In the early twentieth century, the amphetamines and their derivatives were first abused as bronchodilators [1]. In this regard, the methamphetamine (crystal) is a strong stimulant of addictive substances that affects the central nervous system, which is easily produced in underground laboratories [2, 3]. The acute effects of methamphetamine usage are related to increasing the energy and attention, increasing the positive mood, and decreased appetite [4].
The half-life of methamphetamine is approximately long, as compared to other stimulant substances such as cocaine and nicotine, which is between 8–12 hours. Here, it should be mentioned that this substance is a central nervous system stimulant, it facilitates the release of Norepinephrine and Dopamine from Neurotransmitter and delays their re-absorption to some extent [5]. Besides, the methamphetamine deprives tissues of oxygen by vasoconstriction, while the high norepinephrine circulation can lead to tissue damage [6, 7]. Moreover, the continued usage of methamphetamine can damage various organs in the body. In this regard, the heart risks such as chest pain, arrhythmia, hypertension, cardiomyopathy and even heart attack have noticeably been observed in young consumers [7–9].
The results of a conducted study of 353 methamphetamine consumers who went to the emergency department indicated that about 18.7% of them, had mental health problems, 18.4% suffered from trauma, 11.11% suffered skin infections, and 9.6% suffered from oral problems [10]. At the meantime, the heart attack and seizures have also been reported in methamphetamine consumers [11–13].
Other problems such as movement problems such as hyperkinetic movements, the stereotyped and repetitive behaviors may also be observed [14, 15]. In this matter, recent studies confirmed the relationship between methamphetamine usage and severe dental disease, known as "meth mouth" [16, 17]. Other studies reported that about 40 percent of methamphetamine consumers have experienced complete neurodegenerative psychological damage [18]. Here, the crystal usage would cause tolerance and dependence on it that would lead to creating a condition called psychosis methamphetamine, which is a paranoid schizophrenic [19].
The relevant researches have shown that crystal usage is rising among teens and young around the world, which can lead to complications such as pathology, mental retardation, auditory hallucinations, suicidal ideation, depression, anxiety, violence, and fatigue, suspicion, aggression, severe temptation to usage, high-risk sexual behaviors, cardiovascular problems and even death [20, 21].
In this way, a 2015 UN report revealed that the production of stimulant substances has been increased from 34 tonnes in 2009 to 88 tonnes in 2013 [21], which this is probably why the Iranian studies have reported that in recent years, the usage pattern has been changed from the traditional substances to industrial, while the usage type has been converted from tobacco to injection. In 2008, more than 6% of drug addicts over the age of 12 in Iran were crystal consumers, while most of them were young people. Hence, the amount of crystal usage has dramatically increased from 2008 to 2012. A conducted study in 2010 by praying people found that 25%of drug addicts were crystal consumers, in which the average age of them was 18 years [22, 23]. The results of an implemented study in the country showed that 15% of Iranian addicts abuse the crystal [25]. The results of a study in Zahedan also confirmed that the amount of crystal usage among people referring to a methadone maintenance center has been increased from 6% in 2009 to 20% in 2011 [26]. To succeed in the addiction control and prevention programs, it is essential to identify the main causes of people's addiction and its contributing factors. In the meantime, the qualitative studies can provide vital and valuable information to the researcher by reaching the mental content of individuals due to they are more in-depth. For this reason, to determine the main causes of people's tendency to abuse the crystal, such (qualitative) studies can provide access to the real conditions of people and their experience, based on which without any change or intervention, they can gather data and prepare an accurate reflex of the main causes of the crystal usage [27].
Here, it should be noted that methods based on questionnaires and closed-ended questions that are commonly employed, may restrict the depth of participants' answers, and as a result, the quality of the data gathered may be either reduced or incomplete. As such, the questionnaire-based methods, where there is little or no information on an issue or area of content or information, are not the proper method to choose. In such cases, the qualitative methods are strongly better [28]. Regarding the fact that the number of qualitative, in-depth and comprehensive studies on the causes of crystal usage in our country is limited to obtain comprehensive, in-depth and first-hand information, this paper was conducted in Golestan province to explore the main factors related to the first usage of crystal among its consumers.