Meth, ADHD and work productivity: How ADHD people who use meth struggle with stigma (Part 2)
Thursday, 27 February, 2025.
Photo courtesy: Unsplash.
Note: this article is part two in a two-part series. It’s also a long one. We’ve pieced together a series of stories from peers with ADHD who have used meth, and these nuanced stories deserve space to breathe. If you’re short on time or your attention span isn’t great – it’s on theme for this article – we suggest you dip in and out of this one. Come back to it when you’re ready or read the sections of most interest. You can navigate through the article using the subheadings.
Several years ago, Rick saw a psychiatrist for the first time to get tested for ADHD.
“It was in Sydney’s North Shore, which is a hub for conservative old wealth values,” he recounts. “This psychiatrist must have talked to the psychologist I was seeing at the time prior to our session. I’d told that psychologist all about my drug use, which was mostly party drugs on the weekend and smoking weed semi-regularly. Anyway, the very first thing this psychiatrist said when I walked into her office was ‘you’re a meth addict, right?’ I hadn’t even sat down yet!”
“She implied that I was addicted to it. It really threw me off being judged for my use of one particular drug right off the bat. Unsurprisingly, the session did not go well. She ended up scribbling down a list of drug counsellors, shooing me out the door and telling me to come back after being clean from all drugs from a number of months, so she could assess me ‘properly’, whatever that means”.
Rick had always viewed his use of goey, the powder form of meth, as recreational, even performance enhancing, as the drug helped him achieve great results at uni. It made him feel focused and normal, not high out of his mind. He estimates that he got on it once a week for a couple of years, maybe twice a week at the absolute max.
The irony of his first experience of ADHD testing was that he hadn’t even consciously bought the crystallised form of methamphetamine at that stage in his life. That came later and it was only a brief phase that lasted 3 weeks or so.
Around 2022, Rick finally had his suspicions confirmed. After seeing a different psychiatrist, he was formally diagnosed with ADHD and prescribed dexamphetamine.
It’s a common experience for drug users who often face stigma in healthcare settings and denial of medications due to ill-informed beliefs that patients will abuse any mind-altering drug they’re given. But, as we explored in the first article in this series, many ADHD people self-medicate with goey and meth. Sometimes, it’s simply an accessibility issue because psychiatrist appointments are really expensive and the wait lists are long. Sometimes it’s a gender response because women find it harder than men to get diagnosed with ADHD.
So just how deep does this stigma towards meth run? Can our choice of words really be harmful? How does stigma affect meth users?
Users News is here to try answer these questions as best we can with some help from some ADHD peers.
Meth stigma and the double standard of ADHD medication misuse
Aaron has both ADHD and autism. Excited to share his story, he’s chatty on the phone and spares no details.
“When I got diagnosed with ADHD before I got my autism diagnosis, I initially went to a clinician who asked me if I’d ever injected methamphetamine. Being my classic honest and autistic self, I said I had.”
The doctor used this as an excuse to not prescribe Aaron any stimulant-based medications, such as Ritalin or Vyvanse (lysdexamphetamine), because he thought there was a possibility of misuse. He confirmed that Aaron does indeed have ADHD but prescribed him Strattera instead, a non-stimulant medication which isn’t as effective.
Unwilling to fork out for more costly sessions, Aaron decided it was easier and more effective to continue to use ice instead. He describes this in explicit terms as “self-medicating” and it helps to explain why he sees a double standard in public perceptions of illegal and legal amphetamines (prescribed ADHD medications such as dexamphetamine).
It’s a permanent source of confusion for him because the effects of amphetamine-based ADHD meds and meth are remarkably similar and they’re almost identical at the chemical level. Compared to dexamphetamine and powdered speed on the street (amphetamine sulphate), crystallised methamphetamine essentially involves one extra step in the cooking process. That’s all.
One study looking at the effects of snorting crystal meth versus snorting dexamphetamine (many people crush up the pills to snort them) found the effects of both are very similar. The only real difference is that the crystal prompted more feelings of being “high” and a higher heart rate. The study’s researchers got people to snort the drugs blind in a controlled environment away from people and cultural influences. In these circumstances, the study showed, the abuse potential of ADHD medications and meth is extremely similar. Of course, smoking or injecting ice is a much stronger experience. But these are still interesting results.
This study seems to confirm our suspicion at Users News that dexies are much more similar to meth than people generally recognise. While the abuse of dexamphetamine is widespread, socially acceptable and understudied, particularly among society’s most privileged (lawyers, politicians, finance bros, university students, for instance), meth dependence is highly stigmatised. This skewed narrative is embedded in mainstream news reporting. It has created a general belief that meth is a lower class drug used predominantly in regional and remote areas of Australia.
There are people out there smashing dexamphetamine with or without a doctor’s script who express disdain for people who use meth. But these Vyvanse warriors experience the same side effects. They may be awake for days. They may rapidly lose weight. They may be intensely productive. They may experience wild mood swings.
“I cannot take anyone seriously who feels a moral or social bias towards methamphetamine but has no problem with ADHD medication,” Aaron says.
