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Amphetamines are a class of synthetic drugs that have stimulant properties. Being central nervous system stimulants, the use of amphetamines results in increased alertness and wakefulness. Due to these stimulant properties, individuals may abuse amphetamines to enhance academic or athletic performance, work longer, or to postpone sleep.
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Amphetamines are also used recreationally due to their euphoric and pleasurable effects. These pleasurable effects of amphetamines are produced by increasing dopamine levels in the brain’s reward pathway.
Amphetamines were first synthesized in the late 19th century. Following the discovery of its stimulant properties, medical professionals began prescribing amphetamines to treat a wide variety of medical conditions, including depression and nasal congestion. British and American soldiers also used amphetamines during the Second World War to remain awake for extended periods of time.
Researchers soon recognized the addictive properties of amphetamines during the middle of the past century. Following an epidemic of addiction and a series of fatal overdoses, the FDA imposed restrictions on the use of amphetamines in the 1970s.
Currently, the FDA has approved amphetamines only for the treatment of:
In 2018, 1.8% of individuals over the age of 12 had misused prescription amphetamines during the previous 12 months.NSDUH
The term “amphetamines” refers to both the compound, amphetamine, and the chemically related drug methamphetamine. Amphetamine, the chemical compound, occurs in two forms that share the same chemical formula but differ in their spatial organization. These forms or isomers are known as dextroamphetamine (d-amphetamine) and levoamphetamine (l-amphetamine).
Although both d-amphetamines and l-amphetamines share the same chemical formula, the two isomers differ in their physiological effects.
Amphetamines used for medical purposes include:
The term “amphetamine-type stimulants” refers to substances that are chemically similar to amphetamines. Some examples of amphetamine-type stimulants include MDMA (Ecstasy), pseudoephedrine (decongestant), and methylphenidate (Ritalin).
In 2018, almost 1% of individuals over the age of 12 had used methamphetamine at least once during the previous 12 months.NSDUH
Amphetamines are highly addictive substances. The Drug Enforcement Agency has categorized them as Schedule 2 substances. Schedule 2 substances, like amphetamines, have high abuse potential but also have medical uses as described above.
For example, the use of prescription amphetamines in the treatment of ADHD or narcolepsy involves only low doses of the drug that are generally safe. In contrast, individuals who use amphetamines for recreational purposes tend to take much higher doses of the drug. Furthermore, recreational use of amphetamines often involves injecting or snorting the drug to facilitate a rapid supply of the drug to the brain.
In certain instances, Individuals may accidentally or purposefully chew or crush prescription amphetamines instead of swallowing them. Such misuse of prescription amphetamines can also increase the risk of developing an addiction.
Amphetamine intake results in the activation of the brain reward pathway that involves dopamine. Changes in this reward pathway result in the reinforcement of drug-seeking behavior and the development of dependence on the drug.
Cessation of amphetamine intake after prolonged drug use results in withdrawal symptoms as the body reacts to the absence of the drug. Dependence on amphetamines can occur while using the drug as prescribed for ADHD or narcolepsy. However, the severity of dependence in such cases is mild and does not interfere with social life.
In contrast, the abuse of amphetamines can lead to an addiction that is characterized by a severe dependence that adversely impacts physical health and social functioning.
0.4% of individuals over the age of 12 were addicted to methamphetamine in 2018, whereas 0.2% of the same age group was addicted to prescription stimulants such as amphetamine products and Ritalin.NSDUH
The desirable effects of amphetamines include a sense of euphoria, alertness, and increased energy. Due to these effects, individuals may use amphetamines for recreational purposes or to enhance their physical and academic performance. In particular, the use of prescription amphetamines like Adderall to improve academic performance has witnessed an upsurge on college campuses. However, amphetamine use can also have life-threatening short- and long-term side-effects.
Some of the less severe short-term side effects of amphetamines at lower doses may include:
Higher doses of amphetamines can lead to an overdose, which can be fatal. However, even low doses are sufficient to cause a lethal overdose, with considerable variation observed in the dose required to produce toxic effects. Besides the symptoms above, other symptoms present during an amphetamine overdose may include:
Long-term use of amphetamine can lead to the development of an addiction to the drug. Addiction to amphetamines can have a devastating impact on interpersonal relations and adversely impact work life.
Other long-term effects of amphetamine abuse include:
Addiction to amphetamines involves an inability to control drug use despite its negative consequences on the individual’s social and occupational functioning. Another key symptom of amphetamine addiction includes a severe dependence on the drug that results in unpleasant withdrawal symptoms upon discontinuation of drug use.
These withdrawal symptoms, involving depression, anxiety, fatigue, and intense drug cravings, are often responsible for the continuation of drug use. Another symptom of addiction is developing a tolerance for amphetamines. Tolerance involves requiring higher doses of the drug to achieve the previously experienced pleasurable effects.
Other core symptoms of amphetamine addiction include:
A multitude of factors, including social, biological, and economic factors, can predispose an individual to develop an addiction to amphetamines. Such risk factors include:
Besides these factors, heritable factors also contribute to the development of amphetamine addiction. These include certain genes that code for enzymes, receptors, and other proteins involved in mediating the action of amphetamines.
Unlike addiction to certain drugs, such as opioids, the FDA has not approved any medications for the treatment of amphetamine addiction. Thus, treatment for amphetamine addiction involves different forms of behavioral therapies. Although both outpatient and inpatient facilities provide treatment for amphetamine addiction, the severity of dependence generally requires enrollment at an inpatient rehab.
Detoxification is the first step in the treatment of amphetamine addiction. Detoxification involves the removal of the drug from the body while safely managing the withdrawal symptoms.
Treatment at a detox center involves constant medical supervision. It may also require medications to treat the withdrawal symptoms as they arise. Following detoxification, treatment at a rehabilitation center involves addressing the causes underlying the addiction.
Treatment for amphetamine addiction involves various forms of behavioral therapy, such as:
Amphetamine addiction has devastating consequences on the social, physical, and mental health of an individual. Overcoming amphetamine addiction without professional help can be difficult. Find treatment today.
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Winslow, Bradford T., Voorhees, Kenton I., and Pehl, Katherine A. "Methamphetamine abuse." American family physician. Oct 2007.https://www.aafp.org/afp/2007/1015/p1169.html
Heal, David J et al. “Amphetamine, past and present--a pharmacological and clinical perspective.” Journal of psychopharmacology. Jun 2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666194/
Substance Abuse and Mental Health Services Administration. “ 2018 National Survey on Drug Use and Health Annual Report.“ Aug 2019. https://www.samhsa.gov/data/report/2018-nsduh-detailed-tables
Berman, Steven M., et al. "Potential adverse effects of amphetamine treatment on brain and behavior: a review." Molecular psychiatry Feb 2009. https://www.nature.com/articles/mp200890
National Institute on Drug Abuse. “What is Methamphetamine?” NIDA, May 2019, https://www.drugabuse.gov/publications/drugfacts/methamphetamine