Increase In Anxiety and Depression Linked to Increased Problem Drinking

Should we be concerned about an increase in alcohol use post-COVID?

In a letter published in the Journal of General Internal Medicine in late 2020, public health scientists Dawn Sugarman, PhD, and Shelly Greenfield, MD, of McLean Hospital at Harvard University warned that an increase in alcohol use in response to the stress caused by the coronavirus pandemic raised “significant public health concerns.”

The two doctors cited observed increases in alcohol consumption in the U.K. and Australia as potential indicators of similar increases here at home, and pointed out the disturbing fact of the treatment gap for people with alcohol use disorder (AUD): in the U.S. only 7.9% of people diagnosed with AUD receive the specialized treatment they need to address their disordered alcohol use.

They go on to point out that increased drinking – and substance use – is a common response to trauma, stress, and events involving large-scale suffering, injury, or death. A study published in 2009 analyzed the use of alcohol and drugs in response to one of the most infamous mass-trauma events in U.S. history – the 911 terrorist attacks – and concluded the following:

• 7.3% of a population can be expected to increase alcohol consumption in the first two years following a terrorist event
• There is a 20% probability that 14% of a population will increase alcohol consumption following a terrorist event
• An estimated 16.3% of a population can be expected to increase the use of both prescription and narcotic drugs following a terrorist event

Evidence from the aftermath of the 911 attacks is relevant because, although the coronavirus pandemic is not a terrorist attack, it is a mass casualty scenario. At the time they wrote the letter, we were still early in the pandemic. Sugarman and Greenfield made another critical point: unlike the 911 attack, the coronavirus pandemic was ongoing, and no one knew when it would stop.

Stay-at-Home Orders, Isolation, and Stress

In retrospect, the ongoing nature of the public, pandemic-related trauma was something mental health experts did not appreciate fully. Whereas single-incident events cause significant distress and trauma, their finite nature allows people who experience them to process the experience and move forward. That’s to say that their trauma does not persist. Rather, it means that the traumatic event can be contextualized and understood with the benefit of hindsight. This is not the case with the coronavirus pandemic.

Sugarman and Greenfield identified several layers of ongoing pandemic-related stressors that had the potential to lead to increased alcohol consumption:

1. Fear of contracting SARS-COV-2 itself

2. Psychological distress due to lack of social contact

3. Reduced participation in social support groups such as Alcoholic Anonymous (AA) due to public health guidelines

4. Reduced access to specialized treatment for Alcohol Use Disorder (AUD)

5. Job loss, income insecurity, and worry about finances

These five groups of potential stressors increased the risk of heavy and/or disordered drinking, which can lead to significant physical and emotional problems. Negative physical consequences of excess drinking include liver disease, cancer, high blood pressure, stroke, impaired immunity, and fatalities from drunk driving accidents. Negative emotional and psychological consequences of excess drinking include increased risk of depression, suicide, intimate partner violence, child abuse, and child neglect.

According to Sugarman and Greenfield, that was our current situation early in the pandemic: a perfect storm of stress that had the potential to lead to a nationwide alcohol consumption crisis, which, as noted above, itself had the potential to create a new public health emergency, in addition to the coronavirus pandemic.

And it turned out they were right. Studies published in 2020 and 2021 showed:

• Increases in anxiety disorders
• Increases in depressive symptoms
• A 60% increase in alcohol consumption
• An increase heavy drinking and binge drinking

That’s why it’s important for us to look back at the prescient insight Sugarman and Greenfield offered. The steps they recommended we take a year ago are just as important now as they were then. They may even be more important now.

Steps to Take: Awareness, Assessment, and Treatment

In light of the heightened risk of problem drinking related to coronavirus-related stressors, Sugarman and Greenfield recommended a series of proactive steps we, as a nation, can take to “moderate and reduce alcohol consumption in the face of this pandemic.” They reiterated that the full scope of the pandemic was not yet known and that it’s wise to look to the data provided by researchers in other countries in order to prepare for the potential collateral damage the pandemic may cause in the U.S.

Here’s what they recommended:

Step 1:

We should raise awareness about the fact that stress related to the coronavirus pandemic created and continues to create the risk of increased alcohol consumption, which may escalate to another nationwide health crisis in addition to the coronavirus pandemic.

Step 2:

We should realize our response to this risk needs to be nuanced, multi-faceted, and include everyone with any known risk factors for drinking or excess drinking.

Step 3:

We should advocate forward-thinking public health talking points. Public media outlets can counter the cultural messages (present in the form of social media posts and memes) that promote excess drinking. Public officials can prioritize messaging efforts that promote managing anxiety and stress without alcohol and substance use.

Step 4:

We should be ready for an increase in the need for treatment across a “continuum of severity” that includes “drinking-related exacerbation of other co-occurring medical conditions.”

