Ice is crystal methamphetamine, the same molecule as the powder sold as speed, in a purer form that can be smoked. That difference matters more than most pages on this subject admit.
This page covers what ice does to the mind, the heart and the teeth, what stopping feels like, and what treatment can and cannot offer. Where a widely repeated harm is thinner in the evidence than the internet suggests, we say so.
Australian treatment and services sit on our ice addiction help for Australia page, and yaba, the methamphetamine and caffeine tablet that dominates mainland Southeast Asia, has its own.
If you or someone else is in danger now, call your local emergency number. In the UK that is 999, in Australia 000 and in the United States 911. For urgent help that is not an emergency, UK readers can call NHS 111 or Samaritans on 116 123, and Australian readers can call Lifeline on 13 11 14.
What ice is, and why the crystal form changes things
The European Union Drugs Agency drug profile gives the clearest statement of the chemistry: “Illicit products mostly consist of powders, but the pure crystalline hydrochloride is known as ‘ice’.” The Alcohol and Drug Foundation calls it “stronger and has more harmful side effects than the powder form of methamphetamine known as speed”, and lists the names it goes by: ice, crystal meth, shabu, glass, shard, Tina and, in New Zealand, P.
The route is where the risk sits. “Unlike the sulfate salt of amphetamine, methamphetamine hydrochloride, particularly the crystalline form (ice), is sufficiently volatile to be smoked,” the EUDA profile says, and “when methamphetamine is smoked it reaches the brain much more quickly”. It adds that “drugs which are smokable (e.g. methamphetamine, crack cocaine) are much more addictive and more likely to cause problems when consumed in this way than when taken orally”. Our reading is that this is what matters most: the crystal form is not a different drug, it is the same drug delivered in a way that makes dependence considerably more likely.
Where the supply comes from, and how much is being used
In May 2025 the UN Office on Drugs and Crime reported a record 236 tonnes of methamphetamine seized across East and Southeast Asia, a 24 per cent rise on 2023, with production concentrated in Shan State, Myanmar. UNODC added the caveat itself: “The 236 tons represent only the amount seized; much more methamphetamine is actually reaching the market.”
Australia is where the word “ice” is standard, and where the numbers get misused. The National Drug Strategy Household Survey found around 200,000 people, or 1.0 per cent of the population, had used methamphetamine or amphetamine in the previous 12 months, and that more mainly used crystal or ice (43 per cent) than powder or speed (31 per cent).
Almost nobody quoting it mentions the warning alongside. The survey changed how it asked the question, and the AIHW states that “results for methamphetamine and amphetamine in 2022 to 2023 should not be compared to meth/amphetamines results from previous survey waves”. Any headline saying Australian ice use has risen or fallen according to that survey is doing what its own publisher says cannot be done.
Wastewater answers a different question. Australian monitoring recorded methylamphetamine consumption rising by 23 per cent between 2023 to 2024 and 2024 to 2025, and New Zealand police reported “markedly elevated levels” continuing through 2025. Our observation is that a survey counts people and undercounts the heaviest use, while wastewater counts the drug and cannot say how many people it came from.
Psychosis, and how long it actually lasts
This is the effect most often described badly, in both directions.
The strongest evidence is a prospective cohort study of 278 methamphetamine-dependent people in Sydney and Brisbane, none with a lifetime diagnosis of schizophrenia or mania. Following the same individuals across four separate months, it found “a 5-fold increase in the likelihood of psychotic symptoms during periods of methamphetamine use relative to periods of no use” (OR 5.3, 95% CI 3.4 to 8.3), strongly dose-dependent. Comparing people against themselves answers the objection that those prone to psychosis use the drug anyway.
How long symptoms last is where reputable sources openly disagree.
| Source | What it says about duration |
|---|---|
| Alcohol and Drug Foundation | “These symptoms usually disappear a few days after the person stops using ice” |
| WHO withdrawal management guidelines | Psychotic symptoms “will usually resolve within a week of ceasing stimulant use” |
| Voce et al, systematic review of 94 studies | “The median percentage of participants with persistent psychotic symptoms (>1 month duration) across studies was 25%” |
| Murrie et al, meta-analysis of 50 studies | 22 per cent of amphetamine-induced psychoses transitioned to schizophrenia (95% CI 14 to 34 per cent) |
Our reading is that these are not in conflict. The harm-reduction pages describe the common course, which is short; the research describes the tail, which is not. Only one usually gets quoted, and someone told it clears in days has not been prepared for the version that does not.
The Voce review also found negative symptoms, the flattening characteristic of schizophrenia, mostly absent. NIDA notes that “heavy drinking and stress have been shown to increase the odds that someone who has experienced methamphetamine-associated psychosis in the past will have psychosis symptoms again”.
The heart and the teeth, and which part is overstated
NIDA lists “cardiovascular events like stroke and heart failure” among the long-term risks, and the Alcohol and Drug Foundation lists heart and kidney problems and an increased risk of stroke. Set against that, the EUDA profile states that “fatalities directly attributed to methamphetamine are rare”. Our reading is that they describe different things, the EUDA sentence acute poisoning deaths and the other two cumulative disease. No source states that reconciliation, so we are not asserting it.
