By The Recovery VillageThe Recovery VillageAbout our Editorial TeamEditor Jonathan StrumJonathan StrumJonathan Strum graduated from the University of Nebraska Omaha with a... read moreMedically Reviewed By Deep Shukla, PHD, MSDeep Shukla, PHD, MSDr. Deep Shukla graduated with a PhD in Neuroscience from Georgia State University in December 2018. He has a diverse background in... read more×This medical web page has been reviewed and validated by a health professional. The information has been screened and edited by health professionals to contain objective information on diagnosis and treatment of diseases. Contains bibliographic reference sources. If you are a healthcare professional and you find any issue, please reach out to [email protected]Updated on 10/07/21 Key Points Long-term methamphetamine use results in dependence on the drug, and stopping use can lead to withdrawal symptoms. The intensity and duration of methamphetamine withdrawal symptoms depend on the individual’s physiology, severity of dependence and drug use history. Withdrawal symptoms involve depression, anxiety, sleep disturbances, increased appetite and drug cravings. The cravings peak during the first week and gradually decline over the next two to three weeks. Treatment at an outpatient or inpatient detox center is associated with a lower risk of relapse compared to at-home detox. Detox centers may involve behavioral therapy and medications for managing withdrawal symptoms. Medications for the management of withdrawal symptoms include antipsychotics, benzodiazepines and antidepressants. Detox at home must only be done in a supportive environment, and drug intake should be tapered rather than stopped abruptly. Medications should only be used as prescribed by a doctor. What is Meth Withdrawal? Long-term use of methamphetamines, also known as “meth,” results in the development of physiological dependence on the drug. Chronic use of meth also results in increased drug tolerance, which makes a person need larger quantities to achieve the same effects. The body and brain adapt to increased drug use, affecting the reward system and its dopamine neurons. The absence of the reward (the drug) results in a negative emotional and physiological state. The adverse effects that result from stopping methamphetamine use are referred to as withdrawal symptoms. These withdrawal symptoms involve depression, anxiety and intense drug cravings, and they may be severe enough to cause a relapse. Treatment at a detox center helps manage these symptoms under medical supervision and reduces the chances of relapse. Meth Withdrawal Symptoms The severity and duration of methamphetamine withdrawal symptoms depend on the person’s drug use history and physiological characteristics. Some of the symptoms include: Acute Withdrawal Symptoms (Week 1)Acute symptoms of meth withdrawal occur in the first week of abstinence and include dysphoria (a general uneasiness or dissatisfaction), anhedonia (inability to experience pleasure), fatigue, hypersomnia (excessive sleeping), increased appetite, and intense cravings for meth. Symptoms of psychosis may also be present, but they generally resolve within a week. Depressive symptoms during the acute phase include an inability to feel pleasure, general dissatisfaction and irritability. Most of these symptoms reach their peak within the first few days and gradually subside, continuing at a low intensity during the subacute phase. Sleep disturbances, such as difficulty sleeping and unpleasant dreams, do not subside during the acute phase and usually continue through the subacute phase. Drug cravings also tend to persist for more than five weeks. The intensity of drug cravings often predicts relapse and is usually related to the severity of depression symptoms. Subacute Symptoms (Weeks 2 & 3)Subacute symptoms of meth withdrawal occur in the two weeks following the acute phase and include depression, insomnia, increased appetite, psychomotor agitation (purposeless, repetitive motions like pacing or toe-tapping), psychomotor retardation (pronounced reductions in activity or emotion), vivid dreams or nightmares, and cravings. Post-Acute Withdrawal Syndrome (PAWS)Meth withdrawal symptoms generally peak during the first week and then gradually recede over the next two to three weeks. However, residual withdrawal symptoms may persist for several months after abstinence begins. These symptoms include fatigue, sleep disturbances, depression, anxiety, other mood disturbances and drug cravings. Symptoms that persist beyond the initial withdrawal period make up a condition called post-acute withdrawal syndrome. Methamphetamine use can also cause psychotic symptoms involving delusions, hallucinations and paranoia. Psychotic episodes can occur even months after meth use has ended, especially in individuals who have experienced drug-induced psychosis before. About Meth AddictionMeth AddictionMeth Addiction Treatment and RehabMeth Related TopicsSee More Meth Withdrawal Timeline The duration and severity of methamphetamine withdrawal symptoms vary from individual to individual. Duration and intensity depend on a person’s drug use history, which includes the duration and frequency of drug use. Physiological characteristics such