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| {{SummarySheet}}
| | In the bathroom someone threw up, it's probably your girlfriend Power, energy, amphetamine Your homie is fucking semi-conscious girl on the wash machine Power, energy, amphetamine In the kitchen, two tweenies, hand, tit, saliva, saliva Power, energy, amphetamine And someone in the room knelt, with swallowing will be final Power, energy, amphetamine Yesterday melange on tablets, but today is entering amphetamine. |
| {{SubstanceBox/Methamphetamine}}
| | Correct eyebrows. Where is the pencil? |
| | | Fuck that, where pencil pouch. It is handbag of amphetamine. |
| '''N-Methylamphetamine''' (also known as '''Methamphetamine''',<ref name="erowid">Erowid. (1992). Erowid Methamphetamine (Speed, Crank) Vault. Retrieved from https://erowid.org/chemicals/meth/meth.shtml</ref> '''Meth''',<ref name="erowid" /> '''Glass''',<ref name="erowid" /> '''Ice''',<ref name="erowid" /> '''Shard''',<ref name="erowid" /> '''Crank''',<ref name="erowid" /> '''Tina''',<ref name="erowid" /> '''Tweak''',<ref name="erowid" /> '''Yaba''',<ref name="erowid" /> and '''Crystal'''<ref name="erowid" />) is a potent [[psychoactive class::stimulant]] substance of the [[chemical class::amphetamine]] class. Along with [[heroin]] and [[cocaine]], it has a notorious reputation as a dangerous and highly addictive "street drug".{{citation needed}} It is structurally related to [[amphetamine]]; the addition of the methyl group is thought to increase its ability to cross the blood-brain barrier, significantly enhancing its potency.{{citation needed}} It produces its effects by increasing levels of the [[neurotransmitters]] [[serotonin]], [[dopamine]], and [[norepinephrine]] in the brain.
| | Rolled new hundred. You to the town in these toe shoes? With Zara still hanging tag. Straight from the Gatty fishnet tights. Wet plate amphetamine sticky. Well, pat in the gums. Each leg toddle, toddle. Chill out, oh the tissue. Think that here is hectare of jive. Lay down on a couch. Do not outflow, it is not a berth. Power, energy, amphetamine Power, energy, amphetamine Power, energy, amphetamine Power, energy, amphetamine Morning gym and a little Metanobol, and in the evening enters amphetamine. |
| | | Nose or bomb is a roulette. Additionally to phase bottle burst. On the windowsill while a meter away. The nose is clogged? Then unplug! Gang in Tico van. Tico is jumping, so it’s orgy. Aeroplane flight over the city. Windows down, chill elbow. Good clothing is a badge, a good shoe is a label. For the party is a cash. For girls chat catch. Each one willing, blonde, brunette. Turbo tongue, cunnilingus master In the bathroom someone threw up, it's probably your girlfriend Power, energy, amphetamine Your homie is fucking semi-conscious girl on the wash machine Power, energy, amphetamine In the kitchen, two tweenies, hand, tit, saliva, saliva Power, energy, amphetamine And someone in the room knelt, with swallowing will be final |
| Methamphetamine was discovered in Japan in 1893, shortly following the discovery of amphetamine. However, it was not widely used until World War II, in which both Allies and Axis forces utilized its stimulant effects.{{citation needed}} As the addictive properties became known, governments began to place strict controls on methamphetamine manufacture and distribution. Despite these efforts, methamphetamine abuse has become a major public health problem throughout the world.
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| [[Subjective effects]] include [[motivation enhancement]], [[stamina enhancement]], [[appetite suppression]], [[increased libido]], and [[euphoria]]. Chronic high-dose use can induce states of [[anxiety]] & [[paranoia]], [[delusions]], [[thought disorganization]], [[psychosis]], and violent behavior. It is associated with [[compulsive redosing]], especially when it is [[vaporized]] ("smoked") or [[injected]], due to the overwhelming [[euphoric]] rush it produces in the user upon initial administration.
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| Methamphetamine has been shown to have extremely high abuse and addiction potential; it is widely considered to be one of the most addictive substances due to the intense euphoria it produces.{{citation needed}} Additionally, unlike [[amphetamine]] at therapeutic doses, methamphetamine at moderate to heavy [[recreational drug use|recreational doses]] is considered to be directly neurotoxic to humans, damaging both [[dopamine]] and [[serotonin]] [[neurons]] within the central nervous system.{{citation needed}} It also displays cardiotoxicity, including [[increased blood pressure]] and elevated risk of stroke. It is highly advised to use [[responsible drug use|harm reduction practices]] if using this substance.
