View source for Harm Reduction: Meth harm reduction: The complete guide for tweakers and meth-heads (III): The final round - The definitive smoke tutorials

== Interaction with drugs ==
=== Interaction with prescription drugs: ===

<strong>Monoamine oxidase inhibitors (MAOIs):</strong> Use of methamphetamine with MAOIs can result in a potentially life-threatening condition called serotonin syndrome. Symptoms may include agitation, rapid heartbeat, high blood pressure, tremors, and hyperthermia. This combination should be strictly avoided.

<strong>Tricyclic antidepressants (TCAs):</strong>  Methamphetamine's stimulant effects may be potentiated when used concomitantly with TCAs, leading to an increased risk of cardiovascular effects such as hypertension, tachycardia, and arrhythmias. Close monitoring of blood pressure and heart rate is recommended.

<strong>Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs):</strong> Combining methamphetamine with SSRIs or SNRIs may further enhance the serotonergic effects, increasing the risk of serotonin syndrome. Caution should be exercised, and close monitoring for symptoms of serotonin syndrome is advised. This risk seems much lower than MAOIs or TCAs and most of these drugs can be used in combination with safety in most cases.

<strong>Benzodiazepines:</strong>  Benzodiazepines are central nervous system depressants, while methamphetamine is a stimulant. Combining the two can mask the effects of each drug, potentially leading to increased risk of overdose or misuse. Caution should be exercised when using both drugs concurrently, and close monitoring for adverse effects is advised.

<strong>Pump Protons Inhibitors:</strong>  A class of medications used to treat a wide variety of pathologies related to the stomach's acid production (Omeprazol, Lansoprazol, Rabeprazol...)lowers the level of toxicity for methamphetamine.

== Recreational/scheduled drugs ==
=== Alcohol ===
<strong>Impaired metabolism and increased stimulation:</strong> Alcohol consumption may inhibit the metabolism of methamphetamine, leading to increased absorption and distribution of methamphetamine in the body. This can result in an amplified stimulating effect of methamphetamine on the brain and heart

<strong>Increased cardiac strain:</strong> Both methamphetamine and alcohol can independently affect the cardiovascular system. Combining these substances can lead to increased cardiac work, elevated heart rate, decreased systolic blood pressure, and increased myocardial oxygen consumption. This combination can put additional strain on the heart, increasing the risk of adverse cardiovascular events.

<strong>Diminished subjective effects of alcohol:</strong> The concurrent use of methamphetamine and alcohol can diminish the subjective effects of alcohol. This can lead individuals to underestimate the level of alcohol intoxication, potentially resulting in higher alcohol consumption levels and an increased risk of alcohol toxicity. This combination may also increase the likelihood of engaging in risky behaviors associated with alcohol use.

<strong>Impaired judgment and decision-making:</strong> Methamphetamine is a stimulant that can increase alertness and decrease fatigue. When combined with alcohol, which is a depressant, the stimulant effects of methamphetamine may mask the sedative effects of alcohol.

<strong>Increased risk of overdose and toxicity:</strong> Combining methamphetamine and alcohol can lead to increased tolerance to the effects of both substances. This can result in individuals consuming higher amounts of methamphetamine and alcohol to achieve the desired effects, increasing the risk of overdose and toxicity for each substance.

<strong>Impaired cognitive and motor function:</strong> The combination of methamphetamine and alcohol can impair cognitive function, attention, and motor coordination.

=== Opioids ===
<strong>Increased stimulation and behavioral effects:</strong> When methamphetamine is taken with an opioid, it can lead to heightened stimulation of behavior compared to either drug used alone. This combination may result in increased agitation, restlessness, and impulsivity, potentially leading to risky or dangerous behaviors.

<strong>Enhanced analgesic effects:</strong> Methamphetamine may enhance the analgesic (pain-relieving) effects of certain opioids. This can lead individuals to take higher doses of opioids, potentially increasing the risk of opioid overdose.

<strong>Altered metabolism with methadone:</strong> Methadone is commonly used as a maintenance treatment for opioid dependence. When methamphetamine is combined with methadone, it may affect the metabolism of methamphetamine, leading to altered drug concentrations and potential changes in efficacy or side effects.

<strong>Increased risk of fatal overdose:</strong> Combining methamphetamine with opioids, especially when used concurrently with injected heroin, significantly increases the risk of a fatal overdose. Methamphetamine can mask the sedative effects of opioids, leading individuals to underestimate the respiratory depressant effects of the opioids and increasing the likelihood of overdose.

=== Cocaine ===
Cocaine may have an additive stimulant effect , with increased risk of adverse/serious adverse effects. Metabolism of methamphetamine may be decreased also

=== Psychedelic drugs ===
Increased hallucinatory experiences have been communicated , particularly when taken with ketamine 

=== GHB ===
There are some data suggesting that the combination GHB + meth may be cardiotoxic. It also may increase the risk of seizures from GHB 

=== Cannabis ===
There is an increased risk of paranoid symptoms, particularly in people sensitive to this effect

=== MDMA and amphetamine ===
Severity of adverse effects can be increased when meth is combined with other amphetamine-type stimulants , increasing risk of acute amphetamine toxicity .
There is an increased risk of serotonin syndrome from combined use with MDMA, although this seems less likely

== Meth mouth ==
The following guidelines can help reduce the harm associated with methamphetamine use and promote oral health:
=== Maintain good oral hygiene ===
• Brush teeth thoroughly at least twice a day using a soft-bristled toothbrush and fluoride toothpaste. <br>
• Floss daily to remove plaque and food particles from between the teeth and along the gumline. <br>
• Rinse with an antimicrobial mouthwash to reduce bacteria and plaque buildup. <br>
=== Stay hydrated ===
• Drink plenty of water to combat dry mouth, which is a common side effect of methamphetamine use. <br>
• Dry mouth can contribute to dental decay and other oral health issues. <br>
=== Avoid sugary and acidic foods and drinks ===
• Limit consumption of sugary foods and beverages as they can increase the risk of tooth decay. <br>
• Acidic foods and drinks can erode tooth enamel. Instead, opt for a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. <br>
=== Limit smoking and alcohol consumption ===
• Smoking and excessive alcohol consumption can exacerbate oral health problems. <br>
• If possible, reduce or eliminate these habits to minimize the risk of dental complications. <br>