as age and genetics may also influence the duration of withdrawal symptoms. The severity of symptoms may determine the chances of relapse. Withdrawal symptoms begin within the first 24 hours after abstinence. The initial phase, called the acute phase, lasts for around seven days. Withdrawal symptoms are most severe during this phase. The acute phase is followed by a sub-acute phase that lasts for around two to three weeks. The symptoms still occur but are less intense during this phase. Initial ReactionThe first 24 hours after stopping use will be characterized by exhaustion, fatigue, lack of energy and depression. If people are able to sleep at all, it will be of poor quality and unsatisfying. Mental states are often foggy and depression is common. Although not everyone will experience cravings, they may be present. For many people, symptom severity peaks around 24 hours after quitting. Crash & Peak of SymptomsThe “crash” describes the acute phase of withdrawal, and typically lasts for up to seven days, although some cases may have acute symptoms that persist for up to 10 days. This phase is characterized by increased appetite, long periods of poor-quality sleep, low energy, intense cravings, depression, anhedonia, restlessness, and insomnia. Other symptoms may include anxiety, irritability, vivid dreams or nightmares, and poor concentration. Following the crash, subacute symptoms may persist for up to five weeks, although most people report that their symptoms resolve during the two weeks following acute withdrawal. Increased appetite and sleep are the most significant symptoms of subacute meth withdrawal, and acute symptoms like depression, dysphoria, psychomotor agitation or retardation gradually subside during this phase. Recently, a great deal of research has been published showing that exercise can provide some relief from meth withdrawal symptoms. Post-Acute SymptomsUnfortunately, many people in recovery from meth use experience persistent symptoms that are considered post-acute withdrawal syndrome (PAWS). PAWS is a frustrating component of recovery for many people. PAWS symptoms can be physical and psychological and tend to be milder versions of acute and subacute symptoms. In extreme cases, PAWS may be experienced for months, even years, after quitting. It is important to understand that the presence of PAWS is normal, and experiencing symptoms and cravings for months after quitting does not mean that recovery has failed. These uncomfortable symptoms gradually subside over time. RecoveryMeth treatment does not have any shortcuts to overcoming withdrawal symptoms. No medications have been validated as effective therapeutic agents. It can be difficult to resist cravings in the first days and weeks of recovery, so professional treatment for meth withdrawal is often the most effective way to overcome the early challenges associated with addiction and maximize long-term success in recovery. People who are facing a meth use disorder should seek an evaluation with a rehab professional who is experienced in treating meth use. In many cases, medically supervised detox will be appropriate. Medical detox provides 24/7 care and supervision over the first several days of recovery, after which clients can transition into a residential or outpatient rehab program. Meth addiction has a powerful psychological component, and residential rehab addresses this by providing individual and group therapy sessions that are geared towards clarifying why someone used meth and why sobriety is important, along with identifying short- and long-term goals for recovery. The most effective rehab programs include traditional therapy as well as newer methods like motivational interviewing and cognitive behavioral therapy. Following residential care, outpatient and aftercare programs aim to provide people in recovery with the tools and techniques they need to successfully reintegrate into their new, sober lives. In most cases, recovery is a life-long pursuit that requires regular maintenance. Being proactive about participating in healthy new activities and developing a strong support network are often crucial components of long-term success. Seeking Help for Meth Abuse? Whether you're calling for yourself or a loved one, our Intake Coordinators are here to help. We are ready and waiting to answer your questions and there's no pressure to commit to treatment until you're ready. 24/7 Meth Helpline Meth Detox Detoxification is the first step toward meth addiction recovery, and it involves eliminating the drug from the body. Treatment at a medical detox facility involves 24-hour care provided by medical professionals. These facilities use medications and behavioral therapy to help patients cope with severe withdrawal symptoms. Detoxification may also be undertaken at home, but it involves a higher risk of relapse. Treatment at a detox center only helps with the elimination of methamphetamine from the body and with withdrawal symptoms. Inpatient or intensive outpatient treatment is generally necessary after detox to help address the underlying issues that are responsible for drug use. Detoxing at HomeQuitting Cold TurkeyMedically Assisted Detox for Meth WithdrawalWithdrawal symptoms can be severe, and they often