Crystal meth signs of use: how to spot shabu (ice) and why it harms the mind

Crystal meth signs of use: the short answer first

The signs of crystal meth use (shabu or ice) don't come down to one clue. They show up as a fast change with no reasonable explanation in sleep, weight, mood and behavior over a few weeks. What families usually notice first: staying awake for days with almost no sleep, extra energy and talking, clear loss of appetite and weight, then a sudden crash into very long sleep, along with irritability and suspicion of the people closest to them.

Methamphetamine is a powerful synthetic stimulant with a very high potential for addiction, as the US National Institute on Drug Abuse (NIDA) describes it. So the shabu drug is simply this substance under a local name: shabu, ice and crystal in Egypt, shabbu in the Gulf and Yemen, and crystal in Iraq. English-language sources call it "ice" or "crystal meth".

Worried about a relative? Here is what deserves attention:

• Sleep: stays awake for long stretches, sometimes several days in a row, then sleeps heavily for a long time. If they can't be woken or their breathing seems unusual, that isn't ordinary sleep: call an ambulance on 123 (or your local emergency number) now.
• Weight and appetite: eats very little and loses weight noticeably fast.
• Energy: sudden activity, rapid nonstop talking and restlessness, followed by deep exhaustion.
• Mood: explosive over the smallest things, then depressed and flat.
• Thinking: suspicious of family, feels watched or plotted against.
• Daily life: drops out of work or study, money goes missing, new friends, sudden absences from home.

Each of these signs can have a completely different cause: late nights, depression, bipolar disorder, a thyroid problem or work stress. Together they raise suspicion but don't diagnose anything; a doctor makes the diagnosis after an examination. This article helps you know when to ask for a medical assessment, not reach a verdict at home.

Physical signs of meth use

Short-term physical effects of use include dilated pupils, dry mouth, teeth grinding and jaw clenching, a rise in body temperature, fast heartbeat and breathing, and loss of appetite, according to Australia's Alcohol and Drug Foundation. They come and go with use, so you won't see them daily.

With continued use, clearer and longer-lasting signs appear, as described by NIDA, the US National Library of Medicine (MedlinePlus) and the Alcohol and Drug Foundation:

• Obvious weight loss, with a thin face and body and a poor appetite.
• Dental problems: decay, broken and lost teeth with a dry mouth, known as "meth mouth".
• Severe itching, so you may notice them scratching often.
• High body temperature, sometimes to the point of passing out.
• Disturbed sleep: long insomnia, then broken, unrefreshing sleep.
• Heart and kidney problems as use goes on.

Meth psychosis signs and other psychological symptoms

The psychological side is the hardest for families to face, and the most misunderstood. Parents often believe their son has "changed character" or been struck by the evil eye, when what they see is the drug's direct effect on the brain. The best-known psychological symptoms of shabu:

• Paranoia: believes family members are spying on them or want to turn them in, or that someone follows them in the street.
• Hallucinations: hears voices or sees things that don't exist, and may talk to them.
• Fixed false beliefs (delusions) held onto however much you reason with them.
• Agitation and aggression, quick to explode, sometimes threatening or breaking things.
• Severe anxiety and tension, unable to sit still.
• Depression and complete flatness after use.

NIDA notes that these psychotic symptoms, hallucinations and delusions, can appear even when the person is not under the influence of the drug. This matters: suspicion or hallucinations after stopping don't necessarily mean the person is using again, but they do call for psychiatric follow-up.

The high-then-crash cycle

Someone using shabu can look contradictory from outside: days awake, talkative and confident, starting many things and finishing none, then a sharp crash of long sleep, waking irritable, sad and hungry. The MSD Manual describes how heavy use over several days ends in extreme exhaustion and a strong need to sleep. Families who don't know this cycle blame "laziness" or "moodiness", but it's the typical stimulant pattern.

In a small Iraqi study published in Frontiers in Psychiatry in 2024, of 73 men receiving treatment for methamphetamine dependence at a hospital in Baghdad, men with major depression scored higher on an aggression scale, and higher levels of the drug in urine tests went along with more severe depression and more loneliness. A study this small shows a link, not a proven cause, but suggests that depression, aggression and social withdrawal may be part of the illness itself, not just "bad character".

Why has meth spread in Egypt, the Gulf, Iraq, Sudan and Yemen?

Methamphetamine is made in labs, as NIDA describes it, not extracted from a farmed plant, and its local names vary by country. Published figures on its spread in the region are few, but those that exist point one way:

• Iraq: an Iraqi study published in Frontiers in Psychiatry in 2024 cites earlier research (2014) reporting a sharp rise in the use of amphetamine-type stimulants, especially methamphetamine and captagon, with a notable increase in Basra province.
• Saudi Arabia: a forensic study published in 2026 in the Journal of Analytical Toxicology found that investigated methamphetamine-related deaths ("shabu" locally) in Jeddah rose from 10 cases in 2018 to 27 in 2022, about 2.7 times as many.

We found no reliable, up-to-date published figures on ice use in Egypt, Sudan, Yemen or the rest of the Gulf, so be wary of any country figure circulating without an official source.

