甲基苯丙胺
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臨床資料 | |
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商品名 | Desoxyn |
其他名稱 | N-methylamphetamine, desoxyephedrine |
AHFS/Drugs.com | Monograph |
核准狀況 | |
依賴性 | 生理: 無 心理: 高 |
成癮性 | 高 |
给药途径 | Medical: oral Recreational: oral, intravenous, insufflation, inhalation, suppository |
ATC碼 | |
法律規範狀態 | |
法律規範 |
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藥物動力學數據 | |
生物利用度 | Oral: Varies widely[1] Rectal: 99% IV: 100% |
血漿蛋白結合率 | Varies widely[1] |
药物代谢 | CYP2D6,[3] DBH[4]、FMO3,[5] XM-ligase,[6] and ACGNAT[7] |
生物半衰期 | 9–12 hours[2] |
排泄途徑 | 腎 |
识别信息 | |
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CAS号 | 537-46-2 ![]() |
PubChem CID | |
IUPHAR/BPS | |
DrugBank | |
ChemSpider | |
UNII | |
KEGG | |
ChEBI | |
ChEMBL | |
CompTox Dashboard (EPA) | |
ECHA InfoCard | 100.007.882 |
化学信息 | |
化学式 | C10H15N |
摩尔质量 | 149.24 g·mol−1 |
3D模型(JSmol) | |
熔点 | 3 °C(37 °F) [9] |
沸点 | 212 °C(414 °F) [8] at 760 mmHg |
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甲基苯丙胺或甲基安非他命(英語:methamphetamine,全名N-methylamphetamine[note 1]),化学式:C₆H₅CH₂CH(CH₃)NHCH₃(N-甲基-1-苯基丙-2-胺、N-甲基-α-甲基苯乙胺),其结晶形态俗稱冰毒、黑话「豬肉」,是一种強效中樞神經系統興奮劑,主要被用於毒品,較少被用於治療注意力不足過動症和肥胖症,即便有也被當成第二線療法[15]。甲基苯丙胺是在1893年發現,有二種对映异构:分別是左旋甲基苯丙胺(levo-methamphetamine)及右旋甲基苯丙胺(dextro-methamphetamine)。「甲基苯丙胺」一般是指左旋甲基苯丙胺及右旋甲基苯丙胺各佔一半的外消旋混合物。甲基安非他命較少被醫師處方,因為可能會毒害神經,以及有用作春藥和欣快感促進劑等風險。而且已有療效相同,而對人體危害風險更低的替代藥物。
甲基苯丙胺可用在非醫療用途上,會被非法交易販售。甲基苯丙胺的非法使用在亚洲部分地区、大洋洲和美国最为普遍。在美国,消旋甲基苯丙胺、左旋及右旋甲基苯丙胺均为第二类管制药品。左旋甲基苯丙胺的吸入型鼻塞緩解劑是美國的非处方药,因此能直接在市面上購買[note 2]。在國際上,甲基安非他命名列《精神药物公约》中的第二級分類表(schedule II),因此在從事甲基安非他命的生產、散播、銷售和加工等活動都被許多國家嚴格管制或禁止。右旋安非他命(Dextromethamphetamine)的藥效比甲基苯丙胺更加強烈,但因為甲基苯丙胺的化学合成難度較低,其前体較容易取得,因此比較容易非法製造生產甲基苯丙胺。
低劑量服用甲基安非他命,會產生欣快感、提振警醒度、專注力和精神,同时会导致食慾降低、體重減輕。高劑量服用甲基安非他命则會引起中樞神經刺激劑引起的精神病、横纹肌溶解症、全身癲癇和顱內出血。 長期攝取高劑量的甲基安非他命可能加快一些不可預期且速度極快的副作用,如:心情擺盪、中樞神經刺激劑引起的精神病(譬如:偏執、幻觉、譫妄和妄想等),及具有侵略性的行為。 在娛樂用途上,甲基安非他命提升能量的效果主要體現於提振心情和增加性慾,讓使用的人能連續從事性行為好幾天[18]。 已知甲基安非他命能產生高度的成瘾依賴(亦即:長期使用或超高劑量使用有相當高的可能性導致使用者出現衝動用藥。)和高度物質依賴(亦即:在戒除甲基安非他命時有高度的可能性會有戒斷症狀發生) 甲基苯丙胺的高劑量非醫療使用可能會造成急性戒断综合征,其持續時間可能會比一般的戒断時間更長。甲基苯丙胺和苯丙胺不同,甲基苯丙胺有神經毒性,會影響人類多巴胺能的神經元[19],也已證實甲基苯丙胺會傷害中樞神經系統中的血清素神經元[20][21],這些傷害包括腦部結構及功能的不良變化,例如不同腦部區域中灰质體積的減少,以及代謝整合性標誌物的不良變化[21]。