result in relapse. This makes at-home detox difficult. Detoxification at home may also expose people to triggers, such as peers who use drugs, and may result in relapse. Detoxification can be done at home with the help of family and the careful use of medications as prescribed by a doctor. The environment must be safe and non-threatening, and the individual must not have access to the drug. When undertaking detoxification at home, methamphetamine intake should be gradually decreased instead of ended at once. Quitting “cold turkey” can result in more severe withdrawal symptoms that are associated with a higher likelihood of relapse. These withdrawal symptoms may involve psychotic symptoms or severe depression, which can lead to self-harm or suicide. Treatment at a medical detox involves 24-hour care provided by medical professionals to help the individual cope with withdrawal symptoms. Although there are no medications that are approved for the treatment of meth withdrawal symptoms, symptoms can be managed with the help of medications and behavioral therapy. Medications for managing withdrawal symptoms may include antipsychotics and benzodiazepines to treat symptoms of anxiety, irritability and agitation. Antidepressants may be used for depressive symptoms. Drugs that have shown promise in managing meth withdrawal symptoms include: Bupropion: Bupropion is an antidepressant that increases the levels of dopamine and norepinephrine in the brain. The levels of these neurotransmitters tend to decline and create withdrawal symptoms when meth use is ended. Bupropion manages these symptoms by restoring neurotransmitter levels. Modafinil: Modafinil is a stimulant that enhances cognitive functioning in adults, including memory, attention and executive function. Modafinil has low addiction potential and mimics some of the actions of the methamphetamine to reduce the intensity of withdrawal symptoms. Modafinil has been effective in managing meth withdrawal symptoms when combined with behavioral approaches, but there is also evidence showing that its effectiveness is limited. Selective serotonin uptake inhibitors (SSRIs): SSRIs, such as paroxetine and fluoxetine, are mostly ineffective in the treatment of meth withdrawal symptoms. Mirtazapine: This antidepressant also has sedative and anti-anxiety effects. It can help with hyperarousal and depressive withdrawal symptoms. Mirtazapine is not as effective as modafinil in treating symptoms. Finding a Meth Detox Center Choosing the right detox center for methamphetamine misuse may be difficult since many facilities offer similar treatments. Some of the following points must be considered while choosing a detox center: Inpatient vs. outpatient detox: An inpatient detox provides 24-hour care in a drug-free and supportive environment. This is preferred for individuals with moderate to severe meth dependence. Outpatient detox, however, does not require residence at a detox center and allows the individual to continue with their job or education. This approach may expose the individual to triggers that can cause relapse. Outpatient detox is a better option for people who do not have a severe dependence on meth. Cost: Inpatient clinics tend to be more expensive than outpatient clinics. It is also essential to ensure that treatment at the particular detox center is covered under the insurance plan. Location: Choosing a detox center in the patient’s city of residence may allow family visits. This can help provide the support needed to cope with withdrawal symptoms. Effectiveness: The treatment provided at the detox should be individualized since the severity and duration of withdrawal symptoms can vary from person to person. The treatment must be evidence-based and must be provided by trained, professional medical staff. Our Drug Detox Center If you or a loved one is suffering from a substance use disorder, The Recovery Village Palm Beach at Baptist Health can help. Contact us today to learn more about our comprehensive treatment programs. The Recovery Village Palm Beach at Baptist Health 4905 Lantana Rd Lake Worth, FL 33463 561-340-7269 SourcesAustralian Government Department of Health. “Amphetamine Withdrawal Syndrome.” April 2004. Accessed July 24, 2019. Colino, Stacey. “Running (or Walking Briskly) Away From Addiction.” U.S. News Health, June 2018. Accessed September 14, 2019. Mancino, Michael J.; et al. “Characterizing methamphetamine withdrawal in recently abstinent methamphetamine users: a pilot field study.” The American journal of drug and alcohol abuse, March 2011. Accessed July 24, 2019. McGregor, Catherine; et al. “The nature, time course and severity of methamphetamine withdrawal.” Society for the Study of Addiction, March 2005. Accessed September 14, 2019. Karila, Laurent; et al. “Pharmacological approaches to methamphetamine dependence: a focused review.” British journal of clinical pharmacology, June 2010. Accessed July 24, 2019. Science Daily. “How exercise could reduce relapse during meth withdrawal.” November 2014. Accessed September 14, 2019. Zorick, Todd; et al. “Withdrawal symptoms in abstinent methamphetamine-dependent subjects.” Addiction, October 2010. Accessed September 14, 2019. Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.