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Meth and Psychosis

What Is Meth?

You might call it speed, chalk, ice, crystal, or glass. All of these typically refer to methamphetamine, a powerful stimulant that is usually found in the form of a white, odorless, bitter-tasting crystalline powder. The drug brings on a surge of energy, an intense euphoria, incessant chattiness, and decreased appetite—along with a host of problems after long-term use.

Related to amphetamine, which has been used in some nasal decongestants and ADHD medication, methamphetamine is much more potent because larger amounts of the drug are able to get to the brain. Because of this, the drug is extremely addictive and has longer-lasting, harmful effects on our bodies and brains.

Effects on Chronic Users

Research on long-time meth users reveals they almost always become addicted, whether they’re shooting, smoking, or snorting it. Meth provides an intense high that brings the user back for more, but the effects of meth on chronic users are severe.

Meth can cause insomnia, weight loss, and increased heart rate and blood pressure. Those who choose to smoke meth have serious problems with their teeth decaying and falling out. Chronic users also exhibit extreme mood swings, as well as confusion and memory loss.

Effects on the Brain

Many of these physical problems can improve with abstinence from meth. But, there are effects on the brain that can take over a year to repair, and they are often only partially reversible. According to research gathered by The Meth Project, the drug can impair a chronic user’s ability to learn, to perform basic verbal tasks, and their motor skills. The user can develop uncontrollable twitches, ticks, or tremors.

Meth disrupts the brain’s inhibitory controls which leads to obsessive behaviors, the user repeating tasks over and over. It impairs the frontal lobe, which controls judgment and impulse control. Meth also over-stimulates the amygdala, our emotional control center. These effects on the brain combined cause an amped up state of anxiety which leads to aggression and violence.

As a user becomes addicted and experiences the huge dopamine surges induced by meth, they can develop anhedonia—the inability to experience pleasure. There is a theory that drug abuse “resets” our reward pathway, so it’s harder to experience the pleasure from a normally enjoyable experience. Many long-term meth users report depression, and that they don’t feel like the same person anymore.

Meth also actively damages non-neural brain cells called microglia. Microglia defend our brain against infections and remove any damaged neurons. Meth users typically have two times the amount of microglial cells as a normal brain. With too many microglia in the brain, they actually begin to attack our healthy neurons, causing measurable brain damage.


Perhaps the most infamous effect of meth on long-term users, though severely understudied, is psychosis. Often called “tweaking,” there are many aspects of psychosis—a severe mental disorder in which people lose contact with reality, very similar to acute paranoid schzophrenia.

A psychosis is generally characterized by:

Strong delusions

  • strange beliefs about things that aren’t plausible

  • grandiosity

  • insects crawling under the skin

Extreme paranoia

  • feeling overly suspicious of people

  • feeling like other people are ‘out to get you’


  • hearing voices

  • seeing things that aren’t there

  • talking to people who aren’t real

Obsessive-compulsive behavior

  • cleaning

  • peeking out the window

  • taking things apart and putting them back together

Often, the paranoia a user experiences becomes debilitating. Paranoia is a self-reinforcing loop of beliefs that escalates in a fearful emotional state. Meth can distort reality, altering belief systems, and lessens the ability to control emotions, making fear and anxiety prevalent.

From my own experience with psychosis, symptoms arise gradually and intensify. I started having vivid hallucinations, seeing things like Einstein’s head blooming out of a tulip in my ceiling. I began to hear voices of the underworld coming through my air vents. I started peeking out my window, running to the door in the middle of the night to check the peephole.

As I progressed with my using, my hallucinations became more tactile. I would feel a tug on my hand or a kiss on my cheek when no one was in the room. An enormous glow worm erupted from the center of my bed one night, and it felt so hot and real that it knocked me to the ground. I was often visited by a tiny girl in a cat costume who would meow at me and I would chase her around my room. Eventually, I started seeing invisible beings spray painting my walls, my room lit up in a laser light show, and I began to believe that aliens were casing my room and trying to communicate with me – so much so that I told one of my friends about it and considered reporting my experience to BBC.

This may sound humorous or light-hearted, but much of my psychosis was dark and terrifying. There came a point where no one could reason with me and I became violent in confrontations, a 90-pound girl swinging punches in the grocery store. Eventually my hallucinations continued even when I wasn’t high, I couldn’t turn them off. I would be speaking to someone and my roommate would ask “who are you talking to?” I lived in persistent delusions for months that people were watching me, that the cops were outside waiting for me, that I had a brain aneurysm and I was about to die.

A psychosis can last for hours or days, or it can persist for months and years. Some scientists argue that a meth is the only drug that can leave a user in a permanent psychosis.

There are many users who experience psychosis even after they’ve stopped using methamphetamine. Extreme stress, especially, can precipitate the spontaneous reoccurrence of psychosis in a former methamphetamine abuser.

Is It Just Meth?

In a study by the Australian National University in Canberra, they found that 60% of meth abusers in their study reported psychotic symptoms. Many factors affect the occurrence of psychotic symptoms, like the number of years of abuse, sleep deprivation, and mixing meth with other drugs. After 16 or more days of consistent meth use, participants in the study were 48% more likely to have psychotic symptoms. If users mixed meth with alcohol or marijuana, they were were 69% more likely to have psychotic symptoms.

Other drugs also have the potential to induce a psychosis. Other stimulants, like cocaine, can also cause severe delusions. Marijuana can increase a person’s risk of developing psychosis by 40% to 200%, depending on how much and how long a person has been using it.

People with underlying mental health conditions, especially schizophrenia, are much more likely to experience a drug-induced psychosis. An underlying anxiety disorder can also play a role.

What to Do

If you find yourself in drug-induced psychosis, you may not be able to realize it or to listen to a loved one’s suggestion for help. If you are concerned about psychosis, for you or for someone else, the best initial step is to stop the use of all substances. A visit to a doctor can also help, opening up access medical resources like anti-psychotic medications to ease the transition from psychosis back into a sober reality.

If you are trying to help someone who is in the midst of a psychosis, speak to them calmly. Try to avoid confrontation and argument. Keep a safe distance in case they become upset or violent. Ultimately, be reassuring and supportive, be the person who is on their side rather than one who is ‘out to get them.’ Depending on the severity of the psychosis, your efforts to help may or may not be well-received. The most that can be done in some cases is to simply ensure that the person is safe, whether that entails close monitoring of them or institutionalization. There is no “cure” for a drug-induced psychosis, though most symptoms improve with time and consistent abstinence from substances.

My concept of reality is still skewed after my chronic meth abuse. When I went to treatment, I thought that I was schizophrenic or losing my mind. My psychotic symptoms continued for weeks with no substances in my body. But eventually, my hallucinations faded, I no longer heard voices that weren’t there, and I never imagined that I could recover my sanity. Psychosis is a terrifying experience, constantly questioning oneself and what is real, but a life of recovery offers hope.

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