Step 5:

In primary care settings, we should improve efforts to identify addiction and mental health issues early, by being aware of risk factors for increased drinking such as financial insecurity, and the presence of symptoms of anxiety and depression.

Step 6:

We should focus attention on targeted interventions for people with alcohol use disorder at risk of relapse, and expand access to telehealth, virtual therapy, and online social support communities for people in recovery. Increased access to these services and expanded insurance coverage for mental health/substance use treatment should last through the pandemic and beyond.

Integrated Effort with Full Collaboration

The open letter published by Sugarman and Greenfield – addressed to the medical community as a whole – is an important reminder that while we strive to manage our response to the primary health crisis, the coronavirus pandemic, the secondary effects of the pandemic, such as misuse of alcohol and an increase in alcohol use disorder (AUD), can create severe, chronic physical, emotional, and social consequences that may persist years after we get COVID-19 under control.

The sooner we can identify at-risk individuals, offer accurate diagnoses of AUD when necessary, and provide appropriate treatment and support, the more likely those individuals are to achieve and maintain sustained, long-term sobriety. Any steps we take in this direction will help to contain the scope of harm caused by the pandemic, and give people hope by offering a lifeline of support.

The Ridge in Cincinnati offers inpatient and outpatient rehab facilities. Besides, alcohol detox programs and other amenities help you identify the extent of the problem and get the right solution. Contact us today!

Opioid addiction is a serious condition that can affect physical health, mental well-being, relationships, and daily life. It can develop from the misuse of prescription pain medications or the use of illicit opioids such as heroin and fentanyl. As opioid-related overdoses continue to affect communities across the country, understanding the risks associated with opioid use is more important than ever.

Learning to recognize the warning signs of opioid addiction and understanding available treatment options can help individuals and families take the first steps toward recovery. 

What Are Opioids? 

Opioids are a class of drugs used to relieve pain. Some opioids are prescribed by healthcare providers to help manage moderate to severe pain, while others are manufactured and distributed illegally. Although opioids can be effective for pain management, they also affect areas of the brain involved in pleasure, reward, and motivation.

Common opioids include:

• Oxycodone (OxyContin, Percocet, Percodan, Endocet)
• Hydrocodone (Vicodin, Norco, Lortab, Lorcet)
• Meperidine (Demerol)
• Hydromorphone (Dilaudid)
• Morphine (MS Contin, Kadian) 
• Codeine (Tylenol with Codeine) 
• Fentanyl (Duragesic, Actiq) 
• Heroin

Prescription opioids are often used to treat pain following surgery, injury, or certain medical conditions. When taken as prescribed and closely monitored, these medications can play an important role in medical treatment. However, opioids also have the potential for misuse because of the way they affect the brain and body.

Both prescription opioids and illicit opioids produce similar effects, including pain relief, relaxation, and feelings of euphoria. Repeated opioid use can change how the brain responds to these substances, increasing the risk of developing opioid use disorder. Understanding what opioids are and how they affect the body can help individuals recognize potential problems and seek help when needed.

How Opioid Addiction Develops

Opioid addiction often develops gradually over time. Many people first use opioids after surgery, injury, or treatment for a medical condition, while others may begin using them recreationally. Regardless of how opioid use starts, repeated exposure can change how the brain responds to these substances.

As opioid use continues, the body may develop tolerance. This means a person needs larger or more frequent doses to achieve the same effects. Regular opioid use can also lead to physical dependence, which occurs when the body adapts to the presence of the drug and has difficulty functioning normally without it.

Physical dependence and addiction are not the same thing. However, dependence can increase the risk of developing opioid use disorder, especially when opioid use begins to interfere with a person’s health, relationships, work, finances, or daily responsibilities.

The widespread use of prescription opioids contributed significantly to rising rates of opioid misuse in the United States. As some individuals developed dependence, many turned to illicit opioids such as heroin or fentanyl when prescription medications became more difficult to obtain. This transition has played a major role in the ongoing opioid crisis and the increase in opioid-related overdose deaths.

Understanding how opioid addiction develops can help individuals recognize when opioid use is becoming problematic and seek professional support before the condition becomes more severe.

Signs and Symptoms of Opioid Addiction 

The signs of opioid addiction can vary from person to person. Some individuals experience noticeable physical symptoms, while others show changes in their behavior, emotions, or daily functioning. Recognizing these warning signs can help individuals and families identify when professional support may be needed.

Common physical signs of opioid addiction may include:

• Drowsiness or excessive fatigue
• Constricted (pinpoint) pupils
• Nausea or constipation
• Changes in sleep patterns
• Slowed breathing
• Frequent flu-like symptoms when opioids are unavailable

Common behavioral signs of opioid addiction may include: 

• Using opioids more often or in larger amounts than intended
• Neglecting work, school, or family responsibilities
• Social withdrawal or isolation
• Financial problems related to opioid use
• Seeking multiple prescriptions or obtaining opioids illegally
• Continuing opioid use despite negative consequences

Common psychological signs of opioid addiction may include: 

• Strong cravings for opioids
• Mood swings or irritability
• Anxiety or depression
• Difficulty concentrating
• Loss of interest in previously enjoyed activities

Experiencing one or more of these symptoms does not automatically mean a person has an opioid addiction. However, when opioid use begins to affect daily life, relationships, responsibilities, or overall well-being, a professional assessment can help determine whether treatment may be beneficial.

