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Stimulant Drug Abuse

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Stimulants, both illicit and prescription, are known to increase energy and alertness. Prescription stimulants can offer therapeutic benefits when used as prescribed. However, both prescription and illicit stimulants have a high propensity for misuse, which can lead to serious potential health effects and/or a substance use disorder (SUD).1,2,3

A 2019 survey of substance use patterns among Americans aged 12 and older showed that 5.5 million people reported using cocaine within the last year. In that same time period, 4.9 million people in this same age group reported misusing prescription stimulant medications within the last year, and nearly 2 million people reported using methamphetamine in the last year.5

Considering the potential health effects, it’s important to understand the risks of using stimulants. If you or a loved one have questions about stimulants and their misuse this article can help. It will cover:

  • What a stimulant is.
  • What stimulant abuse is.
  • How stimulants are abused.
  • The signs and symptoms of stimulant abuse.
  • The side effects of stimulants on your physical health and behavior.
  • Stimulant addiction statistics.
  • Abuse of stimulant “study drugs.”
  • How stimulant addiction is treated.

What is a Stimulant?

Stimulants are a class of drugs that increase certain types of central nervous system activity and can include prescription medications or illicit substances.1, 2 Taken as prescribed, prescription stimulants can offer therapeutic benefits to people with conditions such as attention deficit hyperactivity disorder (ADHD) and narcolepsy.2

Common prescription stimulants include:1,2

  • Amphetamines (Adderall, Dexedrine).
  • Methylphenidate (Concerta, Ritalin).

Common illicit stimulants include methamphetamine and cocaine. 1

Unfortunately, many illicit and prescription stimulants are prone to misuse and are highly addictive due in part to the rush of euphoria and exhilaration they often provide.7, 8

In addition to other pharmacological effects, this rewarding rush of stimulants is caused by an increase in levels of certain brain chemicals, including dopamine and norepinephrine.9 Dopamine plays a role in reinforcing pleasurable behaviors within the reward circuitry of the brain.2 Norepinephrine is involved with many of the physical effects of stimulants, such as changes in blood pressure, heart rate, body temperature, and respiratory rate.2, 11

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What is Stimulant Abuse?

The misuse of stimulants is a serious concern as many people of all ages turn to prescription and illicit stimulants for their euphoric and/or alleged performance enhancing effects. But what is stimulant abuse exactly?

Stimulant misuse and abuse occurs when someone takes prescription drugs inappropriately (e.g., without a prescription) or when they use illicit stimulant drugs.4, 5 Stimulants are abused for different reasons depending on the substance and its effects. Stimulants may be misused to: 4, 6, 10

  • Create feelings of euphoria.
  • Lose weight.
  • Feel more alert.
  • Focus and think more clearly.
  • Increase self-confidence.
  • Boost libido.
  • Improve performance at school, work, or in sports.

Whether stimulants are prescription or illicit, the potential adverse side effects are similar, including:10

  • Cardiovascular stressors such as accelerated heart rate and vasoconstriction.
  • Elevated body temperature and hyperthermia.
  • Panic attacks.
  • Psychosis.
  • Hostility.
  • Violent behavior.

Stimulants are also highly addictive because of how they affect brain chemistry.2, 8, 12, 13 Significant increases in dopamine levels affect the reward areas (or reward circuit) of the brain and reinforce stimulant use.2, 6, 8 When a person’s brain is exposed to the substance over and over again, the circuit eventually gets used to the presence of the drug and without it, a person can struggle to feel those positive effects, making it more difficult to stop using.25

How Are Stimulants Used?

Stimulants can be taken in a number of ways with varying effects. Prescription stimulants are most commonly available as tablets or capsules intended for oral use.1, 4, 2 In some cases, people may attempt to crush and snort the pills, or dissolve their contents into water to be injected.2 Illicit stimulants in their various forms are typically snorted, smoked, or injected.1, 6, 14

How a stimulant is used can influence how quickly the effects are felt and how long they last.6, 11, 14 Stimulant effects may be felt most rapidly and intensely when the substances are injected or smoked, although they aren’t felt for as long as they would be with certain other methods of use.11, 14 Snorting stimulants still leads to somewhat rapidly felt effects, though they may be relatively less strong and longer lasting than smoking or using needles.11, 14 Orally ingested stimulants have the slowest onset but the longest duration of effects.11, 12

The way a stimulant is taken may increase the likelihood of certain health risks. Stimulants can be taken by:

  • Injecting stimulants increase the risk of overdose and developing infections and abscesses. Shared needles can lead to blood-borne illnesses such as HIV or hepatitis C.14, 15, 16
  • Smoking stimulants puts a person at increased risk for developing breathing issues.
  • Snorting stimulants can damage the nasal tissue.14, 15

Additionally, the risk of developing an addiction may greatly increase when stimulants are used in ways that produce desired effects more quickly and/or with more intensity.11, 15, 16

Signs and Symptoms of Stimulant Abuse

Blood pressure checked by doctor

If you are worried that you or a loved one may be misusing or abusing stimulants, be aware of some of the potential signs and symptoms associated with problematic stimulant use, which may include:15, 17

  • Frequently dilated pupils.
  • Talking more or faster, or rambling.
  • Having more energy than usual.
  • Eating and sleeping less than usual.
  • Noticeable weight loss.
  • Paying less attention to personal hygiene.
  • Strange smell on the breath, hair, or clothing.
  • Sudden changes in behavior.
  • Getting in trouble at school or work.
  • Skipping days at school or work.
  • Isolating from friends or family.
  • Legal problems due to possession, theft, or driving under the influence, or as a result of erratic or violent behavior.
  • Experiencing money problems, such as needing to borrow money, stealing money or valuables, or going into debt.
  • Spending time with a different group of friends.
  • Using substances in a pattern lasting hours or days, followed by long periods of sleep.

While it can be difficult to identify or admit when you or a loved one is struggling with stimulant abuse, if numerous signs and symptoms listed above are present, misuse of stimulants may be a factor.

Proper diagnosis of stimulant use disorder should be made by a medical professional and based on a person exhibiting 2 or more of the several criteria found in the Diagnostic and Statistical Manual of Mental Disorder’s (DSM-5) regarding substance use disorder. Examples of these criteria include:15

  • Using substances in larger amounts over a longer period of time.
  • Unsuccessful attempts at cutting down or controlling use of substances.
  • Craving substances.
  • Continued use despite knowing it could be physically dangerous.
  • Giving up or reducing time spent engaging in social, recreational, or occupational situations.

It’s important to seek help if you believe you or a loved one is misusing stimulants. Stimulant abuse can increase the likelihood of developing a stimulant use disorder, which can include adverse physical and behavioral health effects. 6, 15 Like other types of addiction, the development of a stimulant use disorder may be accompanied by certain brain changes that themselves make it increasingly challenging to control impulses and stop using the substance.15

Effects of Stimulant Abuse

Woman with paranoia

Stimulant abuse is associated with a variety of health and behavioral effects.4 Some stimulant side effects occur after short periods of use, while others appear after long-term use.4 Stimulant use, either short-term or
long-term, can affect a person’s physical or mental health, and/or change the way a person behaves.

These effects are influenced by factors such as:

  • The type of stimulant being used or misused.
  • How much is taken.
  • How often it’s used.
  • The way it’s consumed
  • How long a person has been using or misusing it.
  • Being used in combination with other substances.4, 7, 10

It is common to develop a tolerance to stimulants, where larger doses of these drugs are needed to get high or feel the same effects that a person is used to.7 The resulting increase in use needed to overcome this tolerance can place people even more at risk for certain adverse drug effects.

Physical Effects of Stimulant Abuse

Stimulant abuse can have a major impact on one’s physical health, whether use or misuse is short- or long-term. The range of adverse health consequences can impact the heart, brain, and teeth.1, 4, 6 Some of the effects that can be experienced even with short-term use may include:1, 2, 4

  • Anxiety.
  • Insomnia.
  • Headache.
  • Dizziness.
  • Increased blood pressure and heart rate.
  • Chest pain.
  • Heart palpitations.
  • Trouble breathing.
  • Decreased appetite.
  • Shakiness.
  • Sweating.
  • Itching skin.

Chronic stimulant abuse also causes physical effects, including: 2, 4, 6

  • Weight loss that can be extreme.
  • Chronic high blood pressure.
  • Cumulatively increased risk of hemorrhagic stroke.
  • Cumulatively increased risk of heart muscle damage and fatal cardiac events.
  • Problems with memory.
  • Damage to the lungs if stimulants are smoked.
  • Difficulty with sexual performance and infertility.
  • Decreased functioning of the immune system.
  • Cumulatively increased risk of skin infections as well as contraction of HIV, hepatitis, and sexually transmitted diseases from sharing needles and risky sexual behaviors.
  • “Meth mouth,” which involves severe dental decay, gum disease, and rapid loss of teeth.
  • Chronic respiratory system inflammation and/or damage to nasal mucosal surfaces if stimulants are snorted.