甲基苯丙胺在化合物分類上屬於苯乙胺衍生物及苯丙胺衍生物,和其他的二甲基苯乙胺互為结构异构,有共同的分子式:C10H15N 。
用途
医用
d-甲基安非他命,药品商标Desoxyn®,医疗上用于治疗注意力不足過動症(ADHD)、嗜睡症以及极端的肥胖症等。它的右旋异构体(R+异构体)可以用于治疗注意力不足過動症,但不带甲基的安非他命更常用。它的右旋异构体药品商标为「Desoxyn」,可以用于治疗嗜睡症及肥胖。当安非他命和甲基安非他命致使患者太多副作用时,Desoxyn作为次选药物。在精神方面的作用上,右旋的R(+)构型是左旋的S(-)构型的5倍[22]。
精神性毒品
因其具有强效的欣快作用和催情作用[18],通常被用于娱乐,根据国家地理频道关于甲基苯丙胺的纪录片,有些派对亚文化中以性和甲基苯丙胺作为基础[18],由于其强烈的兴奋性和催情作用(对射精具有抑制作用),重复使用后可能连续几天都会发生性关系[18] 。甲基苯丙胺对精神的影响是强烈的,一段时间后会明显伴有睡眠过度的状况(白天过度嗜睡)。这些派对和游戏的亚文化流行于旧金山和纽约两大城市[18][23]。
禁忌症
有以下症状的人不能使用甲基苯丙胺:曾有物質使用疾患、心血管疾病的人;嚴重易怒或焦慮的人;患动脉血管硬化、青光眼、甲状腺功能亢进症或嚴重高血壓的人;[24]。
美国食品药品监督管理局(FDA)表示,若以往曾對其他的興奮劑有超敏反應,或是正在使用单胺氧化酶抑制剂,也不得使用甲基苯丙胺[24]。FDA也建議有躁鬱症、重性抑郁障碍、血壓偏高、有肝腎臟疾病、狂躁、思覺失調、雷诺氏综合征、癲癇發作、甲状腺問題、抽动综合症或是妥瑞症的病患,若要使用甲基苯丙胺需監控其症狀[24]。因為甲基苯丙胺有可能造成生長發育遲緩,FDA也建議若用甲基苯丙胺對兒童或青少年進行治療,需監控其身高及體重的資訊[24]。
副作用
生理
甲基苯丙胺在生理上造成的副作用包括:食欲不振、過動、瞳孔放大(散瞳)、過度流汗、精神運動性激動、口乾及磨牙(會造成甲基苯丙胺嘴)、頭痛、心律不整(可能是心跳过速或心跳过缓)、呼吸急促、高血壓或低血壓、體溫過高、腹瀉或便秘、視線模糊、頭暈、肌束震顫、麻木、顫抖、皮膚乾燥、痤疮及皮膚蒼白或皮膚發紅[25]。慢性高劑量使用的副作用有搔癢障礙、身體異常的搔癢[26]。[不可靠的醫學來源]及蟻走感(感覺有昆蟲在身上爬的感覺)[27]。可能會有腳抽筋之類的症狀,有時會格外嚴重,且時間會拉長,若長期使用下,因為飲食不當以及脱水造成的電解質不平衡,此症狀會格外危險[28]。
冰毒嘴
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甲基苯丙胺使用者和成瘾者牙齿会快速脱落[29],不管吸食毒品的方式如何都会造成此非正式命名的口腔疾病(俗称“冰毒嘴”)。注射者的状况最严重。根据美国牙科协会的说法,冰毒嘴“可能是由所导致口干症(口干),以及药物引起的心理和生理上的变化,长时间较差的口腔卫生,经常摄入高热量食物、碳酸饮料和磨牙症联合作用所致”[29][30],由于口干也是其他兴奋剂的常见副作用,而这些药物并不会直接导致严重的龋齿,许多研究人员认为甲基苯丙胺相关的龋齿更多是由于吸食者的其他因素导致。他们认为该副作用被夸大和风格化,以创造冰毒吸食者的刻板印象,以作为对新吸食者的威慑。[31]
性病的传播
甲基苯丙胺的使用被发现与艾滋病阳性和未知性伴侣中无保护性交频率更高有关,这种关联在艾滋病阳性参与者中更为明显,[32]这些研究结果表明,甲基苯丙胺在未受保护的肛交中的使用和参与是共同发生的危险行为,这些行为可能会增加男同性恋和双性恋男性艾滋病病毒传播的风险。[32]使用甲基苯丙胺使男女使用者都能进行长时间的性活动,这可能导致男性生殖器疼痛和擦伤以及阴茎勃起功能障碍[33],甲基苯丙胺还可能通过磨牙症引起口腔溃疡和擦伤[33],增加了性传播感染的风险。除了性传播外通过注射器共用造成性病的传播。[34]
過量時的症狀