Opioid Withdrawal Symptoms and Detox 

Withdrawal symptoms can occur when a person who has developed physical dependence on opioids reduces or stops opioid use. Although opioid withdrawal is not typically life-threatening, the symptoms can be intense enough to make quitting difficult without professional support. In many cases, the discomfort associated with withdrawal contributes to continued opioid use and increases the risk of relapse.

Common opioid withdrawal symptoms may include:

• Muscle aches and body pain
• Sweating and chills
• Nausea, vomiting, or diarrhea
• Anxiety, irritability, or restlessness
• Insomnia or difficulty sleeping
• Yawning
• Runny nose or watery eyes
• Tremors
• Increased heart rate
• Strong cravings for opioids

The severity and duration of withdrawal vary from person to person. Factors such as the type of opioid used, the amount used, the length of use, and overall health can all influence the withdrawal experience. Symptoms often begin within hours to a few days after the last use and may continue for several days or longer.

Because withdrawal can be physically and emotionally challenging, many individuals benefit from medical detox. A medically supervised detox program can help manage symptoms, provide medical monitoring, and reduce the risk of returning to opioid use during the early stages of recovery. 

Fentanyl and Opioid Overdose Risks 

Fentanyl is a synthetic opioid that has become a major contributor to opioid-related overdose deaths in the United States. While pharmaceutical fentanyl is prescribed in certain medical settings to manage severe pain, illicitly manufactured fentanyl is frequently found in the illegal drug supply and poses significant risks to individuals who use opioids.

One of the greatest dangers associated with fentanyl is its potency. Fentanyl is estimated to be 50 to 100 times more potent than morphine, meaning even small amounts can produce powerful effects and significantly increase the risk of overdose. In recent years, fentanyl has increasingly been found in heroin, counterfeit prescription pills, and other illicit substances. In many cases, individuals may be unaware that fentanyl is present in the drugs they are using.

An opioid overdose can slow or stop breathing, which can quickly become life-threatening. Common signs of an opioid overdose may include:

• Slow, shallow, or stopped breathing
• Extreme drowsiness or inability to wake up
• Pinpoint pupils
• Blue or gray lips, fingernails, or skin
• Choking, gurgling, or snoring sounds
• Loss of consciousness

The growing presence of fentanyl in the illicit drug supply has contributed significantly to rising opioid overdose deaths. Recognizing the warning signs of an overdose and understanding the risks associated with fentanyl can help individuals and families respond quickly during an emergency.

If opioid use has become difficult to control, professional treatment can help reduce the risk of overdose and support long-term recovery.

Treatment for Opioid Addiction 

Opioid addiction is a treatable condition, and many people achieve long-term recovery with professional support. Effective treatment often follows an integrated approach that addresses the physical, psychological, and social effects of addiction. Because opioid use disorder can affect many areas of a person’s life, treatment typically involves more than simply stopping opioid use.

Treatment often begins with medical detox to help individuals safely manage withdrawal symptoms. After detox, ongoing treatment focuses on understanding the factors that contribute to addiction, developing healthier coping strategies, and building the skills needed to support long-term recovery.

Treatment for opioid addiction may include:

• Medication-Assisted Treatment (MAT), including medications such as methadone or buprenorphine
• Residential treatment programs
• Partial hospitalization, intensive outpatient, or outpatient treatment programs
• Individual counseling
• Cognitive Behavioral Therapy (CBT)
• Dialectical Behavior Therapy (DBT)
• Motivational Interviewing (MI)
• Group therapy
• Family counseling and family support services
• Relapse prevention planning
• Peer support and recovery groups
• Aftercare and ongoing recovery support

Many individuals struggling with opioid addiction also experience co-occurring mental health conditions such as anxiety, depression, trauma, or post-traumatic stress disorder. In these situations, dual diagnosis treatment can help address both addiction and mental health concerns at the same time, supporting more comprehensive and effective recovery.

Because every person’s experience with opioid addiction is different, treatment plans should be individualized to meet specific needs, challenges, and recovery goals. With evidence-based treatment, ongoing support, and a commitment to recovery, many people are able to overcome opioid addiction and build healthier, more fulfilling lives.

Recovery From Opioid Addiction Is Possible

Recovery from opioid addiction is possible, and many people go on to live healthy, productive, and fulfilling lives after treatment. While recovery can present challenges, it also creates opportunities to improve physical health, strengthen relationships, rebuild trust, and develop a greater sense of stability and purpose.

