Is there a link between crystal meth and HIV?
Yes. One of the biggest health risk from using crystal meth is the increased chance of HIV infection through unprotected and uninhibited sex while under the influence. Crystal meth increases the sex drive and enhances the sexual experience, and also increases euphoria and reduces inhibitions. The liberating feeling that comes with crystal meth use means that safer sex is often discarded while higher risk sexual activity increases greatly.

Are there any other health risks associated with crystal meth?
Yes. Along with an increased chance of HIV infection, there is also a risk of getting other sexually transmitted diseases (syphilis, gonorrhea, hepatitis A and B, herpes, chlamydia, and intestinal parasites such as Cryptosporidium) through unprotected sex while under the influence.

In addition, some other blood-borne infectious diseases can be transmitted by using crystal meth, depending on how it is consumed. When smoking, pipes can get hot and cause damage and bleeding to someone’s lips. If one shares a pipe, there is a chance that a small amount of blood from an infected person can remain on the pipe, and get onto someone else’s lips. The blood can get in contact with a small cut or sore on the lips, providing an opportunity for the transmission of hepatitis C. Similarly, the lining inside the nose can bleed onto a straw used for snorting. There is a chance that a small amount of blood from an infected person can remain on the straw. If one shares a straw to snort meth, that blood can find its way into the nose of another person and transmit hepatitis C. Hepatitis C. Unlike the HIV virus, the Hepatitis C virus survives well in dried blood exposed to air, therefore increasing the risk of transmission when sharing drug paraphernalia. Hepatitis C causes damage to the liver and is very difficult to treat. It is a major cause of cirrhosis of the liver, liver failure and liver cancer.

Sharing needles is a high risk activity for spreading blood-borne diseases such as HIV and hepatitis C. This can be prevented by not sharing syringes and using a new, clean needle and syringe every time. Supplies for injecting drugs can be obtained from a local needle exchange program.

Who uses crystal meth?
Crystal meth is popular with street youth, and in gay clubs and circuit parties, although its use is spreading into mainstream culture and clubs. It is becoming the drug of choice for teens.

Crystal meth’s ability to keep users awake and feeling good for long periods of time have made it a popular drug in the dance club scene and in circuit parties. Cocktails of club drugs are popular. Crystal meth is often mixed with other drugs such as ecstasy. Club drugs consumers may even be inadvertently taking crystal meth as ecstasy-like pills have been found to contain crystal meth.

Because of its potent effect on stamina and sex drive, the drug has become popular with gay and bisexual men who attend dance clubs and sex parties. Rituals of multipartner barebacking have been developed around crystal meth. Crystal meth is often used with ketamine (known as Special K), a drug which loosens the sphincter, and with Viagra to overcome what is known as “crystal dick”, or impotence that often accompanies the use of crystal meth.

For a few decades now, men who have sex with men have been inundated with messages of safer sex, and there appears to be “condom fatigue” within that community. In addition, today’s gay and bisexual men in the 20s and 30s have not witnessed their friends and acquaintances’ frequent deaths from AIDS-related illnesses as in AIDS’ early days, and may not feel that it is a serious threat. These factors combined with deeper issues of built-up shame, insecurity, loneliness and alienation render them particularly vulnerable to drugs such as crystal meth.

Men who are HIV positive are drawn to crystal meth as it helps them overcome fatigue, a low libido and depression, and gives them a sense of feeling desirable. For people who are HIV positive, using crystal meth may decrease adherence to HIV medications. Interruptions in medication can provide an opportunity for the virus to become resistant to medication. The virus then becomes “treatment-resistant”, and the spread of such a potent virus can lead to serious public health consequences. As crystal meth also results in loss of appetite, users often skip meals. This can lead to vitamin depletion and weight loss. Sleep is also affected. All of these factors can contribute to a faster progression of HIV disease.

What is crystal meth?
Crystal methamphetamine, also known as speed, methamphetamine, crank, crystal, tweak, meth, ice Tina, jib, is made from a substance called amphetamine. It is a synthetic stimulant that affects the central nervous system.

What does crystal meth do?
It speeds up the body’s functioning by increasing the heart rate and pulse, increasing wakefulness, and intensifying concentration and thought processes. It elevates the mood and provides a high or a feeling of euphoria. It stimulates the part of the brain that is responsible for pleasure and reward, fine motor control, sex drive, and increased energy levels. It can also cause increased irritability, restlessness, insomnia, anxiety, and panic. At high doses, it can induce a confused and disorganized behaviour, paranoia, hallucinations, increased aggressiveness and antisocial behaviours. Overdoses are relatively common. Symptoms include agitation, hostility, hallucinations, high temperature, convulsions, suicidal tendencies, circulatory and respiratory collapse, coma and possible death.

