Hope after meth abuse?

Hello Alice.

I have been trying to find information about the hope for recovery for previous meth users, but there doesn't seem to be a consensus. Some sources say that meth causes permanent damage to the brain, while others are a little more hopeful and say some important brain functions might recover.

I used meth about fifteen times, which I gather isn't a lot in comparison to other meth users but is still a considerable amount. For a while I have felt paranoid and anxious and it has been more difficult to perform daily tasks and just generally think straight. Also, things I used to enjoy are not really that enjoyable anymore.

My question is, will I be able to have my brain back? If so, how much of it? Will I ever go back to being my old self?

Thank you very much for your valuable service.

— HopingforHope

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Answer

Dear HopingforHope,

Your comment about not being able to find a consensus on long-term effects of meth is right on the mark: the science behind the issue is mixed, and figuring out exactly how to study the long-term effects has proven to be tricky for researchers. This leaves scientists a bit uncertain and — you guessed it — in disagreement on the topic (more on that in a bit). You asked whether there’s hope for getting your brain back and being your old self again. The changes in your mood and personality might be due to one or more factors: the short-term effects of withdrawal, slightly longer-term damage to the brain cells, or even a reaction to unrelated stressors. The good news is that some research points to brain recovery after halting use of methamphetamines, and there may also be a few actions you can take to start feeling more like yourself again in the meantime.

The feelings that meth brings — euphoria, increased energy, and the feeling of everything being sped up — are the results of the drug triggering neurotransmitters in your brain, most notably serotonin and dopamine. It does this by tricking the receptors on the nerve cells to release more of these neurotransmitters. After repeated use, this can lead to addiction (a dependence on the drug) and withdrawal when not using it. Withdrawal symptoms can include drug cravings, depression, anxiety, and fatigue.

This explains the short-term, but how does this tie into any longer-term effects? Some scientists believe that repeated use may actually cause damage to the dopamine receptors in the brain due to a combination of excess dopamine, glutamate (another chemical that your brain releases), and increased body temperature (a side effect of meth use). This damage might make nerve cells less efficient at taking up and reacting to the dopamine that the body naturally produces, even when not currently high. In turn, this has led researchers to think that there could be long-term impacts of meth use on cognition, memory, or movement. Other potential long-term effects of meth use may include mood changes, confusion, paranoia, or anxiety. Some people may even experience hallucinations or delusions, especially when exposed to stress. 

Here’s where the research gets a bit tricky and less certain. At least a few studies have shown some long-term changes in these dopamine-receiving brain cells and decreased performance on tasks. Recent studies have confirmed that meth use does reduce areas of the brain containing gray matter, which handles self-control, decision making, and muscle movement. This could contribute to a decrease in information retention and analytical skills. However, it’s good to note that these studies were conducted on rats and primates, and it’s not totally clear how these findings translate to humans, if at all. It's also unclear if gray matter is impacted differently based on its location in the brain. Neuroimaging (CT scans and MRIs) in humans who use meth have also shown some changes in areas of the brain with lots of dopamine receptors. However, there are questions about whether neuroimaging is the best way to assess changes in cognition because there are still a lot of unknowns about brain imaging. In tests of long-term memory, attention, and quick thinking, former meth users tend to score lower than those who have never used meth. But, even though their scores are lower, it’s often not by a large degree, and the scores are still within a range that is considered normal. Additionally, a lot of these studies haven’t separated out the effects of methamphetamines from other recreational drugs (such as cocaine, marijuana, or alcohol), so there is some skepticism about whether meth is really the only culprit for cognitive changes.

More to your question, many of these studies, from rodents to humans, have shown at least some reversal of the damage to the brain cells given enough time. For humans, the damaged areas seem to start to bounce back after about 12 to 17 months of quitting meth, with nerve damage easing after about one year, which in turn improves motor and verbal function. Recent studies also show that two years without meth use may return brain activity to pre-use levels, and that greater improvements are generally seen the longer abstinence is maintained. This isn't a guarantee that all former users will be completely back to “normal” after a certain amount of time; some report still having psychotic episodes and feelings of stress and anxiety many years after stopping meth. But, the good news is that it does look like some of the damage to the brain may be reversed over time. 

Because using meth can have short and long-term health effects, abstaining may help keep your brain and body healthy. Obviously, this is easier said than done, especially once a dependency is developed. If you're struggling to stop using meth, know that you aren't alone. Unfortunately, it’s not uncommon to relapse after quitting, but there are several treatment options to help, if you need or want them. While there are no prescribed medications to treat meth addiction, there are several therapeutic options that have demonstrated success, such as cognitive behavioral therapy (CBT), where participants work to respond to negative thoughts with supportive coping mechanisms, or contingency management therapy, where meaningful incentives are provided throughout treatment. Some people also find support groups to be helpful in maintaining abstinence from meth use. If you're looking to try this, you may wish to check out Crystal Meth Anonymous, an organization that hosts online and in-person meetings to connect people in recovery.

Since you report no longer enjoying your usual activities, it may be helpful to take stock of stressors or circumstances in your life that might be making it hard to feel like your usual self. Your description of no longer finding certain activities enjoyable might be associated with depression, which could be a symptom of withdrawal or might be connected to the circumstances that led you to try meth in the first place. Even if you take the effects of meth out of the equation, have any other circumstances in your life changed lately that might be making you feel the way you do? Additionally, focusing on everyday healthy habits may also help. Have you thought about starting or changing an exercise regimen (sometimes seen as a natural high)? How about giving a new hobby a try, or finding a new social activity to join? You may also want to talk to a provider about your feelings of depression. For more on that, check out Q&A When do I need to get treatment for depression. Finally, eating well, getting adequate sleep, and finding people and activities that make you happy — even if they aren’t the same things that used to make you happy — may help set you on a path toward finding your way back to a something like “your old self,” or maybe even a new self you’ve yet to discover.

