Last reviewed: 30/09/2026

Guidance

Methamphetamine

We need to understand the effects of methamphetamine use, its impact on the safe care of tamariki and rangatahi, and how to respond safely and effectively.

Updates made to this guidance

30 September 2026: This guidance has been refreshed.

Supporting practice

Our practice is delivered through our practice framework, our practice models Te Toka Tūmoana and Va'aifetū, our practice standards, and our tools and resources.

What is methamphetamine

Methamphetamine is a highly addictive and powerful synthetic stimulant that affects the central nervous system. It is produced and sold illegally in various forms: pills, capsules, powder and crystals. It can be swallowed, snorted or injected, but is most often smoked using a glass pipe.

In Aotearoa New Zealand, methamphetamine is commonly known as 'P' but is also called ice, crystal, crack, tina, go, and meth.

Effects of methamphetamine

Methamphetamine affects people differently. The impact depends on how it is taken (smoking, inhalation, injection or ingestion), the amount used, and a person's mood and personality.

Methamphetamine increases dopamine in the brain. Dopamine is a 'feel-good' brain chemical that creates a strong sense of pleasure and energy. It also suppresses hunger and prevents sleep. The effects can last from 4 to 16 hours.

Following use, many people experience a 'crash' that can last for days and include exhaustion, low mood, irritability, and long periods of sleep. To relieve these symptoms, the user often takes more methamphetamine, which contributes to patterns of larger amounts and more frequent use.

Methamphetamine use is associated with increased emotional reactivity, impaired judgement, and higher rates of paranoia and agitation. These effects are not solely caused by the drug itself but emerge from the interaction between methamphetamine’s neurobiological effects and other factors such as sleep deprivation, withdrawal, trauma history, mental health, and existing behavioural patterns. As a result, individuals may present with heightened or more extreme expressions of behaviours that were already present.

Recognising methamphetamine use

Signs of use can change over time and should always be considered alongside context, patterns and impact rather than in isolation.

Short-term signs during or soon after use:

high energy, alert or unusually talkative
overconfident or impulsive behaviour
difficulty concentrating
unusual chemical smells, like nail polish remover, cat urine, rotten eggs or burning plastic.

Signs after several consecutive days of use may include:

agitation, mood swings, anxiety or hallucinations
visible confusion
verbal or physical aggression
reduced food and sleep
a dry mouth, nausea, psychosis and paranoia
dilated pupils.

Long-term or sustained use:

memory loss, poor judgement and decision-making
depression, anxiety, panic and suicidal thinking
reduced empathy and impaired social functioning
ongoing psychosis, aggression
weight loss
physical health issues, such as tremors or twitching, dental problems, skin sores, irregular heart rate, seizures, stroke risk.

Interventions and treatment for problematic use of methamphetamine and other amphetamine-type stimulants (PDF 1.3 MB) | Ministry of Health

Use of methamphetamine by tamariki and rangatahi

Understanding methamphetamine use alongside alcohol and other drug use is important. The Substance and Choices Scale (SACS) can be used to screen use.

SACs, Kessler and Suicide screens (SKS)

Working together with alcohol and drug specialists is essential. Seeking expert advice will ensure we are responding to the right substance use and underlying needs. Support should address both substance use and contributing factors such as trauma, mental health needs, and social stressors.

Building understanding of methamphetamine use in a parenting context

If parents or carers are using methamphetamine, it can present significant risk to tamariki and rangatahi because it impacts parental or carer supervision, responsiveness or safety, but it does not automatically mean they are unable to provide safe care for tamariki or rangatahi.

We focus on building a clear understanding of how their use is affecting their caring capacity and the oranga, including safety, of tamariki or rangatahi in their care.

