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Ice, along with speed and base, is a form of the potent stimulant drug methamphetamine.

Also referred to as shabu, crystal, crystal meth or d-meth, ice is the purest and most potent form of methamphetamine. It comes as a powder or crystals that are usually snorted, injected or smoked.

The latest figures from the National Drug Survey suggest 2 per cent of Australians use methamphetamine – a figure that hasn’t really changed much over the last decade, says Nicole Lee an Associate Professor at the National Centre for Education and Training on Addiction at Flinders University.

But about half of those who use methamphetamines say they prefer to take ice, and the number of people using ice has doubled since the last survey, says Lee.

The initial high

How quickly you feel the effect of methamphetamine depends on the form, the route of administration and how much of it you use, explains Lee.

Smoking it can make you high within a couple of minutes, whereas it takes about 20 minutes to feel the effects if you inject it through your stomach.

The immediate effects from ice are intense pleasure and clarity. User say they have lots of energy and can think clearly, feel like they can make good decisions, and plan effectively.

This is because methamphetamine dramatically increases the levels of the hormone dopamine – by up to 1,000 times the normal level – much more than any other pleasure seeking activity or drug.

Physical effects can include dilated pupils, an increased heart and breathing rate, a reduced appetite and an increased sex drive.

The effects usually last for between four and 12 hours, although methamphetamine can be detected in blood and urine for up to 72 hours.

Coming down

It might sound obvious, but if you’re coming down from methamphetamine you’re likely to feel the opposite of what you feel when you’re the high. So you’ll have trouble making decisions, poor concentration and difficulty planning.

You may also have headaches, blurred vision and start to feel hungry.

It’s pretty common to feel flat, depressed, jittery and anxious. As well you may feel exhausted and want to sleep for a day or two, although you may have difficulty sleeping, explains Lee.

Some people may also feel very irritable or have mild psychotic symptoms like paranoia and hallucinations.

“The ‘come down’ period is like a hangover, a recovery period after which people may move into withdrawal if they are dependent,” she says.

How addictive?

Methamphetamine can be addictive, but it is not the most addictive drug around, says Lee.

Among all methamphetamine users who use regularly around 15 per cent are dependent compared to 50 per cent of heroin users and 95 per cent of cigarette smokers.

“Compared to some of those drugs, it’s moderately dependent and is probably about the same as cannabis,” she says.

Lee and colleagues have done research in this area and found there was a year between when people first started using ice regularly – weekly or more than weekly – and when they started experiencing problems including dependence.

However, it’s hard to predict who will become dependent and who won’t. And once you are dependent, it is quite hard to get off because of how it affects your brain, says Lee.

Double-whammy harm

Once users start to take ice at higher doses or to use it more frequently, the pleasurable effects tend to give way to less pleasurable ones, says Lee.

Physically this might involve a racing heart and increased breathing rate, a rise in body temperature, a dry mouth and sometimes nausea and vomiting.

At ‘critical toxicity’ or overdose levels, people can also have stroke or heart failure, and occasionally seizures.

Once you start taking higher doses you may also start to feel jumpy or anxious, hostile and aggressive. This can escalate to feelings of intense paranoia or psychotic episodes.

This is caused by methamphetamine’s release of another neurotransmitter (brain chemical) called noradrenaline, which induces a ‘fight or flight’ response.

It’s these users that typically turn up in emergency departments and pose a challenge to medical staff, says David Caldicott an Emergency Consultant at the Calvary Hospital in Canberra.

This is because they are often dealing with methamphetamine’s “double-whammy” of physical as well as psychological effects, he says.

For instance a user could present to emergency with stroke like symptoms but be severely agitated and aggressive.

“It’s kind of a Benjamin Button type drug so… [you could] see a stroke or aortic dissection in someone using ice in their 20s or 30s,” he says.

What is drug dependence?

There’s a whole range of symptoms that indicate you’re dependent on a drug.

These include:

needing more of drug to get the same effect,

having withdrawal symptoms, including irritability, panic attacks, excessive, tiredness, extreme hunger,

spending large amounts of time seeking out the drug, using it or recovering from it.

If it is starting to affect home life, work life, schooling – that’s an indicator that you are dependent.

Regular lows

It takes between 10 to 14 days to physically detox from methamphetamine, almost twice as long as many other drugs. After an acute withdrawal period, there’s a more chronic withdrawal period that may take 12 to 18 months.

“It makes it very difficult for people to get off because having cravings, feeling really flat, jumpy and anxious for over a year and a half is a long time,” says Lee.

One of the reasons it’s so difficult to come off ice and other methamphetamines is that the drugs target the dopamine system. Regular and huge bursts of dopamine can effectively wear the relevant brain regions out, so the brain is no longer able to produce enough dopamine.

“The feeling that you get when you have lots of dopamine in your system is a feeling of incredible pleasure so when the dopamine system wears out, people really feel very flat, and depressed,” says Lee.

In order to feel ‘normal’, users need more methamphetamine on board, which is one of the reasons relapse rates are so high.

But Lee says research shows that changes to the dopamine system are recoverable over time.

Long-term effects:

  • Extreme weight loss
  • Restless sleep
  • Dental problems
  • Increased risk of sickness
  • Trouble concentrating
  • Breathlessness
  • Drug dependence
  • A need to use more of the drug to get the same effect
  • Mental health problems such as anxiety, depression and paranoia
  • Heart and kidney problems
  • Relationship, work, and financial problems
  • Snorting the drug can lead to nosebleeds and sinus damage
  • Injecting can put users at risk of blood borne diseases such as hepatitis and HIV

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