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Symptoms of Meth Psychosis and What to do for Recovery

Methamphetamine is a potent and dangerous stimulant drug that releases a flood of dopamine and serotonin into the brain. This causes a surge of physical energy, ranging from excitement to tremors; higher blood pressure and heart rate; dangerous elevations in body temperature; excited euphoria; paranoia; aggression toward oneself or others; and unpredictable behavior, among other symptoms.

Although it is a Schedule II drug according to the U.S. Drug Enforcement Administration (DEA) — meaning it has some prescription uses — meth is mostly abused as a street drug. In fact, meth abuse in the United States has been on the rise again as purer, cheaper meth is produced in super labs in Mexico and shipped into the U.S.

Struggling with addiction to meth leads to damage to both the brain and body. One problem found in as many as 40 percent of people struggling with meth abuse is meth psychosis, a condition caused by long-term abuse. This sustained abuse damages dopamine receptors and nerve terminals in their brain and eventually leads to symptoms similar to schizophrenia.

This is a chronic mental illness that does not go away even after the person detoxes from the drug. Meth psychosis requires long-term medical treatment.

What Does Meth Psychosis Look Like? Who Is at Risk?

Psychosis is a potential risk during withdrawal from meth, especially if you do not have medical oversight in an evidence-based detox program. However, meth abuse itself can also lead to psychosis, whether you have withdrawn from the drug or not.

Long-term abuse of this drug will cause your brain chemistry to change, which changes the structure of some areas of the brain.

It can lead to various symptoms, including:

  • Anxiety
  • Confusion
  • Delusions
  • Insomnia or other sleep difficulties
  • Mood disturbances
  • Violent behavior

This is not psychosis, and in many cases, these symptoms will go away with time following medical detox. However, these symptoms (along with psychotic symptoms that may develop later) can last for months or years after achieving abstinence. In some cases, the condition will never disappear, and it may be difficult to diagnose due to a few differences between symptoms of meth psychosis and schizophrenia.

If these mental health symptoms appear, and you do not stop abusing meth, psychosis is more likely to become a side effect of meth addiction. Chronic meth abuse reduces the binding of the mood-elevating neurotransmitter dopamine onto dopamine receptors, particularly in the striatum, a region of the brain involved in memory and physical movement. With a long enough period of abstinence from meth (often years), these dopamine receptors can be restored to their original functionality.

The drug also negatively impacts non-neural brain cells called microglia, which are involved in brain health by removing damaged neurons and fighting infections. When the microglia are too active, they can assault healthy neurons, killing them.

A study reported that there were more than twice as many microglial cells in the brains of people who used to abuse meth compared to those who had no history of meth abuse. However, people who remained abstinent from meth for more than two years exhibited more normal microglial levels.

A second study found some recovery in a few brain regions with abstinence periods of 14 months, but not at six months. This indicates that a long-term detox and recovery period is not the only solution to overcoming meth addiction, but that aftercare will be crucial, too.

Stress is one factor found to precipitate a spontaneous recurrence of meth psychosis in people who are recovered meth abusers. During detox, the body and brain are under stress while trying to chemically stabilize, and this —along with social, financial, legal, or other types of stress — may trigger a psychotic episode. Sleep deprivation, often due to tweaking, increases the chance of developing meth psychosis.

Predisposition to or beginning formation of other psychotic disorders will increase the likelihood of meth psychosis. Schizophrenia, schizoaffective disorder, and schizotypal personality all increase the risk of developing meth psychosis or psychosis related to other substances if those are abused.

Physical dependence on meth also increases the risk of meth psychosis. One study found that between 26 percent and 46 percent of people who are physically dependent on meth due to chronic abuse have meth psychosis. Additionally, people who inject meth, rather than smoke it, are at greater risk of developing more severe symptoms if they develop meth psychosis; however, both smoking and injecting were found to have an equal risk of meth psychosis.

Abusing other drugs while abusing meth, especially alcohol and cannabis, increased the risk of developing meth psychosis.

Signs and Symptoms of Meth Psychosis

Signs that someone is struggling with meth psychosis include:

  • Difficulty comprehending reality, confusion
  • Hallucinations, usually auditory and visual
  • Tactile hallucinations, especially formication (the feeling of insects on the skin)
  • Paranoia
  • Picking at the skin
  • Self-absorption

A study involving 278 participants who met the medical criteria for meth dependence found that, among the observed period, participants reported psychotic symptoms for 25 percent of the reporting months; 60 percent of the sample group reported psychotic symptoms for at least one of the study’s months.

During the psychotic episodes, symptom frequency was reported:

  • 71 percent experienced suspiciousness
  • 35 percent reported unusual thought content, including delusions
  • 51 percent developed hallucinations

Most reported symptoms were self-reported as moderate rather than severe, indicating that more people who abuse meth may struggle with mild or moderate psychotic symptoms than has been previously reported.

How Is Meth Psychosis Treated?

psychosis treatment

If meth psychosis leads to hospitalization or appears during medical detox, there are some approaches to managing this problem, including supervised doses of benzodiazepines to manage paranoia and extreme anxiety, along with antipsychotic medications as the primary prescription.

After the person has been physically and mentally stabilized, psychosocial treatment in both individual and group therapy, often through a rehabilitation center that can address both mental illness and meth abuse, is the best course of action to understanding this condition, managing symptoms, and staying sober.

It will also be important for clinicians to diagnose whether the psychosis is caused by meth abuse or by an underlying psychotic condition that may have been exacerbated by meth abuse. Signs that the condition may be schizophrenia or a related psychotic condition rather than meth-induced psychosis include: 

  • Symptoms are in excess of the amount of meth abused
  • The person has a history of previous psychotic episodes before drug abuse
  • Psychotic symptoms persist after withdrawal

However, if the psychosis is caused by meth abuse:

  • The most prominent symptoms will be hallucinations or delusions
  • These symptoms develop during, or soon after, quitting meth
  • Psychotic symptoms and delirium are separate events

Getting medical help to safely detox means you can know if you develop meth psychosis because you will have a team to help you manage symptoms as soon as they appear. Medically supervised detox is crucial to ending meth addiction.


(October 29, 2013). Methamphetamine. Center for Substance Abuse Research. Retrieved November 2018 from

(July 2013). Methamphetamine. Drug Enforcement Administration (DEA), Office of Diversion Control, Drug & Chemical Evaluation Section. Retrieved November 2018 from

(September 19, 2016). Methamphetamine Psychosis: Epidemiology and Management. HHS Public Access. Retrieved November 2018 from

(June 2018). What is Methamphetamine? National Institute on Drug Abuse (NIDA). Retrieved November 2018 from

(September 2013). What are the Long-Term Effects of Methamphetamine Abuse? National Institute on Drug Abuse (NIDA). Retrieved November 2018 from

(January 9, 2013). Dose-Related Psychotic Symptoms in Chronic Methamphetamine Users. Journal of the American Medical Association (JAMA), Psychiatry. Retrieved November 2018 from

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