I've known anorexic insomniacs, and they don't look nearly as bad as these meth users do.

I guess it's all in the hygiene?

In my experience, meth makes you feel amazing at first - full of creative energy, alert and extremely motivated (to get more meth, mostly). It's not until you've been up for four days straight that the extreme paranoia and delusion sets in that it starts to go terribly wrong. I've never heard or seen anything like a "doorway" described but then I haven't done any meth in years (thankfully) so maybe that's a new thing.

Yeah, the main problems with meth aren't the effects of the meth, they're the effects of the sleep deprivation induced psychosis that binging on meth can bring about.

I too would like to know this.

Those are from the crank bugs, either actual paranoid hallucinations or simply the inability to stop fixating on and picking the skin or face.

Also all the stuff Zircon mentioned -- Most of these people are just victims of hard living, the meth only accelerates their trip to the grave.

Picking is part of it, but the sores mostly come from the fact that meth decreases your immune system which leads to simple little infection that you normally wouldn't notice (pinprick type stuff) getting really infected. If the person is already predisposed to acne or something, the acne will be many times worse because of the meth effects.

According to a friend of mine that used to do meth, the smoke is somewhat caustic (which accounts for the teeth). It's essentially a combination of the two- you might get a small blemish or some zits or something from smoking it, then you've got all the attention span in the world to pick at whatever tiny wounds you have.

Meth causes blood vessels to constrict, which can lead to the weakening of these vessels over time. This obviously can inhibit the body's ability to repair itself. In addition to what others have said about picking, these conditions together can cause nasty sores.

I've also heard that staph is a culprit too, since poor hygiene is likely present.

I would disagree. Plenty of people don't look horrible like that. It depends on the person and how much they use. People respond differently. Although, what exactly does "long time meth use" mean? I can't honestly say I know many people that didn't do it at some point, but I also don't know anybody doing it now. It seems like a somewhat self limiting drug given the way the negative effects just keep getting worse.

Yeah I've known people with a crack habit that still functioned in society for extended periods of time.