Abstinence may restore some functions but not others and there is no doubt that methamphetamine(“meth”) can cause progressive and sometimes profound damage to the brain. The question is whether the damage is reversible once a person stops.
Unfortunately, the answer is rarely simple. While it is possible that some of the damage will begin to reverse when a user stops, there are other types of damage that may be harder to turn back.
Types of Brain Damage
Heavy or long-term methamphetamine use damages the brain both biochemically and physiologically.
Because the brain becomes accustomed to the drug during the addiction, the altered biochemical activity may take time to normalize once the drug is stopped. But, in most cases, it will, and any dysfunction in the biochemistry will eventually right itself.
From a physiological standpoint, reversal may not be so easy. Ultimately, meth causes damage to brain cells, and the ability to reverse this damage is largely dependant on where the injury occurred.
If it is in an area where other brain cells can compensate, then an improvement in symptoms is likely. If, on the other, it occurs where cells are more specialized and have fewer redundancies, then repair can be difficult, if not impossible.
Ultimately, there are three ways in which long-term meth use can damage the brain:
- Causing acute neurotransmitter changes
- Rewiring the brain’s reward system
- Causing brain cell death
Acute Neurotransmitter Changes
Long-term meth exposure directly alters the brain’s cellular transporters and receptors (the systems responsible for delivering messages throughout the brain).
With that being said, the methamphetamine itself does not hurt the nerve cells (neurons) which receive the chemical messages. They remain intact.
As such, the cessation of meth can lead to the normalization of transporter and receptor activity. In some people, this can take a few weeks. In others, it may require up to 18 months to fully reverse the dysfunction.
Rewiring the Brain’s Reward System
Methamphetamine addiction also damages the brain’s so-called pleasure (or reward) center. These are regions of the brain that include the ventral tegmental area, nucleus accumbens, and frontal lobe.
Chronic methamphetamine use causes the increase in the level of cytokines in the brain. This is a class of chemicals that that, among other things, trigger the development of new synapses (connections) between brain cells. The more often that meth is used, the more that the cytokines will produce extra pathways between neurons to accommodate the increased brain activity.
Once these changes have occurred, they are usually permanent.
Brain Cell Death
Heavy meth use is known to cause cell death in parts of the brain associated with self-control, including the frontal lobe, caudate nucleus, and hippocampus. Damage in this area can manifest with psychiatric symptoms seen in later-stage addiction, including dementia, psychosis, and schizophrenia.
Unfortunately, these are the types of cells are not considered redundant. Their function cannot be compensated by other brain cells, and any damage caused to them can be considered permanent.
Likelihood of Reversal
In recent years, scientific studies have aimed to evaluate the effect of long-term abstinence on brain activity in former methamphetamine users.
A 2010 review of studies conducted by the Department of Psychology and Center for Substance Abuse Research at Temple University looked at the restoration of brain function after cessation of different recreational drugs, including cannabis, MDMA, and methamphetamine.
With methamphetamine, former users who had been abstinent for six months scored lower on motor skills, verbal skills, and psychological tasks compared to a matched set of people who had never used. After 12 and 17 months, however, their ability to perform many of the tasks improved with motor and verbal skills equal to that of the non-users.
The one area where they lagged behind was with psychological tasks, where former users were more likely to exhibit depression, apathy, or aggression.
What to Expect After Quitting
The ability to restore normal brain function after quitting meth can vary from person to person. It is largely related to how long you used the drug, how regularly you used it, and how much you used.
With that being said, a former user can expect an improvement in the following functions and/or symptoms within six to 12 months of stopping:
- Restoration of neurotransmitter activity in parts of the brain regulating personality
- Normalization of brain receptors and transporters
- Improvement in depression and anxiety
- Stabilization of mood swings
- Improvement in focus and attention
- Fewer nightmares
- Reduction in jitteriness and emotional rages
The one thing that may not readily improve is the drug cravings a person can experience even after years of abstinence. It is a problem commonly caused by damage to the brain’s self-control tract (namely, the fasciculus retroflexus and ventral tegmental area).
To deal with these cravings, a former user should commit to an extensive rehabilitation program and the process of neurogenesis wherein a person learns to exercise self-control in order to stimulate activity in the fasciculus retroflexus and ventral tegmental area.
Gould, T. “AddictionandCognition.” Addict Sci Clin Pract. 2010; 5(2):4-14. PMCID: PMC3120118.
National Institute on Drug Abuse. “What are the long-term effects of methamphetamine abuse?” Bethesda, Maryland; updated September 2013.