The teeth are the more interesting case. A study of 571 people who used methamphetamine, published in the Journal of the American Dental Association, found high rates of dental and periodontal disease with “a dose-response relationship, with greater levels of MA use associated with higher rates of dental disease”. Around 96 per cent had caries and 58 per cent had untreated decay (full text).
The damage is real. The popular explanation is not the one dentistry gives. The American Dental Association attributes it to reduced saliva, since methamphetamine acts on adrenergic receptors, “causing decreased salivary flow, leading to xerostomia”, and to bruxism and clenching, large quantities of sugared carbonated drinks, and plaque building up where oral hygiene has lapsed. It does not say the drug is corrosive to enamel. Those causes can be treated; enamel dissolved by a caustic chemical could not be. That study also found current cigarette smokers disproportionately affected, a reminder that this group differs from the comparison population in more than one way.
What withdrawal is actually like
South Australia’s health department describes an initial crash of one to two days, with prolonged sleeping, depressed mood, overeating and some cravings, then “several days to weeks” of mood changeability, cravings, disturbed sleep and lethargy. Psychotic symptoms may emerge in the first one to two weeks, particularly in people who had them while using, and amphetamine withdrawal “is largely subjective, but may be difficult to manage”.
The most cited timing study, run in Chiang Mai Province in Thailand, found an acute phase of seven to ten days and a subacute phase of at least a further two weeks. It rests on 21 inpatients and nine comparison participants, a small study carrying a lot of citation weight. WHO withdrawal guidelines add that acute stimulant withdrawal “is followed by a protracted withdrawal phase of 1-2 months duration”, marked by lethargy, unstable emotions, erratic sleep and strong cravings.
That same document says of alcohol that “in rare cases, alcohol withdrawal can be life-threatening”, and applies no equivalent language to stimulants, recommending supportive care and symptomatic medication instead. Reading the omission as deliberate is our inference, not a statement the document makes. Ice withdrawal is not usually the kind that hurts you medically. It is the kind people relapse out of, and weeks of flat mood, broken sleep and craving are harder to sit through alone than a few dramatic days.
Coming off ice alongside alcohol or benzodiazepines is different, because those withdrawals can be dangerous, which is one reason polysubstance use changes the plan. WHO advises that severe psychiatric symptoms in withdrawal are referred for assessment rather than managed at home.
Treatment: no approved medicine, and one therapy with the best evidence
NIDA is unambiguous: “There is no FDA-approved medication for methamphetamine use disorder or any other stimulant use disorder.” South Australia’s guidance says the same of withdrawal, that no medication has been demonstrated to be effective in alleviating it, and that “the mainstay of treatment is supportive care and counselling”.
What has evidence is behavioural. NIDA states that “the best-studied form of behavioral treatment for methamphetamine use disorder, and the one most associated with treatment success, is contingency management”, which offers small tangible rewards for verified abstinence and for attending. A network meta-analysis of 50 randomised trials, 6,942 participants and 12 psychosocial interventions found contingency management combined with a community reinforcement approach “was the only intervention that increased the number of abstinent patients at the end of treatment”, holding up at longest follow-up. Its authors flag their own limitation, that the trials could not be blinded, though a urinalysis outcome is harder to bias than a questionnaire.
Two inconvenient halves. Contingency management is not as available as its evidence would suggest. Writing about the United States, NIDA’s director notes that “providers unsure about the legality of contingency management often do not provide it at all”, rules meant to prevent inducements having capped the rewards, and concludes that “we need more treatment centers to implement it”. We found no equivalent statement for Australia or New Zealand.
Durability is the second. A meta-analysis of 23 randomised trials following people for up to a year after the incentives stopped opens by acknowledging that contingency management “is often criticized for limited long-term impact”. Abstinence was still more likely in the contingency management groups at that follow-up, but the odds ratio was 1.22 (95% CI 1.01 to 1.44): a genuine effect, and a small one beside what the same approach achieves while the incentives run.
Medication trials remain disappointing. The most promising recent one reported a response in 13.6 per cent of participants on a combination treatment against 2.5 per cent on placebo: a real difference, and a reminder that most people in that trial did not respond. Our reading is that treating ice dependence is currently a psychological and social undertaking with medical support at the edges: an argument for time, structure, therapy and distance from where use happens.
Where The Orchid Recovery fits
The Orchid Recovery is a residential addiction and mental health treatment centre in Hang Dong District, Chiang Mai, Thailand, for international English speaking adults. Our boutique centre takes a maximum of 20 clients, with a full-time on-site psychiatrist.
Our pages on meth addiction treatment, medically supervised drug detox and residential treatment set out what that involves, and dual diagnosis treatment covers psychosis, depression or trauma alongside it. Our clinical team is listed here, and you can speak to us if it would help.
