Today, Explained: Methamphetamine – The Most Misunderstood Drug?

Released on May 25, 2025 | Hosts: Sean Rameswaram and Noel King | Part of the Vox Media Podcast Network

1. Introduction to Methamphetamine's Reputation

In the episode titled "Methamphetamine: The Most Misunderstood Drug?" hosted by Vox's Wendy Zuckerman, the pervasive stigma surrounding methamphetamine is critically examined. Traditionally portrayed through "Just Say No" campaigns and government PSAs as an exceptionally dangerous and addictive substance, methamphetamine's true impact and complexities are explored to challenge these often one-dimensional narratives.

2. Understanding Methamphetamine and Its Effects on the Brain

Wendy Zuckerman delves into the scientific underpinnings of methamphetamine’s effects, seeking to unravel the truths behind its notorious reputation.

User Experiences: The Highs of Meth

Listeners who have used meth describe its immediate effects vividly:

• Jonquillen [05:35]: "Meth makes your whole body kind of tingly instantly in like a nice way, almost like glistening, almost like Edward in Twilight."

• Tina [05:47]: "I felt very on alert. You know, everything was sort of heightened. I was wide awake, probably not blinking as much as a regular person."

• Theo [05:56]: "I remember just being like, really horny... a really intense feeling of wanting to be with someone in every way possible."

• Fallon [06:12]: "It just felt like it unlocked everything, every pathway in my head. I remember feeling socially perfect. No anxiety, it just makes like all of your best parts better."

Expert Insights: The Science Behind the High

Professor Martin Paulus, the scientific director at the Laureate Institute for Brain Research, explains methamphetamine’s powerful impact on the brain’s dopamine system:

• Martin Paulus [07:03]: "Meth essentially makes a drop of dopamine seem like it's an ocean of dopamine."

Meth amplifies dopamine levels— the brain's "feel-good" chemical—leading to intense euphoria. Unlike cocaine, which increases dopamine by about 350%, meth can surge dopamine levels by over 3,000% in rats, according to research cited by Zuckerman. Additionally, meth crosses the blood-brain barrier swiftly, enabling rapid onset and prolonged effects compared to other stimulants.

However, this euphoria is fleeting. Continuous use leads to tolerance as the brain reduces dopamine receptors, diminishing meth’s pleasurable effects and driving the cycle of addiction.

3. The Myth of Meth Mouth

A long-standing myth suggests that methamphetamine directly destroys teeth, a condition popularly known as "meth mouth." Zuckerman investigates this claim with insights from researcher Kate O'Melley from Columbia University.

• Kate O'Melley [23:59]: "It's very unlikely that methamphetamine itself is eating away at your teeth."

Research indicates that the severe dental issues observed in meth users are less about the drug’s direct corrosive effects and more about associated behaviors, such as teeth grinding (bruxism), dry mouth reducing saliva protection, poor dental hygiene, and high consumption of sugary beverages. Notably, a study highlighted that intravenous meth users exhibited worse dental health than those who smoked it, challenging the belief that smoking meth is particularly harmful to teeth.

Listener testimonials further illustrate this nuance:

• Fallon [22:53]: "After smoking meth for just a couple of years, a few of my back teeth were pretty messed up."

Conversely, some meth users, like Tina, maintained good dental health through rigorous oral hygiene practices:

• Tina [26:06]: "I still have all my teeth. Excellent teeth."

4. Meth's Impact on the Heart and Mortality

Methamphetamine's dangers extend beyond its neurological effects. Zuckerman discusses its cardiovascular risks, emphasizing that meth use can lead to severe heart conditions even in young users.

• Martin Paulus [27:02]: "You can see 20-year-olds having strokes. You can have 20-year-olds having heart attacks."

Additionally, meth is increasingly implicated in overdose deaths in the U.S., ranking as the second most common cause of drug-related fatalities after opioids. These fatalities often result from heart attacks, suicides, and accidents rather than direct overdose.

5. The Addictiveness of Methamphetamine

Contrary to popular belief that meth is extraordinarily addictive, research reveals a more nuanced picture.

Statistical Insights

A vast survey in 2023 indicated that out of over 16 million people in the U.S. who had tried meth once, approximately 11% developed a meth use disorder. When compared to other substances:

• Alcohol: Higher rates of use disorder.
• Cannabis: Slightly higher prevalence of use disorder.
• Tobacco: Three times more likely to lead to dependence than meth.

This data suggests that while meth is indeed addictive, it does not surpass all other drugs in terms of addiction potential.

Personal Stories: The Path to Addiction

Listeners Theo and Tina share their harrowing journeys with meth addiction:

• Theo [32:16]: "I couldn't stop using. I was stealing it, using everything fast. I was so desperate."

Facing the brink of losing everything, Theo reached out for help, leading to his recovery journey:

• Theo [34:24]: "I texted my sister saying I needed help... I felt something wanted me to live."

• Theo [36:17]: "I'm super happy and proud."

Similarly, Tina leveraged life changes to overcome her addiction:

• Tina [36:35]: "I've totally turned my life around. Graduated, have a great job I love, and have been off meth for almost 10 years."

Rapid Onset of Dependency

Professor Paulus notes the swift progression from occasional use to dependency:

• Martin Paulus [30:33]: "The rapidity with which you develop methamphetamine use disorder is unbelievable."

A survey cited by Zuckerman found that on average, individuals developed a meth use disorder within three months of first use—faster than with alcohol, cocaine, or cannabis.

6. Recovery and Treatment Options

Despite meth’s challenges, recovery is attainable. Researchers like Krista Seyfried from the University of New South Wales are pioneering innovative treatments:

• Cognitive Behavioral Therapy (CBT) for Meth: Teaches coping strategies to manage cravings. Seyfried describes techniques such as "urge surfing," where individuals visualize cravings as waves that crest and recede.

• Incentive-Based Programs: Providing financial rewards for abstinence has shown effectiveness in encouraging users to stay off meth.

• Medication Research: Investigations into ADHD medications like lisdexamphetamine show promise in reducing meth use.

Seyfried emphasizes the importance of understanding and reducing the stigma associated with meth use:

• Krista Seyfried [38:53]: "Meth has earned itself a reputation whereby it's highly stigmatized. It's a highly misunderstood drug."

7. Conclusion: Is Methamphetamine the Most Misunderstood Drug?

Wendy Zuckerman synthesizes the episode's insights, acknowledging that while methamphetamine is undeniably harmful—impacting the brain, heart, and dental health—it does not reside alone in its capacity for addiction and damage. The severe consequences experienced by a minority of users have fueled its formidable reputation, overshadowing the broader context of drug use and societal factors influencing addiction.

Ultimately, methamphetamine emerges as a complex substance with significant risks, but not uniquely so among drugs. Its portrayal as the "most misunderstood drug" holds weight in highlighting the need for informed, nuanced discussions rather than relying solely on fear-based narratives.

Notable Quotes:

• Wendy Zuckerman [07:22]: "Studies in rats have found that meth increases dopamine in a part of their brain by more than a third thousand percent."

• Theo [33:22]: "I just felt like there was something spiritual wanting me to live."

• Krista Seyfried [37:38]: "So, for example, how to surf an urge to use methamphetamine."

Final Thoughts

While methamphetamine remains a significant public health issue, understanding its true effects, addiction potential, and avenues for recovery can foster more effective interventions and reduce the stigma that hinders many from seeking help. This episode of "Today, Explained" serves as a comprehensive exploration, inviting listeners to reconsider preconceived notions and engage with the science behind methamphetamine.