Amphetamine Overdose

What are Amphetamines?

Amphetamines are psychostimulants that affect both the central and peripheral nervous systems. Some amphetamines may be prescription drugs, such as Adderall®, or over-the-counter medications, like ephedrine.

Other common brand names for prescription stimulants include: 

• Concerta®
• Dexedrine®
• Focalin®
• Metadate®
• Methylin®
• Ritalin® 

However, other amphetamines, like crystal meth, may be illegal substances.  

Street names for misused or abused amphetamines include: 

• Bennies
• Black Beauties
• Crank
• Ice
• Speed
• MDMA
• Molly
• Uppers

This type of drug enters into the brain more easily to affect neurotransmitters (dopamine, norepinephrine, serotonin, etc.). 

The interaction between the neurotransmitters and the drug can cause behavioral effects that include, but are not limited to:

• Alertness
• Higher levels of concentration
• Restlessness 

However, these behavioral effects can vary depending on the amphetamine. For example, methamphetamine has proven to impact serotonin more than other amphetamines. However, another amphetamine called methylphenidate has more effect on norepinephrine than on serotonin.

Additionally, behavioral effects can differ according to the dose. This means that while some doses can have therapeutic effects, higher doses can result in toxic psychosis (a psychotic episode caused by a drug) or overdose.

People can begin to feel the effects of amphetamines depending on how they take the drug:

• Smoking or shooting up — smoking the drug or injecting it into a vein can cause an immediate and intense high. The “rush” lasts a few minutes. 
• Snorting — the high does not set in until 3 to 5 minutes have passed. Once it does, the sensation will not be as intense as smoking or shooting up. The effects will last between 15 and 30 minutes. 
• Orally — the high does not set in until 15 to 20 minutes have passed. Compared to smoking, shooting up, or snorting, the effects of amphetamine lasts the longest depending on the dose taken.

Side Effects & Risks of Amphetamines

Amphetamines can have different sides, including:

• A decrease in appetite and weight loss
• Cardiovascular problems, such as fast heart rate (tachycardia), irregular heartbeat (arrhythmia), higher blood pressure (hypertension), and heart attack
• High body temperature (hyperthermia) and skin flushing
• Problems with memory loss
• Mood and emotional issues, such as aggressive or violent behavior, depression, or suicidal ideation (suicidal thoughts)
• Auditory and visual hallucinations 
• Restlessness and tremors
• Skin sores
• Sleep difficulties
• Tooth decay (meth mouth)

Individuals who take amphetamines can develop movement sequence behaviors that are repetitive or compulsive. This may include compulsive cleaning or putting together and taking apart an object.  

Also, amphetamines are highly abused substances because of their ability to cause pleasure, ecstasy, and euphoria. The drug’s “good-feeling” effects can last for a long time. This is due to its elimination half-life of 6 to 12 hours. In other words, because it takes an individual 6 to 12 hours to metabolize half of the dose taken, the drug can still affect the body for an extended period. 

However, there are risks associated with amphetamine use, including:

• Overdose 
• Death 
• Poorer decision-making processes
• Unsafe sex and sexually transmitted infections 
• Injury to one’s self or others 
• Schizophrenia-like psychosis

These risks increase much more among individuals who take amphetamines for an extended period. For example, it is common to see violent, erratic behavior or psychosis among chronic users of amphetamines. 

People who use amphetamines, particularly methamphetamine, face a higher likelihood of developing HIV and hepatitis B and C. Transmission of these diseases can occur through sharing used needles with a person who has the infection and is not under treatment.

Can You Overdose on Amphetamines?

The U.S. Drug Enforcement Administration (DEA) classifies most amphetamines as Schedule II stimulants. This means that these drugs have a high potential for abuse and could cause individuals to develop severe psychological and physical dependence. 

Amphetamines have stimulating effects and can make users feel more energetic, confident, and focused. Because of these habit-forming characteristics, though, people taking these drugs face a high risk of overdose. 

Also, methamphetamine is more dangerous than some other amphetamines. Higher amounts of methamphetamine can reach the brain at similar doses of other amphetamines. Because of this, there can be longer-lasting, more dangerous effects on the central nervous system (CNS). 