Why do young people try it? The common reasons are understandable, if misleading:

• The illusion of energy: someone working long hours or studying for an exam hears it "keeps you awake and sharp", and no one mentions the crash a few days later.
• The illusion of weight loss: losing appetite is sold as a benefit, when it is really malnutrition and exhaustion.
• The illusion of control: "just once, at parties, I won't get hooked", which the drug's very high addiction potential proves wrong.
• Social pressure: friends who use, night work, or a time of loss, unemployment, war and displacement in some countries of the region.

How can a family stay safe during a paranoid or violent episode?

If your relative is in intense suspicion, hallucinations or agitation, what they see and hear is real to them in that moment. Arguing, proving them wrong or mocking them increases their fear, and fear is what turns into violence. Your goal then is not to convince or treat them, but to calm things down and keep everyone safe.

1. Lower your voice and slow down, using short, simple sentences. Shouting raises tension instantly.
2. Don't approach suddenly or from behind; keep a comfortable distance and leave an open way out of the room for both of you.
3. Don't argue with the hallucinations or confirm them; you might say: "I don't see what you see, but I believe you're scared, and I'm here with you."
4. Move children and older relatives away, and quietly put sharp objects out of reach without making a show of it.
5. Don't corner them or lock them in, and don't try to restrain them on your own.
6. Ask an adult they trust for help if you can, and don't face it alone if you feel in danger.
7. Get yourself and others to safety and call for help as soon as you feel in danger; don't wait for actual violence.

Effects of crystal meth on the brain, heart and mental health

The harm isn't limited to the hours of use. NIDA reports that long-term use can lead to insomnia, memory loss, anxiety, confusion and mood disturbances, and that there is evidence of declining mental abilities with prolonged use, such as difficulty with verbal learning and slower reactions, though this still needs more research.

In the body, NIDA says the drug can cause a fast, irregular heartbeat, high blood pressure and kidney damage, and is linked to the risk of stroke and heart failure. Add tooth decay, weight loss and a higher risk of infections spread through blood and sex, such as HIV and hepatitis.

The mental picture is the hardest: depression and anxiety that can last months after stopping, and suspicion and psychosis that can appear even outside times of use. Some people have two diagnoses at once, a substance use disorder and a separate mental illness (depression, bipolar disorder or schizophrenia), called a dual diagnosis. Both need treating together, so our psychiatrists and addiction specialists share one plan: treating one and neglecting the other can weaken the chances of recovery.

The good news is that recovery is possible. With stopping, regular treatment and follow-up, and attention to nutrition and sleep, many people gradually regain their ability to work, study and share in family life.

Why can't they just stop on their own?

Every family asks: "He knows it's destroying him, so why won't he stop?" Continuing to use despite harm is the very definition of addiction, not proof of weak willpower. The drug has changed the brain's reward system, so everything else, food, success, relationships, feels dull next to it.

Stopping is also harsh. Per NIDA and the Alcohol and Drug Foundation, its symptoms include depression, anxiety, irritability, aches, severe fatigue, disturbed sleep, poor concentration and intense cravings. NIDA notes they peak two to three days after the last use and last about a week, after which low mood, anxiety and cravings may remain for several months; the Alcohol and Drug Foundation notes most symptoms ease within about a month, while psychological effects can last longer. The MSD Manual adds that some people, especially those prone to depression, may become depressed and have thoughts of suicide after stopping.

That's why stopping suddenly at home without follow-up is not advised, especially if other substances are used too (alcohol, sedatives or pills), because withdrawal from some of them is dangerous and needs medically supervised detox. For the stopping period day by day, see our article on crystal meth withdrawal symptoms.

When to get help and how treatment starts

Don't wait for "rock bottom" or a disaster. Ask for a medical assessment now if any of these apply:

• Suspicion, hallucinations or aggression, even once.
• Days without sleep, fast weight loss, or clear neglect of health and teeth.
• Use continues despite losing work, study or relationships, or despite failed attempts to stop.
• Depression or thoughts of self-harm.
• Other substances used alongside ice.
• Pregnancy, heart disease or high blood pressure, or a family history of mental illness.

Treatment usually begins with a doctor's appointment and a full assessment of physical health, mental state and any co-occurring disorder. There is currently no medication approved by the US Food and Drug Administration (FDA) for methamphetamine use disorder itself, as NIDA explains. A doctor may prescribe medicines for related symptoms such as psychosis, depression or insomnia; that is the doctor's decision alone, and no medicine should be started or stopped on your own.

The backbone of treatment is behavioral therapy. NIDA explains that contingency management (small rewards for drug-free tests and for sticking with treatment) is most strongly linked to treatment success, alongside cognitive behavioral therapy, motivational interviewing and support groups. Long-term follow-up to prevent relapse and family involvement complete the plan.

In Oxygen Center's addiction treatment program, this all happens in one plan: medical and psychological assessment, a supervised stopping period, individual and group behavioral therapy, and family counseling within the rehabilitation program, because how things are handled at home shapes the outcome. Inpatient stays at the center are for males aged 15 and over (under 18 with a guardian's consent); women are welcome for outpatient doctor appointments, therapy sessions, behavior-modification sessions and drug tests. The stages and length of treatment are in our article on crystal meth addiction treatment.

If you're unsure whether what you see is drug use, a mental illness or exhaustion, don't settle it alone. Get in touch on +20 101 687 0711 by phone or WhatsApp. Recovery from ice is possible, and the first step can be taken today.