fact sheet - methamphetamine
("meth" "tik", "tuk", "Speed", "crystal")
Andreas Plüddemann, Bronwyn Myers and Charles Parry, Alcohol and Drug Abuse Research Unit, Medical Research Council, 1st November 2006

What is methamphetamine?
It is a powerfully addictive stimulant that affects many areas of the central nervous system. It is a white, odourless, bitter-tasting crystalline powder that readily dissolves in water or alcohol. The drug can easily be made in clandestine laboratories from relatively inexpensive over-the-counter ingredients and can be purchased at a relatively low cost (about R15-R30/‘straw’).

Modes of administration
It can be smoked, snorted, orally ingested or injected intravenously. In South Africa it is typically smoked by placing the powder/crystal in a light bulb, from which the metal threading has been removed. A lighter is used to heat the bulb and the fumes are smoked.

Consequences of methamphetamine use

Acute intoxication and/or overdose
Methamphetamine triggers release of epinephrine, norepinephrine and dopamine in the sympathetic nervous system. Common effects of intoxication are euphoria, increased energy and self-confidence, insomnia, restlessness, irritability, heightened sense of sexuality, and tremors. Respiratory effects include increased respirations, pulmonary edema, pulmonary hypertension and decreased lung capacity. Cardiovascular effects include increased heart rate and blood pressure, tachycardia (abnormally rapid heart beat) and/or arrhythmias. Users run the risk of overdose characterised by dehydration, hyperthermia, convulsions, renal failure, stroke and myocardial infarction.

Long-term/chronic use
Prolonged use can result in severe weight loss/anorexia, severe dermatological problems, higher risk of seizures and uncontrollable rage/violent behaviour. Chronic mental health effects include confusion, impaired concentration and memory, hallucinations, insomnia, depressive reactions, psychotic reactions, paranoid reactions, and panic disorders. Long term use also increases the risk of contracting HIV and Hepatitis C due to injection drug use and sexual risk behaviour.

Epidemiology of methamphetamine use in Cape Town:
The following statistics were collected via the Medical Research Council’s South African Community Epidemiology Network on Drug Use on patients presenting with methamphetamine problems in Cape Town since 2002.

Table 1 shows the proportions of patients who had methamphetamine as a primary or secondary substance of abuse for each respective 6-month period since January 2002 (where 2002a refers to January – June 2002, 2002b to July – December 2002, etc.). The ‘Total patients’ row refers to the total number of patients treated at over 25 specialist treatment centres/programmes for ANY substance (including alcohol, cannabis, Mandrax, heroin, cocaine, etc.). A graphic illustration is provided in Figure 1.

Table 1: Patients with methamphetamine as primary or secondary substance of abuse

* Patients who have methamphetamine as primary OR secondary substance of abuse

These findings are unprecedented in terms of the sharp increase in the number of patients seeking treatment for methamphetamine related problems. The majority (86%) were in treatment for the first time.

The average age of patients who reported methamphetamine as their primary substance of abuse in 1st half of 2006 was 22 years and 73% were male. Most of the patients (91%) were Coloured, 7% were white, less than 1% Indian/Asian and 1% were Black/African. Notably 44% of the patients were younger than 20 years of age (see Figure 2). The ages ranged from 11 to 53 years.

Figure 1: Treatment trends - methamphetamine

Figure 2: Age distribution of patients with methamphetamine as primary substance of abuse: 2004 & 2006a

Patients coming to treatment centres in Cape Town having methamphetamine as their primary drug of abuse in the 1st half of 2006 came from over 150 suburbs. The following suburbs had 20 or more patients reporting to treatment centres with methamphetamine (‘tik”) as their primary substance of abuse: Athlone, Belhar, Bishop Lavis, Bonteheuwel, Delft, Eerste River, Elsies River, Kuils River, Manenberg, Mitchells Plein, Paarl, Strand and Worcester. 

Of the 724 patients coming to drug treatment in the 1st half of 2006 who were under 20 years of age, 60% had methamphetamine (“tik”) as their primary drug of abuse (compared to 53 % in the 2nd half of 2005, 49% in the 1st half of 2005, 42% in the 2nd half of 2004, 25% in the 1st half of 2004, 5% in the 2nd half of 2003 and 4% in the 1st half of 2003).  Currently more than two-thirds (73%) of persons under 20 years of age coming to treatment for substance abuse problems in Cape Town have “tik” as a primary or secondary drug of abuse. There is some indication that this might be stabilizing.

Promising strategies for addressing methamphetamine in SA:

Prevention strategies

1. Raise awareness and provide accurate information to the public and policy makers on methamphetamine.
2. Introduce specific, science-based prevention programmes that target individual, family and community risk and protective factors for substance use.
3. Actively promote the development of broad-based school-based drug policies.

Treatment strategies

1. Ensure that there is adequate access to affordable and effective treatment.
2. Establish methamphetamine treatment protocols in public hospitals and specialized care facilities.
3. Equip primary health care providers/ER personnel to provide brief screening and interventions.
4. Train health and social service providers, especially those in emergency room settings, to identify, assess and manage methamphetamine-induced psychosis, anxiety, withdrawal and overdose.
5. Introduce science-based models of substance abuse treatment into community settings, especially cognitive-behavioural approaches which are particularly effective in treating methamphetamine abuse.
6. Develop a systemic criminal justice approach with substance abusing offenders, using screening, assessment, monitoring and treatment.

Interdiction strategies

• Introduce laws governing the sale of precursor chemicals (e.g. pseudoephedrine, ephedrine, anhydrous ammonia and red phosphorous) used in the manufacture of methamphetamine.
• Investigate companies that distribute chemicals or equipment used in clandestine methamphetamine laboratories and seek harsher penalties for such crimes.
• Expand community policing strategies to engage the public in methamphetamine issues.
• Continue to put pressure on drug-related organised crime (especially focusing on certain related crimes such as perlemoen smuggling as well as on high intensity drug dealing/trafficking areas).