Amphetamine Overdose Symptoms

Amphetamine overdoses can include the following symptoms:

• Agitation 
• Chest pain
• Increased body temperature
• Auditory and tactile hallucinations
• Convulsions or seizures
• Increased blood pressure 
• Irregular heartbeat
• Heart failure
• Possible death

It is important to take an individual suspected of overdose to the emergency department. 

Can Adderall Interact With Other Medications?

Adderall is an amphetamine used to treat: 

• Attention deficit hyperactivity disorder (ADHD)
• Narcolepsy (a disorder that makes an individual fall asleep at inappropriate times). 

Amphetamines like Adderall can interact with other medications, especially over-the-counter and decongestants or those used to treat depression. It is always important to consult a healthcare provider before mixing drugs. Unwanted or worsened side effects can result due to drug interactions in the body. 

In the case of Adderall, the following list describes possible drug interactions: 

• MAO inhibitors (MAOI) — MAOI antidepressants slow Adderall metabolism. Because of this, the drug can have a more potent effect on the body and, in some cases, result in headaches and other signs of hypertensive crisis (severely elevated blood pressure).
• Antihistamines — Adderall can offset the sedative effects of antihistamines. 
• Alkalinizing agents — these types of agents (e.g., sodium bicarbonate or antacids) increase absorption of Adderall. Blood levels rise, and the effects of Adderall are stronger.  
• Acidifying agents — gastrointestinal acidifying agents like fruit juices or ascorbic acid (vitamin C) can decrease Adderall absorption. 

How is an Overdose Treated?

If an individual overdoses on amphetamines, it is important to seek immediate medical help. 

In cases of overdoses (or acute intoxication), clinicians will place physical restraints to avoid self-harm or harm to others. Individuals who overdose may become hostile due to a paranoia caused by the amphetamine.  

Clinicians will address life-threatening signs and symptoms, if present, including:

• Compromised airway
• Seizures 
• Cardiac dysrhythmias (irregular heartbeat)

Clinicians may also administer supportive therapy (no dire medical intervention), including benzodiazepines for sedation and seizure management. If individual patients are awake, activated charcoal may be a treatment option to limit amphetamine absorption in the digestive tract. To combat dehydration, doctors may set up an IV to provide fluids. 

Death due to amphetamine toxicity is not frequent. However, if someone combines amphetamines with other drugs, the risk of death increases.

Can a Stimulant Overdose Cause Permanent Damage?

Yes. A stimulant overdose could cause permanent damage depending on the severity of the case. 

Because of very high blood pressure and body temperature, overdosing on amphetamines may cause a stroke or heart attack. Like other complications that could occur in different body organs, the damage caused by such conditions can be irreversible despite treatment.

Also, memory loss and trouble sleeping may result due to both stimulant overdose and long-term use.

Treatment for Amphetamine Abuse/Addiction

If you or a loved one suffer from substance abuse or a substance use disorder, different therapy options are possible, including:

• Cognitive-behavioral therapy (CBT) — healthcare providers may recommend the Matrix Model, a 16-week approach for amphetamine addiction. It includes behavioral therapy, family education, personal counseling, 12-step support, drug testing, and encouragement for non-drug-related activities.
• Inpatient treatment centers — these clinics can provide supervision and support throughout the detoxification process and ensure a healthy withdrawal. 
• Contingency management interventions — these are programs that offer incentives in exchange for treatment adherence and maintaining abstinence.

Chronic drug use can build physical and psychological dependence, which means that withdrawal symptoms may occur after stopping. These symptoms can include:

• Strong drug cravings
• Severe mood swings, such as depression or agitation
• All-day fatigue
• Hallucinations 
• Inability to concentrate 

There are currently no drugs available to counteract the effects of amphetamines or those caused by prolonged abstinence. 

In the United States, the National Institute on Drug Abuse offers MIEDAR (Motivation Incentives for Enhancing Drug Abuse Recovery), an effective, incentive-based method that encourages cocaine and methamphetamine abstinence.