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The methamphetamine problem: Commentary on … Psychiatric morbidity and socio-occupational dysfunction in residents of a drug rehabilitation centre

  • Niall Galbraith (a1)

This paper introduces the reader to the characteristics of methamphetamine. Explored within are the drug's effects on those who consume it as well as the history and prevalence of its use. The highly addictive nature of methamphetamine is compounded by its affordability and the ease with which it is produced, with North America and East Asia having become established as heartlands for both consumption and manufacture. The paper discusses recent cultural depictions of the drug and also the role that mental health professionals may take in designing and delivering interventions to treat methamphetamine addiction.

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This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Correspondence to Niall Galbraith (
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See original paper, pp. 213–217, this issue.

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The methamphetamine problem: Commentary on … Psychiatric morbidity and socio-occupational dysfunction in residents of a drug rehabilitation centre

  • Niall Galbraith (a1)
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Why isn't UK Breaking Bad?

Wiktor L Kulik, ST5 General Adult Psychiatry, Barts and The London Training Scheme, East London NHS Foundation Trust
14 October 2015

I recently finally got to see the pilot of the ‘Breaking Bad’ series. This coincided with two very interesting articles by Ho et al and Niall Galbraith in the October issue of BJPsych Bulletin (1) on methamphetamine use. And this made me reflect on my 1.5 years of experience in NHS addictions and a few more of working in mental health – methamphetamine use is rarely seen. I vividly remember one highly disinhibited patient and a few MSM (men who have sex with men) describing occasional use in a context of chemsex, but not much more than this.

The article describes that in the USA 4.7% of respondents to a national survey admit to lifetime use of methamphetamine (1). So why is it not as popular in the UK? Home office estimates (2012) indicate around 17000 users, whereas cannabis is estimated at around 2 million users in the UK. The author describes an already congested stimulant market in Europe and this obviously is an important factor. This market is served well by the availability of cocaine, MDMA, amphetamine, mephedrone and until recently ‘legal high’ stimulants. Gary Sutton of the charity Release is cited in a BBC article (2) saying that the lack of open spaces to produce the drug is a contributing factor. But surely if the demand was there then the same black market that supplies users of other substances would find a way. Some of the difference in popularity can be explained by a high price, but again this is mainly a result of small supply rather than excessive demand.

This also in part might be to do with the drug's reputation – that crystal meth has long lasting effects and unpleasant side effects, perhaps a success of the US ‘Faces of Meth’ campaign. But what I also found in discussion with patients is 'fashion'. I understood it when I realised that it is being used, with the users not always aware. Patients described taking crack or 'super crack' but tested negative for cocaine. A test for methamphetamine metabolites was however positive. An interesting case of creative branding by the black market, but people in the UK still drive Vauxhalls and often have separate taps for hot and cold water, so maybe we shouldn’t be surprised after all.


1. Galbraith N, Commentary on…Psychiatric morbidity and socio-occupational dysfunction in residents of a drug rehabilitation centre. BJPsych Bulletin (2015), 39, 218-220


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