There is no single path to recovery. Some individuals benefit from residential treatment, while others continue their recovery through outpatient care, therapy, peer support, and ongoing recovery services. The most effective recovery plans are tailored to an individual’s unique needs, challenges, and long-term goals.

Maintaining sobriety often requires continued commitment and support. Ongoing participation in therapy, recovery groups, aftercare services, and relapse prevention planning can help individuals build confidence, strengthen coping skills, and navigate challenges as they arise. 

If you or someone you care about is struggling with opioid addiction, professional treatment can help. The Ridge Ohio offers evidence-based treatment programs that address the physical, emotional, and behavioral aspects of addiction, helping individuals build a strong foundation for lasting recovery.

In 2017, the Department of Health and Human Services (HHS) declared the opioid crisis a national health emergency. This triggered nationwide, coordinated efforts to stem decades-long increases in opioid misuse, overdose, overdose fatalities, and other opioid-related deaths. The response involved the public and private sectors. Federal, state, municipal, and local authorities participated, from the White House all the way to neighborhood groups. Progress was made. Before the coronavirus pandemic arrived in the U.S., total opioid overdose rates began to decline. Although deaths from illicit, synthetic opioids increased from 2017 to 2018, the template for an effective response to this increase is in place.

It’s still a bad situation, but we’re going in the right direction with the opioid crisis.

During the period when opioid use and overdose deaths rose at alarming rates – 2012 to 2018 – the use of another dangerous and addictive drug also increased, also at alarming rates: cocaine. The opioid overdose and addiction numbers dwarf the cocaine addiction numbers, but that doesn’t change the fact that in the U.S., right now, cocaine use, cocaine-related overdose, cocaine-related deaths, and cocaine addiction rates are more than double those reported in the 1980s, when cocaine use was prevalent across a wide range of demographic subgroups.

This article presents the latest statistics on cocaine use, discusses cocaine addiction and withdrawal, and ends with information on the treatment of and recovery from cocaine use disorder, a.k.a. cocaine addiction.

Statistics: Cocaine Use, Cocaine Use Disorder, and Cocaine Overdose in the U.S.

The Department of Health and Human Services (HHS), in collaboration with the Substance Abuse and Health Services Administration (SAMHSA) and the University of Michigan, conducts an annual research effort called the National Survey on Drug Use and Health (NSDUH).

The purpose of the NSDHU is to collect and analyze “…information for youths aged 12 to 17 and adults aged 18 or older on drug, alcohol, and tobacco use, as well as substance use disorder (SUD), risk and availability of substance use, treatment, health topics, and alcohol consumption.”

Policymakers, health officials, and medical professionals use the results of the survey – which includes data from over seventy-thousand people – to make evidence-based, data-driven decisions on matters regarding substance use, mental health, and treatment.

The following two sets of statistics were reported in the 2018 NSDUH.

Cocaine Use: Age 12 and older, Age 18-25, Age 26 +

• An estimated 5.5 million people age 12 or older reported using cocaine in the 12 months prior to taking the survey
  • That’s about 2.0% of people age 12 or older in the U.S.
• An estimated 2.0 million young adults age 18-25 reported using cocaine in the 12 months prior to taking the survey
  • That’s about 5.8% of young adults age 18-25 in the U.S.
• An estimated 3.5 million adults reported using cocaine in the 12 months prior to taking the survey
  • That’s about 1.6% of adults aged 26 or older in the U.S.

Now we offer data on cocaine use disorder, a.k.a. cocaine addiction.

Cocaine Use Disorder: Age 12 and older, Age 18-25, Age 26 +

• About 977,000 people aged 12 or older in 2018 had a cocaine use disorder in the 12 months prior to taking the survey
  • That’s 0.4 percent of people age 12 or older in the U.S.
• About 212,000 young adults age 18 to 25 in 2018 had a cocaine use disorder in the 12 months prior to taking the survey.
  • That’s 0.6 percent of young adults age 18-25 in the U.S.
• About 760,000 adults aged 26 or older had a cocaine use disorder in the 12 months prior to taking the survey
  • That’s about 0.4 percent of adults in this age group

To round out the data section of this article, we offer the numbers on cocaine overdose in the U.S. published by the Centers for Disease Control (CDC).

Cocaine Overdose: Trends from 1999-2018

• Age adjusted rates for cocaine overdose deaths rose from 1.4 per 100,000 in 1999 to 2.5 per 100,000 in 2006.
  • For 1999, that’s 4,000 overdose deaths
  • For 2006, that’s about 7,500 overdose deaths
• Age adjusted rates for cocaine overdose deaths decreased from 2.5 per 100,000 in 2006 to 1.5 per 100,000 in 2011.
  • For 2006, that’s about 4,000 overdose deaths
  • For 2011, that’s about 4,500 overdose deaths, representing an overall increase, but a decrease as a percentage of the total population
• Age adjusted rates for cocaine overdose deaths rose from 1.4 per 100,000 in 2012 to 4.5 per 100,000 in 2018.
  • For 2012, that’s about 4,400 overdose deaths
  • For 2018, that’s about 14,500 overdose deaths

That last set of numbers – the increase in cocaine overdose deaths from 2012-2018 – represents a total increase of around 200 percent, or over 25 percent per year. That’s why it’s important for us to keep an eye on the trends in drug use for all drugs of misuse – not only opioids. That’s an alarming increase because cocaine use disorder – like opioid use disorder – can cause long-term damage to cocaine users, their families, and society at large.