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| [[File:Crystal Meth.jpg|250px|thumbnail|right|Pure "shards" of Methamphetamine Hydrochloride, commonly known as "crystal meth".]]
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| ==History and culture==
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| Amphetamine was first synthesized in 1887 in Germany by Romanian chemist Lazăr Edeleanu who named it phenylisopropylamine.<ref>Lazăr Edeleano: Über einige Derivate der Phenylmethacrylsäure und der Phenylisobuttersäure. In: Berichte der Deutschen chemischen Gesellschaft zu Berlin; 20. Jg. (1887), Band 3, S. 616–622. https://doi.org/10.1002/cber.188702001142</ref> Shortly after, methamphetamine was synthesized from ephedrine in 1893 by Japanese chemist Nagai Nagayoshi.<ref>Grobler, Sias R.; Chikte, Usuf; Westraat, Jaco (2011). "The pH Levels of Different Methamphetamine Drug Samples on the Street Market in Cape Town". ISRN Dentistry. 2011: 1–4. PMC 3189445 Freely accessible. PMID 21991491. https://doi.org/10.5402/2011/974768</ref> Neither drug had a pharmacological use until 1934, when Smith, Kline, and French began selling amphetamine as an inhaler under the trade name Benzedrine as a decongestant.<ref>Rasmussen N (July 2006). "Making the first anti-depressant: amphetamine in American medicine, 1929–1950". J. Hist. Med. Allied Sci. 61 (3): 288–323. PMID 16492800. https://doi.org/0.1093/jhmas/jrj039. SKF first packaged it as an inhaler so as to exploit the base's volatility and, after sponsoring some trials by East Coast otolaryngological specialists, began to advertise the Benzedrine Inhaler as a decongestant in late 1933.</ref>
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| During World War II, amphetamine and methamphetamine were used extensively by both the Allied and Axis forces for their stimulant and performance-enhancing effects.<ref>Rasmussen N (2011). "Medical science and the military: the Allies' use of amphetamine during World War II". J. Interdiscip. Hist. 42 (2): 205–233. PMID 22073434. https://doi.org/10.1162/JINH_a_00212</ref><ref>Defalque RJ, Wright AJ (April 2011). "Methamphetamine for Hitler's Germany: 1937 to 1945". Bull. Anesth. Hist. 29 (2): 21–4, 32. PMID 22849208. https://doi.org/10.1016/s1522-8649(11)50016-2.</ref> Eventually, as the addictive properties of the drugs became known, governments began to place strict controls on the sale of the drugs.<ref>"Historical overview of methamphetamine". Vermont Department of Health. Government of Vermont. Retrieved 29 January 2012.</ref> For example, during the early 1970s in the United States, amphetamine became a schedule II controlled substance under the Controlled Substances Act.<ref>"Controlled Substances Act". United States Food and Drug Administration. 11 June 2009. Retrieved 4 November 2013.</ref>
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| Despite strict government controls, both amphetamine and methamphetamine have still been used legally or illicitly by individuals from a variety of backgrounds for different purposes.<ref>Gyenis A. "Forty Years of On the Road 1957–1997". wordsareimportant.com. DHARMA beat. Archived from the original on 14 February 2008. Retrieved 18 March 2008.</ref><ref>Wilson, Andrew (2008). "Mixing the Medicine: The Unintended Consequence of Amphetamine Control on the Northern Soul Scene" (PDF). The Internet Journal of Criminology. SSRN 1339332 Freely accessible.</ref><ref>Hill J (4 June 2004). "Paul Erdos, Mathematical Genius, Human (In That Order)" (PDF). untruth.org. Retrieved 2 November 2013.</ref><ref>Liddle DG, Connor DJ (June 2013). "Nutritional supplements and ergogenic AIDS". Prim. Care. 40 (2): 487–505. PMID 23668655. https://doi.org/10.1016/j.pop.2013.02.009</ref>
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| Due to the large underground market for these drugs, they are frequently illegally synthesized by clandestine chemists, trafficked, and sold on the black market.<ref>Chawla S, Le Pichon T (2006). "World Drug Report 2006" (PDF). United Nations Office on Drugs and Crime. pp. 128–135. Retrieved 2 November 2013.</ref> Based upon drug and drug precursor seizures, illicit amphetamine production and trafficking is much less prevalent than that of methamphetamine.{{citation needed}}
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| Methamphetamine hydrochloride is approved by the United States Food and Drug Administration (USFDA) under the trade name "Desoxyn".<ref>Desoxyn Label (FDA) | http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/005378s028lbl.pdf</ref> However, it is rarely prescribed due to its abuse potential, typically being reserved for cases of severe obesity or ADHD in which all other treatment options have been exhausted.
