I have had issues with excessive tiredness for many years. I've been tested for thyroid, leukemia, sleep apnea and others. I do have sleep apnea and use a CPAP. But we have never been able to resolve the fatigue. I started using methamphetamine and have way more energy. I know it's awful and I need to quit but I'm terrified of going back to sleeping 10 to 14 hours. What options are there?
Answer by addiction medicine specialist Kenneth Zoucha, MD:
Methamphetamine isn't a good solution for fatigue because of how it affects your body. We also know that a good portion of methamphetamine is adulterated with fentanyl. The good news is, there are a lot of other options. We just need to have a better idea of your situation to find something that works.
When you use methamphetamine, the dopamine and serotonin system in your body adapt by lowering the natural levels of these neurotransmitters. Low levels of dopamine and especially serotonin can be very disruptive to your sleep and energy levels. Methamphetamine also decreases energy levels like motivation and changes the melatonin system which leads to a lot of sedation.
A few questions for you:
- Do you have any psychiatric diagnoses, like depression or attention deficit hyperactivity disorder (ADHD)?
- Are you using any other substances, like alcohol, bath salts or kratom, in addition to methamphetamine?
- How does your sleeping affect you functionally? Does your fatigue cause you to miss work, sleep through family activities or ruin your time with friends? Do you fall asleep while working or doing these things?
- Are you prescribed any other medications?
Depending on those answers, we would be able to try something different without the ill effects.
You might need to see a sleep specialist or have a home sleep study done off methamphetamine to see what things are like. They could make a diagnosis of a possible sleep-wake disturbance. If you have narcolepsy or ADHD that doesn't respond to bupropion, stimulant medications may help.
Either way, we would rather have you taking a medication that doesn't disrupt the natural levels of your neurotransmitters like methamphetamine does.
A substance use disorder can be treated, just like any other illness. Call 402.552.6007 to make an appointment with Nebraska Medicine Addiction Services.