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      Methamphetamines Methamphetamine, also known as crystal, meth, ice, tina, speed, chalk, glass, and crank, has become one of the top illicit drugs in the west and Midwest . May of the US emergency departments are seeing more meth overdoses than cocaine-intoxicated patients. Fatalities related to amphetamine use have been associated The drug was developed early in this century from its parent drug, amphetamine, and was used originally in nasal decongestants and bronchial inhalers. Methamphetamine's chemical structure is similar to that of amphetamine, but it has more pronounced effects on the central nervous system. Methamphetamine can appear in different forms. The meth powder can be inhaled, ingested, or injected. The inhaled or ingested powder is longer lasting and is often odorless, colorless, and tasteless. Snorting produces effects within 3-5 minutes, and oral ingestion produces effects within 15-20 minutes. Crystal , also known as crank, is a white or yellow product easily manufactured in amateur laboratories. As a powerful stimulant, even in small doses, it can increase wakefulness most often is used in a "binge and crash" pattern. Because tolerance occurs within minutes, meaning that the pleasurable The most dangerous stage of meth abuse for abusers, medical personnel, and law enforcement officers is called "tweaking". A tweaker is an abuser who probably has not slept in 3-15 days and is irritable and paranoid. When you respond to the scene of someone who is reportedly using methamphetamines or "tweaking", you may find the patient agitated and in a psychotic state. After the initial stimulating rush, a state of agitation typically ensues, which may lead to violent and dangerous behavior. During this time the user may have delusions, hallucinations, and paranoia. The paranoia can result in homicidal as well as suicidal thoughts. Seek additional help from police or other EMS providers if personal safety is an issue prior to transport.
Methamphetamine highs can last up to 20 hours, heavy users may stay awake for several days. This is a highly addictive drug, damaging nerve cells, thus causing mental impairments. As a health care provider, use extreme caution in treating these patients. Detaining and transporting of these patients should not be done alone. Avoid any sudden movements, loud noises, or bright lights. These things will increase the paranoia and may cause them to become more violent with you. These patients present a special challenge to the health care arena. There are no specifics on the treatment they receive, and they will all present differently. Just remember that safety is the most important issue, safety for the patient and for you. Resources: E-Medicine "Toxicity, Methamphetamine" - www.emedicine.com/EMERG/topic859.htm National Institute on Drug Abuse - www.nida.nih.gov KCI Anti-Meth Site - www.kci.org/meth_info/faq_meth.htm |
with assaults, driving impairments, suicides, homicides, and maternal-fetal and infant exposures. 
effects disappear even before the drug concentration in the blood falls significantly, users try to maintain the high by binging on the drug. 
Most cases can be managed supportively, although in severe overdose, immediate supportive care, including airway control, oxygenation, and ventilation is required. May will present with complaints of chest pain and palpitations. They will have tachycardia and be hypertensive, although with massive overdose they may have a complete circulatory collapse resulting in hypotension, bradycardia, and metabolic acidosis. They may have cardiac dysrythmias. Many will develop seizures, muscle hyperactivity, and will be hyperthermic. Prehospital IV access is warranted to allow for treatment of seizures and agitation using IV benzodiazepines according to medical direction and local protocol. High doses of methamphetamine can elevate body temperature to dangerous, sometimes lethal levels.