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| ==Chemistry==
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| Methamphetamine, or N-methylamphetamine, is a synthetic molecule of the [[amphetamine]] family. Molecules of the amphetamine class contain a phenethylamine core featuring a phenyl ring bound to an amino (NH2) group through an ethyl chain with an additional methyl substitution at R<sub>α</sub>. Amphetamines are alpha-methylated phenethylamines. Methamphetamine contains an additional methyl substitution at R<sub>N</sub>, a substitution which is shared with [[MDMA]], [[methcathinone]], and [[mephedrone]].
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| ===Stereoisomers===
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| Methamphetamine exists as two [[enantiomers]]: dextrorotary and levorotary. Dextrorotatory or dextromethamphetamine (also known as d-methamphetamine) is a stronger central nervous system (CNS) stimulant than levomethamphetamine; however, both are considered to be dependence-forming and addictive when misused and capable of producing similar toxicity symptoms at heavy recreational doses.{{citation needed}}
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| ==Pharmacology==
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| Methamphetamine primarily affects the central nervous system (CNS) by acting as a [[releasing agent]] for [[neurotransmitters]] such as [[dopamine]], [[norepinephrine]], and [[serotonin]] {{citation needed}}. It also acts as a [[reuptake inhibitor]], increasing levels of monoamines by forcing the neurotransmitters out of their storage vesicles and expelling them into the synaptic gap by making the dopamine transporters work in reverse.<ref>Canadian Institutes of Health Research. How Drugs Affect Neurotransmitters. Web 2007. Available from: URL: http://thebrain.mcgill.ca/flash/i/i_03/i_03_m/i_03_m_par/i_03_m_par_cocaine.html#drogues</ref> Other mechanisms by which methamphetamine are known to increase monoamine levels are by:
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| *Blocking the reuptake of [[monoamines]] (i.e. [[norepinephrine]], [[dopamine]], and [[serotonin]]) by inhibiting the activity of their transporters, allowing them to accumulate in the [[synaptic cleft]] between neurons in various brain regions {{citation needed}}.
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| *Decreasing the expression of dopamine transporters at the cell surface, which has the same effect as listed above.
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| *Increasing cytosolic levels of monoamines by inhibiting the activity of [[MAOI|monoamine oxidase]] (MAO)
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| *Increasing the activity and expression of the [[dopamine]]-synthesizing enzyme tyrosine hydroxylase (TH)
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| In addition to releasing potent amounts of monoamines, MA has a high lipid solubility which leads to a relatively fast transfer of the drug across the blood-brain barrier and a quick onset in comparison to other [[stimulant]]s.<ref>Barr AM, Panenka WJ, MacEwan GW, Thornton AE, Lang DJ, Honer WG, et al. The need for speed: an update on methamphetamine addiction. Journal of Psychiatry and Neuroscience 2006 Mar 6;31(5):301-13.</ref> All of this results in feelings of reward, euphoria, and stimulation as well as an unpleasant offset.
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| ==Subjective effects==
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| {{Preamble/SubjectiveEffects}}
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| {{effects/base
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| |{{effects/physical|
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| *'''[[Effect::Stimulation]]''' - In terms of its effects on the physical energy levels of the user, methamphetamine is usually considered to be extremely energetic and stimulating in a fashion that is identical to that of [[amphetamine]], but stronger than that of [[modafinil]], [[caffeine]], and [[MDMA]]. It is similar yet distinct from the stimulation experienced on [[MDMA]], encouraging physical activities such as dancing, socializing, running, or cleaning. The particular style of stimulation which methamphetamine presents can be described as forced. This means that at higher dosages, it becomes difficult or impossible to keep still as jaw clenching, involuntarily bodily shakes and vibrations become present, resulting in extreme shaking of the entire body, unsteadiness of the hands, and a general lack of motor control.
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| **'''[[Effect::Physical euphoria]]''' - As a potent stimulant, [[methamphetamine]] is capable producing states of intense physical euphoria, especially when it is [[vaporized]] or [[injected]]. However, the initial rush of euphoria can wear off well before the substance has run its course which can promote compulsive redosing, which can have extremely damaging cumulative effects.
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| *'''[[Effect::Abnormal heartbeat]]'''
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| *'''[[Effect::Increased blood pressure]]'''
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| *'''[[Effect::Increased heart rate]]'''
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| *'''[[Effect::Appetite suppression]]'''
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| *'''[[Effect::Body odor alteration]]''' - Methamphetamine can potentially leave a very distinct and unpleasant odor within one's urine, sweat and general bodily secretions.
