Stimulant: Drug Addiction

Stimulant, any of a group of drugs that excite the central nervous system, increase alertness, and alleviate fatigue. Caffeine is perhaps the most socially acceptable and commonly used stimulant. Other stimulants include cocaine and amphetamines, which create intense feelings of euphoria (well-being). Amphetamines, commonly known as pep pills or diet pills, also decrease appetite. Stimulants work by mimicking the fight-or-flight response, in which the hormone epinephrine (also known as adrenaline), is released during stressful situations to produce an increased heart rate and increased blood flow to the muscles.

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Stimulants produce a similar, but often more powerful, response by increasing levels of the neurotransmitters dopamine and norepinephrine in the brain. Stimulants also appear to act on the limbic system, a group of cell structures in the center of the brain that reward behaviors beneficial to the continuation of the species. These behaviors—sexual intercourse, eating, and drinking—are normally accompanied by positive sensations, which may primarily result from increased levels of dopamine in the limbic system. Stimulants produce an even more potent, euphoric sensation by directly increasing dopamine levels in the limbic system.

The appetite-suppressing effect of amphetamines is also thought to derive from the manipulation of this brain reward system: The brain no longer requires food to elevate dopamine levels because the drug has already induced both this elevation and the desired euphoria. For similar reasons, sex drive is often reduced in heavy users of stimulants like cocaine and amphetamine. To achieve these potent feelings of well-being, some stimulants are used for recreational purposes—that is, they are used to produce pleasurable effects rather than for medicinal purposes under a physician’s supervision.

But the recreational use of stimulants is dangerous because the drugs can both inspire erratic behavior and produce unpleasant withdrawal symptoms. When the stimulant is eliminated by the body, dopamine levels in the brain fall, producing drug craving, depression, and anxiety. In some cases prolonged use creates a tolerance for the drug, requiring larger and larger doses to produce a comparable effect. And in many instances stimulants are highly addictive (see Drug Dependence). | | II. | TYPES OF STIMULANTS| Cocaine and amphetamines produce closely related biological effects that nclude excitement, alertness, euphoria, a sense of increased energy, and decreased appetite. Both cocaine and an amphetamine derivative called methamphetamine, commonly known as speed, come in forms that are particularly potent when smoked. They are also highly addictive. Cocaine is sometimes used clinically as a local anesthetic, and amphetamines are commonly prescribed to treat hyperactivity in children, and narcolepsy. Amphetamines were once prescribed as appetite suppressants, but this practice is now discouraged because of negative side effects and the potential for abuse.

Nicotine, a highly addictive stimulant found in tobacco, also directly affects dopamine release in the limbic system. The drug, which is quickly absorbed into the bloodstream from the lungs when smoked, causes muscle relaxation, increased heart rate, and release of epinephrine. Withdrawal symptoms include anxiety, anger, restlessness, and insomnia. The basic mechanisms involved in nicotine addiction are nearly identical to those of cocaine and amphetamine addiction. Caffeine, found in coffee, tea, cola drinks, and chocolate, is a highly popular stimulant.

Caffeine produces increased mental alertness and reduced fatigue, and increases the heart rate slightly. Caffeine is relatively nontoxic, but clearly has addictive potential. Withdrawal symptoms in heavy users can include severe headache, fatigue, and difficulty in concentrating. Overuse can lead to insomnia, gastrointestinal disturbances, and hypertension. Microsoft ® Encarta ® 2009. © 1993-2008 Microsoft Corporation. All rights reserved. Caffeine, an alkaloid (C8H10O2N4·H2O) found in coffee, tea, cacao, and some other plants. It is also present in most cola beverages. Caffeine was discovered in coffee in 1820.