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Summary of informative links

Related Q&As:

  • Methamphetamines and their side effects 

    • Nature of methamphetamines and their uses are explained. Its effects on the brain are explained. Likewise, a few of the side effects are broken down as well as long term effects. The most fatal long term effect is addictiveness. There is also the risk of meth being mixed with other, fatal substances.

  • Reaching out for help with a drug addiction

    • The reader has taken the first step in addressing their drug problem. They are encouraged to reach out to family or a doctor for support. While the reader may be scared of their reactions, this small uncomfort outweighs the long term risks. The reader can also use a hotline as the first step for help. 

  • Long term effects of caffeine based drugs

    • Nature of coffee and how common it is is explained. The effects of caffeine on the body are then broken down. Withdrawal symptoms are explained and it is emphasized that more sleep is far more beneficial than more caffeine. A few reflective questions are asked to help the reader understand their use of caffeine.

  • Recreational codeine use - Health effects?

    • Nature of codeine is broken down and is warned to be highly addictive. A few short term and long term effects are listed. Likewise, some more serious side effects are explained. The reader should expect withdrawal symptoms given they stop their use of codeine. The reader is encouraged to seek safer ways to achieve a “high” feeling. 

  • Trapped in a trip

    • Reader’s concern is eased as there is no factual research on staying trapped in a trip. The issue with HPPD is then explained. The nature of LSD and its association with HPPD is broken down. As expected, the use of LSD has its long term effects.

 Definitions:

  •  Grey Matter - Section of the brain that involves muscle control, senses, decision making, and self-control. 

 

Source 1: Gray-matter structure in long-term abstinent methamphetamine users

SUMMARY

This source studies the effects of meth on the brain; more specifically, on gray matter. While some findings remain ambiguous, the key points of the study are summarized as follows:

  • As time increases without meth use, the volume of gray matter was greater
  • Previous arguments that meth use reduce gray matter are confirmed
  • Structural changes in the brain can cause a lack of ability to retain information and the inability to analyze information well
  • Ambiguity in how long term meth use influences gray matter in different parts of the brain differently

 

Overall, the use of meth contributes to neurocognitive dysfunctions. More research is needed to understand how long term use of meth will induce different effects on the brain.

 

Source 2: What are the long-term effects of methamphetamine misuse?

SUMMARY

This source talks about the long term effects of meth use. Of course, the biggest risk is addiction as it is a relapsing disease and causes changes in the brain. Withdrawal symptoms include depression, anxiety, fatigue, and intense cravings for meth. Long term effects include anxiety, confusion, insomnia, mood swings, and violent behavior. 

 

Some more severe effects are paranoia, hallucinations, and delusion. According to neuroimages, meth alters the activity of the dopamine system, leading to reduced motor speed and difficulty with verbal learning. Likewise, decision making and the suppression of useless habits becomes more difficult.

 

The effects of meth use appear to be reversible to an extent. In one study, being meth free for two years showed brain activity similar to subjects who have not used meth. Likewise, nerve damage was seen to ease after a year without its use. This resulted in improved motor and verbal tests. Some final physical effects are mentioned such as tooth loss, weight loss, etc.

 

Source 3: What treatments are effective for people who misuse methamphetamine?

SUMMARY

This source from the NIH provides a straightforward answer as to what treatments are best for meth addiction. The verdict: interactive methods like behavioral therapies, contingency management interventions, and motivation. There are no medications that can help with this issue.

  • Behavioral therapies: includes therapy, family interventions, counseling, drug testing, and encouragement
  • Contingency management: provides incentives if one engages with treatment
  • Motivation: the program MIEDAR has demonstrated success in the past

 

Source 4: Crystal Meth Anonymous

SUMMARY

This source is a resource for meth users, or those in recovery, to seek out other individuals with similar experiences. There are no fees or dues to join, only a passion to work against meth addictions. Given the virus, there are now online programs established to make the program accessible to anyone!

 

OVERALL CONCLUSIONS:

Looking at the previous response, it does a fantastic job at addressing the issues the reader has. Nonetheless, more recent research has been published that we can add in. Likewise, there are a few points that could provide them more support through recovery.

The introduction accurately captures the complexity of the topic and briefly outlines what is going to be talked about. For this reason, it should be kept as it is. 

Current research is consistent with the second paragraph. Still, it can be more detailed for readers who may not know much on the effects of meth use. Using source 2, we can embed the different short and long term effects it can have on our body. Of course, we want to emphasize the effects on the brain to align with the concerns of the reader.

Looking at the third paragraph, we should alter the writing to include more recent studies. Following the line “changes in areas of the brain with lots of these dopamine receptors,” we can incorporate source 1 to talk about the effects on gray matter. This is because the response then talks about the concerns of memory and lack of information on whether meth is the true cause of cognitive changes that the new study also mentions.

With the fourth paragraph, using source 2 to alter the information on when reversal of damaged brain cells should be done. The source summary can help with this.

Before closing, a new paragraph should be added talking about treatments and possible areas for support with meth use. Because relapse with meth use is very high, we can use source 3 to talk about current treatments. Emphasis should be made on how there is no medication that can be prescribed. After, mentioning the benefits of support groups would be nice. We can link source 4 to do so.

Finally, I really like the closing paragraph. Not only is it personal to the reader and their situation, but anyone can take this advice on their path to recovery.

 

Notes on research:

Information on this topic was somewhat accessible. As expected, resources for meth recovery were easily accessible. On the other hand, studies on the effects of meth on the brain were limited. Nonetheless, the few sources included make the verdict on the effects of meth more clear. After reviewing research once again, there are no updates to the sources used or additional research made.

 

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