It’s a topic he feels very passionately about. He says this unfair judgement of meth users supports “really racist” laws which result in police disproportionately targeting marginalised communities for drug arrests, such as rough sleepers and First Nations people. As an African American man who witnessed the heavy-handed policing of crack cocaine use in the US in the 80s and 90s, a government-led crack down and PR campaign which framed crack use as a black phenomenon, it’s a point Aaron feels especially deeply.
“This is personal for me because I’m black,” he states. “I could rant about this until the cows come home.”
What’s more in some countries, such as the United States, doctors prescribe methamphetamine itself for ADHD under the brand name Desoxyn. Yes, literal meth with that extra cooking step involved, meaning it’s super strong. So it’s not helping anyone to judge meth users and it’s simply hypocritical if you use ADHD medications.
But what about the really harmful side effects particular to meth?
We’re not denying that meth is a hardcore drug. Injecting the drug, vaporising those rocks in a glass pipe with a jet lighter or chasing the dragon with some aluminium foil is a different ballgame to swallowing or snorting a dexy. Meth is linked to increased chances of psychosis. There’s no way around it. Roughly one quarter of regular meth users experience psychosis, many of whom don’t have any personal or family history of schizophrenia. While it’s hard to generalise because everybody’s experiences of a drug are wildly different, research has linked increased frequency of use and larger doses to a higher likelihood of violent behaviour. In short, you can become very unpredictable, especially on the come down. Beware the short fuse.
That said, some people studying the drug and some meth users claim that the drug doesn’t cause people who are kind and compassionate to become violent. Rather, they argue, it can simply make people who are already feeling aggro more violent, which suggests that personality and environmental factors are the real influence on meth-related violence.
What we should take away from all this though is that meth users, as opposed to people who misuse ADHD medications, face constant judgement from those around them for choosing to use an illegal drug. Moreover, few people recognise that responsible meth use, while difficult, is entirely possible. Unfortunately public opinion is very black and white.
What does meth stigma look like?
The mainstream media plays a big role in fuelling meth stigma. Tabloid newspapers and TV networks in Australia seem to have an obsession with announcing the nation’s new “ice capital” on a weekly basis. In these media stories, meth usually features as the beginning of an individual’s downward spiral. Anyone who uses the drug and is associated with it is apparently morally corrupted, instantly hooked, irrational and violent. This is a really unsympathetic portrayal of ice-using communities. It defines people and regions by their level of meth use and suggests the drug completely controls the individual.
In a similar way, rude individuals will sometimes turn their nose up at meth users and label us “junkies”.
Remember: we are always more than the drugs we put in our bodies! Just because you use meth on an occasional or regular basis doesn’t mean that that alone is who you are.
People with ADHD seem particularly prone to name-calling and judgement because, according to data, the proportion of ADHD people who use meth is noticeably high. It’s all the more unfair because meth can sometimes work well in a recreational and medicinal way for people with ADHD.
Aaron says meth allowed him to “take control” of his mental health and disability. He recounts in a peer story published by Unharm’s Story Lab that “methamphetamine slowed down the world so that I could feel at ease. How I acted and felt on it is how neurotypical people act and feel most of the time.”
But he expresses frustration with the judgement he receives for managing his mental health with an illegal drug and tells Users News that his reputation as a staunch advocate of drug law reform has coloured his interactions with police.
“I’m sick of people using my methamphetamine use against me and blaming the substance for behaviours that may instead be symptoms of autism and ADHD,” he says.
“One time I was on the bus and a passenger flicked her freshly washed hair in my face. Because autism and ADHD are all about sensory reactions, I suddenly became very overwhelmed by the smell, the sensation, the sounds.”
“I got off the bus and felt extremely agitated. I imagine I presented like someone who was drug affected or who was having a psychotic break. All I wanted to do was get to a quiet place where there were no sensory stimuli but I couldn’t articulate this or answer basic questions. Many autistic black people have similar experiences to mine. We are constantly misunderstood by the police, first responders and healthcare professionals. Sometimes I wish I had a visible disability, so that people would understand that I need extra care and patience.”
The effects of meth stigma
In his book about crystal meth use in Australia and his own self-described addiction journey, The Ice Age, Australian journalist Luke Williams argues that data about meth use in Australia is almost certainly under-reported. He writes that some meth users wouldn’t answer a government survey full stop or wouldn’t answer accurately if they took part due to stigma, denial and paranoia. Moreover, he argues, some surveys fail to reach groups of people that are statistically more likely to use meth, such as imprisoned populations and rough sleepers.
Many people, it turns out, agree with him. Under-reporting is a point academic researchers are now emphasising too. So it’s likely more people are using ice around us than we even realise.
The flip side of this under-reporting phenomenon is that many meth users who slip into dependence don’t seek help or treatment. In fact, there’s a whole lot of published research that proves this. This happens when people are too ashamed to admit to the people around them they use meth or they’re too ashamed to explain they can’t stop using the drug.
So clearly there are real world consequences to the public’s judgement of ice and skewed media narratives.
However, once we recognise our internal biases and we begin to take sensationalist news stories with a grain of salt, we can start to push for change. It may also help those around us struggling with meth dependence to seek help. This is a win-win outcome.