甲基苯丙胺過量時會出現許多的症狀[2][24]。甲基苯丙胺中等程度的過量會有以下的症狀:心律不整、意識不清、排尿疼痛、血壓偏高或是偏低、高熱、过度活跃和/或过度反应的反射、肌肉痛、嚴重精神運動性激躁、呼吸急促、顫抖、排尿猶豫以及無法排尿[2][28]。特別嚴重的過量會有肾上腺素风暴、甲基苯丙胺精神病、无尿症、, 心源性休克、顱內出血、循環系統崩潰、危險性的发热、肺高壓、腎功能衰竭、横纹肌溶解症及血清素症候群[sources 1]。甲基苯丙胺過量會因為多巴胺激活及血清素激活的神經毒性而造成輕微的腦損傷[19][21]。甲基苯丙胺中毒死亡一般會出現在驚厥及昏迷之後[24]。
精神病症
濫用甲基苯丙胺會造成興奮劑精神病症,有許多不同的症狀(例如偏執狂、幻觉、譫妄及妄想等)[2][39]。考科藍研究有針對因濫用苯丙胺,右旋苯丙胺和甲基苯丙胺等興奮劑造成精神病症治療,進行的回顧研究,指出其中約有5%至15%的濫用者無法完全復原[39][40]。同一份回顧研究也指出,根據至少一次的試驗,抗精神病药可以有效改善急性甲基苯丙胺精神疾病的症狀[39]。
緊急治療
急性甲基苯丙胺中毒的治療主要是在治療其症狀,治療過程一開始可能會包括活性炭及鎮靜劑[2],有關血液透析或腹膜透析應用在甲基苯丙胺解毒上的效果,目前還沒有足夠證據來確認其是否有效[24]強制性利尿(例如透過维生素C)會增加甲基苯丙胺的排泄量,不過會增加重度酸中毒、引發癲癇或橫紋肌溶解的風險,因此不建議使用[2]。高血壓會有顱內出血的風險,若是嚴重的話,可以用注射苄胺唑啉或硝普钠來治療[2],若提供足量苯二氮䓬类鎮靜劑以及提供安靜的環境,血壓會漸漸下降[2]。
在治療甲基苯丙胺過量造成的躁動和精神病時,可以用氟哌啶醇等抗精神病藥[41][42]。具有親脂性及中樞神經系統滲透性的β阻断药(例如美托洛尔及拉贝洛尔)可以治療中樞神經系統及心血管的毒性[43]。混合的α-及β-阻断药拉貝洛爾在治療甲基苯丙胺引起的心動過速和高血壓上格外有效[41],在使用β阻断药來治療甲基苯丙胺中毒的過程,目前還沒有unopposed alpha stimulation的紀錄[41]。
成瘾的治療與管理
认知行为疗法是目前最有效治療精神興奮劑成瘾的療法[44]。截至2014年[update],還沒有有效治療甲基苯丙胺成瘾的藥物療法[45][46][47]。甲基苯丙胺成瘾主要會透過多巴胺受體的增強活化及伏核中共定位N-甲基-D-天門冬胺酸受體(NMDA受體)來調整[note 3][49][50]。镁離子可以阻断受体钙通道,因此可以抑制NMDA受体[48][51]。
依賴及戒斷症狀
若固定的使用甲基苯丙胺,會出現藥物耐受性,若是因為非醫療的原因而使用,其耐受性會快速增強[52][53]。若是有依賴性的使用者,其戒斷症狀和藥物耐受性的程度呈正相關[54]。甲基苯丙胺戒斷產生的抑郁會持續的比可卡因戒斷症狀要長,其情形也較可卡因戒斷症狀要嚴重[55]。
依目前考科藍文獻回顧有關甲基苯丙胺非醫療使用者的物質依賴及藥物戒斷資料來看,「若慢性重度使用者突然停用[甲基苯丙胺],許多人會有時間限制的戒斷症狀,會在最後一次用藥後24小時內出現。」[54]。慢性重度使用者的戒斷症狀相當常見,慢性重度使用者中有87.6%會有戒斷症狀,會持續三週到四週,第一週會有明顯的「崩潰期」[54]。甲基苯丙胺的戒斷症狀包括焦慮、藥物渴望、煩躁、疲勞、胃口變好、運動增加或運動減少、失去動力、失眠或是嗜睡症以及清醒夢[54]。
若孕婦使用甲基苯丙胺,其體內循環系統會有甲基苯丙胺,而且會透過胎盤傳遞給胎兒,嬰兒也會在母乳中攝取到甲基苯丙胺[56]。甲基苯丙胺濫用的婦女所生的嬰兒,考慮妊娠年齡調整後的頭圍數據顯著較小,而且其出生重量也會較輕[56]。新生兒暴露在甲基苯丙胺下,也和其新生兒戒斷症狀症候群有關,其症狀有激動,嘔吐和呼吸加快[56]。不過此戒斷症狀相對較輕微,只有4%需要藥物干預[55]。
化學
甲基苯丙胺爲人工合成,結構與苯丙胺和MDMA(摇头丸)近似,比起其他毒品,結構較簡單,分子量較小。
合成过程
甲基苯丙胺与甲卡西酮(methsy)、苯丙胺、以及其它兴奋剂的结构相似,可以用化学还原方法从麻黄碱或伪麻黄碱制得。大多数制备的原料属于日用品或可以从商店直接买到。因此合成甲基苯丙胺显得简单易行。在网络上可以找到许多转化合成方法,通常不大可信。最有经验的行家或求教于化学课,或从那些生产安非他命的人员那儿学来。几乎每一种方法都要用到高度危险的化学品和流程。大多数的生产方法涉及到将麻黄碱/伪麻黄碱分子中羟基的氢化。在美国最通常的方式用到红磷和碘,形成氢碘酸。另一个日渐普遍的方法是使用Birch还原法[57],用一次性锂电池中的金属锂替代金属钠(金属钠较难获得)。Birch还原法是极其危险的,因为碱金属和无水液氨都有极高的反应性。而且当加入反应物时,液氨的温度使其极易爆沸。另一种方法是苯基丙酮与甲胺的还原胺化反应(Borch还原)[58],所用的都是美国缉毒局的I级化学品。其他较不常见的方法使用其他的氢化法,比如用氢气和催化剂。
历史及各国管制政策
