Methamphetamine, or crystal meth, addiction is a dangerous and widely available drug—the National Institute of Health estimates that there are as many as 50 million users worldwide. Unlike other recreational drug abuse, methamphetamine addiction does not have a specific withdrawal medication, and the individual is dependent on natural withdrawal to clear their system from the drug. While the methamphetamine withdrawal process is different from other substances' withdrawal processes, it can still result in a successful recovery when managed in a medical detox setting.

Meth Comedown

Methamphetamine users experience what is called a comedown. Comparable to an alcohol hangover, comedowns occur as the effects of methamphetamine begin to wear off. Comedown symptoms usually only persist for a day or two or until the next dose of meth and result from what is happening in a person's body underneath the feelings of euphoria that meth gives to the person who is using. The comedown is a combination of things, including a chemical imbalance in the brain caused by meth, toxins within the body, and the exhaustion experienced by the person using. 

Methamphetamines affect the amount of dopamine and serotonin released in the brain almost immediately upon using meth. These chemicals increase and spike as the drug is taken and decrease when the drug wears off. The immediate depletion of these chemicals directly after the drug wears off can lead to immediate feelings of depression and loneliness until the next dose. 

Many people use meth as a party drug and will combine it with alcohol. This combination can lead to extreme exhaustion when the drug and alcohol wear off. When the meth begins to wear off, the feelings of tiredness begin to overtake the high, leaving the individual more drained and dehydrated than they were before. Because of how it's made, meth contains multiple toxins, which can cause severe digestion issues the day after using methamphetamines due to the drug not affecting the liver and kidneys. 

In general, comedown symptoms include:

• Hopelessness

• Sadness

• Depression

• Muscle weakness

• Decreased appetite

• Fatigue

• Lack of motivation

• Anxiety

• Insomnia despite exhaustion

• Headache from dehydration

• Muscle pain, especially in the jaw from clenching

The main difference between comedowns and withdrawal is that comedown symptoms will subside within a day or two, just as hangover symptoms usually only last a day. Comedown is more of an immediate reaction to the lack of substance in the body rather than withdrawal's long term effects that illustrate a process of detoxification.

Comedown symptoms will resolve on their own if meth intake does not continue, but it is likely that if a person is addicted, withdrawal symptoms may begin.

Meth Withdrawal

Meth withdrawal is mostly a psychological and emotional experience for the user. However, there are still physical symptoms in withdrawal, just not as many as would be present in alcohol or opioid withdrawal.

Withdrawal symptoms may begin in the middle of a comedown if not directly after—symptoms arise about 24 hours post-ingestion, and they continue for an average of 14 days. Research shows that around the middle of these 14 days is where the withdrawal symptoms will be at their most severe.

The National Library of Medicine emphasizes that the most common symptoms of those experiencing meth withdrawal are feelings of:

• Drowsiness

• Increased appetite

• Dry mouth

• Inability to sit still

Symptoms can range from depression to severe psychosis, both of which require medical treatment, especially if a person becomes a danger to themselves or others. In general, meth withdrawal is not physically damaging, but some symptoms can spiral into behavior that can be a risk to the individual. 

Methamphetamine withdrawal is not treatable by medication as there are no FDA approved medications specifically designated for meth withdrawal. However, some medications can be used to help minimize some of the symptoms. Antidepressants like Wellbutrin, Paxil, Remeron, and Prozac and medications like Provigil to relieve physical discomfort can be used to help ease the most severe symptoms. 

While meth withdrawal does not have any extremely concerning symptoms like alcohol or benzodiazepines, the potential for depressive and psychotic symptoms to turn into self-harm are good reasons to seek treatment during the meth detoxification process. It is safest to withdraw from meth in the presence of professionals who may administer helpful medication and psychological support throughout recovery.

Once withdrawal is complete, those suffering from substance use disorders should seek behavioral and psychological therapy to address their addiction's underlying causes and provide a stable foundation for long-term recovery.