In 1838 it was established that theine, discovered in tea in 1827, is identical to caffeine. The drug increases the blood pressure, stimulates the central nervous system, promotes urine formation, and stimulates the action of the heart and lungs. Caffeine is used in treating migraine because it constricts the dilated blood vessels and thereby reduces the pain. It also increases the potency of analgesics such as aspirin, and it can somewhat relieve asthma attacks by widening the bronchial airways. Caffeine is produced commercially chiefly as a byproduct in making caffeine-free coffee (see Coffee).

Caffeine has been suggested as a possible cause of cancer and of birth defects. No studies, however, have yet confirmed any of these charges. Persons who stop drinking coffee do sometimes experience withdrawal headaches. Microsoft ® Encarta ® 2009. © 1993-2008 Microsoft Corporation. All rights reserved. Stimulants are medications that increase heart rate, breathing rate, and brain function. Some stimulants affect only a specific organ, such as the heart, lungs, brain, or nervous system. Some medications are given for their stimulant effect. For example, epinephrine is given during cardiac arrest to make the heart beat.

Other times, stimulants can cause unwanted side effects. For example, pseudoephedrine found in some cold medicines can increase the heart rate http://www. nlm. nih. gov/medlineplus/ency/article/002308. htm Stimulants is a name given to several groups of drugs that tend to increase alertness and physical activity. The groups include pharmaceuticals such as amphetamines and the street drugs commonly called “uppers” or “speed,” and cocaine. The more widely abused stimulants are amphetamines and cocaine. Cocaine has limited commercial use and its sale and possession are strictly controlled.

Amphetamines are sometimes prescribed by physicians, and their availability makes them prime candidates for misuse. Used properly, amphetamines increase alertness and physical ability. They are often prescribed to counter the effects of narcolepsy, a rare disorder marked by episodes of uncontrollable sleep, and to help children with minimal brain dysfunction. Amphetamines increase the heart and respiration rates, increase blood pressure, dilate the pupils of the eyes, and decrease appetite. Other side effects include anxiety, blurred vision, sleeplessness, and dizziness.

Abuse of amphetamines can cause irregular heartbeat and even physical collapse. A common form of abuse of amphetamines is by people who use them to counter the effects of sleeping pills (barbiturates) taken the night before. This roller coaster effect is damaging to the body. While amphetamine users may feel a temporary boost in self-confidence and power, the abuse of the drug can lead to delusions, hallucinations, and a feeling of paranoia. These feelings can cause a person to act in bizarre fashion, even violently. In most people, these effects disappear when they stop using the drug.

Amphetamines are stolen or acquired through scams involving pharmacists or physicians who are duped into writing prescriptions for the drugs. These illegally acquired drugs are either sold as is or reduced to yellowish crystals that can be ingested in a number of ways, including sniffing and by injection. Another means of illegal sale of amphetamines involves “look-alike” drugs produced in illicit laboratories. One danger in these look-alikes is that the potency may vary from batch to batch. A person accustomed to using a weak look-alike may unwittingly suffer an overdose taking the same volume of a stronger look-alike.

Symptoms Amphetamines are psychologically addictive. Users become dependent on the drug to avoid the “down” feeling they often experience when the drug’s effect wears off. This dependence can lead a user to turn to stronger stimulants such as cocaine, or to larger doses of amphetamines to maintain a “high”. People who abruptly stop using amphetamines often experience the physical signs of addiction, such as fatigue, long periods of sleep, irritability, and depression. How severe and prolonged these withdrawal symptoms are depends on the degree of abuse.

That boost we get from that morning cup of coffee is the result of the caffeine that naturally occurs in coffee. Caffeine is a common stimulant and is found not only in coffee and tea, but also in soft drinks and other foods. It can also be bought over-the-counter in tablet form. Too much caffeine can cause anxiousness, headaches, and the “jitters. ” Caffeine is also addictive and a person who abruptly stops drinking coffee may experience withdrawal symptoms. http://www. well. com/user/woa/fsstim. htm What Are They? Stimulants are a class of drugs that elevate mood, increase feelings of well-being, and increase energy and alertness.