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| *'''[[Effect::Bronchodilation]]'''
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| *'''[[Effect::Dehydration]]'''
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| *'''[[Effect::Frequent urination]]'''
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| *'''[[Effect::Increased bodily temperature]]'''
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| *'''[[Effect::Increased perspiration]]'''
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| *'''[[Effect::Muscle contractions]]'''
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| *'''[[Effect::Muscle spasms]]'''
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| *'''[[Effect::Neurotoxicity]]''' -- from long-term use.
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| *'''[[Effect::Stamina enhancement]]''' - This effect is more prominent than with any other commonly used [[stimulant]].
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| *'''[[Effect::Tactile enhancement]]'''
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| *'''[[Effect::Tactile hallucination]]''' - High doses and/or prolonged usage of certain stimulants like methamphetamine and [[cocaine]] can lead to hallucinatory sensations of bugs crawling on the surface of or underneath one’s skin. This is typically referred to as ''delusional parasitosis'' or more informally as “meth mites”.
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| *'''[[Effect::Teeth grinding]]'''
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| *'''[[Effect::Temporary erectile dysfunction]]'''
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| *'''[[Effect::Vasoconstriction]]'''
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| *'''[[Effect::Pupil dilation]]'''
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| *'''[[Effect::Vibrating vision]]''' - At high doses or certain routes of administration, a person's eyeballs may begin to spontaneously wiggle back and forth in a rapid motion, causing the vision to become blurry and temporarily out of focus. This is a condition known as [http://en.wikipedia.org/wiki/Nystagmus nystagmus].
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| *'''[[Effect::Seizure]]''' - This is an uncommon effect but can happen in those predisposed to them, especially while in physically taxing conditions such as being dehydrated, fatigued or undernourished, or if miusing the substance for extended periods of time.
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| }}
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| {{effects/visual|
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| The visual effects of methamphetamine are usually less consistent and are only mildly noticeable at higher dosages. They are somewhat comparable to the visuals produced by [[deliriants]] and are more frequent in darker areas. Scenarios consisting of severe sleep deprivation caused by [[wakefulness]] can lead to more intense visual effects and even [[External hallucinations|hallucinations]].
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| ====Suppressions====
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| *'''[[Effect::Double vision]]'''
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| ====Distortions====
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| *'''[[Effect::Visual drifting]]''' - This effect is usually subtle or barely noticeable and only occurs at higher dosages or when combined with [[cannabis]]. It is most prominent when smoked or taken intravenously and is usually [[Deliriants|delirious]] in nature. Commonly this, high dosages or prolonged use can cause level 1-2 visual drifting.
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| *'''[[Effect::Brightness alteration]]'''
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| ====Hallucinatory states====
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| *'''[[Effect::Transformations]]''' - This effect occurs very rarely, and typically only when the user has taken high doses, is coming down, or has been awake for unusually long periods. They are usually very mild when they do happen to occur.
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| }}
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| |{{effects/cognitive|
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| The cognitive effects of methamphetamine can be broken down into several components which progressively intensify proportional to dosage. The general head space of methamphetamine is described by many as one of extreme mental [[stimulation]], [[Focus enhancement|increased focus]], [[ego inflation]] and powerful euphoria. It contains a large number of typical [[stimulant]] cognitive effects. Although negative side effects are usually mild at low to moderate dosages, they become increasingly likely to manifest themselves with higher amounts or widespread usage. This particularly holds true during the offset of the experience.
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| The most prominent of these cognitive effects generally include:
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| *'''[[Effect::Analysis enhancement]]'''
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| *'''[[Effect::Compulsive redosing]]'''
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| *'''[[Effect::Ego inflation]]'''
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| *'''[[Effect::Cognitive euphoria]]''' - This effect is often very intense when compared to other dopaminergic stimulants such as [[Amphetamine]] or even [[Cocaine]]
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| *'''[[Effect::Empathy, affection and sociability enhancement]]''' - This effect is mild to moderate and usually disappears within the first few uses or after any form of tolerance has developed.
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| *'''[[Effect::Focus enhancement]]''' - This component is most effective at low to moderate dosages as anything higher will usually impair concentration.
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| *'''[[Effect::Immersion enhancement]]'''
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| *'''[[Effect::Increased libido]]'''
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| *'''[[Effect::Increased music appreciation]]'''
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| *'''[[Effect::Memory enhancement]]'''
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| *'''[[Effect::Motivation enhancement]]'''
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| *'''[[Effect::Thought acceleration]]'''
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| *'''[[Effect::Thought organization]]'''
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| *'''[[Effect::Time distortion|Time compression]]''' - This can be described as the experience of time speeding up and passing much quicker than it usually would when sober.