Now that we’ve presented the latest data on cocaine use, cocaine use disorder (cocaine addiction), and cocaine overdose, we’ll talk about how cocaine works on the brain and body, then offer tips to spot problem cocaine use.

How Cocaine Works

Cocaine is an addictive stimulant derived from the leaves of the South American coca plant. Using cocaine results in short-term euphoria, a burst of energy, and extreme talkativeness. Cocaine also causes a dangerous increase in both heart rate and blood pressure.

Cocaine is most often used in powdered form. Users inhale cocaine powder through the nose, where it’s absorbed into the bloodstream through nasal tissue. Cocaine can also be dissolved in water, smoked, or injected directly into the bloodstream. A cocaine high from inhaling or drinking lasts about 15-30 minutes, while the high from smoking cocaine lasts from 10-15 minutes.

When the cocaine high – which users report is intensely euphoric – begins to fade, the user often begins to crave more of the drug immediately.

Cocaine use disorder develops when users take the drug repeatedly, over short periods of time, in order to achieve and maintain its euphoric effects. However, this binge pattern – due in large part to the short duration of the cocaine high – can quickly lead to a state of disordered use. Significant changes in the brain occur – and occur quickly.

These changes cause cocaine users to seek more of the drug at increasingly higher doses.

Inside the brain, cocaine increases the level of the neurotransmitter dopamine, a chemical that regulates pleasure and movement in the body. Typically, dopamine is recycled back into brain cells relatively quickly. Cocaine, however, prevents dopamine recycling (called reuptake) and causes excessive, unnatural, and atypical amounts to accumulate between neurons. The dopamine then disrupts normal communications within the brain, causing the euphoria associated with the cocaine high. In addition, cocaine impairs cognitive function and rational decision-making, which can lead to impulsive, risky behavior.

Cocaine Use Disorder: Signs and Symptoms

While the signs and symptoms of cocaine use vary from individual to individual, they manifest in three general categories: physical, behavioral, and psychological.

Physical symptoms of cocaine use include, but are not limited to:

• Dilated pupils
• Impaired sense of smell
• Nosebleeds
• Runny nose
• Gastric ulcers
• General gastrointestinal difficulties
• Impaired sexual function

Behavioral symptoms of cocaine addiction include, but are not limited to:

• Excess energy
• Rapid, excited speech
• Financial problems
• Impaired interpersonal relationships
• Difficulty managing work, family, and school responsibilities
• Lying about cocaine use
• Lying about financial problems
• Legal issues

Psychological symptoms of cocaine addiction include, but are not limited to:

• Paranoia
• Hallucinations
• Delusions
• Anxiety
• Depression
• Panic

The signs and symptoms listed above may appear obvious in some cases, but in other cases, they may not appear. It’s possible for an individual to develop a cocaine addiction and keep it hidden from almost everyone in their lives. When that happens, the cocaine use disorder may not become visible until the user tries to stop using cocaine – which results in withdrawal or an attempt to detox.

Cocaine Withdrawal: Signs and Symptoms

The signs and symptoms of cocaine withdrawal include, but are not limited to:

• Intense cravings for cocaine
• Agitation
• Fatigue
• Anhedonia: reduced ability to feel pleasure
• Increased appetite
• Decreased energy
• Vivid, unpleasant dreams
• Tremors
• Chills
• Depression
• Anxiety

The prolonged disordered use of cocaine can, in some instances, lead to a condition known as Post-Acute Withdrawal Syndrome (PAWS). PAWS refers to a group of symptoms that continue to bother an individual after initial withdrawal symptoms pass. PAWS can persist for weeks, months, and, in rare cases, for years.

Characteristics of PAWS include:

• Confusion
• Mood swings (including an outward defensiveness)
• Inconsistent energy levels
• Low enthusiasm
• Impaired cognitive function
• Insomnia
• Anxiety

The difficulties of withdrawal, the intensity of cravings, and the long-term effects of PAWS make recovery from cocaine addiction challenging. Decades of research show the best way to achieve sustained sobriety after cocaine addiction is through clinical treatment delivered by mental health professionals.

Evidence-Based Treatment for Cocaine Addiction

The most effective treatment for cocaine use disorder follows an integrated treatment model. Integrated treatment addresses the entire person, which means it accounts for and supports all areas of life, including biological, psychological, and social factors that may be at play. If an individual with cocaine use disorder is also diagnosed with a co-occurring mental, behavioral, or mood disorder, than any treatment plan must address that diagnosis as well: integrated treatment plans, by definition, must be customized to meet the specific therapeutic needs of each individual.

