One group of commonly abused drugs are called stimulants. Major stimulants include:

• Amphetamine
• Methamphetamine
• Cocaine

The first of these, amphetamine, has a number of medical uses—managing attention deficit hyperactivity disorder (ADHD), narcolepsy (a sleep disorder), obesity, etc. Nevertheless, amphetamine is sometimes abused, such as when individuals who do not have ADHD take amphetamine that was prescribed for their friends or family who do have ADHD.

Another commonly abused stimulant is methamphetamine. Though related to amphetamine, methamphetamine is more potent and has higher abuse potential. Thus, its long-term use results in more severe side effects. For instance, methamphetamine use causes “meth mouth,” meaning severe dental problems (e.g., tooth loss, decay, erosion).

The third major stimulant, cocaine, is also a painkiller and may be used as an anesthetic. Its stimulant effects are comparable with amphetamine, but they last a much shorter time.
The effects of major stimulants

Despite their different properties and modes of use and abuse (e.g., snorted, smoked, injected), what major stimulants share in common is that they temporarily increase alertness, energy, and activity levels. They also produce a sense of well-being.

Since stimulants can help people stay awake, remain focused, and improve their performance on tasks, stimulants are more likely to be abused by certain groups of people, like students or truck drivers. Nevertheless, anyone may abuse stimulants.

These drugs have significant side effects. Since they stimulate the nervous system, they cause physiological changes like increased heart rate, blood pressure, and body temperature. Especially with repeated use, paranoia, hallucinations, and aggressive behaviors can result. At high doses, heart attack, seizure, and even death are possible. Abusing stimulants might also lead to stimulant use disorder (stimulant addiction).

Stimulant addiction or stimulant use disorder

As described in the recent Diagnostic and Statistical Manual of Mental Disorders (DSM-5), stimulant use disorder reflects a “pattern of an amphetamine-type substance, cocaine, or other stimulant use leading to clinically significant impairment or distress.” It is diagnosed based on the occurrence of two or more of the following, during a year-long period:

• Experiencing strong cravings for the stimulant.
• Taking the stimulant for longer (or in larger amounts) than initially planned.
• Failing to stop or cut down, despite wanting to do so.
• Spending a lot of time getting or using the drug, or recovering from its effects.
• Inability to meet obligations and duties (e.g., at work) because of drug use.
• Continued use despite recurring personal or social problems.
• Reducing important activities (e.g., exercising) due to stimulant use.
• Taking stimulants in dangerous situations (e.g., driving while high).
• Continued use even when it has worsened health problems.
• Tolerance (i.e. not experiencing the same high when using equal amounts as before).
• Withdrawal (described below).

People who stop or significantly reduce their stimulant use may experience withdrawal symptoms. These symptoms include greater appetite, fatigue, sleep disorders, disturbing dreams, agitation or slowing of movements, and depression. According to the DSM-5, risk factors for stimulant use disorder consist, among others, of parental drug use, exposure to violence in childhood, unstable home life, personality traits like impulsivity and antisocial tendencies, and mental health conditions like bipolar disorder, schizophrenia, and other substance use disorders.

Stimulant abuse is a serious concern in the US, especially in California. California Health Care Foundation notes that over 7% of Californians between the ages of 18 and 25 years used cocaine between 2015 and 2016.2 And according to the Orange County Health Care Agency, nearly a quarter of drug deaths in Orange County, between 2013 and 2015, involved amphetamines.3

This article is provided by Dr. Anthony Mele. Dr. Mele is specialized in the use of dialectical behavior therapy (DBT), motivational interviewing (MI), and attachment theory-based interventions to treat individuals who struggle with multiple addictions, long-standing depression and anxiety, and those who seek to integrate spirituality into their psychological treatment. The most common cannabis use disorder treatment methods are Cognitive-behavioral therapy, Contingency management, and motivational enhancement therapy.

Next: Learn about ways to treat stimulant use disorder.

References
1. https://www.amazon.com/Drugs-American-Society-Erich-Goode/dp/0078026598
2. https://www.chcf.org/wp-content/uploads/2018/09/SubstanceUseDisorderAlmanac2018.pdf
3. https://www.ochealthinfo.com/civicax/filebank/blobdload.aspx?BlobID=64090