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| *'''[[Effect::Wakefulness]]'''
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| }}
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| {{effects/aftereffects|
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| The effects which occur during the [[offset]] of a [[stimulant]] experience generally feel negative and uncomfortable in comparison to the effects which occurred during its [[peak]]. This is often referred to as a "comedown" and occurs because of [[neurotransmitter]] depletion. Its effects commonly include:
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| *'''[[Effect::Anxiety]]'''
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| *'''[[Effect::Appetite suppression]]'''
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| *'''[[Effect::Cognitive fatigue]]'''
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| *'''[[Effect::Depression]]'''
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| *'''[[Effect::Irritability]]'''
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| *'''[[Effect::Motivation suppression]]'''
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| *'''[[Effect::Sleep paralysis]]''' - Some users note sleep paralysis after consuming methamphetamine.
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| *'''[[Effect::Suicidal ideation]]'''
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| *'''[[Effect::Thought deceleration]]'''
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| *'''[[Effect::Psychosis]]'''
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| *'''[[Effect::Wakefulness]]''' - This particular after effect is more pronounced than it is with any other commonly used [[stimulant]].
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| }}
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| }}
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| ===Experience reports===
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| Anecdotal reports which describe the effects of this compound within our [[Experience index|experience index]] include:
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| * [[Experience:Methamphetamine (20-40 mg insufflated) + cannabis - Hallucinatory Overdose]]
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| Additional experience reports can be found here:
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| *[https://www.erowid.org/experiences/subs/exp_Methamphetamine.shtml Erowid Experience Vaults: Methamphetamine]
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| ==Toxicity and harm potential==
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| ===Neurotoxicity===
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| There is evidence that methamphetamine causes brain damage from long-term use in humans; this damage includes adverse changes in brain structure and function, such as reductions in gray matter volume in several brain regions and adverse changes in markers of metabolic integrity.{{citation needed}}
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| Unlike [[amphetamine]], methamphetamine is directly neurotoxic to [[dopamine]] neurons.<ref>Malenka RC, Nestler EJ, Hyman SE (2009). "15". In Sydor A, Brown RY. Molecular Neuropharmacology: A Foundation for Clinical Neuroscience (2nd ed.). New York: McGraw-Hill Medical. p. 370. ISBN 978-0-07-148127-4. "Unlike [[cocaine]] and [[amphetamine]], methamphetamine is directly toxic to midbrain dopamine neurons."</ref> Moreover, methamphetamine abuse is associated with an increased risk of Parkinson's disease due to excessive pre-synaptic dopamine autoxidation, a mechanism of neurotoxicity.<ref>A review of the clinical pharmacology of methamphetamine (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/19426289</ref><ref>Methamphetamine-induced neurotoxicity: the road to Parkinson’s disease | http://www.if-pan.krakow.pl/pjp/pdf/2009/6_966.pdf</ref><ref>Intraneuronal dopamine-quinone synthesis: a review (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/12835101</ref><ref>Dopaminergic neuron-specific oxidative stress caused by dopamine itself (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/18596830</ref> Similar to the neurotoxic effects on the dopamine system, methamphetamine can also result in neurotoxicity to [[serotonin]] [[neurons]].<ref>Methamphetamine toxicity and messengers of death (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/19328213</ref> It has been demonstrated that a high core temperature is correlated with an increase in the neurotoxic effects of methamphetamine.<ref>Relationship between temperature, dopaminergic neurotoxicity, and plasma drug concentrations in methamphetamine-treated squirrel monkeys (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/16293712</ref> As a result of methamphetamine-induced neurotoxicity to dopamine neurons, chronic use may also lead to post acute withdrawals which persist beyond the withdrawal period for months, and even up to a year.<ref>A review of the clinical pharmacology of methamphetamine (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/19426289</ref>
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| ===Dependence and abuse potential===
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| As with other [[stimulant]]s, the chronic use of methamphetamine can be considered [[Addiction potential::extremely addictive with a high potential for abuse]] and is capable of causing psychological dependence among certain users. When addiction has developed, cravings and [[withdrawal effects]] may occur if a person suddenly stops their usage.
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| Tolerance to the effects of methamphetamine [[Time to full tolerance::rapidly develops with prolonged and repeated use]].<ref>Efficacy of psychostimulant drugs for amphetamine abuse or dependence (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/23996457</ref><ref>http://www.merckmanuals.com/home/special_subjects/drug_use_and_abuse/amphetamines.html</ref> This results in users having to administer increasingly large doses to achieve the same effects. After that, it takes about [[Time to half tolerance::3 - 7 days]] for the tolerance to be reduced to half and [[Time to zero tolerance::1 - 2 weeks]] to be back at baseline (in the absence of further consumption). Methamphetamine presents cross-tolerance with [[Cross-tolerance::all [[dopamine]]rgic [[stimulants]]]], meaning that after the consumption of methamphetamine all [[stimulants]] will have a reduced effect.
