast RoAs like smoking or injecting it where you get the really crazy instant spike. (That last sentence is just from my general understanding, I've never taken meth in a non-oral RoA so I can't speak from experience)
Adding on: the problem with vyvanse is that there's no way to mess around with the dosage to get it "just right."
It's like a more strict version of extended release (EX) and timed release formulations (there's a difference!).
Vyvanse is metabolized to d-amphetamine in your blood cells (the specific mechanism escapes me right now), unlike the regular non-prodrug versions which get "metabolized" first in your stomach and intestinal tract, and then your liver.
However, there is a set speed that vyvanse gets converted into free-circulating d-amphetamine, determined by how quickly (or slowly) your blood cells metabolize it. Unlike regular d-amphetamine, where the speed, and effect, can be "messed" with (or rather "tuned") on a variety of factors, such as:
0. Carbohydrate intake (regular, non-fructan and non-galactin, carbs get released into the bloodstream and trigger an insulin release response, which also happens to dull the effect of excitory neurotransmitters)
1. Stomach pH (acidicity == lesser effect, basicity == higher effect. E.g. drinking orange juice with d-amphetamine will lessen its effect, while taking tums will increase its effect, many times TOO much)
2. Certain liver enzyme inhibitors (mainly those in black pepper and grapefruit/pomegranate) will decrease the rate of amphetamine clearance, thereby intensify its effects
3. Caffeine (will potentiate amphetamine)
4. Personal physiology (not much you can do except play around with dosage and the aforementioned 4 factors)
Now, with the regular IR version, you can take more or less (1-5mg here and there) depending on your specific circumstances to get into the "right" spot where you're not overly or under stimulated, but just enough to be in that Goldilocks zone of flow.
However, with the ER version you lose the ability to get your "Goldilocks Dosage." You can still play around with the aforementioned factors, but this time you're restricted to a specific dosage now (say 5mg) and a specific dosage in some set amount of time later (say another 5mg, about 4-6 hours later).
Yet, with vyvanse you get even less of an ability to play around with the dosage. Take 60mg, and your body will slowly metabolize it to a set amount per hour, regardless of almost anything you can control. If that amount/hour rate doesn't coincide with your Goldilocks zone, you're shit out of luck -- and Vyvanse will not "work" for you.
There's so much more that goes into this, but I've frankly written way too much of an essay at this point.
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Meth causes your mouth to produce to less saliva which removes the bacteria moderating ability of your mouth.
Combine that with also constricting the blood vessels of your gums, and you get a great mix of infection of dying tissue.
It's a myth. I have met hundreds, maybe thousands of long term addicts of meth, crack, and heroin... Lifestyle addicts suffer from massive tooth decay & dental problems, in similar proportions, regardless of which drug they were using.
Whatever the pharmacological impact of meth usage on oral health, it's pretty clear to me that it's a much smaller factor than the general gone-to-hell life of a full time addict.
The 'dirty secret' you refer to (1) is mostly wrong because partying with LSD was popular in the early 80s, not meth, and (2) the gay community is and always has been very up front about risky behaviors and how to minimize the risks. Just because you're unaware of something doesn't make it a secret.
In the American urban gay community, neither LSD nor meth were nearly as popular as prescription amphetamines (pills) until the 1990s, when bathtub meth (crank) manufacturing really took off. They were all always available, but the pills were so cheap & easily obtainable that they were a natural favorite.
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All other literature have told me exactly the contrary in terms of attitudes concerning risk. So, do you have a non politicized source for your statements?
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My somewhat large reading about this and some real life knowledge says this is a very true POV.
Amphetamines also cause capillary vasoconstriction which eventually kills off your gums
Pharmacologically, amphetamines are no worse on your mouth than regular nicotine or caffeine usage. And while cigs & coffee aren't necessarily good for your oral health, they also don't generally cause major gum disease and tooth loss.
