Meth Head is a character deck card in Back 4 Blood is an Offense Type Card with Reflex 
Affinity. Meth Head gives the most melee bonuses of all cards in Back 4 Blood and is a staple to many melee builds.
Card Ability
Each Melee swing grants 5% Melee Speed and 5% Melee Stamina Efficiency for 6 seconds. stacking up to 10 times.
Your Melee Attacks no longer stick in tough enemies.Disables: Aim Down Sights
The Meth Head card in Back 4 Blood gives 1 stack of +5% Melee Speed, +5% Melee Stamina efficiency for 6 seconds up to 10 stacks. It also ensures melee attacks no longer get stuck in tougher enemies. All of these bonuses come at the cost of losing the ability to aim down sights.
Pros
- Much faster melee swing
- Less stamina cost per swing
Cons
Meth Head has only 1 negative effect by disabling the ability to aim down sights but it radically changes the way players will use their primary weapon.
To lessen this disadvantage, players can use shotguns at closer ranges where accuracy isn’t needed or include accuracy-boosting cards in their deck to improve shooting at all ranges.
Card Synergies
In Back 4 Blood, choosing the best cards to go with Meth Head will help your build go much further into runs than choosing random cards. For the most part, Meth Head synergizes well with two types of cards: other melee cards or other cards with aiming down sights disabled.
Melee Cards
Brazen – Like Meth Head, Brazen gives melee stamina efficiency (20%) and melee attack speed (30%) but with smaller bonuses. When paired together, players will use half stamina per swing while swinging at 1.7x base speed.
Battle Lust – Another melee-focused card that greatly increases survivability by healing 2 health per kill.
Spiky Bits – A great beginning card since it increases melee damage by 20% and damage resistance by 10% while using a melee weapon. And if you’re using Adrenaline Fueled, you’ll be able to swing your weapon at full strength for a long time.
Adrenaline Fueled – It helps keep player stamina up to melee almost indefinitely by regenerating 7 Stamina over 5 seconds for each melee kill. This effect can stack up to 5 times.
Similar Negative Effect Cards
Killer’s Instinct – Killer’s Instinct also disables the ability to aim down sights but will increase weakspot damage +30%. This card helps players take down Mutations more quickly.
Quick Kill – Quick Kill in Back 4 Blood gives the highest single card increase to accuracy at 50% while also disabling aiming down sights. It greatly reduces bullet and pellet spread. When added with other accuracy cards or attachments to 100%, hip-fired shots will be perfectly accurate to where all bullets/pellets will hit the center of the crosshair every time.
Mag Coupler – Gives 50% faster reload speed. Great for players who choose to use pump shotguns or bolt-action sniper rifles because reload speed also increases the firing rate for these weapons.
Motorcycle Helmet – Similar to Meth Head, Motorcycle gives the highest bonus for 1 stat (15% Damage Resistance) and also gives +10 Health at the cost of aiming down sights.
Card Alternative
For some players, not being able to aim down sights may be a deal-breaker for running Meth Head in their melee build.
Instead, players can include Brazen and Slugger in their build to replicate the 30% Melee Stamina Efficiency Bonus.
The pros of running these 2 cards in place of Meth Head are +5 Health, 10% more Melee Attack Speed (50% vs 40%), and the ability to aim down sights.
The cons of runnings these 2 cards in place of Meth Head are -5% Damage Resistance and using 1 extra card.