What does crystal meth look like?
Crystal meth can appear as crystals, chunks, and fine to coarse powders, off-white to yellow in colour. It is supplied loose (in plastic or foil bags) or in capsules or tablets of various sizes and colours.

^{Source: Straight Facts about Drugs and Drug Abuse, Health Canada, 2000 © Reproduced with the permission of the Minister of Public Works and Government Services Canada, 2004.}

What is crystal meth made of?
It is made of highly volatile, toxic substances melded in a variety of combinations that are never exactly the same. It can be produced very easily and cheaply by obtaining ingredients from local hardware stores and pharmacies, making the drug readily available. Ingredients include ephedrine (from over-the counter cold medicine), ether, battery acid, insecticides, solvents, and lye. There is no quality control on this product. The quality of the drug will vary depending on the supplier. There are a few precautions that can be taken to increase safety. It is a good idea to sample a small amount of the crystal meth first, especially if it came from a new supplier. Finding a regular supplier that is trustworthy can also minimize risks.

How is crystal meth used?
Crystal meth can be swallowed, snorted, smoked or injected. Swallowing a capsule or tablet is the safest way to use crystal meth. It takes longer to take effect, from 15 to 30 minutes, as it has to pass through the stomach and liver before getting to the brain. Snorting crystal meth provides a faster high, within 3 to 5 minutes, as the drug is absorbed by the blood vessels in the nose. Smoking crystal meth has the quickest effect, within 7 to 10 seconds, as the vapors enter the lungs, and are absorbed rapidly through the blood vessels lining the lungs, and then get pumped throughout the body and brain. Injecting crystal meth is also quick and potent. It is important to inject crystal meth right into the veins. Injecting it in skin or muscle greatly increases the risk of abcesses and can cause damage to skin and muscles, as it is very difficult for these tissues to absorb the drug. Crystal meth can also be used as a suppository.

What are the short-term and long-term effects of crystal meth?

Short-term effects
Crystal meth increases attention, wakefulness, and physical activity, and decreases appetite and fatigue. There is a brief intense sensation or rush, followed by a long-lasting high or euphoria. It also brings about rapid breathing and heartbeat, high blood pressure, dilated pupils, and an elevated body temperature. It can cause stomach cramps, shaking, and anxiety. Short-term effects of crystal meth appear soon after a single dose and disappear after a few hours or days. With larger doses, effects can include fever, sweating, headache, blurred vision and dizziness. The body temperature can elevate to dangerous, sometimes lethal levels that may cause convulsions.

Once the drug’s effect disappears, known as the “crash”, the user may experience symptoms such as fatigue, nightmares, insomnia, disorientation, confusion, increased appetite, severe depression and suicidal tendencies. The term “Suicide Tuesday” has been coined due to the number of weekend users that feel the severe depression a few days after they have stopped using during the week. To avoid the unpleasant effects of crashing, some people will take more crystal meth. Paradoxically, the more one uses crystal meth, the harder one crashes.

To minimize the unpleasantness of crashing, it is advised to eat, sleep and drink plenty of water and juice, even if not hungry and especially if on a binge. Acupuncture may help stabilize and balance the damage from overuse of crystal meth.

Overuse of crystal meth can bring on paranoia, short-term memory loss, extreme mood swings, and some damage to your immune system.

Overdoses are relatively common. Symptoms include agitation, hostility, hallucinations, high temperature, convulsions, suicidal tendencies, circulatory and respiratory collapse, coma and possible death. Overdoses can be avoided by sampling a small amount of the crystal meth first, especially if injecting, or when the drug is from a new supplier. Doing half a hit is also advised, especially if it has been a while and tolerance may be down. Injecting the hit extra slowly will also help. Mixing crystal meth with other drugs increases the risk of overdose.

Long-term effects
Like some other drugs, the more one uses crystal meth, the more the body needs to get the desired effect as it develops a tolerance to crystal meth. Binging is common to try to sustain the desired effect. Tolerance happens more rapidly if crystal meth is smoked or injected. Prolonged use at high levels leads to tolerance and both psychological and physical dependence on the drug. Psychological dependence occurs when you feel that you cannot function without the drug. Physical dependence occurs when your body has adapted to the presence of the drug, and withdrawal symptoms occur if its use is stopped.