"Meth mouth" is mostly caused by neglect, not the biological effects of amphetamines. Long-term heroin & crack users suffer the same kind of severe tooth decay as meth addicts. If you smoke meth every day, but still somehow manage to brush & floss your teeth every day, your oral health won't be any worse than the average American.
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This "new meth" thing seems like a PR push by government contractors. It's redolent of the UK "skunk" scare (it's not the pot you used to smoke, mommies and daddies - it's special pot that will definitely make your children think they can fly and jump out of windows, and become prostitutes to pay for more.)
What makes you say that?
I'm not 100% sold on it yet, but my city has always been "welcoming" to homeless folks and it has never been a huge problem. Now it looks like an actual zombie apocalypse out there in some parts, and there are periodically meth busts of hundreds of pounds in just random apartments, not even kingpin types.
Combined with the anecdotal evidence from social workers, there's a whole lot of smoke out there that the "new meth" theory might explain.
As the article points out, the big change is in the production levels and the price. If meth is cheap and every dealer is flooded with it, more people are going to be using it and in higher quantities that will produce more visible (and negative) effects.
The random apartments are probably stash houses used for storage of bulk quantities that would be broken down and distributed to dealers.
Yes because what people are taking now is super pure and potent where before what was common was “dirty” meth.
> government contractors
I’m not sure I follow? I know drug fear-mongering is a favorite tactic of politicians but I’m not sure I understand what government contractors have to do with it. Are you alluding to private prisons? Or perhaps some other piggy-back industry that I’m unaware of?
It sounds like someone just watched Breaking Bad.
More that breaking bad was picking up the story that was taking place at the time when sourcing their material. There's been a lot written about the superlabs in Mexico that produce hundreds of pounds of pure product a batch. There are probably thousands of facilities like this now making this P2P cook at industrial scales.
> When you take the normal dose (10-30mg) it can cause some euphoria but for the most part it helps you focus, gives energy (makes you more happy, talkative.) But when it is abused (60+mg) it can cause serious psychosis with all kinds of mental side effects.
Background: I'm prescribed 20mg/day of extended release Adderall, via a legitimate ADHD diagnosis. If we take the article's "meth is 2x as potent as Adderall" statement at face value, that would mean I'm taking 10mg equivalent of meth per day.
Now, since part of the reason I take this medication is to remember to take my medication (a joke, yes, but not without its kernel of truth!), I've accidentally double dosed myself before. I've also done the same previously when I was prescribed instant release Adderall. In either case, I've never experienced anything like a euphoric high, but I have experienced the kind of "uselessly driven"/tweaker sort of side of it. And, let me tell you, I do not like it when that happens. Although I'm in no hurry to find out, I honestly find it hard to imagine what the high must actually be like in order for people to voluntarily subject themselves to the negative effects of this drug. And, I don't even exceed the therapeutic range when this happens!
I wish there was some way to actually understand why people abuse meth without actually smoking meth myself, which I'm unwilling to do, for obvious reasons.
This is off the top of my head, so no citations, but d-methamphetamine is something like 30% more potent than d-amphetamine. The fact you're taking Adderall makes the comparison more complicated though because you're not taking d-amp. In general d-amp is 3-4x more cognitively powerful than l-amp. So we can consider l-amp to be about 25% the potency of d-amp, except IIRC the 75:25 d-amp:l-amp ratio of adderall synergizes a bit, so let's say that d-amp is ultimately 2.5-3x as strong as l-amp.
Your 20mg of XR addy is equivalent to 10mg IR and another 10mg taken roughly 4 hours after, but let's forget the XR part and just assume it's a 20 IR for convenience (it doesn't change the math anyway, just the pharmacokinetics).
20mg IR Adderall is 15mg dextroamphetamine and 5mg amphetamine. That's about 17mg dextroamphetamine equivalent. Given my estimate of d-meth being 30% more potent than amphetamine, you're taking an equivalent of about 13mg of d-methamphetamine a day.
