What is amphetamine abuse?

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 to be 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 their introduction for medical use in the 1930s. Amphetamines were widely abused by soldiers 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 distribution of commercially manufactured amphetamines, manufacture by clandestine laboratories increased dramatically. In addition, the Internet has become a popular source for nonprescription amphetamines.

Abuse now occurs primarily among young adults (age eighteen to thirty years). A common venue for their abuse is the rave, an all-night music and dance concert or party. 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 and 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 with the youth’s well-being, and not on the act of 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, 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. 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 his or her 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

As there are medical indications for amphetamines, 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.

Bibliography

Abadinsky, Howard. Drug Use and Abuse: A Comprehensive Introduction. 7th ed. Belmont: Wadsworth, 2011. Print.

Julien, Robert M. A Primer of Drug Actions. 11th ed. New York: Worth, 2008. Print.

Kuhn, Cynthia, Scott Swartwelder, and Wilkie Wilson. Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy. 3rd ed. New York: Norton, 2008. Print.

Lowinson, Joyce W., et al., eds. Substance Abuse: A Comprehensive Textbook. 4th ed. Philadelphia: Lippincott, 2005. Print.

Rogge, Timothy. “Substance Abuse—Amphetamines.” MedlinePlus. US Natl. Lib. of Medicine, 21 May 2014. Web. 28 Oct. 2015.