Objective: Methamphetamine abuse remains a significant public health concern since its assent to peak popularity in Iran. Methamphetamine possesses one of the most domestic markets among other drugs of abuse in Kermanshah, Iran. Clandestine methamphetamine laboratories employ different methods and consequently a wide range of chemicals for the illicit production of methamphetamine. Yet there is limited information about active pharmaceutical ingredients in methamphetamine samples seized in Kermanshah, Iran. The current study aimed to identify active pharmaceutical ingredients and manufacturing by-products in methamphetamine samples seized in Kermanshah, Iran. As no organ in the body remains unscathed by methamphetamine and its impurities abuse, the other purpose of the present study was to discuss health effects associated with impure methamphetamine abuse in a brief review.Methods: Analytical study was conducted on 53 methamphetamine samples using gas chromatography/mass spectrometry method. We reviewed the health outcomes of methamphetamine abuse and the evidences supporting pharmacological effects of methamphetamine impurities.Results: Analysed methamphetamine samples contained methamphetamine, amphetamine, ecstasy, phenmetrazine, pseudoephedine, tramadol, benzaldehyde, acetic acid and other chemicals. Information has been discussed for common harmful effects of methamphetamine and its impurities abuse. Conclusion:Illicit methamphetamine crystals contained different chemical impurities originated from manufacturing processes and active pharmaceutical ingredients deliberately added to them. The main prominent synthetic routes for methamphetamine synthesis are Leuckart and Nagai methods in Kermanshah, Iran. In addition to the chemical hazards present in methamphetamine laboratories, there are many hazards posed to anyone involved in direct and indirect contact with these contaminants.
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