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| The evidence on effective treatments for [[amphetamine]] and methamphetamine dependence and abuse is limited.<ref>Treatment for amphetamine dependence and abuse (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/11687171</ref> In light of this, [[fluoxetine]] and [[imipramine]] appear to have some limited benefits in treating abuse and addiction, "no treatment has been demonstrated to be effective for the treatment of methamphetamine dependence and abuse".<ref>Treatment for amphetamine dependence and abuse (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/11687171</ref> | |
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| In highly dependent [[amphetamine]] and methamphetamine abusers, "when chronic heavy users abruptly discontinue methamphetamine use, many report a time-limited withdrawal syndrome that occurs within 24 hours of their last dose".<ref>Treatment for amwithdrawal (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/19370579</ref> Withdrawal symptoms in chronic, high-dose users are frequent, occurring in up to 87.6% of cases, and persist for three to four weeks with a marked "crash" phase occurring during the first week.<ref>Treatment for amphetamine withdrawal (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/19370579</ref> Methamphetamine withdrawal symptoms can include anxiety, drug craving, dysphoric mood, fatigue, increased appetite, increased movement or decreased movement, lack of motivation, sleeplessness or sleepiness, and vivid or lucid dreams.<ref>Treatment for amphetamine withdrawal (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/19370579</ref> Withdrawal symptoms are associated with the degree of dependence (i.e., the extent of abuse).<ref>Treatment for amphetamine withdrawal (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/19370579</ref> The mental depression associated with methamphetamine withdrawal lasts longer and is more severe than that of [[cocaine]] withdrawal.<ref>Methamphetamine abuse (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/17990840</ref>
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| Although it is clear that vaporised methamphetamine is more addictive than oral or insufflated amphetamine, there is debate as to whether the drug itself is inherently more addictive, and if so, how important the difference is. Besides the duration of action, the main difference between the two drugs is that methamphetamine is proportionally more centrally and less peripherally active. One reason is because the increased lipid solubility of the methyl group causes faster central absorption. Another cause is the fact that methamphetamine releases proportionally more dopamine at an equivalent dose. D-methamphetamine releases a dopamine:norepinephrine ratio of ~1:1.3 from synapses versus ~1:2 for d-amphetamine.<ref>https://en.wikipedia.org/wiki/Monoamine_releasing_agent#Activity_profiles</ref> Their effect on the norepinephrine (NET) and dopamine (DAT) transporters are more alike but there is a slight difference. D-methamphetamine favours NET by a factor of about 4 vs 5 for d-amphetamine. D-methamphetamine is also slightly more serotonergic. This may be a negligible difference, as the ratio of serotonin:norepinephrine release is only 1:60 for d-methamphetamine and 1:80 for d-amphetamine. Neither drug has any appreciable affinity for the serotonin transporter (SERT).
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| This increased central vs peripheral effect of methamphetamine agrees with the common subjective feeling among stimulant users that the methamphetamine high has less of an inherently 'jittery' quality to it. The downside is that this aversive effect may be helpful as it discourages harmful levels of use. It is unclear what real world impact this difference has. A double-blind but small study of 13 methamphetamine users revealed only a minor preference towards methamphetamine, and this may be explained by the users having a greater familiarity with the drug.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3475187/</ref>
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| It is strongly recommended that one use [[responsible drug use|harm reduction practices]] when using this substance.