If too much of a stimulant is taken at one time, it is possible to overdose.1 This can lead to extremely high body temperature, seizures, and even death.1, 2, 4 Chronic stimulant use or misuse can also put one at an increased risk of experiencing sudden death from a heart attack or stroke, or persistent health consequences related to these potentially devastating cardiovascular events.4, 6 If you believe you or a loved one is experiencing a stimulant overdose, call 911 immediately.

Behavioral Effects of Stimulant Abuse

Stimulant abuse can impact a person’s psychological health and behavior as well.4, 6 Chronic use can exacerbate these effects and make them more noticeable.2, 7, 8 These may include:1, 12, 14, 15

  • Becoming agitated, aggressive, anxious, or hostile.
  • Becoming socially isolated.
  • Engaging in repetitive behaviors that don’t serve any specific purpose.
  • Grinding one’s teeth, clenching jaw, and drinking sugary beverages, which exacerbate “meth mouth.”
  • Impaired ability to think, remember, and communicate.
  • Inability to sleep.
  • Inappropriate behavior.
  • Lack of coordination.
  • Mood swings.
  • Prioritizing stimulant use above all else.
  • Psychotic behavior, which can include hallucinations and paranoia.
  • Risky sexual behavior, such as promiscuity or not using protection.
  • Hallucinating “meth mites” and compulsively scratching at your skin, leading to sores.
  • “Tweaking,” where you may exhibit rapid movements of the eyes, lack of coordination, and fast speech that doesn’t make sense.
  • Unpredictable behavior.
  • Using until exhaustion.
  • Violent behavior, which can include homicidal or suicidal tendencies.

Stimulant misuse can quickly turn into stimulant use disorder—in as little as a week in some cases of amphetamine-type stimulant use.2, 15 It can also lead to the development of mental health challenges such as anxiety or depression.10, 12 , 15

Stimulant Addiction Statistics

Stimulant misuse continues to be a concern, as seen in the following stimulant addiction statistics:

  • A 2019 national survey of Americans aged 12 and older showed that 1 million people had an addiction to cocaine in the last year.5
  • The number of people with an addiction to methamphetamine in the last year had increased to 1 million, while the number of people with an addiction to prescription stimulant drugs in the last year stayed steady at 558,000 people.
  • Stimulant overdose rates have been rising, with more than half of the stimulant overdose deaths in 2018 involving opioids.21, 22
  • About 40% of overdose deaths in 2018 were due to stimulants.10
  • In 2019, there were 16,167 deaths caused by psychostimulants, mainly methamphetamine.22
  • In 2019, there were 15,883 deaths caused by cocaine.22

Students and Study Drugs

Prescription stimulants such as Adderall and Ritalin are commonly misused by students to help them stay more alert, improve their focus, and improve their memory.2, 18, 20 In fact, the misuse of prescription stimulants by teens continues to rise and be a significant problem affecting younger populations.27 In the early 2000s, the
non-medical misuse of prescription stimulants was second only to marijuana in terms of illicit drug use taking place in college.20

The misuse of prescription stimulants as study drugs can involve significant risks, a danger that is often overlooked.2, 17, 20 Young people who misuse prescription stimulants may also be more likely to misuse other substances and experience a range of polysubstance use associated health effects.2, 20

Stimulant Addiction Treatment

Professional rehabilitation has helped many people recover from addiction to stimulants.16 Treatment will be tailored to meet each individual’s unique needs and may include a combination of medical care, psychiatric services, counseling, behavioral therapy, vocational training, and other links to social services to best support the whole person throughout recovery.6, 21, 26

If stimulant use is causing problems in your life or that of someone you love, or you have questions about stimulant addiction treatment, call American Addiction Centers at 1-877-751-2819 to receive valuable information and find a program that provides the compassionate and effective care you need.

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Dr. Thomas received his medical degree from the University of California, San Diego School of Medicine. During his medical studies, Dr. Thomas saw firsthand the multitude of lives impacted by struggles with substance abuse and addiction, motivating him to seek a clinical psychiatry preceptorship at the San Diego VA Hospital’s Inpatient Alcohol and Drug Treatment Program. In his post-graduate clinical work, Dr. Thomas later applied the tenets he learned to help guide his therapeutic approach with many patients in need of substance treatment. In his current capacity as Senior Medical Editor for American Addiction Centers, Dr. Thomas, works to provide accurate, authoritative information to those seeking help for substance abuse and behavioral health issues.
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