Brain Recovery Possible for Meth Users

Abstinence Can Reverse Some Brain Damage

PET Scan Images of Brains
PET Scans Show Visible Improvement. NIDA

It's no doubt that methamphetamine use does damage to the brain. The question is whether or not that damage is reversible when someone stops using meth.

Unfortunately, the answer to that question is not so simple. Some of the damage that methamphetamine does to the brain will begin to reverse when the user become abstinent, but there is other damage to the brain that meth does that some scientists believe is irreversible.

However, there are other researchers who think that even the parts of the brain most severely damaged by meth use will show improvement, but only after a long, extended period of absolute abstinence.

Types of Meth Brain Damage

Heavy or long-time methamphetamine use damages the brain both chemically and physically, to state a very complex topic as simply as possible. The chemical damage that meth does begins to reverse when the person stops using and continues to improve the longer the person is abstinent.

The physical damage meth does to the brain - the actual destroying of brain cells - falls into two categories: in regions of the brain that can be compensated for by the brain when they stopped working, and in regions of the brain that are not redundant - those areas the brain cannot compensate for if they become damaged.

Three Ways Meth Damages the Brain

Chronic, long-term methamphetamine use can damage the brain in three different ways:

  • Acute neurotransmitter changes
  • Rewiring of the brain's reward system
  • Physical brain cell death

Acute Neurotransmitter Changes

Repeated methamphetamine intoxication damages the brain's cellular transporters and destroys receptors. But, this damage is biochemical and can begin to reverse after the meth user maintains a period of abstinence, which could mean weeks for some and months for others, research shows.

Meth use leaves the actual neurons intact and they can begin to replace their neurotransmission transporters and receptors. But, it can take 12 to 18 months before the damage is completely reversed in some users.

Because these transmitters and receptors are involved in the emotional control functions of the brain, methamphetamine addicts who experience anxiety, irritability, apathy, rage, depression and insomnia will usually see these conditions reverse when neurotransmitter levels become restored.

The process can take weeks or even months after meth detoxification.

Reward Center Wiring Changes

Methamphetamine addiction also damages the regions of the brain involved in the sensation of pleasure and the desire (craving) for pleasure. These regions include the ventral tegmental area, nucleus accumbens, and frontal lobe.

Chronic meth use causes an increase in the levels of cytokines in the brain. This class of chemicals causes brain cells to produce new synapses and projections from the brain's neurons.

As one researcher explained it, with the repeated use of methamphetamine, the brain's neural circuits "add lanes to the old highways and build entirely new expressways to accommodate increased traffic."

Unfortunately, these new highways are permanent changes in the actual structure of the brain.

Brain Cell Death

Heavy meth use can cause brain cell death in the regions of the brain that are involved in self-control and rewards. Other areas where meth can actually kill brain cells include the frontal lobes, caudate nucleus, and hippocampus - areas which are involved in the development of dementia and schizophrenia.

Sometimes when brain cells are destroyed, the brain can adjust by "rerouting connections" to other areas of the brain that can perform the same function.

Unfortunately for meth addicts, some of these cells that are killed are in areas of the brain that a not "redundant." That means when those cells stop doing their job, other brain centers cannot take over their function.

Because the brain cannot compensate for the loss of these non-redundant dead cells, the psychosis and dementia that long-time meth addicts can experience are thought to be irreversible, although possibly treatable, some researchers believe.

Permanent Brain Damage?

Because meth use can cause permanent damage to the regions of the brain that controls pleasure, craving, and self-control, it means that meth addicts are prone to face a life-long battle to maintain abstinence.

Studies have found that some meth addicts have the propensity to relapse even after they have accomplished years of abstinence, due to their brain's inability to control their craving and impulses.

Some Damage Can Be Reversed

The good news for meth addicts is there are many scientific studies that shown that some brain function lost to methamphetamine use can be reversed.

Research at the Brookhaven National Laboratory in Upton, New York found that meth users in early abstinence scored lower on tests for gross motor function, fine motor coordination, memory, and attention. However, after nine months of abstinence, those same addicts improved their scores on gross motor function, memory, and attention.

Another study at the University of California, Davis, used proton magnetic resonance spectroscopy (MRS), to make images of the biochemical markers linked to meth damage to the neurons of the brain. The study found improvement in these biomarkers in the areas of the brain that are involved in selective attention and memory.

In another study led by Nora Volkow, who is now the director of the National Institute on Drug Abuse, used positron emission tomography, or PET scanning, to capture images of the level of dopamine transporters in meth users after varying periods of abstinence.

Volkow's images showed a visible improvement (see image above) of dopamine transporter levels in meth users who were drug-free for at least nine months. The addicts in the study also showed a "trend toward improvement" on cognitive and motor function tests, although the actual scores were not statistically significant.

What Happens When You Quit Meth?

According to various research studies, during the first six to 12 months of meth abstinence:

  • New receptors are produced
  • New transporters are created
  • Neurotransmission is re-established in areas of the brain involved in regulating personality
  • Depression improves
  • Anxiety diminishes
  • Mood swings stabilize
  • Nightmares cease
  • Focus and attention improve
  • Drug-induced rages decrease

What does not change during meth abstinence is the craving for the drug or the ability of the addict to control those cravings. If meth use has caused significant damage to the brain's self-control tract (fasciculus retroflexus and ventral tegmental area), the addict loses the ability to control his impulses.

To deal with these cravings and the resulting compulsive drug use, research shows that the addict must actively participate in an extensive rehabilitation program that includes, among other aspects, a process known as "neurogenesis," in which the addict learns how to "exercise" his self-control so that his brain grows new connections, new dendrites, new synapses, and he slowly regains self-control.

According to multiple studies, recovery from methamphetamine addiction requires a prolonged effort by the addict using a variety of tools including psychiatric medications, cognitive behavioral therapy, discipline, nutritional support, and spiritual support.

No single treatment method is successful for all meth addicts, many researchers agree.

Holley, M. "How Reversible Is Methamphetamine related Brain Damage?" North Dakota Law Review 2006.

Nordahl, TE, et al "Methamphetamine Users in Sustained Abstinence - A Proton Magnetic Resonance Spectroscopy Study." JAMA Psychiatry April 2005

National Institute on Drug Abuse. "What are the long-term effects of methamphetamine abuse?" Methamphetamine Research Report Series September 2013.

Wang GJ, et al "Partial recovery of brain metabolism in methamphetamine abusers after protracted abstinence." American Journal of Psychiatry February 2004

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