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| ===Psychosis===
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| {{Main|Stimulant psychosis}}
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| Abuse of methamphetamine can result in a stimulant psychosis that may present with a variety of symptoms (e.g., [[Paranoia|paranoia]], [[External hallucinations|hallucinations]], [[delusions]]).<ref>Treatment for amphetamine psychosis | [http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003026.pub3/abstract?systemMessage=Wiley+Online+Library+will+be+disrupted+Saturday%2C+15+March+from+10%3A00-12%3A00+GMT+%2806%3A00-08%3A00+EDT%29+for+essential+maintenance 1]</ref> A review on treatment for [[amphetamine]], [[dextroamphetamine]], and methamphetamine abuse-induced psychosis states that about 5–15% of users fail to recover completely.<ref>Treatment for amphetamine psychosis | [http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003026.pub3/abstract?systemMessage=Wiley+Online+Library+will+be+disrupted+Saturday%2C+15+March+from+10%3A00-12%3A00+GMT+%2806%3A00-08%3A00+EDT%29+for+essential+maintenance 1]</ref><ref>Hofmann FG (1983). A Handbook on Drug and Alcohol Abuse: The Biomedical Aspects (2nd ed.). New York: Oxford University Press. p. 329. ISBN 9780195030570.</ref> The same review asserts that, based upon at least one trial, [[antipsychotic]] medications effectively resolve the symptoms of acute amphetamine psychosis.<ref>Treatment for amphetamine psychosis | [http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003026.pub3/abstract?systemMessage=Wiley+Online+Library+will+be+disrupted+Saturday%2C+15+March+from+10%3A00-12%3A00+GMT+%2806%3A00-08%3A00+EDT%29+for+essential+maintenance 1]</ref> Psychosis very rarely arises from therapeutic use.<ref>Stimulant Misuse: Strategies to Manage a Growing Problem | http://www.acha.org/prof_dev/ADHD_docs/ADHD_PDprogram_Article2.pdf</ref><ref>http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021303s026lbl.pdf</ref>
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| ===Overdose===
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| A methamphetamine overdose may result in a wide range of symptoms and is potentially fatal at heavy dosages.<ref>"Desoxyn Prescribing Information" | http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/005378s028lbl.pdf</ref> A moderate overdose of methamphetamine may induce symptoms such as abnormal heart rhythm, confusion, dysuria, high or low blood pressure, hyperthermia, hyperreflexia, myalgia, severe agitation, tachypnea, tremor, urinary hesitancy, and urinary retention.<ref>Westfall DP, Westfall TC (2010). "Miscellaneous Sympathomimetic Agonists." In Brunton LL, Chabner BA, Knollmann BC. Goodman & Gilman's Pharmacological Basis of Therapeutics (12th ed.). New York: McGraw-Hill. ISBN 978-0-07-162442-8.</ref> An extremely large overdose may produce symptoms such as adrenergic storm, methamphetamine psychosis, anuria, cardiogenic shock, cerebral hemorrhage, circulatory collapse, hyperpyrexia, pulmonary hypertension, renal failure, rhabdomyolysis, [[serotonin syndrome]], and a form of stereotypy ("tweaking"). A methamphetamine overdose will likely also result in mild brain damage due to dopaminergic and serotonergic neurotoxicity.<ref>Malenka RC, Nestler EJ, Hyman SE (2009). "15". In Sydor A, Brown RY. Molecular Neuropharmacology: A Foundation for Clinical Neuroscience (2nd ed.). New York: McGraw-Hill Medical. p. 370. ISBN 978-0-07-148127-4. "Unlike cocaine and amphetamine, methamphetamine is directly toxic to midbrain dopamine neurons."</ref><ref>http://www.ncbi.nlm.nih.gov/pubmed/19328213</ref> Death from fatal methamphetamine poisoning is typically preceded by convulsions and coma.<ref>"Desoxyn Prescribing Information" | http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/005378s028lbl.pdf</ref>
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| ===Harm reduction===
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| Studies have shown that [[N-acetylcysteine]] (NAC) can block the harmful neurotoxic effects of methamphetamine while preventing neurotransmitter depletion in rats<ref>Effect of antioxidant N-acetyl-L-cysteine on behavioral changes and neurotoxicity in rats after administration of methamphetamine (ScienceDirect) | https://www.docdroid.net/DChH6IC/101016-at-jbrainres200404072.pdf</ref> and clinical trials in humans to treat methamphetamine dependence are currently underway. NAC may be effective for reducing the cravings and psychological dependence as well.<ref>The efficacy of N-acetylcysteine in the treatment of methamphetamine dependence: a double-blind controlled, crossover study. (PubMed.gov / NCBI) | https://www.ncbi.nlm.nih.gov/pubmed/25556383</ref> NAC has a short half life and a sustained release formulation may be preferred for harm reduction purposes. Selenium has also been shown to protect the brain against meth induced neurotoxicity.<ref>Selenium, an antioxidant, protects against methamphetamine-induced dopaminergic neurotoxicity (ScienceDirect) | https://www.sciencedirect.com/science/article/pii/S0006899398013110</ref> However, it is worth noting that this data is preliminary and may not be applicable to humans.
