Stimulant Addiction and Abuse

Stimulants activate the central nervous system to promote alertness and cognitive functions. They function by increasing the levels of dopamine and norepinephrine in the brain. The surge of such chemicals helps promote concentration while also lessening fatigue, which is common amongst individuals who suffer from Attention Deficit Hyperactivity Disorder (ADHD). Stimulants can be prescription medications or illegal substances such as cocaine. Stimulants can be consumed orally, snorted, or injected.

Prescription stimulants are generally used in treating patients with ADHD, narcolepsy, and occasionally obesity. These medications enhance focus, alertness, control, and concentration. Some of the most popular prescription stimulants are amphetamines, methylphenidates, and dextroamphetamine. While there are molecular variations between amphetamines (such as Adderall) and methylphenidates (such as Ritalin), the effects of abusing such stimulants are basically the same.

Few of the most well-known prescription stimulants are:

The stimulant classification would not be complete without discussing its illicit form of stimulants such as cocaine, crack, and crystal meth. All of these drugs have similar effects to those of prescription stimulants. However, as opposed to prescription stimulants that are designed as time-release drugs, illicit stimulants generate a shorter and more intense high.

Prescription stimulants are categorized as Schedule II drugs under the Controlled Substances Act since they retain a high potential for abuse and addiction. Most people abuse prescription stimulants to boost performance rather than to get high. In fact, athletes and students have a long history of using prescription stimulants to outshine their peers. Around 900,000 Americans misuse prescription stimulants every month.

Some of the effects of stimulants are:

• Euphoria
• Decreased appetite
• Wakefulness
• Talkativeness
• Increase in energy
• Enhanced concentration
• Difficulty sleeping
• Nervousness
• Increased pulse and blood pressure

Stimulants function by activating an excess amount of dopamine, the pleasure-inducing chemical in the brain. Prolonged use of stimulants can result in the formation of dependence. During this stage, the brain no longer produces dopamine naturally, as it has grown to rely upon the drug. The patient’s who develop dependence may undergo agonizing symptoms of withdrawal during the abrupt cessation of drug consumption. Prolonged consumption can further lead to tolerance and addiction over time.

Some of the signs of a stimulant addiction are:

• Requiring increasing doses of stimulants to attain the desired effect.
• Experiencing withdrawal symptoms when trying to reduce or discontinue drug use.
• Failing to reduce or discontinue drug use despite many attempts.
• Prioritizing substance use over other obligations in life.
• Continuing to use the drug despite being aware of its negative consequences.

Individuals who frequently abuse stimulants, regardless of their intentions, are at a greater risk of developing an addiction.

A few of the common signs of stimulant abuse are:

• Restlessness
• Dilated pupils
• Hyperactivity
• Loss of appetite
• Drastic weight loss
• Profuse sweating
• Excessive energy or motivation
• Mood swings
• Jitteriness
• Rapid heartbeat or pulse
• Elevated blood pressure
• Racing thoughts
• Impulsive behaviors
• Anxiety or nervousness
• Aggressive behaviors or sudden angry outbursts
• Increase in personal confidence
• Deceptive behaviors such as lying or robbing
• Doctor shopping
• Consuming more of the medication than originally prescribed
• Using stimulant drugs without a prescription
• Using illicit stimulant drugs

The short-term consequences of stimulant abuse include overdose and hospitalization. These side effects typically occur when stimulants are taken in large doses.

Some of the negative effects of taking large doses of stimulants are:

• Nausea
• Fever
• Abnormal heartbeat
• Sweating
• Headache
• Increased breathing rate
• Seizures
• Cardiac arrest
• Dizziness

• Aggression
• Anxiety
• Psychotic behavior
• Malnutrition
• Damages to the blood vessels
• Kidney and lung damage
• Stroke
• High blood pressure
• Addiction

The most evident danger of stimulant abuse is their capacity to form an addiction. Individuals who abuse stimulants are also at a considerably high risk of developing cardiac arrest, stroke, and cardiac arrhythmia. Abuse of stimulants to improve athletic performance is extremely harmful since stimulants tend to elevate blood pressure. The combination of physical exercise and stimulants increases the chances of cardiac arrest or stroke.

Individuals abusing illicit stimulants are at a higher risk of a fatal overdose due to the potency of these drugs. Frequent abuse of prescription stimulants can result in psychosis, anger, or paranoia. If the drug is injected, individuals may also increase their risk of contracting infectious diseases such as HIV and hepatitis.

• In 2012, there was a rough 1.2 million non-medical use of stimulants (aged 12 or over) in the United States.
• Alcohol and stimulants were present in around 38 percent of emergency room visits in 2011.
• Approximately 360,000 people received treatment for stimulant addiction in 2012.
• A steady increase of 2,303 to 17,272 emergency room visits directly linked to stimulants were recorded between 2004 to 2011.

Stimulants affect the body’s central nervous system and accelerate neurotransmitter activity within the brain. Prolonged use of stimulants can negatively affect the brain’s capacity to produce its natural chemicals without the influence of the drug. This is caused by the formation of dependence. During this stage, the brain starts to rely on these drugs to regulate cognitive function and focus.