Consider the following key areas when building an understanding of the impact of methamphetamine use:

Effect of methamphetamine use – consider how it affects behaviour and mental state, and how withdrawal is managed.
Substance use patterns – consider if methamphetamine is used alongside alcohol, cannabis or other drugs.
Frequency and intensity of methamphetamine use – consider how often and how heavily methamphetamine is used, and what this tells us about how and when tamariki or rangatahi are at risk, and what supports might be required.
Trauma and mental health – consider the person’s history of trauma and how it impacts on their use and current situation. Co-existing trauma or psychological issues can compound risks.
Impact on parenting or care – consider if the supervision, emotional support or home safety of tamariki or rangatahi is compromised, and if tamariki or rangatahi are being exposed to risk or instability.
Vulnerability and needs of each tamaiti or rangatahi – consider their age, developmental stage, disability, health needs, trauma history, communication needs, dependency on the parent or carer, and ability to seek help or keep themselves safe.
Financial cost – consider if methamphetamine use is placing pressure on finances and the carer's ability to meet the needs of tamariki and rangatahi in their care.

How use of methamphetamine by parents or carers can affect tamariki and rangatahi

The impacts on tamariki and rangatahi when parents or carers are using methamphetamine vary depending on patterns of use, the presence of protective adults, and the stability of the home environment.

Depth of assessment is important. We need to build our understanding about:

where tamariki and rangatahi are while use is occurring, and who they are around
who is caring for them, and how consistently
what supports are in place, especially during periods of use or 'crash'
who parents or carers are with while using and where they are using, and what this means for the safety, supervision and vulnerability of tamariki or rangatahi.

When tamariki and rangatahi observe their parents or carers, they are at risk of learning to respond to distress in paranoid or violent ways, perceive intervention from professionals as intrusive and adopt maladaptive coping skills consistent with the environment they grew up in.

Immediate safety and care risks

These risks can occur during active use or the crash period that follows:

Reduced supervision and responsiveness, particularly during crashes when parents or carers may sleep for long periods or experience low mood and lethargy. This can leave tamariki unsupervised and may result in older tamariki or rangatahi taking on caring roles.
Reduced ability to meet basic care needs (for example, food, hygiene, safe housing conditions).
Reduced capacity to respond to emotional needs.
Increased irritability, paranoia or agitation, which may heighten the risk of conflict or harm.
Risk of tamariki and pēpi ingesting methamphetamine from contaminated surfaces. Tamariki, particularly toddlers, may not be able to eliminate chemicals from the body as well as adults can.
Exposure to physical hazards (such as unsafe paraphernalia, unstable environments, risk of burns or injury), including risk of accidental ingestion or contact with substances, particularly for pēpi and young tamariki.

Emotional and developmental impacts

Emotional and developmental impacts may emerge over time, including:

unpredictable routines or caregiving, reducing a sense of safety and stability
exposure to high-stress or unsafe environments, impacting emotional wellbeing
inconsistent caring, influencing attachment, trust and emotional regulation
development of adaptive coping responses (for example, hypervigilance, withdrawal, taking on responsibility beyond age).

Exposure risks

Consider what tamariki or rangatahi may see, experience or learn, including:

presence during adult behaviour that is unsafe, confusing or not age-appropriate, particularly where substance use affects judgement and limits inhibitions or boundaries
exposure to environments where substance use or illegal activity occurs, which may influence norms and expectations over time
frequent or unpredictable movement in and out of the home by adults connected to methamphetamine can increase exposure to harm, especially when tamariki or rangatahi are young, vulnerable, poorly supervised, or unable to safely leave or seek help
potential exposure to sexualised behaviour or boundary-crossing interactions
environments where methamphetamine is used or produced, creating health and safety risks (such as hazardous substances, unsafe equipment).

Prenatal impacts on pēpi

Methamphetamine use during pregnancy is associated with:

reduced fetal growth and higher rates of premature births
placental abruption (separation of the placenta from the wall of the uterus, which is potentially life threatening for mother and pēpi)
miscarriage
stress in infants when methamphetamine is used in the first trimester
more lethargy in infants when methamphetamine is used in the second trimester
poorer quality of movement and greater physiological stress when methamphetamine is used in the third trimester.

Methamphetamine-exposed infants are often irritable as newborns and may need calm, responsive soothing and safe settling strategies, guided by health advice and safe sleep practice. They typically have no feeding issues and do gain weight.

While early feeding and early weight gain may appear normal, ongoing developmental monitoring and support for carers is recommended as subtle developmental delays affecting movement, thinking, attention and self-control may emerge over time.

