I am currently being told they’re completely different, even though they’re both amphetamines with a similar side effect profile and potential for abuse. So whats the difference?
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Lots of chemicals have relationships like this.
A glass of 10% ethanol – 2 carbons and a hydroxide (OH) – will at best make you slightly intoxicated, that’s a strong beer or weak wine.
Cut off one of those carbons and you have methanol, now that glass will render you hospitalized and permanently blind at best, more likely dead.
Despite being structurally similar, there are plenty of differences between an Adderall pill and a typical meth dose. First, you take more meth, typically from 100mg (twice my daily Ritalin intake) up to 500mg for impure stuff/high tolerance.
Second, an Adderall pill isn’t pure, not even close. They’re mostly fillers, stuff to pad it out and slow the absorption so you don’t get so much of a rush and short peak, it’s absorbed over maybe half an hour into the bloodstream then starts working. But you don’t have the delay with meth, you either snort it where its rapidly absorbed almost right away, smoke it where it’s absorbed into the lungs then pumped basically right to your brain, or inject it directly to the blood.
There’s no build up, just an instant rush.
Much like the difference between smoking a joint and eating brownies, one takes way longer.
I’m sure if you had access to pure, crystalline versions of the amphetamines in Adderall, and you smoked/snorted it, you’d be pretty well messed up but medicine is all about taking powerful chemicals and packaging them in ways that allow your body to use them.
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From a pharmacological point of view, there are not big differences between pure methamphetamine (meth) and pure amphetamine (Adderall). Both are amphetamines that are nearly identical structurally and mechanistically. But there are big differences between methamphetamine and amphetamine that play out in the real world.
Compared to amphetamine, methamphetamine is easy to make with normal household items that can be bought at normal stores. In that way, it is a good candidate to be a street drug. People can make it easily and sell it without government regulation and detection. With this come a set of problems that amphetamine/Adderall largely don’t have:
* The synthesis of methamphetamine by people selling it on the street usually leaves toxic impurities because its made recklessly by people who don’t really know (or care to know) the chemistry behind what they’re doing
* Street-made methamphetamine does not come with a dosage label. If you are addicted to meth, you have no idea how much methamphetamine you’re actually ingesting.
* As is the case with most people who have addiction and substance abuse issues, most people who turn to street methamphetamine are unlikely to have good social support from family and friends.
This set of problems is far from ideal. Amphetamines generally reduce one’s ability to eat enough, drink enough and sleep enough. When somebody doesn’t have family or friends to help make sure he’s taking care of himself and he’s taking un-managed doses of an amphetamine with toxic impurities in it, there is a good chance he’ll end up “tweaking out” in the way meth addicts are famous for from:
* Sleep deprivation
* Lack of food
* Dehydration
* Impurity toxicity
* An overdose
* Any combination of the above factors
It is rarely just the methamphetamine itself. If amphetamine was easier for non-chemists to manufacture than methamphetamine, there is a decent chance that amphetamine would be a street drug carrying the same stigmas as methamphetamine. Both drugs are addictive and do essentially the same thing, but one is managed by the healthcare system and the other is managed by black markets.
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Meth has a much higher affinity for dopamine receptors and makes the synapses release alot more than amphetamine does. It think it was 3-4x stronger in affinity and action. Amphetamines just kindly tells you synapses to release some dopamine, meth yells and screams at them to release it all at once.
Psychiatrist here – lots of very good information here, couple of other things in addition:
1) dose: most people using methamphetamine use much higher doses (100-1000mg/day) than dexamphetamine (typically 10-60mg/day, rarely up to 100mg/day). I’ve had some patients who’ve used low doses of methamphetamine and report it’s quite similar to being on a prescription psychostimulant.
2) mode of delivery: some modes cause a rush of the substance into the blood causing higher peak levels in the blood which create different and greater effects. Many prescription psychostimulants get absorbed slowly.
I strongly emphasise you must not take more dexamphetamine than prescribed or in any way other than tablet form. It can be very dangerous and if used in a certain way can easily cause serious health problems. If used as prescribed, dexamphetamine is generally very safe.
I’ve had to counsel a lot of patients about the difference between psychostimulants and illicit amphetamines. The reality is that for most illicit drugs (hallucinogens being the exception for now) there is a medication with a similar structure. Part of the reason for this is that many substances started off having medical uses and then people realised the recreational effects. Examples are:
Heroin / fentanyl – both very effective pain medications, quite safe when used appropriately and not dissimilar to opioids available from the pharmacy.
Cocaine – has some use as a topical anesthetic and structurally similar to a lot of local anaesthetics.
Marijuana – started to be used medically, some other medications (eg paracetamol) are suspected to work on the endocannabinoid system
Special K (ketamine) – used regularly as an anaesthetic and anti-depressant
Valium / xannies – if prescribed on rare occasions can be effective anti-anxiety medicines
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