Methamphetamine abusers are the hardest to treat of all drug addicts, tyically in extreme denial of their problem and resistant to any form of intervention support.

"You have a better chance to do well after many types of cancer than you have of recovering from methamphetamine dependence."
~ Dr. Martin Paulus [Professor of Psychiatry, University of California]

While evidence of his destructive behaviour is often overwhelming to any onlooker, unless the abuser himself faces up to his addiction or the realisation that he has a major problem then he may have to hit rock-bottom before choosing to commence the process of recovery. If he continues to remain steadfast in his denial, however, his uncontrollable addiction to meth will, eventually, destroy him.

"The average life expectancy of hardcore meth addicts, according to stastistics, is five to seven years."
~ Sheriff Burgess [Crossville Justice Centre, Tennessee]

If the abuser's helplessness forces him to awaken to his situation, he can seek medical help comprising CBT (cognitive behavioural therapy) or MET (motivational enhancement therapy) – programs which are designed to confront negative thinking, modify negative beliefs and attitudes to situations and increase skills in coping with stressors, thereby improving psychological and physical wellbeing – or attend a 12-Step recovery and support program such as  Crystal Meth Anonymous  (CMA), which has a 100-strong network of regular, informal meetings across North America.

Although relapse rates are high, CMA boasts one of the greatest success rates of any organisation specialising in the rehabilitation of meth abusers. It embraces a spiritual approach which inspires members to admit that they are powerless over their meth use, thereby encouraging them to place their faith in a higher power and, in due course, empower themselves to abstain from using. CMA isn't suitable for all, however:

• The need for the addict to place his faith in a higher power can be alienating and disconcerting to those with a fractured belief system or in conflict with such a concept;

• Others can find their craving triggered by others graphically recounting their meth using experiences;

• Some find the CMA doctrine – an addict is an addict for life – unpalatable, potentially harmful and guilt-invoking.

The path to recovery varies from person to person. The severe effects of withdrawal – suicidal depression, irritability, fearfulness, loss of energy, insomnia, palpitations, sweating, hyperventilation – can last several weeks, but the wall (craving period) continues for around six-eight months for casual users and up to two-three years for hardened abusers. Because there is no methadone-like bridge to sobriety for crystal addicts, the relapse rate is very high; 94% according to a recent University of California study. A full return to sobriety can take up to several years.

Users in recovery can find it almost impossible to find employment unless they cover up their addiction. "Otherwise, most end up working at Burger King, even if they have an education," says Clancy Miller, co-founder of Dual Diagnosis Anonymous, which provides support, counseling and meetings for drug addicts with mental illnesses. "We have a psychologist with a Ph.D. in recovery, and he finds it hard to get a job." Once fully recovered, former users can achieve great success. Rufus Wainwright (above) overcame addiction to crystal meth to become one of the most acclaimed singer/songwriters of our time.

“It's so cunning because it's such a fun drug at first. You lose weight and look great for a while, but I don't care if it takes six months or five years, it will creep up on you."
Fergie [Lead singer, The Black Eyed Peas]

The National Institute on Drug Abuse (NIDA) is experimenting with several compounds used in other areas of medicine to treat meth addiction, and is at various stages of clinical trials.

These include:

• Calcium-channel blockers, which treat high blood pressure and may inhibit the excessive release of neurotransmitters, thereby reducing the "reward" of using methamphetamine;

• The anti-nausea drug Zofran, which has been shown to work against relapse in alcoholics;

• Tyrosine, an amino acid that's a precursor of dopamine and may increase production of the neurotransmitter;

• Wellbutrin and other antidepressant medications, studied for their potential to reduce relapse based on their ability to boost levels of neurotransmitters associated with pleasure.

Dr. Thomas F. Newton, a psychiatrist at the University of California who led the four-week study into Wellbutrin, announced in November 2005 that the 20 patients involved in the test reported a lesser high from meth after treatment, as well as a less-intense craving after watching a video of actors stimulating using meth.

NIDA is also developing an antidote for use in overdose situations, which would literally drain meth out of body tissue, thereby decreasing concentrations of the drug in the body and reducing the duration of the high and some of the adverse effects. Such a treatment is still years away from being tested on people.

Other treatment developments:

• Scientists at The Scripps Research Institute have found evidence in laboratory studies that the immune system may be able to recognise methamphetamine and boost tolerance to the drug through an unusual vaccine-like mechanism, a finding that could lead to new treatments for those addicted to the drug;

• Columbia University's HIV Clinical Research Program trialed the drug Provigil (modafinil) – used to treat excessive daytime sleepiness – over three months, combined with four months of therapy, on HIV+ gay male volunteers who want to stop using meth;

• The Integrated Substance Abuse Program at University of California sponsored a multi-site, double-blind, placebo-controlled study on the Prometa treatment protocol for meth dependence, which developer Hythiam Inc. claims eliminates all cravings for the drug. Initial results announced May 16 showed no adverse events and reported that more than 80% of study participants experienced a significant clinical benefit.

Research also shows that taking supplements of the two omega-3 fatty acids found in fish oil – eicosapentaenoic acid (EPA) and docoasohexaenoic acid (DHA) – increase dopamine supply, although the amounts required to have an effect are more than double the US National Institute of Health's recommendation fopr omega-3 at less than 2g a day.