Prescription & Illicit Stimulant Addiction
What Are Stimulant Drugs?
Stimulants are drugs have an accelerating effect on the body’s systems, increasing heart rate, breathing, blood flow, and other physical processes.1,4 Stimulants generally increase alertness, attention, and energy.1, 4 Prescription stimulants are used to treat attention-deficit hyperactivity disorder (ADHD) and narcolepsy.1
Common prescription stimulants include:1
- Ritalin (methylphenidate).
- Dexedrine (dextroamphetamine).
- Adderall (dextroamphetamine/amphetamine).
Common illicit stimulants include:4,5
- Khat (plant with naturally occurring cathinones).
- Synthetic cathinones manufactured in labs (“bath salts”).
Both legal and illegal stimulants increase dopamine, norepinephrine, and serotonin activity in the brain and have the potential to produce a euphoric high. 1-3 Euphoria combined with other desirable effects such as increased wakefulness, sociability, and decreased appetite contribute to the abuse potential of these drugs.6
How Does Prescription Stimulant Abuse Start?
People that are prescribed stimulants may begin misusing them for their pleasurable effects. Others may acquire prescription stimulants illicitly (without a prescription), such as by taking a friend’s unwanted medication or purchasing it illegally.1
Nonmedical use of ADHD medications (e.g., Adderall) is especially problematic among adolescents and young adults. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), it is estimated that anywhere from 5to 35% of U.S. college students report misusing Rx stimulants to improve their academic performance, control their weight, or to get high.7,8
Long-term use of prescription stimulants may cause someone to develop a tolerance, meaning they will need stronger or more frequent doses to feel the drug’s effects. Many serious negative health effects (discussed below) can occur when someone takes excessive and increasing doses of stimulants, particularly over long periods of time.1
Over time and with chronic use, dependence may also develop. A stimulant-dependent person will need to keep taking a stimulant to avoid withdrawal. Tolerance and dependence are both criteria used to diagnose a stimulant use disorder, the clinical term for stimulant addiction. Someone taking stimulants prescribed by a physician may also develop tolerance and dependence; however, since these adaptations are expected and managed by a doctor, they are not considered as criteria met during an evaluation for a stimulant use disorder.” 1
Short-Term Stimulant Effects
In addition to the primary effects of increased energy, wakefulness, or attention, stimulants have several side effects, some of which are potentially lethal. These side effects of stimulant use may include:1-3,5
- Increased blood pressure and decreased blood flow.
- Increased heart rate.
- Irregular heartbeat.
- Loss of appetite.
- Involuntary jaw clenching and teeth grinding.
- Elevated blood sugar.
- Increased body temperature.
- Heart failure.
What Are the Long-Term Effects of Stimulants?
Chronic use of stimulants can also cause: 1- 3,5,8-9
- Unhealthy weight loss.
- Dental problems.
- Impaired sexual function.
- Chest pain, cardiovascular dysfunction, and heart problems.
- Cognitive impairment, including problems with learning and memory.
- Symptoms of psychosis, including paranoia, delusions, and hallucinations (visual, auditory and tactile).
People who snort stimulants risk damage to nasal membranes including perforation of the bone and cartilage (i.e., nasal septum) that separates the nostrils. Smoking crack cocaine can worsen asthma and damage the lungs.10 Smoking meth has been associated with an increased risk of lung infection (e.g., pneumonia) as well as acute respiratory failure.11 People that inject stimulants are at increased risk of contracting HIV or hepatitis as well as other infections through the use of shared needles and other injection equipment.2,3
Signs of Prescription and Illicit Stimulant Misuse
Any use of an illegal stimulant, such as cocaine or meth, constitutes drug abuse. 12 When it comes to legal, prescription stimulants, misuse can take several forms:12
- Taking stimulants for non-therapeutic reasons (i.e., for the euphoric high).
- Taking higher or more frequent doses of stimulants than prescribed.
- Using prescription stimulants in a way they were not prescribed (e.g., crushing and snorting pills).
- Taking prescription stimulants that are prescribed to someone else.
Some signs a person may be misusing prescription or illegal stimulants include:8
- Appearing abnormally euphoric or energetic.
- Being extra sensitive to lights, sounds, and touch.
- Repetitive, agitated actions such as scratching.
- Behavior that becomes bizarre, aggressive, or violent.
- Sudden weight loss.
What to Do If You Suspect Someone Is Abusing Stimulants
Someone suffering from a stimulant addiction is not experiencing a failure of willpower but rather a chronic brain disorder for which professional treatment is often necessary.13,14 It’s important to avoid feeling like you alone can fix the problem for someone else.15 Instead, you can encourage your loved one to take steps toward seeking help.15
Consider the best way to provide encouragement to someone who is struggling. There is no evidence that confrontational “interventions” like those you may see on TV can help someone achieve long-term sobriety. This approach also has the possibility of backfiring or even erupting into violence.15
Often, individuals are more receptive to advice or statements from specialists than they are from family and friends, so providing them with resources and information or providing incentives for them to visit or doctor or addiction specialist may be helpful.15
If your loved one decides to get treatment, the support of friends and family during and after rehabilitation can make a big difference. Facilitating a positive network and being a champion for their recovery can help them prevent relapse.16
Stimulant Addiction Treatment
It is very possible to recover from a stimulant use disorder with professional care and support.20 Treatment plans look different for everyone, but often addiction treatment involves a period of detox followed by inpatient or outpatient rehabilitation.
Stimulant Withdrawal and Detox
The prospect of going through withdrawal may deter someone from starting treatment.15 It is true that stimulant withdrawal—while seldom life-threatening—can be very unpleasant. Symptoms like depression, fatigue, and insomnia can spur those attempting to quit back to stimulants for relief. 1 Depression during and after withdrawal may range from mild to severe and can last for several weeks. During this time, a person is at increased risk of suicide. 8
Medical detox provides a way for patients to withdraw safely and more comfortably than if they were on their own.17 Medications may be used to combat specific symptoms, and any concerning medical or psychiatric complications that arise can be dealt with immediately by medical staff. 1 The duration of detox varies based on several different factors, but often lasts between 3-5 days.
Addiction Treatment After Detox
While detox is a necessary first step for many, it does little to help someone achieve long-term sobriety. Addiction is a chronic brain disease and lasting recovery requires building the skills needed to recognize and avoid situations that threaten their sobriety and overcome the thought and behavioral patterns that may lead them to relapse or return to stimulant use.8,20
Effective rehabilitation for stimulant addiction is grounded in behavioral therapy. Treatment programs may utilize several different therapy types, which may include:
- Contingency management. By incentivizing positive behaviors with small, tangible rewards, contingency management works to correct unhealthy patterns, foster short- and long-term goal planning, and promote the growth of healthy habits.8,18
- Cognitive-behavioral treatment (CBT). CBT helps patients build effective and safe coping strategies to avoid relapse back to stimulant use.19
- The Matrix Model. The Matrix Model is a therapeutic strategy that draws on multiple treatment approaches including drug education, family therapy, 12-Step involvement and more. This model fosters a healthy, direct but non-confrontational relationship between patient and therapist and raises the patient’s self-esteem and motivation to stay in recovery.8,20
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