Evidence-based treatment plans for cocaine use disorder include, but are not limited to:

• Individual counseling
  • Cognitive behavioral therapy
  • Motivational Interviewing
  • Dialectical behavioral therapy
• Group Counseling
• Family Counseling
• Medication (if needed)
• Community/peer support
  • 12 Step groups such as Narcotics Anonymous (NA)
• Lifestyle Modifications
  • Mindfulness
  • Experiential activities
  • Exercise
  • Expressive therapies (art, music, journaling)
• Relapse Prevention
  • Aftercare plans
  • Ongoing community support

When seeking treatment for cocaine addiction, it’s important to locate a treatment center that includes the elements above. Each piece is important. Each contributes to long-term, sustained sobriety. Well-respected treatment programs – residential, partial hospitalization, intensive outpatient, or outpatient – include the elements above, although they may call them by slightly different names.

Finding the Right Program

While effective cocaine addiction treatment options share many common components, each treatment center has its own identity approach to treatment. The best way to find the right program is to gather all the available information, then call or visit to get a feel for the clinical staff, support staff, and general atmosphere of the treatment center. Committing to an addiction rehab program is the first step in a life-changing process. Choosing a program and treatment center that offers the best possible professional support provided in an atmosphere that matches the unique personality, circumstances, and therapeutic needs of the person in treatment increases their chances of creating a sustainable life in recovery.

Methamphetamine – commonly known as meth or crystal meth – is a common drug of recreational misuse that poses a serious health risk to anyone who uses it. Methamphetamine is a central nervous system stimulant derived from its chemical cousin, amphetamine.

Rates of methamphetamine addiction and misuse are not as high as those of other common recreational drugs in the U.S. However, the health consequences and behaviors associated with the misuse and disordered use of amphetamine make it disproportionately dangerous, a matter of concern for addictions professionals, and a matter of urgency for anyone with a friend or loved one experiencing meth addiction.

If you’re in such a situation, consider enrolling in a detox program or an inpatient rehab facility at your earliest.

Here are the latest statistics on meth misuse and addiction in the U.S. in 2018:

Methamphetamine Use

• About 1.9 million people aged 12 or older reported using methamphetamine in the past year.
  • That’s 0.7% of the population in that age group.
• About 43,000 adolescents age 12-17 reported using methamphetamine in the past year.
  • That 0.2% of the population in that age group.
• About 273,000 people age 18-25 reported using methamphetamine in the past year
  • That’s 0.8% of the population in that age group.
• About 1.6 million adults age 26 or older reported using methamphetamine in the past year.
  • That’s 0.7% of the population in that age group

Methamphetamine Use Disorder

• About 1.1 million people age 12 or older had a methamphetamine use disorder in the past year.
  • That’s 0.4% of the population in that age group.
• About 18,000 adolescents age 12-17 had a methamphetamine use disorder in the past year.
  • That’s 0.1% of the population in that age group.
• About 134,000 people age 18-25 in 2018 had a methamphetamine use disorder in the past year.
  • That’s 0.4% of the population in that age group.
• About 899,000 people age 26 or older had a methamphetamine use disorder in the past year.
  • That’s 0.4% of the population in that age group.

It’s true that the rate and prevalence of meth use and misuse do not rise to the level of rates and prevalence for alcohol, opioids, and cannabis. Nevertheless, meth addiction and misuse is an important issue to understand – it’s one of the most commonly abused recreational drugs in the U.S.

A Quick History of Methamphetamine

German scientists created amphetamine in a laboratory in 1887. Shortly thereafter, in 1893, a group of Japanese scientists synthesized methamphetamine. Both groups of researchers discovered the compounds in an effort to manufacture an alternative to the alkaloid chemical found in the ephedra plant.

Most people know about ephedra from the widespread use of its derivatives, ephedrine, and pseudoephedrine. Physicians first prescribed ephedrine for weight loss in the 1950s. It was available over the counter until 2004, when the Food and Drug Administration (FDA) banned its use due to a growing body of research indicating significant adverse effects on the human brain and body.

Pseudoephedrine is well-known because of its widespread use as a decongestant. It’s a common ingredient in many over-the-counter drugs used to treat runny nose, nasal congestion, and sinus headache. It works by narrowing blood vessels in the nasal passages, which become swollen and inflamed due to allergies, the common cold, or a typical sinus infection. People know about the drug because it’s effective: almost everyone has taken one of the several medications containing the chemical.

Methamphetamine, however, is completely different. First used as a treatment for asthma in the 1930s, its use as a potent stimulant quickly eclipsed its use as a decongestant. In World War II, military personnel on all sides of the conflict used methamphetamine. Foot soldiers used it for energy before combat, and pilots and naval personnel used it to stay awake on long missions and duty watches.