If you think someone is overdosing, with chest pain, seizures, a sudden severe headache, extreme agitation or collapse, call your local emergency number now and read our page on ice overdose afterwards.
Sources
- Alcohol and Drug Foundation, Crystal Methamphetamine (Ice)
- European Union Drugs Agency, Methamphetamine drug profile
- National Institute on Drug Abuse, Methamphetamine
- National Institute on Drug Abuse, What treatments are effective for people who misuse methamphetamine?
- UNODC, Rise in production and trafficking of synthetic drugs from the Golden Triangle, May 2025
- AIHW, National Drug Strategy Household Survey 2022 to 2023, Methamphetamine and amphetamine
- AIHW, Alcohol, tobacco and other drugs in Australia, Wastewater drug monitoring
- New Zealand Police, National Drugs in Wastewater Testing Programme, 2025 Annual Overview
- McKetin et al, Dose-related psychotic symptoms in chronic methamphetamine users, JAMA Psychiatry 2013
- Voce et al, A systematic review of the symptom profile and course of methamphetamine-associated psychosis, Substance Use and Misuse 2019
- Murrie et al, Transition of substance-induced, brief and atypical psychoses to schizophrenia, Schizophrenia Bulletin 2020
- Shetty et al, Dental disease patterns in methamphetamine users, Journal of the American Dental Association 2015
- Shetty et al, Dental disease patterns in methamphetamine users, full text, eScholarship
- American Dental Association, Methamphetamine, Oral Health Topics
- SA Health, Amphetamine withdrawal management
- McGregor et al, The nature, time course and severity of methamphetamine withdrawal, Addiction 2005
- WHO, Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings
- De Crescenzo et al, Comparative efficacy and acceptability of psychosocial interventions for individuals with cocaine and amphetamine addiction, PLOS Medicine 2018
- Trivedi et al, Bupropion and naltrexone in methamphetamine use disorder, New England Journal of Medicine 2021
- Ginley et al, Long-term efficacy of contingency management treatment based on objective indicators of abstinence from illicit substance use up to 1 year following treatment, Journal of Consulting and Clinical Psychology 2021
- NIDA, Nora’s Blog, Five areas where more research is not needed to curb the overdose crisis, 2022
Frequently Asked Questions
What is the ice drug?
Ice is crystal methamphetamine, the crystalline form of the same stimulant sold as a powder under the name speed. The European Union Drugs Agency describes it as the pure crystalline hydrochloride, which unlike powdered amphetamine is volatile enough to be smoked. It also goes by crystal meth, shabu, glass, shard, Tina and, in New Zealand, P.
Is ice the same as meth?
Ice is a form of methamphetamine, so it is meth, but not all meth is ice. Methamphetamine circulates as a powder, as a damp paste and as crystal. The Alcohol and Drug Foundation describes ice as stronger, with more harmful side effects, than the powder known as speed. The chemical is the same. The purity and the available routes differ.
Is ice the same as yaba?
No. Yaba is a pressed tablet combining methamphetamine with caffeine, and it dominates the market in Thailand and mainland Southeast Asia. Ice is high-purity crystalline methamphetamine and is the form most associated with Australia and New Zealand. They share an active ingredient rather than a market, a price point or a typical pattern of use.
How long does ice psychosis last?
Reputable sources disagree, and the honest answer is that it varies. Australian harm-reduction guidance says symptoms usually go within a few days of stopping. A systematic review of 94 studies found a median of 25 per cent of participants with psychotic symptoms persisting beyond one month. A separate meta-analysis found 22 per cent of amphetamine-induced psychoses later met criteria for schizophrenia.
Is ice withdrawal dangerous?
Not usually in the way alcohol or benzodiazepine withdrawal can be, and WHO guidance applies its life-threatening warning to alcohol rather than to stimulants. Reading that omission as meaningful is our inference rather than a claim the guidance makes. It is still hard: an initial crash, then weeks of flat mood, disturbed sleep and craving. Anyone also withdrawing from alcohol or benzodiazepines needs medical supervision.
Is there a medication for ice addiction?
No. NIDA states there is no approved medication for methamphetamine use disorder or any other stimulant use disorder. Trials continue, and the most promising recent combination produced a response in 13.6 per cent of participants against 2.5 per cent on placebo. Behavioural treatment, and contingency management in particular, currently has the strongest evidence base.
Does ice really rot your teeth?
Dental disease is genuinely common and severe, with one study of 571 people finding around 96 per cent had caries. The usual explanation is wrong, though. The American Dental Association attributes the damage to reduced saliva, teeth grinding, sugary drinks and lapsed oral hygiene, not to the drug corroding enamel. That matters, because those causes can be treated.
What does treatment for ice dependence actually involve?
With no approved medicine to prescribe, treatment is structure rather than pharmacology. At The Orchid Recovery that means a residential stay of four, eight or twelve weeks, physical distance from supply, individual and group psychosocial therapy, and a full-time on-site psychiatrist for sleep, mood or psychotic symptoms. Two months of aftercare follows the stay. We do not run outpatient or day programmes.