Examples include cocaine, methamphetamine, amphetamines, methylphenidate, nicotine, and MDMA (3,4-methylenedioxymethamphetamine), better known as “Ecstasy. ” Cocaine comes in two forms. Powder cocaine is a hydrochloride salt, made from the leaf of the coca plant. “Crack” is a smokeable form of cocaine that is processed with ammonia or baking soda and water, and heated to remove the hydrochloride. Methamphetamine is a powerful stimulant, originally derived from amphetamine. It comes in clear crystals or powder and easily dissolves in water or alcohol. Although most of the methamphetamine used in the United

States comes from “superlabs,” it is also made in small laboratories using inexpensive over-the-counter and often toxic ingredients (such as drain cleaner, battery acid, and antifreeze). Amphetamines, such as Adderall, are stimulants that often come in pill form and are sometimes prescribed by doctors for medical problems, most commonly attention deficit hyperactivity disorder (ADHD). Amphetamines can also be abused—that is, used in a way other than as prescribed (e. g. , crushed and snorted) or used by someone without a prescription. Methylphenidate, such as Concerta or Ritalin, is another medication prescribed for people with ADHD.

As seen with amphetamines, including Adderall, numerous studies have shown its effectiveness when used as prescribed. When it is abused, however, methylphenidate can lead to many of the same problems seen with other stimulants. More information about prescription drug abuse can be found at http://www. nida. nih. gov/drugpages/prescription. html. Nicotine and MDMA also are considered stimulants and are covered in separate sections on this Web site (http://www. teens. drugabuse. gov/facts/facts_nicotine1. php andhttp://www. teens. drugabuse. gov/facts/facts_xtc1. php).

What Are the Common Street Names? Cocaine is generally sold on the street as a fine, white, crystalline powder, known as “coke,” “C,“ “snow,” “flake,“ “blow,” “bump,“ “candy,“ “Charlie,” “rock,” and “toot. ” “Crack,” the street name for the smokeable form of cocaine, got its name from the crackling sound made when it’s smoked. A “speedball” is cocaine or crack combined with heroin, or crack and heroin smoked together. Methamphetamine is commonly known as “speed,” “meth,” “chalk,” and “tina. ” In its smokeable form, it’s often called “ice,” “crystal,” “crank,” “glass,” “fire,” and “go fast. Street names for amphetamines include “speed,” “bennies,” “black beauties,” “crosses,” “hearts,” “LA turnaround,” “truck drivers,” and “uppers. ” Street names for methylphenidate include “rits,” “vitamin R,” and “west coast. ” How Are They Abused? Stimulants are abused in several ways, depending on the drug. They can be: * Swallowed in pill form. * “Snorted” in powder form, through the nostrils, where the drug is absorbed into the bloodstream through the nasal tissues. * Injected, using a needle and syringe, to release the drug directly into a vein. * Heated in crystal form and smoked (inhaled into the lungs).

Injecting or smoking a stimulant produces a rapid high—or rush—because the drug is absorbed into the bloodstream quickly, intensifying its effects. Snorting or swallowing stimulants produces a high that is less intense but lasts longer. Powder cocaine is usually snorted or injected (also called “mainlining”), or it can be rubbed onto mucous tissues, such as the gums. Street dealers generally dilute cocaine with other substances (such as cornstarch, talcum powder, or sugar), with active drugs (such as procaine, a chemical that produces local anesthesia), or with other stimulants (such as amphetamines).