![]() | 此章節需要補充可靠的醫學來源。 | ![]() |
甲基苯丙胺與苯丙胺的化學結構非常相似。甲基苯丙胺是由日本化學家長井長義於1893年自麻黃鹼成功合成。1919年由緒方章完成了結晶化。
冰毒的正式學名是甲基安非他命,是一種強力興奮劑,能刺激中樞神經活動,化學結構與人體的腎上腺素類似。由於外貌上為無色的粒狀透明晶體,故俗稱為「冰」。冰毒在發明之初,乃是戰爭時期用作減低士兵勞累,非自然地提升作戰能力的手段以增加其作戰效率,苯丙胺還被提供給必須超長時間工作的軍需廠工人使用,因而成癮者不計其數。戰後,掌握制造方法者開始自行生產並非法販售予平民,冰毒開始被濫用,作為派對藥物,其成癮問題和害處才開始漸漸浮現。由於成癮者向醫療機構求助的數字越來越大,令政府開始關注濫用問題,並研究對社會造成的危害。
甲基苯丙胺在第二次世界大戰分別由同盟國與軸心國以Pervitin[59]之註冊名稱分發予前線,納粹軍廣發甲基苯丙胺予士兵以作興奮劑之用,特別是在蘇德戰爭時的黨衛隊人員及德意志國防軍。希特勒亦曾注射甲基苯丙胺。日本曾给士兵服用冰毒以提高戰鬥力。1941年武田製藥與大日本製藥(日本住友製藥)曾出產市販品,以及提供必須超長時間工作的軍需工廠工人使用,故在日本本土、臺灣、及日佔區都遺留下許多成癮患者。
1950年代,美国政府颁布法令将甲基苯丙胺规定为处方药,根据1951年出版的Arthur Grollman所著的《病理与药理学》一書,它可用于治疗嗜睡、后脑炎、帕金森综合症、酒精中毒,以及肥胖症。
1960年代,製造甲基苯丙胺的地下工廠開始普遍;1962年,冰毒首次作为一种违法毒品,被旧金山的摩托车黑帮制造出来,并在美国太平洋沿岸四处分发。这个黑帮很快便有了大批仿效者:制作冰毒所需要的原料非常普通,并且容易得到,比如外用酒精、碱液、麻黄碱和伪麻黄碱;最后一种当时作为非处方药供应。于是,作坊式实验室曾经生产了大量的违法甲基苯丙胺;墨西哥黑帮把大量廉价品带进了墨西哥。可以放进导管中抽吸的结晶甲基苯丙胺块在1980年代的夏威夷出现,并很快蔓延到美国大陆地区,成为最受欢迎的毒品种类。及至1980年,非醫療使用激增。其中,加州的聖地牙哥市更被稱爲北美的冰毒聖地(英國《經濟學人》,1989年12月2日號)。
美國到1983年才制定法律管制持有甲基苯丙胺的前驅體和製造設備。1986年,美國制定了一份聯邦管制藥物取締法,名爲Federal Controlled Substance Analogue Enforcement Act,以打擊“設計毒品”(designer drugs)泛濫。儘管如此,吸食甲基苯丙胺仍在美國郊區(尤其是中西部和南部)上升,直至今日。而各州都在加緊立法打擊。
1991年,冰毒首次在中国被查获[60]。2008年《中华人民共和国禁毒法》颁布,在法律上正式将甲基苯丙胺纳入毒品管控。2018年甲基苯丙胺成为中国“头号毒品”[61]。
参见
備註
- ^ Synonyms and alternate spellings include: metamfetamine (International Nonproprietary Name (INN)), N-methylamphetamine, desoxyephedrine, Syndrox, Methedrine, and Desoxyn.[10][11][12] Common slang terms for methamphetamine include: speed, meth, crystal, crystal meth, glass, shards, ice, and tic[13] and, in New Zealand, "P".[14]
- ^ 有些美國非處方藥的活化成份會列levmetamfetamine,是levomethamphetamine的INN及USAN[16][17]
- ^ NMDA受體是電壓相依型配体门控离子通道,需要同时结合谷氨酸和共激动剂(D-絲氨酸或甘氨酸)來打開離子通道[48]
來源群組
参考文献
脚注
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Neuroimaging studies have revealed that METH can indeed cause neurodegenerative changes in the brains of human addicts (Aron and Paulus, 2007; Chang et al., 2007). These abnormalities include persistent decreases in the levels of dopamine transporters (DAT) in