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| ===Dangerous interactions===
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| {{DangerousInteractions/Intro}}
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| {{DangerousInteractions/Amphetamines}}
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| ==Legal status==
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| {{legalStub}}
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| The production, distribution, sale, and possession of methamphetamine is restricted or illegal in many jurisdictions.<ref>http://www.unodc.org/pdf/youthnet/ATS.pdf</ref><ref>http://web.archive.org/web/20051205125434/http://www.incb.org/pdf/e/list/green.pdf</ref> Methamphetamine has been placed in Schedule II of the United Nations Convention on Psychotropic Substances treaty.<ref>http://web.archive.org/web/20051205125434/http://www.incb.org/pdf/e/list/green.pdf</ref>
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| *'''Australia''': Methamphetamine is placed under Schedule 8, meaning that it is available for medical use, but possession, production or supply of it is illegal without authority. <ref>https://www.legislation.gov.au/Details/F2019L00032/Html/Text#_Toc532805057</ref>
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| *'''Austria''': Methamphetamine is illegal to possess, produce and sell under the SMG (Suchtmittelgesetz Österreich).{{citation needed}}
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| *'''Canada''': Methamphetamine is listed on the CDSA saa
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| *A in S substancechedule I.<ref>{{cite web|url=https://www.laws-lois.justice.gc.ca/eng/acts/C-38.8/page-13.html#docCont|title=Controlled Drugs and Substances Act - SCHEDULE I|publisher=Government of Canada|access-date=December 19, 2019}}</ref>
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| *'''Germany''': Methamphetamine was added to the Opiumgesetz (''Opium Act'') on July 1, 1941.<ref>{{cite web|url=https://www.spiegel.de/international/the-nazi-death-machine-hitler-s-drugged-soldiers-a-354606.html|title=The Nazi Death Machine: Hitler's Drugged Soldiers|publisher=Spiegel Online|date=May 6, 2005|access-date=December 23, 2019}}</ref> It is controlled under Anlage II BtMG (''Narcotics Act, Schedule II'')<ref>{{cite web|url=https://www.gesetze-im-internet.de/btmg_1981/anlage_ii.html|title=Anlage II BtMG|publisher=Bundesministerium der Justiz und für Verbraucherschutz|access-date=December 23, 2019|language=de}}</ref> as of March 1, 2008. Before that, it could be prescribed on a narcotic prescription form because it was in Anlage III (''Schedule III'').<ref>{{cite web|url=https://www.bgbl.de/xaver/bgbl/start.xav?start=//*%5B@attr_id=%27bgbl108s0246.pdf%27%5D|title=Einundzwanzigste Verordnung zur Änderung betäubungsmittelrechtlicher Vorschriften|publisher=Bundesanzeiger Verlag|access-date=December 23, 2019|language=de}}</ref> It is illegal to manufacture, possess, import, export, buy, sell, procure or dispense it without a license.<ref>{{cite web|url=https://www.gesetze-im-internet.de/btmg_1981/__29.html|title=§ 29 BtMG|publisher=Bundesministerium der Justiz und für Verbraucherschutz|access-date=December 23, 2019|language=de}}</ref>
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| *'''The Netherlands''': Methamphetamine is a List I controlled substance.<ref>{{cite web|url=https://wetten.overheid.nl/BWBR0001941/2009-07-01|title=Opiumwet|publisher=Ministerie van Binnenlandse Zaken en Koninkrijksrelaties|access-date=December 19, 2019|language=nl}}</ref>
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| *'''Switzerland''': Methamphetamine is a controlled substance specifically named under Verzeichnis A.<ref>{{cite web|url=https://www.admin.ch/opc/de/classified-compilation/20101220/index.html|title=Verordnung des EDI über die Verzeichnisse der Betäubungsmittel, psychotropen Stoffe, Vorläuferstoffe und Hilfschemikalien|publisher=Bundeskanzlei [Federal Chancellery of Switzerland]|access-date=January 1, 2020|language=de}}</ref>
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| *'''United Kingdom''': Methamphetamine is a Class A drug as of 18 January 2007.<ref>{{cite web|url=https://www.gov.uk/government/publications/controlled-drugs|title=Corporate report - Controlled Drugs|publisher=Government Digital Service|access-date=December 19, 2019}}</ref>
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| *'''Czech Republic''': Methamphetamine is a Schedule II controlled substance.<ref>https://www.zakonyprolidi.cz/cs/2013-463</ref>
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| ==See also==
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| *[[Responsible use]]
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| *[[Psychoactive substance index]]
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| *[[Stimulant]]
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| *[[Phenethylamine]]
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| *[[Substituted amphetamine]]
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| *[[Amphetamine]]
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| ==External links==
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| *[http://en.wikipedia.org/wiki/Methamphetamine Methamphetamine (Wikipedia)]
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| *[http://www.erowid.org/chemicals/meth/meth.shtml Methamphetamine (Erowid Vault)]
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| *[https://isomerdesign.com/PiHKAL/explore.php?id=2002 Methamphetamine (Isomer Design)]
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| ==References==
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| {{reflist|2}}
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| [[Category:Psychoactive substance]]
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| [[Category:Stimulant]]
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| [[Category:Amphetamine]]
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| {{#set:Featured=true}}
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