Crack cocaine is often smoked in a glass pipe. Methamphetamine is swallowed, snorted, injected, or smoked. “Ice,” a smokeable form of methamphetamine, is a large, usually clear crystal of high purity that is smoked, like crack, in a glass pipe. Amphetamines and methylphenidate are usually swallowed in pill form. How Many Teens Use Them? A 2009 NIDA-funded study reported that the following percentages of 8th-, 10th-, and 12th-graders had abused these drugs at least once in the past year: * Powder cocaine: 1. 6 percent of 8th-graders, 2. 7 percent of 10th-graders, and 3. 4 percent of 12th-graders * Crack cocaine: 1. percent of 8th-graders, 1. 2 percent of 10th-graders, and 1. 3 percent of 12th-graders * Methamphetamine: 1. 0 percent of 8th-graders, 1. 6 percent of 10th-graders, and 1. 2 percent of 12th-graders * Amphetamines: 4. 1 percent of 8th-graders, 7. 1 percent of 10th-graders, and 6. 6 percent of 12th-graders * Nonmedical use of Ritalin: 1. 8 percent of 8th-graders, 3. 6 percent of 10th-graders, and 2. 1 percent of 12th-graders * Nonmedical use of Adderall: 2. 0 percent of 8th-graders, 5. 7 percent of 10th-graders, and 5. 4 percent of 12th-graders http://teens. drugabuse. ov/facts/facts_stim1. php How Do Stimulants Produce Euphoria? Stimulants change the way the brain works by changing the way nerve cells communicate. Nerve cells, called neurons, send messages to each other by releasing chemicals called neurotransmitters. Neurotransmitters work by attaching to key sites on neurons called receptors. Learn more about how neurotransmitters work in the section “How Does Your Brain Communicate? ” (http://www. teens. drugabuse. gov/facts/ facts_brain1. php#brain_communicate). There are many neurotransmitters, but dopamine is one that is directly affected by most stimulants.

Dopamine makes people feel good when they do something they enjoy, like eating a piece of chocolate cake or riding a roller coaster. Stimulants cause a buildup of dopamine in the brain, which can make people who abuse stimulants feel intense pleasure and increased energy. They can also make people feel anxious and paranoid. And with repeated use, stimulants can disrupt the functioning of the brain’s dopamine system, dampening users’ ability to feel any pleasure at all. Users may try to compensate by taking more and more of the drug to experience the same pleasure. What Are the Short-Term Effects?

In the short term, stimulants can produce feelings of tremendous joy, increased wakefulness, and decreased appetite. Users can become more talkative, energetic, or anxious and irritable. Other short-term effects of stimulants can include increased body temperature, heart rate, and blood pressure; dilated pupils; nausea; blurred vision; muscle spasms; and confusion. Stimulants can also cause the body’s blood vessels to narrow, constricting the flow of blood, which forces the heart to work harder to pump blood through the body. The heart may work so hard that it temporarily loses its natural rhythm.

This is called fibrillation and can be very dangerous because it stops the flow of blood through the body. What Are the Long-Term Effects? As with many other drugs of abuse, repeated stimulant abuse can cause addiction. That means that someone repeatedly seeks out and uses the drug despite its harmful effects. Repeated drug use changes the brain in ways that contribute to the drug craving and continued drug seeking and use that characterizes addiction. Other effects of long-term stimulant abuse can include paranoia, aggressiveness, extreme anorexia, thinking problems, visual and auditory hallucinations, delusions, and severe dental problems.

Repeated use of cocaine can lead to tolerance of its euphoric effects, causing the user to take higher doses or to use the drug more frequently (e. g. , binge use) to get the same effects. Such use can lead to bizarre, erratic behavior. Some cocaine users experience panic attacks or episodes of full-blown paranoid psychosis, in which the individual loses touch with reality and hears sounds that aren’t there (auditory hallucinations). Different ways of using cocaine can produce different adverse effects. For example, regularly snorting cocaine can lead to hoarseness, loss of the sense of smell, nosebleeds, and a chronically runny nose.

Cocaine taken orally can cause reduced blood flow, leading to bowel problems. Repeated use of methamphetamine can cause violent behavior, mood disturbances, and psychosis, which can include paranoia, auditory hallucinations, and delusions (e. g. , the sensation of insects creeping on the skin, called “formication”). The paranoia can result in homicidal and suicidal thoughts. Methamphetamine can increase a person’s sex drive and is linked to risky sexual behaviors and the transmission of infectious diseases, such as HIV.

