Methamphetamine
N-methylamphetamine ('crystal meth')
Profoundly addictive and neurotoxic — it damages the brain.
Banned / Harmful evidence
☠️Banned & Harmful
Evidence tier
Banned / Harmful
Research weight
Not supported
Citations
21 verified / 21
Classification
Banned & Harmful
⊘
What the evidence says. Linked to serious harm and/or banned in sport and many jurisdictions. Listed for awareness and safety only — NOT a recommendation.
⚠
Health warning. Methamphetamine is one of the most addictive substances known. It is neurotoxic — permanently damaging dopamine neurons — triggers psychosis in up to a third of users, and devastates physical and dental health.
What is Methamphetamine?
Methamphetamine (N-methylamphetamine ('crystal meth')) is a banned or harmful substance marketed for intense, long-lasting energy and euphoria — followed by severe crash, craving and decline. NutriDex grades the human evidence as Banned / Harmful. Methamphetamine floods the brain with dopamine, producing an intense high — and lasting damage. It is directly neurotoxic, reducing grey matter and impairing dopamine-transporter function on brain imaging, and up to a third of users experience psychosis with paranoia and hallucinations. Chronic use causes the notorious tooth destruction known as 'meth mouth', skin sores, drastic weight loss and profound addiction. Listed strictly as a warning.
Marketed Claims (unproven)
✕Intense, long-lasting energy and euphoria — followed by severe crash, craving and decline
Dosing & Compounds
Use & Legality
No safe dose. Illegal controlled substance.
Active Compounds
Safety & Cautions
⚠ EXTREME HARM. Severe addiction, lasting brain damage, psychosis, 'meth mouth', skin sores, weight loss, stroke, heart attack and overdose. Withdrawal brings depression and intense craving. Illegal, and illicit products are unregulated and often contaminated. Educational only — always check with your doctor or pharmacist before combining Methamphetamine with any medicine.
Evidence & Risk Findings ★ 21 studies
Systematic review/meta-analysis
Depression meta-analysis (2023)
✓ PubMed
Systematic review and meta-analysis found methamphetamine use is associated with significantly increased odds of depression versus non-users.
Systematic review
Methamphetamine-associated heart failure (2023)
✓ PubMed
Systematic review of observational studies found methamphetamine use causes a reversible-to-progressive cardiomyopathy with reduced ejection fraction, and abstinence is associated with improved cardiac recovery.
systematic review / network meta-analysis
Treatment network meta-analysis (2024)
✓ PubMed
A systematic review and network meta-analysis of 72 RCTs (6,836 participants) found no intervention reached moderate-to-high certainty for patient-important outcomes; only low-certainty signals (e.g., contingency management, quetiapine, varenicline) suggested modestly extended abstinence in amphetamine/methamphetamine use disorder.
Meta-analysis
Tardelli 2024
✓ Full text
Network meta-analysis of 72 RCTs (n=6,836) for amphetamine/methamphetamine use disorder found no intervention with moderate-to-high certainty evidence; contingency management plus CBT showed the longest abstinence duration (MD 34.85 days, 95% CI 19.63 to 50.08, very low certainty).
Meta-analysis
European Psychiatry 2025
✓ Full text
Meta-analysis of 3 RCTs (n=249) found topiramate did not improve abstinence in methamphetamine use disorder (pooled RR 1.00, 95% CI 0.94-1.07) with only a non-significant trend toward reduced depressive symptoms (MD -2.52, 95% CI -5.31 to 0.26).
Systematic review/meta-analysis of RCTs
Withdrawal pharmacotherapy RCTs (2022)
✓ PubMed
Systematic review and meta-analysis of randomized controlled trials found no pharmacotherapy reliably reduces methamphetamine withdrawal symptoms, with no clearly effective agent identified.