> In either case, I've never experienced anything like a euphoric high, but I have experienced the kind of "uselessly driven"/tweaker sort of side of it. And, let me tell you, I do not like it when that happens.
See you're amphetamine tolerant. Give your 20mg dose to an amphetamine naive individual, and they will get the euphoria for the first couple days at least of taking it. The euphoria quickly fades, though.
You are correct that when you overdose and aren't stimulant naive, you often end up with mostly the downsides with little upside. There's not too much value in pushing the body past its "equilibrium" level of stimulation (in your case 20mg XR).
> Although I'm in no hurry to find out, I honestly find it hard to imagine what the high must actually be like in order for people to voluntarily subject themselves to the negative effects of this drug. And, I don't even exceed the therapeutic range when this happens!
> I wish there was some way to actually understand why people abuse meth without actually smoking meth myself, which I'm unwilling to do, for obvious reasons.
Have you ever done MDMA? That makes it easy if you have, because MDMA is like a way gnarlier version of methamphetamine: it's shorter lasting and releases WAY more serotonin while still being very dopaminergic. Methamphetamine, taken in oral doses enough to get you slightly tweaking but not at a crazy level, is kind of like 10% of the sensation of "rolling" (rolling means being quite high on mdma) while feeling like a smoother, less physically tweaky version of Vyvanse, which itself is a smoother, less physically tweaky version of adderall.
(For context, when comparing adderall to dexedrine to vyvanse, adderall is by far the tweakiest due to the l-amp. Personally, I'm a dextrorotatory supremacist so I won't touch the l enantiomer with a 10-foot pole)
If you've never done methylynedioxy-methamphetamine, and you clearly haven't done regular methamphetamine, you likely don't "know" what serotonin feels like, unfortunately. But the TLDR is methamphetamine is a smoother and somewhat more dopaminergic version of amphetamine, with the added bonus of some minor (significant when you're smoking it though) serotonin release as well, whereas amphetamine has almost no interaction with serotonin to the best of my knowledge.
Thank you!
I hadn't expected anyone would answer my comment, much less that anyone would provide a concrete reference point that was actually within my experience. I have used MDMA and experienced the high you're describing. For reference, I was high enough that I felt it certainly would not have been a good idea to try driving my car anywhere, but not so high that I felt taking my dog for a walk around the block would have been at all risky.
I found it pleasant, and wished it would last longer, but I don't think it's anything I'd go for if i were only 10% as intense and came with all the twitchy/tweaker effects. The jaw clenching I got from MDMA was more than enough of that.
But, as far as this:
> See you're amphetamine tolerant. Give your 20mg dose to an amphetamine naive individual, and they will get the euphoria for the first couple days at least of taking it. The euphoria quickly fades, though.
When I said "never," I meant "never." I didn't experience it the first time I took amphetamine, the second time, or this morning.
I have experienced some mild euphoria from prescribed dosages of opioids in the past, and, as I mentioned, I've experienced the high of MDMA, so, I think I have some sort of reference point here, although I'm sure they're very different highs.
Maybe it's because the starting dosages my doctors had me trying out initially were very small. Maybe it's because that initial dosage was 10-15 years ago, and I don't really remember it well (which would imply it wasn't very memorable). Or, maybe I did experience some euphoria, but just couldn't classify it as such because of my limited drug experience thus far.
In any case, as you said, I am not amphetamine-naive anymore and certainly don't get high off my medication at prescribed dosages, or even somewhat higher than prescribed dosages.
Again, thank you for helping me understand a bit of the appeal of smoking meth, without actually smoking meth. :-)
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Another factor is just sleep deprivation. It's been shown that sleep deprivation increases the likelihood of mania, hallucinations and psychosis. You force someone to stay awake long enough, they will inevitably act crazy. Amphetamine users tend to go on binges and stay awake for days. Keep taking drugs until they pass out from exhaustion.