Some people are able to keep their crystal meth use under control and usually use in a social setting, mostly on weekends. However, crystal meth is very easy to get addicted to when used for a period of time. It is very inexpensive (as little as $5 a day), and is deeply rooted in some social circles, in that social networks tend to support crystal meth use. When someone has difficulty functioning without crystal meth, it is a sign of trouble. Signs of addiction or dependence on crystal meth include compulsively seeking the drug and wanting to use the drug, violent behaviour, anxiety, confusion, insomnia, psychotic features such as paranoia, hallucinations, mood disturbances, delusions (the most common one is a sensation of insects creeping on your skin), irregular heart beats, a possible stroke, and suicidal thoughts. Withdrawal symptoms such as anxiety, fatigue, a rash, diarrhea, sweats, chills and fevers, severe depression, suicidal thoughts, paranoia, aggression, and an intense craving for the drug. Treatment and support are necessary in this situation. Dealing with addiction requires a period of detoxification, followed by rehabilitation to relearn how to live a sober life. Counseling is recommended to address deeper issues that may be leading you to take crystal meth. People who have become dependent on crystal meth often make many attempts to quit using before they are successful. It can also be difficult to maintain the same social network if trying to quit, as friends may be continuing to use crystal meth.

Effects on others
Crystal meth use can also have effects on others around you. Children of crystal meth users are at risk of neglect and abuse. Using crystal meth during pregnancy can impair growth, and cause premature birth, developmental disorders in newborns, and enduring cognitive deficits in children. Family and friends can also be affected, as crystal meth users have a tendency to pull away from their social network and isolate themselves when they are using excessively.

Where to get help for addiction
The following is a directory of some of the resources available for information or help regarding crystal meth use. We encourage you to also consult your local yellow pages and look for ‘Addiction – Information and Treatment Centres’. Treatment for addiction is covered under provincial health insurance.

By province
To speak with someone about a situation, to obtain information about drugs, to find out about counselling and support groups and treatment centres in your area, call the following numbers:

Other useful resources

Programs
Many AIDS Service Organizations (ASO) will have information on crystal meth and will also be able to refer people to other services. Click here to find your local ASO

Websites

Canadian Centre on Substance Abuse: http://www.ccsa.ca

Canadian Treatment Centres: for alcohol and drugs: http://alcoholism.about.com/cs/pro/a/blprocan.htm

Club Drugs: a service of the National Institute on Drug Abuse (USA): http://www.clubdrugs.org

Crystal Meth: from Spencer Recovery Centers. http://www.crystal-meth.org

Crystal Meth Anonymous: http://www.crystalmeth.org

Crystal Neon: raising awareness and providing options for crystal users http://www.crystalneon.org

DanceSafe: a site by DanceSafe, a coalition of independent, youth-based harm reduction organizations: http://www.dancesafe.org

Gay Men’s Health Crisis: http://www.gmhc.org

Harm Reduction Coalition: http://www.harmreduction.org

Mylifeboat: a site for people who want to change their use of alcohol and drugs:
http://www.mylifeboat.com

Narcotics Anonymous: http://www.na.org or http://www.naquebec.org

National Native Alcohol and Drug Abuse Program: A directory of services throughout Canada at:
http://www.hc-sc.gc.ca/fnihb-dgspni/fnihb/cp/nnadap/treatment_centres/

Tweaker.org: by Stop AIDS. http://www.tweaker.org

Vancouver Addictions Matrix Program (VAMP): an intensive outpatient crystal meth treatment program serving youth and gay/bisexual men. : Part of Vancouver Coastal Health: http://www.vch.ca/

Video
Video: Reduce Speed: A Film about Crystal Meth by Dr. Doug McGhee. $39.95 (free for schools). Call (250) 370-8204 or email <helen.thorne@caphealth.org>. Target audience: Youth.

Report
Canadian Community Epidemiology Network on Drug Use and Addictive Drug Information Council. Methamphetamine Environmental Scan Summit Final Report, 2003. Available at : http://www.ccsa.ca/ccendu/pdf/methamph_summary_2003.pdf

Contact information
If you have comments or questions about this fact sheet, please contact:

Claire Checkland
Programs Consultant
Canadian AIDS Society
309 Cooper Street, 4th Floor
Ottawa, Ontario K2P 0G5
tel: (613) 230-3580 ext. 141
fax: (613) 563-4998
e-mail: clairec@cdnaids.ca
web site: http://www.cdnaids.ca