the orbitofrontal cortex, dorsolateral prefrontal cortex, and the caudate-putamen (McCann et al., 1998, 2008; Sekine et al., 2003; Volkow et al., 2001a, 2001c). The density of serotonin transporters (5-HTT) is also decreased in the midbrain, caudate, putamen, hypothalamus, thalamus, the orbitofrontal, temporal, and cingulate cortices of METH-dependent individuals (Sekine et al., 2006) ...
Neuropsychological studies have detected deficits in attention, working memory, and decision-making in chronic METH addicts ...
There is compelling evidence that the negative neuropsychiatric consequences of METH abuse are due, at least in part, to drug-induced neuropathological changes in the brains of these METH-exposed individuals ...
Structural magnetic resonance imaging (MRI) studies in METH addicts have revealed substantial morphological changes in their brains. These include loss of gray matter in the cingulate, limbic and paralimbic cortices, significant shrinkage of hippocampi, and hypertrophy of white matter (Thompson et al., 2004). In addition, the brains of METH abusers show evidence of hyperintensities in white matter (Bae et al., 2006; Ernst et al., 2000), decreases in the neuronal marker, N-acetylaspartate (Ernst et al., 2000; Sung et al., 2007), reductions in a marker of metabolic integrity, creatine (Sekine et al., 2002) and increases in a marker of glial activation, myoinositol (Chang et al., 2002; Ernst et al., 2000; Sung et al., 2007; Yen et al., 1994). Elevated choline levels, which are indicative of increased cellular membrane synthesis and turnover are also evident in the frontal gray matter of METH abusers (Ernst et al., 2000; Salo et al., 2007; Taylor et al., 2007). - ^ 张建新,张大明,等。从甲基苯丙胺的对映体特征推断前体化学品。卫生研究,2009,04. http://www.cnki.com.cn/Article/CJFDTotal-WSYJ200904015.htm (页面存档备份,存于互联网档案馆)
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Currently, cognitive–behavioral therapies are the most successful treatment available for preventing the relapse of psychostimulant use.