After the war, recreational use of methamphetamine gradually increased until it became a common drug of recreational use, misuse, and addiction in the U.S.

The Dangers of Methamphetamine Use

Methamphetamine is an odorless crystalline powder that can be swallowed, inhaled, or smoked. It’s also possible to prepare the powder for intravenous injection, similar to the way powdered heroin is prepared for injection.

The effects of one dose of methamphetamine last from four to eight hours and include a decrease in appetite, an increase in energy, and a general sense or euphoria and wellbeing. Methamphetamine causes a surge of dopamine in the brain – about twelve times more than is released during any typical activity – but over time the drug destroys the cell surface receptors that bind to dopamine and regulate reuptake into brain cells. This causes methamphetamine users to develop a tolerance to the drug, meaning that over time, they need to take higher and higher doses to achieve the same euphoric effect.

Tolerance can quickly lead to physical and psychological dependence, which, in turn, can lead to a wide range of behaviors known as addiction or substance use disorder (SUD). Clinicians refer to methamphetamine addiction as a stimulant use disorder-amphetamine-type substance. This type of SUD has three classifications: mild, moderate, and severe.

For the purposes of this article, we’ll refer to all three classifications as methamphetamine addiction, methamphetamine use disorder, or substance use disorder. It’s critical for everyone to understand that any recreational use of methamphetamine is dangerous. Short-term use can cause immediate negative side effects, while moderate- or long-term use leads to significant physical, psychological, and emotional damage.

The following bulleted lists include most, but not all, of the negative effects of methamphetamine use, misuse, and addiction.

Consequences of Methamphetamine Use

1. Cardiac Issues (Heart)

• • Chest pain
  • Tachycardia
  • Hypertension
  • Arrhythmias
  • Myocardial Infarction
  • Coronary artery disease
  • Cardiomyopathy

2. Neurologic Issues (Brain)

• • Headache
  • Seizures
  • Stroke
  • Cerebral vasculitis
  • Hyperkinetic movement
  • Neurocognitive impairment

3. Psychiatric Issues (Emotional/Psychological)

• • Paranoia
  • Hallucinations
  • Depression
  • Anxiety
  • Insomnia
  • Suicidality
  • Aggression
  • Poor quality of life

4. Additional Physiological Issues

• • Skin ulcerations
  • Dermatologic infections
  • Dental caries
  • Anorexia
  • Pulmonary hypertension
  • Pulmonary edema
  • Hyperthermia
  • Fetal growth restriction
  • Increased risk of hepatitis C and HIV

Although the recreational use of methamphetamine is not as prevalent as that of other substances of misuse such as alcohol, opioids, and cannabis, the negative effects of methamphetamine use and misuse make it dangerous, and in some cases, life threatening.

Now we’ll discuss the signs and symptoms of meth addiction.

Meth Addiction: What to Watch For

While using methamphetamine only once can be risky, methamphetamine addiction doesn’t happen instantly. That’s a myth, based on media hype and misinformation. Most people who experiment with methamphetamine don’t develop an addiction, but those who do face serious physical, psychological, and social problems. Meth addiction affects every facet of life, from work, to school, to family – that’s why it’s important to know how meth addiction might look in a friend or loved one.

The signs of methamphetamine addiction – those that come with a sudden or prolonged increase in meth use – vary widely from person to person. Within this variety, however, there are three broad categories of symptoms: behavioral, physical, and emotional. We list the signs and symptoms associated with these categories below.

Meth Addiction: Signs and Symptoms

1. Behavioral symptoms of meth addiction may include:

• Preoccupation with obtaining and using meth
• Hiding meth use
• Lying about meth use
• Hyperactivity
• Twitching/facial tics
• Rapid, darting eye movement
• Isolating or withdrawing from friends and family
• Impaired work or school performance
• Relationship problems
• Decrease in personal hygiene
• Impulsive, risky behavior
• Aggressive behavior
• Excess energy
• Constant, rapid talking
• Violent behavior
• Impaired cognitive function
• Memory problems
• Erratic sleep patterns
• Sudden unexplained weight loss

2. Physical symptoms of meth addiction may include:

• Shaking and trembling
• Nausea
• Sweats
• Dilated pupils
• Loss of appetite
• Weight loss
• Intense cravings
• Rotting teeth
• Skin lesions/sores

3. Emotional symptoms of meth addiction may include:

• Paranoia
• Mood swings
• Anger
• Irritability
• Hallucinations
• Delusions
• Anxiety
• Depression
• Panic

In addition to these common signs of meth addiction, long-term use of methamphetamine can lead to rhabdomyolysis, a condition that causes a breakdown of skeletal muscle tissue and leads to a release of muscle fiber – called myoglobin – into the bloodstream. Rhabdomyolysis can lead to permanent kidney damage. Finally, long-term methamphetamine users often fail to eat regularly, resulting in malnutrition. In combination, these consequences of meh use lead to general malaise, illness, and a chronic inability to heal from illness or injury.