Government agency report
CDC overdose data (2023-2024)
✓ Source
CDC NCHS data brief reports US drug overdose deaths involving psychostimulants with abuse potential (chiefly methamphetamine) remained elevated, with methamphetamine the second most common drug in overdose deaths by 2023.
clinical practice guideline
ASAM/AAAP guideline (2024)
✓ PubMed
The 2024 ASAM/AAAP Clinical Practice Guideline on Stimulant Use Disorder recommends contingency management as a primary first-line treatment for methamphetamine use disorder, noting no FDA-approved pharmacotherapy and rising stimulant overdose deaths.
Agency / regulator
CDC MMWR 2025
✓ Source
CDC surveillance of US overdose deaths (Jan 2021-Jun 2024) found methamphetamine involved in 31.2% of deaths (96,614), with the age-adjusted methamphetamine death rate rising from 3.9 per 100,000 in 2018 to 10.4 in 2023.
Meta-analysis
Lecomte 2018
✓ PubMed
Meta-analysis of 17 studies: pooled prevalence of methamphetamine-induced psychotic disorder was 36.5%, rising to 42.7% over a lifetime assessment window and 43.3% among those with methamphetamine use disorder.
Systematic review
Indave 2018
✓ PubMed
First systematic review on amphetamine-type stimulants and stroke (4 cohort + 8 case-control studies): current users had higher ischemic stroke risk than non-users (adjusted rate ratios 1.6 and 3.4); former users had elevated hemorrhagic stroke risk (RR 2.3); hemorrhagic risk was markedly raised in women using ATS (adjusted ORs 16.6 and 3.9).
randomized controlled trial
ADAPT-2 RCT (NEJM, 2021)
✓ PubMed
In a 2-stage double-blind RCT of 403 adults with moderate-to-severe methamphetamine use disorder, extended-release injectable naltrexone plus oral bupropion produced more responders than placebo (weighted response 13.6% vs 2.5%; treatment effect ~11 percentage points, P<0.001).
Narrative review
Stroke in young users (2024)
✓ PubMed
Review found methamphetamine use markedly raises stroke risk in young adults, with hemorrhagic stroke (intracerebral hemorrhage, subarachnoid hemorrhage) being the predominant neurovascular complication.
narrative review
Pulmonary arterial hypertension review (2024)
✓ PubMed
A 2024 review in Chest reports methamphetamine is a recognized cause of pulmonary arterial hypertension, with methamphetamine-associated PAH carrying the highest all-cause mortality (~18%) versus methamphetamine users without PAH or with cardiomyopathy, and frequently more severe hemodynamics.
Observational
Scientific Reports 2025
✓ Full text
Taiwan population-based cohort (17,071 with methamphetamine-related disorders vs 68,264 matched controls) found a 3.42-fold higher adjusted risk of cardiomyopathy in methamphetamine users.
Review
Pregnancy/fetal harm (2021)
✓ PubMed
Review describes prenatal methamphetamine exposure burden and harms to fetus and newborn, including growth restriction, neurodevelopmental impairment, and obstetric complications.
Safety / toxicology
Neurotoxicity reviews
✓ Full text
Damages dopamine/serotonin neurons; imaging shows reduced grey matter.
Cohort
Lee 2021 (Taiwan nationwide cohort)
✓ PubMed
Record-linkage cohort of 23,248 people with methamphetamine use disorder: all-cause mortality 5.4x the general population (SMR 5.4); unnatural-cause SMR 14.8 vs natural-cause 7.5; suicide had the highest cause-specific SMR (16.3), driven by drug-overdose suicide (SMR 24.9).
Epidemiological analysis
Mortality trends 1999-2021 (2023)
✓ PubMed
US methamphetamine-related mortality rose roughly 50-fold from 1999 to 2021, with heroin/fentanyl co-involvement increasing to about 61% of deaths by 2021.
Study
Psychosis data
✓ PubMed
Up to ~33% of users experience psychosis (paranoia, hallucinations).
Study
ADA / dental
✓ Source
Chronic use causes severe decay and gum disease ('meth mouth').