(856) 788-6914

Addiction Treatment

Meth Withdrawal: Symptoms, Timeline, and Getting Help

Written and reviewed by South Jersey Recovery Program · Updated

A man speaking in a support group in a brick-walled room

Methamphetamine withdrawal is what happens when someone who has been using meth regularly stops. The crash comes fast. People sleep for long stretches, wake up hungry, and feel flat, anxious, and low. Cravings show up early and do not leave quickly.

For most people, meth withdrawal is not physically dangerous the way alcohol or benzodiazepine withdrawal can be. The danger is in the mood. The depression that comes with it can bring on thoughts of suicide, and the craving is strongest in the first week or two, when a single use would make the misery stop. Both are reasons to have support, even when no one needs a hospital bed. If you also drink heavily every day or take benzodiazepines regularly, get a medical assessment before you stop. Withdrawal from those can be dangerous.

If someone is in immediate danger, call 911. If you or someone near you is thinking about suicide, call or text 988 now.

At a glance

  • NIDA says symptoms start quickly, peak two to three days after the last use, and may last about a week.
  • The main risks are suicidal thinking, psychosis, and a return to use with a supply that may contain fentanyl.
  • No medication is FDA-approved for methamphetamine use disorder. Behavioral treatment does most of the work.

What does meth withdrawal feel like?

Li and Shoptaw’s 2023 review in Addiction traces stimulant withdrawal to reduced dopamine and serotonin activity after sustained use. The symptoms they list for the first phase are depression, anhedonia (losing the ability to feel pleasure), anxiety, irritability, physical discomfort such as headaches and body aches, fatigue, prolonged sleep, craving, and poor concentration. The National Institute on Drug Abuse (NIDA) gives a similar list, and adds that people who use meth repeatedly can go through withdrawal even without a stimulant use disorder.

The ASAM/AAAP clinical practice guideline on stimulant use disorder (2024) describes 12 to 24 hours of sleepiness and irritability for many patients at the start, and notes that the heavy sleep of early withdrawal is often followed by sleep problems that can persist.

Psychosis is a risk of meth use itself, and it can carry into the first days off the drug. A 2014 review in CNS Drugs by Glasner-Edwards and Mooney estimated that up to about 40% of people who use methamphetamine experience psychotic symptoms. For most, the symptoms pass: in the Zorick study described below, psychotic symptoms were common when people stopped and had largely cleared within a week. In a subset of people psychosis can recur and persist, and it can be hard to tell apart from a primary psychotic disorder such as schizophrenia. Hallucinations, paranoia that will not settle, or someone who seems out of touch with reality needs emergency help right away.

How long does meth withdrawal last?

McGregor and colleagues (Addiction, 2005) tracked 21 inpatients at a treatment center in Thailand through the first three weeks of abstinence. Withdrawal severity was highest within 24 hours of the last use and fell to near the level of a comparison group without methamphetamine dependence by the end of the first week. That week brought increased sleeping and eating and depression-related symptoms, with anxiety and craving to a lesser degree. The authors described an acute phase of 7 to 10 days and a subacute phase lasting at least another two weeks.

Zorick and colleagues (Addiction, 2010) studied 56 people who stayed abstinent on a research ward for up to five weeks. Depressive and psychotic symptoms largely resolved within the first week. Craving was slower. It did not drop significantly until the second week, then continued at a lower level through the fifth.

Put together with NIDA, Li and Shoptaw, and the 2024 guideline, the phases look roughly like this:

PhaseRoughly whenWhat tends to happen
Crash and acute withdrawalFirst 7 to 10 daysHeavy sleep, hunger, exhaustion, depression, anxiety, irritability. Symptoms peak in the first few days.
SubacuteWeeks 2 to 4Most symptoms ease. Cravings continue at a lower level and can spike around the people, places, and things tied to use.
Post-acuteWeeks to monthsLow mood, anxiety, insomnia, paranoia, and cravings can linger.

Symptoms that are getting worse after the first couple of weeks are a reason to be evaluated.

Is meth withdrawal dangerous?

Physically, usually not. Alcohol withdrawal can progress to seizures and delirium tremens; MedlinePlus, the National Library of Medicine’s consumer health site, calls it a condition that may quickly become life-threatening. The FDA warns that stopping benzodiazepines abruptly or tapering too fast can cause withdrawal reactions, including seizures, which can be life-threatening. Li and Shoptaw describe methamphetamine withdrawal as largely non-life-threatening, with the acute symptoms resolving in four to seven days.

That changes when meth is not the only drug. Alcohol and benzodiazepines such as alprazolam (Xanax), clonazepam (Klonopin), and diazepam (Valium) can cause seizures when they are stopped suddenly. If you use either every day along with meth, stopping needs medical guidance, not a wait-and-see approach at home.

Even with meth alone, withdrawal is not something to go through by yourself. The ASAM/AAAP guideline lists the features that typically call for emergency treatment: high fever, seizure, chest pain, psychosis, and suicidality. It warns that suicidal thinking may increase as intoxication wears off and acute withdrawal begins, and recommends screening everyone in stimulant withdrawal for suicide risk. In an analysis of 526 methamphetamine-dependent adults from the Methamphetamine Treatment Project, suicide attempts were linked to injection use, higher depression scores, and a significant psychiatric history.

The other danger is relapse. Li and Shoptaw note that for many people a single use instantly erases the misery of withdrawal.