The abuse of stimulants even over a short period can cause an individual to form a physical dependence on the drug. Abrupt cessation or reduction of dosage during this stage can cause an individual to experience intense withdrawal symptoms as their brain struggles to balance its chemical functions on its own.

Withdrawal symptoms can be physical and psychological in nature and range from mild to severe. Psychological withdrawal from stimulants can be particularly severe, causing many users to relapse, as some may even experience suicidal thoughts or aggressive behavior. Due to such severity of withdrawal, symptoms patients are highly advised to seek specialized medical treatment when trying to quit stimulant consumption.

Stimulant withdrawal symptoms tend to differ between one person to another based on factors such as the person’s tolerance and metabolism, as well as their drug use history. Stimulant withdrawal symptoms are generally the combination of dysphoric mood along with two or more of the symptoms stated below.

• Anxiety
• Jittery reactions
• Chills
• Dehydration
• Dulled senses
• Slowed speech and movements
• Lack of interest
• Slow heart or pulse rate
• Irritability
• Hallucinations
• Paranoia
• Fatigue
• Depression
• Increased appetite
• Impaired memory
• Drastic weight loss or gaunt appearance
• Insomnia or hypersomnia
• Body aches
• Drug cravings
• Abnormal or weird dreams

The depression associated with stimulant withdrawal can be severe, particularly in individuals with a history of clinical depression. Individuals with co-occurring mental health disorders and addictions to other drugs can also undergo a more intense and longer withdrawal period.

Withdrawal symptoms usually emerge within a few hours to several days after the last dose. Most symptoms may peak within a week, while psychological symptoms, such as depression, can remain for weeks or even months after quitting the drug use.

Symptoms that persist after two weeks are known as Post-Acute Withdrawal Symptoms (PAWS) and include poor sleep, anxiety, depression, irritability/agitation, poor concentration, exhaustion, and mood swings. PAWS can linger for 12 to 18 months, depending on the severity of one’s addiction. However, these symptoms tend to fade in severity as time passes.

The first step of addiction treatment is detoxification. During detox, doctors manage the physical aspect of addiction by removing the stimulants from the patient’s system. Detox generally lasts for a week or more, depending on the severity of one’s addiction.

Stimulant detox is best conducted under the supervision of medical professionals. Depending on the type of stimulant, a patient may be advised to stop the drug ”cold turkey” or slowly decrease the doses through a method called tapering during detox. The practice of tapering down helps alleviate the intensity of withdrawal symptoms. Quite often, medications such as clonidine may be utilized to treat certain symptoms of withdrawal during detoxification. For example, antidepressants may be used to help with depression and agitation, while Trazadone may be used to treat insomnia.

After the completion of detoxification, patients undergo further treatment at an inpatient or outpatient treatment center. A drug treatment facility offers a better chance at successful recovery for those suffering from stimulant abuse.  After the completion of detox, patients must address underlying issues that led them towards drug abuse. Treatment centers also provide an essential outlet for patients to connect with support groups while also being taught relapse prevention strategies.

Inpatient rehab is a form of treatment that offers 24-hour monitored care at a live-in facility. Inpatient rehabs provide both psychiatric and physical care that can last anywhere between 30 to 90 days. The primary goal of inpatient rehab is to help patients maintain a healthy lifestyle that does not require the use of addictive substances.

Some of the benefits offered by inpatient rehabs are:

• Education about addiction as a disease.
• Healthy coping skills for relapse prevention, trauma, anxiety, depression, and other struggles.
• Stress management techniques.
• Healthy communication skills and boundaries.
• Support in rebuilding lost or estranged relationships.

Outpatient rehabs are an ideal solution for those diagnosed with a mild addiction. Outpatient rehabilitation provides patients with the flexibility to return home after they receive the treatment they require. This program is a good option for those who have unavoidable responsibilities and obligations at home, work, or school.

The duration of an outpatient treatment program can vary depending on each patient’s needs. Typically, outpatient services require patients to visit several times a week for a few hours, although some treatments can be more rigorous than others. Outpatient treatment programs may include services such as group, individual, and family therapy, while also providing specialized therapy, such as art therapy or music therapy.

Outpatient therapy is also recommended for patients who complete inpatient treatment. This helps the patient’s gradually transition back into their daily life while maintaining recovery.

Receiving treatment after the completion of inpatient or outpatient treatment programs is an integral part of recovery. Addiction is a chronic disease that can last a lifetime. Hence receiving ongoing treatment can drastically increase the chances of a prolonged recovery. Ongoing therapy is used to help combat the psychological element of stimulant addiction. Even after the physical urge for stimulants disappears, compulsive desire to use stimulants may still remain. This makes ongoing treatment vital for those in recovery.

Therapies received by ongoing treatment help patients acknowledge and address triggers in a more positive manner as well as educate patients on relapse prevention techniques. Support groups provide patients with additional support and guidance they require to lead a stimulant-free lifestyle.