Practice considerations

When working with methamphetamine users:

collaborate with addiction professionals to find ways of engaging and working with those using methamphetamine to support our understanding and planning
provide clear, specific instructions and check understanding – people using methamphetamine may struggle to organise and comprehend information presented to them, including directions, and following through on plans
avoid hui or seeking agreement to long-term plans until at least 3 days after use (when they have moved past the 'crash' stage) whenever possible
maintain an open, honest and non-judgemental approach. Recognise they may not be ready to answer some questions until they’ve had support to reflect on their methamphetamine use.

For parents or carers who are using while caring, we need to understand what safety and support are in place for tamariki and rangatahi. Specifically:

identify the people and places they consider safe and who can or does support them
how they protect their tamariki and rangatahi from exposure to methamphetamine
how they ensure there is enough food available and who provides care for their tamariki and rangatahi
identify support networks and safety plans for tamariki and rangatahi during crashes.

Support and treatment

Treatment for methamphetamine addiction requires specialist support.

Spend time exploring:
- their willingness to seek and accept support
- where they are in the stages of change.
Plan with specialists how withdrawal is managed.
Plan for ongoing support. Link parents, carers, tamariki, rangatahi and their whānau and family to services that provide addiction treatment and wraparound care.
Develop safety plans for tamariki and rangatahi, and review regularly to ensure they are addressing the risks.
Acknowledge this is a journey – safety plans and agreements should include strategies for managing relapse.
If the parent, carer, tamaiti or rangatahi has acknowledged use, consider a urine or hair test when they provide value. Tests can:
- offer a snapshot in time of substance use
- inform our safety planning to respond to increasing or decreasing risk
- provide evidence of change if results are negative.

Positive tests require analysis about the impact of use on their behaviour and any risks to themselves or others.

Youth justice and residential care

Tamariki and rangatahi in youth justice may be supported through the Alcohol and Other Drug Treatment Court.

Specialist courts | Ministry of Justice

Tamariki and rangatahi in residence may need added support if they're managing a crash or withdrawal. Medical assessment and advice should guide our care responses.

Policy: Working with tamariki and rangatahi in residences

Policy: Goal Plan for te tamaiti or rangatahi

When tamariki or rangatahi are exposed to a methamphetamine clandestine laboratory

Strange smells, fumes and vapour escaping from windows or ventilators, sealed windows and premises being used for purposes other than normal are some of the signs that indicate premises may be being used as a clandestine lab.

If kaimahi suspect the presence of a methamphetamine clandestine laboratory, they should not enter the area and should alert Police. If kaimahi are already in the building, they should leave immediately.

Take all reasonable steps to ensure the safety of any tamariki or rangatahi present.

Staff resource: New Zealand Police and Oranga Tamariki Joint Standard Operating Procedures for Children and Young Persons in Clandestine Laboratories (PDF 7.9 MB)

Kaimahi safety considerations

Working with whānau or families where there may be methamphetamine use requires thoughtful preparation and ongoing situational awareness.

Before engagement, review known information, plan visits at safer times, plan an exit strategy and consider whether joint visits or additional support are needed.

During visits:

stay aware of changes in behaviour, who is present, and any environmental risks such as unsafe conditions or unfamiliar people
position yourself so you can exit easily, keep appropriate distance, and maintain a calm, respectful approach
if someone appears impaired, agitated or withdrawn:
- focus on immediate safety
- keep interactions brief
- avoid complex or difficult conversations.

Safety is dynamic, so kaimahi need to continually assess and respond to what is happening in the moment. Trust your judgement – if something feels unsafe, it is appropriate to pause, leave or reschedule.

Avoid contact with substances or paraphernalia and take care in environments that may pose health risks. Working as part of a team is key: share information, debrief after visits, and seek specialist or supervisory support where needed.

Staff resource: Health, safety and security | Te Pae

Staff resource: Working in an uncontrolled environment (PDF 562 KB) | Te Pae

Staff resource: Checklist for social worker home visit (PDF 154 KB) | Te Pae