Post-Meth Syndrome—The Long Walk Back

“It’s so nice to be able to speak in full sentences again,” said the 37-year-old gay man we’ll call Oliver with a wry smile. “You think I’m exaggerating, but I’m not.”

Oliver hasn’t used crystal since Memorial Day weekend 2003, and knows better than most people the agonizingly slow pace of recuperation from meth addiction. The restoration of functioning to pre-addiction levels has yet to be adequately studied, but it is clearly a lengthy process that occurs in some surprising stages. And indications are that it is a much longer journey that most users—and their loved ones—are prepared for.

Anyone who knows much about meth—as I’ve learned a lot about in my counseling work with gay men—knows that for a drug with such a powerful, intense high, the coming down period is itself a major part of the experience, and sometimes a harrowing one. A single dose of tina, as some in our community still call meth, can keep someone going for up to 12 hours. Often, people remain high and unable to sleep even after they’ve finished the activity—for many gay men, sex—they take the drug to enhance. That’s when people endlessly read magazines, go on masturbation binges, or decide they really need to clean behind the toilet with a toothbrush—oh, for three or four hours.

Some people who mistakenly think meth is just another white powder best taken in frequent little bursts, like cocaine, wind up ingesting too much and stay revved up for much longer than they intend. Others try to avoid the come down altogether by using different drugs, including marijuana, alcohol, and sleeping pills to shut down their system. And still another category of user stays tweaked for so long—sometimes multiple days—that they literally become psychotic and suffer paranoid delusions.

One man I know was certain after a three-day binge that his neighbors were plotting against him to the point that he stayed in his hallway for hours with his ear to his apartment door listening for them. Aural hallucinations that sounded like whispers to his ears helped boost this fantasy. Another poor guy spent the coming down hours under his bed completely convinced the entire time that a jet plane was going to crash into his apartment building at any moment.

Pretty gruesome stuff, huh?

But usually, the drug-induced psychosis and hallucinations will wear off as the drug’s effect wanes. Certainly, people afterwards remain irritable, exhausted, and depleted both physically and emotionally. But assuming that at some point—often with help from a treatment center or Crystal Meth Anonymous or in extreme cases hospitalization—people are finally able to break the cycle of using, feeling like crap, and using again to feel better, it’s still a huge challenge to deal with the consequences of chronic meth use.

For Oliver, once he was able to put down the pipe, then began a two-and-a-half year odyssey of recovery that continues to this day.

“For me, the first few months after I stopped were solely about getting stabilized. I was really a mess. I couldn’t think straight and I felt constantly triggered to use again. I worried that I wouldn’t be able to say no if someone offered me the drug, even though I knew how horrible it would be for me. I was completely fragile.”

The “not being able to think straight” comment is disturbingly a medical fact. Studies have confirmed that chronic meth use is associated with cognitive impairment that can last for months after use is discontinued and in some cases, may have permanent effects. The inability to resists triggers—or poor impulse control in the scientific parlance—is also a function of the drug’s effect on the brain.

“It wasn’t until I’d been off meth for over a year that I began to feel like things were really returning to normal,” Oliver said. “I knew things were improving when I began to enjoy the little things in life again like shopping for groceries or making plans for improvements around the apartment.”

What we’re really talking about here is the long-term impact of depression. A more specific clinical term—anhedonia—describes the experience of not finding satisfaction in the quotidian experiences of life that frequently occurs post-meth addiction. This period of just not enjoying life very much can linger a remarkably long time into recovery.

Specific areas of previous satisfaction can be impacted, too. For many gay men, recovering from meth manifests as a period of sexual abstinence. Since sex and tina were so bound together during addiction, many guys experience long periods without any sexual activity after they get clean. Part of sobriety can become about learning how to be sexual again without the drug as part of the mix.

For Oliver, the most important area in need of recalibration was his emotional thermometer.

“I tried to return to work in low-stress, temporary, part-time assignments, but in three different scenarios was terminated after emotional outbursts. I even recall confrontations with coffee shop staff and grocery store clerks that in hindsight seem very unnecessary. It is the return to feelings of well-being and calmness that is most significant to me.”

All these dynamics are reasons why relapse is so often a frustratingly common experience with meth. In some ways, getting off meth is a lot like kicking the cigarette habit that can take repeated attempts with so many moments in the day and emotional triggers linked to those Marlboro Lights.

“I was doing all the right things, like going to CMA meetings, getting counseling, seeking out lots of support,” Oliver averred, “but still I had a long slow road—still have—to be rid of the after effects of all the damage I did to myself with crystal meth.”

Oliver’s keeping in place “all the right things,” though it couldn’t fully ameliorate the post-meth syndrome, probably enabled him to stay sober and therefore on the path to full recovery.

Partners, friends, and family of people kicking meth—and ex-tweakers themselves—need to be aware how long and layered recuperation from addiction often is with this drug. Both the user and those who love him or her need to be in it for the haul, for when a beautiful sunset over the Hudson or a great big bear hug is restored to its rightful place as a special moment in an ordinary day, a moment that truly nourishes our souls.