Meth Withdrawal Timeline & Symptoms

Acute symptoms of meth withdrawal occur in the first week of abstinence and include dysphoria (a general uneasiness or dissatisfaction), anhedonia (inability to experience pleasure), fatigue, hypersomnia (excessive sleeping), increased appetite, and intense cravings for meth.

Symptoms of psychosis may also be present, but they generally resolve within a week. Depressive symptoms during the acute phase include an inability to feel pleasure, general dissatisfaction and irritability. Most of these symptoms reach their peak within the first few days and gradually subside, continuing at a low intensity during the subacute phase.

Sleep disturbances, such as difficulty sleeping and unpleasant dreams, do not subside during the acute phase and usually continue through the subacute phase. Drug cravings also tend to persist for more than five weeks. The intensity of drug cravings often predicts relapse and is usually related to the severity of depression symptoms.

Subacute symptoms of meth withdrawal occur in the two weeks following the acute phase and include depression, insomnia, increased appetite, psychomotor agitation (purposeless, repetitive motions like pacing or toe-tapping), psychomotor retardation (pronounced reductions in activity or emotion), vivid dreams or nightmares, and cravings.

Meth withdrawal symptoms generally peak during the first week and then gradually recede over the next two to three weeks. However, residual withdrawal symptoms may persist for several months after abstinence begins. These symptoms include fatigue, sleep disturbances, depression, anxiety, other mood disturbances and drug cravings.

Symptoms that persist beyond the initial withdrawal period make up a condition called post-acute withdrawal syndrome. Methamphetamine use can also cause psychotic symptoms involving delusions, hallucinations and paranoia. Psychotic episodes can occur even months after meth use has ended, especially in individuals who have experienced drug-induced psychosis before.

The first 24 hours after stopping use will be characterized by exhaustion, fatigue, lack of energy and depression. If people are able to sleep at all, it will be of poor quality and unsatisfying. Mental states are often foggy and depression is common. Although not everyone will experience cravings, they may be present. For many people, symptom severity peaks around 24 hours after quitting.

The “crash” describes the acute phase of withdrawal, and typically lasts for up to seven days, although some cases may have acute symptoms that persist for up to 10 days. This phase is characterized by increased appetite, long periods of poor-quality sleep, low energy, intense cravings, depression, anhedonia, restlessness, and insomnia. Other symptoms may include anxiety, irritability, vivid dreams or nightmares, and poor concentration.

Following the crash, subacute symptoms may persist for up to five weeks, although most people report that their symptoms resolve during the two weeks following acute withdrawal. Increased appetite and sleep are the most significant symptoms of subacute meth withdrawal, and acute symptoms like depression, dysphoria, psychomotor agitation or retardation gradually subside during this phase.

Recently, a great deal of research has been published showing that exercise can provide some relief from meth withdrawal symptoms.

Unfortunately, many people in recovery from meth use experience persistent symptoms that are considered post-acute withdrawal syndrome (PAWS). PAWS is a frustrating component of recovery for many people. PAWS symptoms can be physical and psychological and tend to be milder versions of acute and subacute symptoms. In extreme cases, PAWS may be experienced for months, even years, after quitting. It is important to understand that the presence of PAWS is normal, and experiencing symptoms and cravings for months after quitting does not mean that recovery has failed. These uncomfortable symptoms gradually subside over time.

Meth treatment does not have any shortcuts to overcoming withdrawal symptoms. No medications have been validated as effective therapeutic agents. It can be difficult to resist cravings in the first days and weeks of recovery, so professional treatment for meth withdrawal is often the most effective way to overcome the early challenges associated with addiction and maximize long-term success in recovery.

People who are facing a meth use disorder should seek an evaluation with a rehab professional who is experienced in treating meth use. In many cases, medically supervised detox will be appropriate. Medical detox provides 24/7 care and supervision over the first several days of recovery, after which clients can transition into a residential or outpatient rehab program.

Meth addiction has a powerful psychological component, and residential rehab addresses this by providing individual and group therapy sessions that are geared towards clarifying why someone used meth and why sobriety is important, along with identifying short- and long-term goals for recovery. The most effective rehab programs include traditional therapy as well as newer methods like motivational interviewing and cognitive behavioral therapy.

Following residential care, outpatient and aftercare programs aim to provide people in recovery with the tools and techniques they need to successfully reintegrate into their new, sober lives. In most cases, recovery is a life-long pursuit that requires regular maintenance. Being proactive about participating in healthy new activities and developing a strong support network are often crucial components of long-term success.