Stimulant Use Disorder

What is Stimulant Use Disorder?

Stimulant use disorder includes a range of issues associated with the use of different stimulant drugs.

It includes illicit drugs, such as cocaine and methamphetamine, and legal drugs, such as Adderall and Ritalin for treating attention deficit hyperactivity disorder (ADHD). It does not include caffeine or nicotine.

These drugs are used for a variety of reasons, including improving mental performance and staying awake for long periods.

Many stimulants are prescription medications that help with various mental disorders, attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD). 

Other stimulants, including cocaine, are illegal and have no medical benefits. But it’s possible for someone using legal or illegal stimulants to develop stimulant use disorder.

More than half of all drug users use stimulants. Counting prescription stimulants, approximately 20 percent of all adults have used a stimulant. Nearly 10 percent have tried cocaine or methamphetamine.

The National Center for Drug Abuse Statistics

Stimulant use has health benefits, but it also poses a risk to users.

Stimulants are highly addictive, so many of the people who misuse these drugs develop a substance use disorder, including stimulant use disorder and a physical dependence on stimulants. 

Even those who use prescription stimulants to treat mental disorders including attention deficit hyperactivity have a risk of developing an addiction. 

Symptoms of Stimulant Use Disorder

Symptoms of stimulant use disorder include physical, behavioral, and cognitive issues. 

These physical and mental diagnostic criteria vary among stimulant users based on the type of substance use and include:

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Health Effects of Stimulant Use Disorder

Stimulants increase neurotransmitters in the brain.

Stimulant drugs cause the release of dopamine, increase blood pressure, and speed heart and breathing rates. Substance use disorders change how the body functions. 

Once the body adjusts to the presence of a stimulant drug, that drug is needed to function normally. Breaking stimulant dependence requires a period of adjustment that allows the body to return to its normal functions.

Chronic stimulant users sometimes develop an irregular heart rate and might experience heart failure and seizures, both of which can be fatal.

Stimulants put users at risk of different reactions, including:

• muscular weakness
• irregular heartbeat
• suicide attempts
• cardiac arrhythmias
• an intense craving for the drug
• sudden death

Stimulant intoxication, or a high dose of any stimulant, especially if taken at the same time as another drug, puts a user at serious risk for a health emergency or sudden death.

Additionally, cocaine use causes secondary health problems, including damage to the nasal cavity. Chronic use creates potentially lifelong problems.

As the drug leaves the body, withdrawal causes feelings of anxiety, restlessness, and insomnia. People addicted to stimulants experience mood swings, insomnia, hallucinations, headaches, and extreme cravings for their drug of choice. 

There’s also a significant reduction in energy as the stimulant drug wears off and stimulant intoxication ends.

Short-Term Effects

Short-term health effects of stimulant use disorder usually last a few hours and include:

• Anxiety
• Confusion
• Paranoia
• Withdrawal symptoms when not using the drug
• Decreased sexual function
• Poor judgment
• Increased appetite
• Weight loss

Long-Term Effects

Long-term health effects of stimulant use disorder include:

• Aggression
• Hallucinations
• Tooth decay
• Skin sores
• Weight loss
• Social isolation
• Dramatic behavioral changes
• Gastrointestinal problems
• Respiratory, cardiovascular, and nervous system damage
• Kidney failure
• Cognitive deficits and poor judgment
• Loss of short-term memory
• Muscle tenderness
• Muscular weakness

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Who is at Risk of Developing Stimulant Use Disorder? 

Anyone who takes a stimulant drug, whether it’s prescription or not, is at risk of developing an addiction. However, certain things put someone at a greater risk of developing stimulant use disorder.

For example:

• Men are more likely than women to use illicit drugs but have no greater risk of developing a stimulant use disorder once they’ve used the drug. Once someone has used the drug, regardless of gender, they share the same risk to develop stimulant addiction.
• People with psychiatric disorders, including attention deficit disorders and depression, are more likely to misuse stimulants and develop SUD.
• People who mix stimulants and alcohol have a greater risk of developing an addiction. This is, in part, because alcohol and stimulants share a metabolite that extends the high someone experiences after taking a stimulant.
• People with a family history of substance abuse and addiction, especially with stimulant drugs, have a greater risk of developing stimulant use disorder. 

What Causes Stimulant Use Disorder?

The cause of stimulant use disorder or amphetamine use disorder varies from person to person. Some people can use these drugs without misusing them or developing substance use disorders, while others are prone to addiction to stimulant drugs.

In most cases, several factors play a role in why someone develops stimulant use disorder. 

There are environmental and genetic factors that play a role in substance use disorders, including a person’s family history of chemical dependency. In addition to this genetic impact, exposure early in life to family members abusing substances increases a person’s risk of developing a stimulant dependence and stimulant use disorder.

Additionally, people exposed to chronic stress, especially in the workplace or at school, turn to stimulants to help them meet their obligations.

Amphetamines, cocaine, and other stimulants provide energy boosts, help with focus, and enhance performance. Over time, chronic stimulant use to boost energy can develop into an addiction. 

Easy accessibility to cocaine and other stimulants also increases someone’s risk of developing a problem. If a person experiences stimulant withdrawal symptoms, he or she is more likely to re-use the drug to ease the unpleasant feeling.