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Figure 1
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The prevalence of this withdrawal syndrome is extremely common (Cantwell 1998; Gossop 1982) with 87.6% of 647 individuals with amphetamine dependence reporting six or more signs of amphetamine withdrawal listed in the DSM when the drug is not available (Schuckit 1999) ... Withdrawal symptoms typically present within 24 hours of the last use of amphetamine, with a withdrawal syndrome involving two general phases that can last 3 weeks or more. The first phase of this syndrome is the initial "crash" that resolves within about a week (Gossop 1982;McGregor 2005)
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- ^ 《2018年中国毒品形势报告》发布. 中华人民共和国公安部. 2019-06-18 [2019-06-26]. (原始内容存档于2019-06-26).
书目
- Methamphetamine Use: Clinical and Forensic Aspects, by Errol Yudko, Harold V. Hall,and Sandra B. McPherson. CRC Press, Boca Ratan, Fl, 2003.
- YAA BAA. Production, Traffic and Consumption of Methamphetamine in Mainland Southeast Asia", by Pierre-Arnaud CHOUVY & Joël MEISSONNIER Singapore University Press, 232 p., 2004.
- Fighting Methamphetamine in the Heartland: How Can the Federal Government Assist State and Local Efforts? (页面存档备份,存于互联网档案馆) Statement of Armand McClintock Assistant Special Agent in Charge Indianapolis District Office Drug Enforcement Administration Before the House Committee on Government Reform Subcommittee on Criminal Justice, Drug Policy and Human Resources, February 6, 2004
- Phenethylamines I Have Known And Loved: A Chemical Love Story, Alexander Shulgin and Ann Shulgin,(ISBN 978-0-9630096-0-9). a.k.a. PiHKAL. synthesis. online (页面存档备份,存于互联网档案馆)
外部連結
- Second National Conference on Methamphetamine ~ Science & Response: 2007 This year's conference will once again be driven by collaboration and diversity - it will introduce the latest in methamphetamine research and innovative programming to the widest audience possible.
- A Key to Methamphetamine-Related Literature (页面存档备份,存于互联网档案馆) This is a comprehensive thematic index of methamphetamine-related journal articles with links from citations to the corresponding PubMed abstracts.
- Life or Meth - Content Geared Towards The Gay Community (页面存档备份,存于互联网档案馆)
- Newsweek - "America's Most Dangerous Drug" (页面存档备份,存于互联网档案馆), see also Slate - "Meth Madness At Newsweek"
- Erowid Methamphetamine Vault (页面存档备份,存于互联网档案馆)
- Frontline: The Meth Epidemic(Accessed 2/15/06) (页面存档备份,存于互联网档案馆)
- Geopium: Geopolitics of Illicit Drugs in Asia(页面存档备份,存于互联网档案馆)
- Special Report on Meth in California's Central Valley (页面存档备份,存于互联网档案馆)
- "New Yorker" story on the impact of widespread methamphetamine abuse Archive.is的存檔,存档日期2013-01-04
- BBC story on high levels of use of methamphetamine amongst the male gay community (页面存档备份,存于互联网档案馆)
- Drug Enforcement Administration (页面存档备份,存于互联网档案馆):
- Asia & Pacific Amphetamine - Type Simulant Information Centre (页面存档备份,存于互联网档案馆) - a very extensive information source mangaged by the United Nations Office on Drugs and Crime.
- Rotten Library: Methamphetamine
- Meth In Missouri (页面存档备份,存于互联网档案馆) A research blog on meth culture (especially in Missouri) that seeks your input- stories, comments, questions
- Montana Meth Project (页面存档备份,存于互联网档案馆)
- Is Meth A Plague, A Wildfire, Or the Next Katrina? ~ Reason.com (页面存档备份,存于互联网档案馆)
- Crystal Breaks A Chicago-area campaign addressing meth use in the gay community.
- Crystal Meth Anonymous (页面存档备份,存于互联网档案馆) A 12-Step-based Meth Recovery group.
- Meth Strike Force (页面存档备份,存于互联网档案馆) GALLERY and more
- met kullananlar yorumları (页面存档备份,存于互联网档案馆)
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