Amphetamine abuse
Amphetamine abuse refers to the repeated and nonmedical use of amphetamines, which are powerful central nervous system stimulants known for their addictive properties. This behavior often persists despite negative impacts on the user's daily functioning at home, school, or work. Amphetamines increase dopamine levels in the brain, producing feelings of energy, alertness, and well-being, which can lead to rapid tolerance and a need for higher doses. Historically, amphetamines have been misused since their medical introduction in the 1930s, particularly among soldiers during World War II and later among students seeking to enhance focus.
The substance is relatively easy to obtain, often diverted from legal prescriptions or accessed through illicit online sources. Symptoms of abuse include euphoria and physical health issues like increased heart rate, while severe cases can result in aggressive behavior and psychosis similar to paranoid schizophrenia. Withdrawal can lead to significant psychological distress, including depression and anxiety. Treatment options primarily include psychotherapeutic interventions, as there are no specific medications to combat amphetamine dependence directly. Prevention efforts focus on communication and education regarding responsible medication use, especially among youth who may be more vulnerable to misuse.
Amphetamine abuse
DEFINITION: Amphetamine abuse is the repeated, high-dose, nonmedical use of amphetamines, which are potent, highly addictive central nervous system stimulants. Abuse continues despite the user’s inability to function normally at home, school, and work.
Causes
Amphetamines are rapidly absorbed once ingested. When they reach the brain, they cause a buildup of the neurotransmitter dopamine. This leads to a heightened sense of energy, alertness, and well-being that abusers find pleasurable and productive for repetitive tasks. Tolerance develops rapidly, leading to the need for higher doses.
Amphetamines are easy to obtain, often through diversion from legal use, and they are relatively inexpensive. Using them does not carry the social stigma or legal consequences associated with the use of other stimulants, such as methamphetamine and cocaine.
Risk Factors
Amphetamine abuse is widespread and has been present almost since its introduction for medical use in the 1930s. Soldiers widely abused amphetamines during World War II to maintain alertness during long hours on duty. They are still used by some military personnel in combat settings.
After the war, amphetamines became popular among civilians, especially students who used them to keep awake for studying and as appetite suppressants and recreational drugs. By the 1960s, about one-half of all legally manufactured amphetamines were diverted for illegal use. With greater control over the distribution of commercially manufactured amphetamines, manufacture by clandestine laboratories increased dramatically. In addition, the Internet has become a popular source for nonprescription amphetamines. While in the early twenty-first century, amphetamines used to be available from online foreign pharmacies, a crackdown in these pharmacies led many to turn to the dark web, where amphetamines can contain more dangerous substances, such as fentanyl.
In the twenty-first century, abuse occurs primarily among young adults (aged eighteen to thirty years). A common venue for their abuse is the rave, an all-night music and dance concert or party. However, college students looking to study long hours and with access to other students’ prescriptions and shift workers are also likely to abuse amphetamines. Use among males and females is evenly divided, except for intravenous use; in this case, males are three to four times more likely to use the drug intravenously. Abusers can rapidly become both physically and psychologically dependent on amphetamines, with a compulsive need for the drug.
Symptoms
Physical symptoms of amphetamine abuse include euphoria, increased blood pressure, decreased or irregular heart rate, narrowing of blood vessels, dilation of bronchioles (the breathing tubes of the lungs), heavy sweating or chills, nausea, vomiting, and increases in blood sugar. High doses can cause fever, seizures, and cardiac arrest.
Frequent, high-dose abuse can lead to aggressive or violent behavior, ending in a psychotic state indistinguishable from paranoid schizophrenia. Features of this state include hallucinations, delusions, hyperactivity, hypersexuality, confusion, and incoherence. One such delusion is formication, the sensation of insects, such as ants, crawling on the skin. Long-term use can result in permanent memory loss.
Screening and Diagnosis
Routine blood and urine testing do not detect amphetamines in the body. Abusers who use pills or who snort amphetamine leave no outward signs of the abuse. Smokers may use paraphernalia to use the drug. Abusers who inject the drug will have needle marks on their skin.
A change in behavior is the primary clue to amphetamine abuse. The abuser develops mood swings and withdraws from usual activities and family and friends. Basic responsibilities and commitments are ignored or carried out erratically. The abuser becomes hostile and argumentative. Any change in a person’s appearance, such as sudden weight loss, or in behavior, such as agitation or change in sleep patterns, should be addressed. Such changes may indicate amphetamine abuse. Experts recommend that parents focus their concern on the youth’s well-being and not on the act of abuse. Parents need to have an open line of communication with their children to understand where they are obtaining amphetamines to prevent future abuse.
Treatment and Therapy
Symptoms of amphetamine withdrawal can develop within a few hours after stopping use. Withdrawal symptoms include nightmares, insomnia or hypersomnia (too much sleep), severe fatigue or agitation, depression, anxiety, uncontrollable body movements, and increased appetite. Severe depression can produce suicidal thoughts. Withdrawal symptoms usually peak within two to four days and resolve within one week.
No specific medications are available for directly treating amphetamine abuse, as there are for alcohol and opiates. However, antidepressants can be helpful in the immediate and post-withdrawal phases.
The National Institute on Drug Abuse recommends psychotherapeutic intervention utilizing a cognitive behavioral approach. Such an approach helps the abuser learn to identify counterproductive thought patterns and beliefs and to change them so that their emotions and actions become more manageable. The abuser is also taught how to improve coping skills to address life’s challenges and stresses. Narcotics Anonymous and amphetamine-specific recovery groups are also helpful.
Prevention
The problem of disordered amphetamine use, especially among high school and college students, is there are medical indications for amphetamines. Amphetamines are commonly prescribed for conditions, such as attention-deficit/hyperactivity disorder (ADHD), and are, therefore, readily available to this demographic. Parents must be aware of their children's activities and strive for an open line of communication. Experts recommend that prescription formulations be kept from potential abusers. Pill counts should be taken regularly. Young people should be taught the differences between medical use and illegal abuse. Parents should ensure that their children are not attracted to social settings or activities where amphetamine abuse is or might be encouraged or tolerated.
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