The desired effect of the drug might last a few hours or longer. Users put themselves at risk of overdose by taking additional doses of drugs, possibly in other forms, to avoid withdrawal symptoms and keep their energy levels high. 

A high dose of cocaine or any other stimulant poses a variety of serious health effects that often require medical attention.

Finally, people exposed to violence or crime have a higher risk of developing stimulant use disorder and stimulant dependence.

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How Stimulant Use Disorder is Diagnosed

In most cases, the first stage of a stimulant use disorder diagnosis begins with friends and family. People in the addicted person’s life begin to question the changes in their loved one’s stimulant intoxication and reach out to addiction or medical professionals for help.

Medical professionals look for any of the diagnostic criteria outlined in the DSM-V required to diagnose substance abuse disorder. 

Medical professionals begin the diagnosis process by asking the patient questions about their stimulant use.

Common questions that arise during the diagnostic process include:

• How often do you use stimulants?
• Have there been any negative consequences of stimulant use or amphetamine use?
• Have your friends or family approached you about your stimulant drug use?
• Has stimulant drug use or amphetamine use affected your job or school life?
• Do you experience withdrawal symptoms when not using the stimulant?
• Are you suffering physically due to extreme weight loss, elevated or lowered blood pressure, or any other negative effects?

People who meet any two of the 12 criteria for stimulant use disorder are categorized as having the condition. The more criteria met, the more severe the use disorder is.

The 12 criteria include:

1. Wanting to cut down or eliminate the use of the drug but failing to do so
2. Using greater quantities of the substance or using it for extended periods
3. Experiencing cravings to use the substance when not using it
4. Investing time and resources in stimulant use
5. Taking longer to recover from the effects of the drug
6. Continuing to use the substance despite its negative impact on relationships
7. Neglecting obligations and responsibilities to use the substance
8. Abandoning once-loved activities to satisfy your stimulant use disorder and cravings for stimulant use
9. Continuing to use the substance despite its negative physical and psychological impact
10. Using the substance again and again despite the risks
11. Having developed tolerance and needing more of the substance to achieve the same effect
12. Experiencing withdrawal symptoms when not using the substance

Treatment Options for Stimulant Use Disorder

Stimulant use disorder is treatable. Whether someone is addicted to cocaine, meth, amphetamine type stimulants, or struggling with withdrawal after stopping use of medication for attention deficit hyperactivity disorder, help is available.

The most common treatment options include behavioral therapy. This includes treatments such as cognitive behavioral therapy (CBT) and contingency management to help people modify their thinking, resist stimulant intoxication, and end their stimulant use. 

Stimulant treatment options must address the mental effects of the drug, as well as the physical changes caused by amphetamine use and stimulant use disorder. Successful recovery requires lifestyle changes and understanding why you misused drugs. At the same time, treatment helps you identify why you turned to stimulant use to begin with.

Stimulant withdrawal does not trigger withdrawal symptoms as physically dangerous as other drugs like alcohol or heroin, but depression and suicidal ideation is possible. People experiencing stimulant withdrawal must be monitored for suicide risks. 

Treating stimulant use disorders is just as challenging as treating other drug addictions, despite there being fewer health risks during the withdrawal phase. Chronic drug use causes a variety of physical and mental effects that must be addressed during treatment. 

Additionally, medical professionals must also provide treatment options for any other mental disorders, weight loss disorders, or other addictions at the same time they’re treating stimulant addiction. Having more than one disorder makes treatment challenging but not impossible.

Like all substance use disorders, the initial detoxification phase is just the beginning of recovery.

This stage must be coupled with long-term treatment and follow-up care to give stimulant users the greatest chance of sobriety. Chronic use of stimulants changes the body’s chemistry and it takes time to reestablish normal bodily functions. 

If you or a loved one has a stimulant use disorder or you use drugs, treatment options are available.

Stimulant use disorders wreak havoc in one’s life and put you at risk of developing a variety of negative health effects, including:

• respiratory depression
• cardiovascular effects
• problems with your central nervous system

They cause unhealthy weight loss, problems with blood pressure, and long-term cognitive issues. Stimulant addiction is potentially fatal. 

Medical attention and treatment options help you manage withdrawal symptoms and make positive lifestyle changes to break the addiction and receive the follow-up care needed to maintain sobriety and avoid stimulant drugs. The first step is realizing stimulant use disorder is a problem and then committing to finding treatment options to help you deal with the problem.

Common Types of Stimulants & What They Treat

Some of the most common stimulants include:

• Dextroamphetamine (Dexedrine)
• Dextroamphetamine/amphetamine combination (Adderall)
• Methylphenidate (Ritalin and Concerta)

The most common illicit stimulants include cocaine, MDMA (ecstasy/Molly), and methamphetamine. None of these drugs offer medical benefits and all put users at risk of developing stimulant use disorder.

Is Stimulant Use Disorder in the DSM-5?

Yes. The DSM-5 or the Diagnostic and Statistical Manual of Mental Disorders is the manual used by the American Psychiatric Association to identify and diagnose mental health conditions and addictions. 

The fifth edition is the most current version of the manual and was the first version to categorize substance abuse and substance dependence as substance use disorder. 

Stimulant use disorder is one of many mental disorders defined in the DSM-5, which addresses signs of addiction, withdrawal symptoms, diagnostic criteria, and more.

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