Methamphetamine thread:

One reason why methamphetamine is such a problem:

Acute subjective effects (the high) fade over 4 hours, but the bad cardiovascular effects last longer.

So, people tend to dose again (and again) every few hours and cardiovascular effects stack up.
Interesting methamphetamine metabolism feature:

Metabolism mainly in the liver (by CYP2D6) and doesn't increase with chronic use. So, any tolerance is pharmacodynamic(response to drug), not pharmacokinetic (drug levels in body).
Something remarkable about methamphetamine route of administration:

Peak plasma levels are 2.5 hours after smoking and 4 hours after intranasal use. This is delayed. With other drugs, the inhalational route is kinetically pretty similar to injection.
To learn more, a nice review:
https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1360-0443.2009.02564.x
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