Methamphetamine: History, Pathophysiology, Adverse Health Effects, Current Trends, and Hazards Associated with the Clandestine Manufacture of Methamphetamine

eveloped as an amphetamine derivative, methamphetamine quickly ecame a popular medication during the 1940s and 1950s, prescribed for variety of indications. Extensive diversion of methamphetamine during he 1960s and an increasing awareness of the adverse health effects ssociated with methamphetamine led to the withdrawal of most of the ndications for licit methamphetamine use and declines in legal producion of the drug. However, the illicit manufacture of methamphetamine ncreased to meet the demand for methamphetamine, and methamphetmine abuse has increased with variable geographic penetrance over the ast 30 years. Methamphetamine is an indirect sympathomimetic agent that is distinuished from amphetamine by a more rapid distribution into the central ervous system (CNS), resulting in the rapid onset of euphoria that is the esired effect for those abusing the drug. Increases in monoamine eurotransmission are responsible for the desired effects—wakefulness, nergy, sense of well-being, and euphoria—as well as the excess ympathetic tone that mediates many its adverse health effects. Methamphetamine is associated with adverse effects to every organ ystem. Although the most significant morbidity and mortality occur ecause of cardiovascular effects, such as myocardial infarction and ypertensive crisis, no organ system remains unscathed by methamphet-