Methamphetamine Withdrawal

In most cases, it’s not difficult to deduce someone is addicted to meth. The behavioral and emotional signs are often clear to friends and loved ones of the person misusing the drug, while the physical signs make it clear to others familiar with the condition.

Methamphetamine withdrawal – while uncomfortable – is more challenging psychologically than it is physically. When a person with a methamphetamine use disorder stops taking the drug, the levels of dopamine in the brain drop quickly. Because long-term methamphetamine use compromises the dopamine reuptake process, anhedonia – the inability to feel pleasure – sets in quickly. In some cases, it can take up to two years for the dopamine system in the brain to normalize.

The severity of methamphetamine withdrawal varies according to many different factors, including:

• The duration and amount of use
• Age: the older the user, the more difficult the withdrawal
• Overall mental and physical health before methamphetamine misuse began
• The potency/purity of the drug used

Methamphetamine withdrawal typically occurs in two phases:

Phase One

Known as the acute phase, this typically lasts a week to ten days, and begins about 24 hours after last use.

Phase Two

Known as the subacute phase, this typically lasts another two weeks, but may continue for as long as five weeks after last use.

Withdrawal symptoms are similar in both phases. The difference between the phases lies in the intensity and the severity of the subjective experience. In Phase One, symptoms are intense and difficult to endure. After about a week, Phase Two begins, and symptom intensity and severity gradually decline. In cases of mild methamphetamine addiction, withdrawal symptoms may disappear completely by the end of the second, subacute phase. In cases of severe addiction, withdrawal symptoms may last longer than the typical three-week withdrawal period described above.

Methamphetamine withdrawal symptoms include:

• Cravings
• Depression
• Anxiety
• Psychosis
• Paranoia
• Phobia
• Hostility
• Reactivity
• Body aches and pains
• Lethargy

The intensity of the symptoms – especially psychosis, depression, and paranoia – is more severe the longer the individual has been addicted to the drug. This makes abstinence challenging for long-term users, and that’s why relapse is common. However, research shows the best way to achieve sustained sobriety after methamphetamine addiction is through professional treatment at and specialized addiction treatment center.

Evidence-Based Treatment for Methamphetamine Addiction

The Substance Abuse and Health Services Administration (SAMHSA) indicates an integrated, holistic, medical treatment model is the most effective approach to methamphetamine addiction treatment. This approach addresses the entire person. This approach accounts for and supports all areas of life, including biological, psychological, and social factors that may be at play. If a co-occurring mental, behavioral, or mood disorder is present, then it’s essential to treat that as well. An integrated treatment plan must be customized to the needs of each individual.

Holistic treatment plans for methamphetamine use disorder include, but are not limited to:

• Individual counseling
  • Cognitive behavioral therapy
  • Motivational Interviewing
  • Dialectical behavioral therapy
• Group Counseling
• Family Counseling
• Medication (if needed)
• Community/peer support
  • 12 Step groups such as Narcotics Anonymous (NA)
• Lifestyle Modifications
  • Mindfulness
  • Experiential activities
  • Exercise
  • Expressive therapies (art, music, journaling)
• Relapse Prevention
  • Aftercare plans
  • Ongoing community support

When seeking treatment for methamphetamine addiction, it’s important to find a treatment program that includes all the elements above. Each element matters, and each contributes to long-term, sustained sobriety.

For methamphetamine users, the damage to the dopamine system means it may take a long time to feel healthy again. This makes the lifestyle and community support elements of recovery critical. The lifestyle changes give a person in recovery from methamphetamine use disorder a framework within which to live life without drug use, and community support gives them the human contact, compassion, and wisdom to help them make those lifestyle changes last.

Finding the Right Addiction Treatment Program

High-quality treatment programs, whether they’re residential, partial hospitalization, intensive outpatient, or outpatient, will include most, if not all, of the elements listed above. While different treatment programs around the country will have many common components and similar approaches to addiction treatment, each program has its own identity and vision of how to support its patient.

To find a high-quality treatment program, we recommend taking the following three steps:

1. Gather all the information you can about any center/program that may be a good fit
2. Call or visit the treatment center to get a feel for the clinical staff, support staff, and general atmosphere.
3. Confirm they offer the elements listed above. Tip: the best treatment programs also have the best people answering the phones. If the person on the phone is vague, uniformed, or can’t answer questions to your satisfaction, check that center off the list, and move on to the next one.

Committing to an addiction rehab program is a big, life-changing decision. That’s why it’s critical to find the highest quality professional support at a program that’s not only high-quality but also has a treatment philosophy and treatment environment that resonates with the specific needs of the individual in need of support. When an individual with methamphetamine addiction finds the right program for them, their chances of achieving lifelong recovery increase dramatically.