However, research also indicates that long-term methamphetamine use may be associated with decreased sexual function, at least in men. Can These Drugs Be Lethal? Yes, in rare instances, sudden death can occur on the first use of cocaine or unexpectedly thereafter. And, like most drugs, stimulants can be lethal when taken in large doses or mixed with other substances. Stimulant overdoses can lead to heart problems, strokes, hyperthermia (elevated body temperature), and convulsions, which if not treated immediately can result in death.

Abuse of both cocaine and alcohol compounds the danger, increasing the risk of overdose. What Are the Differences Between Cocaine and Methamphetamine? They act in different ways to increase dopamine in the brain. Cocaine works by blocking the dopamine transporter; that is, it doesn’t allow dopamine to be recycled back into the neuron after it has done its work. Methamphetamine interferes with this recycling process as well, but it also causes too much dopamine to be released. Another difference is that cocaine disappears from the brain quickly, while methamphetamine has a much longer duration of action.

The longer presence in the brain ultimately makes methamphetamine more harmful to brain cells. If a Pregnant Woman Uses Stimulants, Will the Baby Be Hurt? In the United States between 2006 and 2007, 22. 6 percent (or 20,000) of teens ages 15 to 17 used an illicit drug during their pregnancy. Scientists have found that exposure to cocaine during fetal development may lead to subtle but significant deficits later in life, including problems with attention and information processing—abilities that are important for success in school. Research is also underway on the effects of methamphetamine use during pregnancy.

So far, the data suggest that it may affect fetal growth and contribute to poor quality of movement in infants. Research in this area is particularly difficult to interpret because it is often hard to single out a drug’s specific effects among the multiple factors that can all interact to affect maternal, fetal, and child outcomes. These factors include exposure to all drugs of abuse, including nicotine and alcohol; extent of prenatal care; possible neglect or abuse of the child; exposure to violence in the environment; socioeconomic conditions; maternal nutrition; other health conditions; and exposure to sexually transmitted diseases.

What Treatments Are Available for Stimulant Abuse? Several behavioral therapies are effective in treating addiction to stimulants. These approaches are designed to help the person think differently, change their expectations and behaviors, and increase their skills in coping with various stresses in life. One form that is showing positive results in people addicted to either cocaine or methamphetamine is called contingency management, or motivational incentives (MI). These programs reward patients who refrain from using drugs by offering vouchers or prizes.

MI may be particularly useful for helping patients to initially stop taking the drug and for helping them to stay in treatment. Currently, there are no medications approved by the U. S. Food and Drug Administration to treat people who are addicted to stimulants, although that is an active area of research for NIDA. What Should I Do if Someone I Know Is Abusing a Stimulant? When someone has a drug problem, it’s not always easy to know what to do. If someone you know is using stimulants, encourage him or her to talk to a parent, school guidance counselor, or other trusted adult.

There are also anonymous resources, such as the National Suicide Prevention Lifeline (1-800-273-TALK) and the Treatment Referral Helpline (1-800-662-HELP). The National Suicide Prevention Lifeline (1-800-273-TALK) is a crisis hotline that can help with a lot of issues, not just suicide. For example, anyone who feels sad, hopeless, or suicidal; family and friends who are concerned about a loved one; or anyone interested in mental health treatment referrals can call this Lifeline.

Callers are connected with a professional nearby who will talk with them about what they’re feeling or concerns for other family and friends. In addition, the Treatment Referral Helpline (1-800-662-HELP)—offered by the Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment—refers callers to treatment facilities, support groups, and other local organizations that can provide help for their specific need. You can also locate treatment centers in your state by going to www. findtreatment. samhsa. gov. http://teens. drugabuse. gov/facts/facts_stim2. php