Crystal meth (ice): Signs of overdose and how to respond

What is methamphetamine? 

Methamphetamine (or methylamphetamine hydrochloride) is a central nervous system (CNS) stimulant.

It is generally available in four forms: 

• Speed – which comes in powder form and is typically of low purity. 
• Base – a damp oily substance with white to yellow or brown colour (also known as “pure”, “paste”, “wax”). 
• Pills/tablets – usually contain only a small dose of methamphetamine. 
• Crystal – the purest form of methamphetamine, which has a translucent to white crystalline appearance. The crystal form of the drug is also known as ice. 

Risks of meth overdose

Because of its high purity, meth overdose or toxicity can occur even with small doses, especially when mixed with other drugs.

The greatest concern in meth overdose is the risk of seizures, stroke and heart attack. Emergency presentations featuring meth toxicity are less common than meth psychosis.

However, risks to the cardiovascular system from high levels are significant, especially when there is a pre-existing health problem.

Meth can be swallowed, snorted, smoked or injected, and each of these methods has different risks. For example:

• Swallowing makes it difficult to work out the dose and when its effects will be felt.
• Smoking is harsh on the lungs and risks burning them.
• Injecting any drug attracts risks of injection-related injury and diseases including blood borne viruses (e.g. HIV, hepatitis C). 

Smoking and injecting ice can have a nearly instantaneous onset of its effects, which might account for the higher likelihood of methamphetamine dependence among people who smoke and/or inject ice. 

Signs of a meth overdose 

Some physical signs of a meth overdose can include: 

• Hot, flushed, sweaty skin 
• Severe headaches 
• Chest pain 
• Unsteady walking 
• Rigid muscles or tremors, spasms, jerky movements of the limbs, and seizures 
• Difficulty breathing 

Some psychological signs of a meth overdose can include:

• Psychotic symptoms in individuals with no prior mental illness 
• Severe agitation or panic
• Altered mental state (e.g. confusion, disorientation) 

How to respond to a meth overdose 

If you suspect someone is experiencing a meth overdose, it’s important to respond quickly:

• Before you act, check for dangers such as needles. 
• Call an ambulance, tell the operator your location, and stay on the line. 
• Move the person to a quiet, safe room away from bystanders, noise, excessive light, heat and other stimulation. 
• Stay until help arrives. Do not leave the person alone. 

Dos and don’ts

Here are a few more first aid essentials while you wait for emergency services to arrive: 

• Do NOT give the person anything to eat or drink, or try to induce vomiting 
• If confused or panicking, try to reassure them. 
• If overheating, try to cool them down by loosening outer clothing or putting a wet towel on the back of the neck or under their arms. 
• If you can’t get a response or the person is unconscious, put them in the recovery position.
• If muscle spasms or seizures occur, remove anything from the immediate environment that might cause injury.