When to get emergency help

Call 911 or go to the nearest emergency department for:

  • Thoughts of suicide with a plan or intent, or any attempt. For suicidal thoughts or a mental health crisis without immediate danger, call or text 988.
  • Hallucinations, severe paranoia, or behavior that puts the person or others at risk
  • Chest pain, a very high temperature, or a seizure
  • Signs of overdose, such as slow or stopped breathing or a person who cannot be woken

If an overdose is possible, give naloxone (Narcan) and call 911. If the person does not respond, or responds and then stops breathing normally again, give another dose every 2 to 3 minutes, using a new device each time, until they respond or emergency help arrives, as the product label directs. Lay the person on their side and stay with them. Naloxone reverses opioids only. It does not reverse sedation from xylazine or medetomidine, which have been found in the illegal fentanyl supply. Give it anyway, because fentanyl may also be present.

For help finding treatment, SAMHSA’s National Helpline is free, confidential, and open 24 hours a day at 1-800-662-4357.

Fentanyl and the risk of going back

According to NIDA, methamphetamine is the second most commonly found drug in people who die of overdose, after synthetic opioids, and opioids may be added as a hidden ingredient in illicit meth. CDC’s final death-certificate data show that the overdose death rate involving psychostimulants with abuse potential, the category that includes methamphetamine, fell from 10.6 per 100,000 people in 2023 to 8.5 in 2024.

The ASAM/AAAP guideline says anyone getting stimulants from nonmedical sources should have naloxone on hand and check every new batch with fentanyl test strips where state law permits. Our guide to the signs of fentanyl addiction covers what to watch for.

Is there a medication for meth withdrawal or meth addiction?

No. According to NIDA, there is no FDA-approved medication for methamphetamine use disorder or any other stimulant use disorder. Withdrawal has no proven drug either: the 2024 guideline notes that a 2009 Cochrane review found no medication effective for general amphetamine withdrawal. Clinicians may treat specific symptoms such as insomnia, agitation, or depression, and the guideline urges caution with sedative sleep medications.

ADAPT-2, a trial published in the New England Journal of Medicine in 2021, tested injectable extended-release naltrexone plus oral extended-release bupropion in 403 adults with moderate or severe methamphetamine use disorder. Over 12 weeks, the weighted response rate was 13.6% with the medications and 2.5% with placebo. The authors called that response low. The combination is not FDA-approved for this use, and the 2024 guideline lists it as an option clinicians can consider off-label. That conversation belongs with a prescriber who knows your full history.

What treatment actually helps?

NIDA calls contingency management, which gives small tangible rewards for staying off the drug, the best-studied behavioral treatment for methamphetamine use disorder, and the ASAM/AAAP guideline calls it the current standard of care. South Jersey Recovery Program does not offer contingency management. If it matters to you, ask about it when you compare programs.

The guideline names cognitive behavioral therapy (CBT) as one of three approaches with the most supportive evidence, recommended alongside contingency management, and gives it a strong recommendation. Li and Shoptaw describe how CBT handles craving: learning to spot the chain of trigger, thought, craving, and use, and to interrupt it before a trigger becomes a thought or a thought becomes a craving. NIDA also lists motivational interviewing and group support among evidence-based approaches.

Depression and anxiety are common alongside meth use: in the Methamphetamine Treatment Project, which enrolled 1,016 people in outpatient treatment, participants reported high levels of depression and anxiety. The 2014 CNS Drugs review calls treating those conditions an important part of preventing relapse, because the symptoms often set it off. That is the job of dual diagnosis care.

How South Jersey Recovery Program can help

We are an outpatient program in Berlin, NJ. We do not provide detox, inpatient, or residential care. If you need medically supervised detox or residential care, we will tell you and help you find it. When there are no emergency signs and no daily drinking or benzodiazepine use that needs its own medical care, the ASAM/AAAP guideline says stimulant withdrawal can be treated in a lower-acuity setting. What people need then is structure in the weeks when mood is lowest and cravings are strongest, and that is where outpatient care fits.

  • Partial care runs Monday through Friday, 9:30 a.m. to 3:30 p.m., for people who need a full day of treatment and still go home at night.
  • Our intensive outpatient program runs 9:30 a.m. to noon, five days a week to start and three as you step down, so people can keep working where they can.
  • Standard outpatient therapy is one or two sessions a week.

Treatment includes cognitive behavioral therapy, individual and group therapy, and care for co-occurring depression and anxiety. We are licensed by the New Jersey Department of Health (license #2001009). Our substance use treatment page explains how we match care to the person.

Call (856) 788-6914 or contact us online. The consultation is confidential.

Sources

This article is for general education and is not a substitute for individualized medical advice. If you or someone else is in immediate danger, call 911. For a mental health crisis, call or text 988. For free, confidential treatment referrals, call the SAMHSA National Helpline at 1-800-662-4357.

From the blog

Keep reading

Addiction Treatment

Why Benzodiazepines Are So Addictive, and Why Stopping Takes a Plan

Xanax, Klonopin, Valium, and Ativan can cause dependence within weeks, even as prescribed. How that happens, why stopping suddenly is dangerous, and what helps.

Addiction Treatment

How to Find the Best Addiction Treatment Program

How to choose an addiction treatment program: match the level of care, verify the license and network status, and ask the questions brochures avoid.

Addiction Treatment

Does Medication-Assisted Treatment Work?

MAT combines FDA-approved medication with counseling to reduce cravings and relapse. Here is the evidence on how well it works and who it suits.

Recovery is waiting for you

Talk with our admissions team. Calls are confidential, and we will check your insurance benefits and call you back with what we find.

Call (856) 788-6914 Verify Your Insurance
Call now Verify insurance