- What Are Stimulants?
- Prescription Stimulants
- Illicit Stimulants
- How Are Stimulants Abused?
- Who Abuses Stimulants?
- Are Stimulants Addictive?
- Statistical Overview of Prevalence of Abuse
- Physical and Neurological Effects of Stimulants
- Stimulant Combinations
- Negative Health Consequences
- Signs & Symptoms of Stimulant Abuse
- Stimulant Withdrawal Symptoms
- Treatment for Stimulant Addiction
- Key Sources
- Medical Disclaimer
Stimulants are a pervasive substance in modern society. From cocaine to ADHD medications — even to your morning cup of coffee — stimulants are a popular class of drugs that are known for their euphoric properties and for improving energy and concentration. While some stimulants are more harmful than others, their mechanisms in the body are similar.
Due to the way these drugs influence alertness, energy, and focus, they pose a high risk for abuse. Whether it’s an illicit substance or a prescription, stimulants are addictive both physically and psychologically, especially when they are used to enhance performance or boost someone’s confidence.
However, treatment is available for those who become addicted to stimulants. Before going into the types of treatment that are available for this type of addiction, this article will provide an outline of what stimulants are and what their long-term effects are.
What Are Stimulants?
Stimulants are a class of drugs that act on the central nervous system to increase alertness and cognitive function. This is achieved by stimulating the production of dopamine — a key neurotransmitter that is responsible for pleasure, reward, and movement. An increase in this brain chemical results in feelings of euphoria, improved concentration, and heightened energy.
Stimulants are available as prescription medications and as illicit street drugs. Sometimes referred to as “uppers,” stimulants come in pills or powdered form and can be taken orally or snorted or injected. Because stimulants speed up mental and physical processes, they can provide immediate short-term benefits. However, when taken long term, stimulant use can result in physical and mental health problems.
Common street names for stimulants include:
- Black Beauties
- Vitamin R
- The Smart Drug
- Black or Blue Mollies
The most popular prescription stimulants are used to treat attention deficit hyperactivity disorder (ADHD). Frequently referred to as “study drugs,” these medications are often abused by students who take them to enhance their academic performance and cram for exams. The issue with prescription stimulants is they can become habit-forming and are often abused in ways that differ from their original intention (e.g., taking the drug regularly to stay awake, rather than for ADHD or narcolepsy).
Approved in 1960, Adderall is the most popular and prescribed medication for ADHD. This stimulant is widely used by students as a study aid, and it is also used recreationally to get high.
Ritalin is another common stimulant medication used to treat ADHD. However, its ingredients differ from Adderall, as it is composed of methylphenidate, rather than amphetamine salts. Ritalin behaves similarly to Adderall in terms of its effects, although it is said to be milder.
Dexedrine (dextroamphetamine) is a potent central nervous system stimulant that has been on the market since 1976. While its primary use is for ADHD, it has also been used in the military to keep soldiers awake during combat.
Concerta is a relatively new drug for ADHD that was approved in 2000. Considered an extended-release version of Ritalin, its effects last longer than other, similar stimulants.
Ephedrine is known for its use in cold and cough medications, but it has similar effects as other stimulants. As an appetite suppressant and bronchodilator, ephedrine can treat chest tightness, wheezing, and shortness of breath. It is also a key ingredient that is used in methamphetamine labs.
Desoxyn is a prescription version of methamphetamine. It was introduced in 1947 as a remedy for obesity and has also been used to treat ADHD.
While most people associate caffeine with their morning cup of Joe, this substance is also a common ingredient in prescription pain relievers and anti-inflammatory medications.
Illicit stimulants (better known as street drugs) primarily take the form of cocaine, crack, ecstasy, and methamphetamine. While cocaine usage seems to be declining over the years, stimulant drugs as a whole are still widely abused.
Cocaine is a white, powdery substance that affects the central nervous system. As one of the most well-known stimulants in the world, cocaine is derived from the South American coca plant and produces intense feelings of euphoria and energy. The most common way to ingest cocaine is to snort it; however, it can also be ingested or dissolved in water and injected.
Crack is a highly addictive form of cocaine that is synthesized by boiling powdered cocaine with water and baking soda or ammonia. The boiling process removes the hydrochloride base, turning it into a crystallized rock that can then be smoked. Crack is purer and more potent than the powdered form of cocaine, and it is also cheap to make.
Methamphetamine — more commonly known as “meth” — is a highly addictive stimulant that produces an intense high. It is available in powdered or crystal form and is usually smoked, snorted, or injected. The high produced from meth is so intense that a person can be addicted after the first hit. This is often followed by a severe “crash” that can leave an individual feeling anxious, jittery, and irritable.
Ecstasy is the street name for MDMA (3,4-methylenedioxy-methamphetamine), a synthetic drug that produces strong feelings of euphoria. It is referred to as ecstasy when it is in pill form, and as “molly” when it is in powder form. As a popular party drug, ecstasy is known for its combination of stimulant and hallucinogenic properties.
How Are Stimulants Abused?
Stimulants are misused and/or abused when they are taken inappropriately or without a prescription. For example, stimulants may be used in excess amounts for recreational purposes or to enhance performance for study. Someone may also take stimulants without a prescription or use multiple substances simultaneously (known as “poly-drug use”).
Stimulants might also be abused for the following reasons:
- To experience feelings of euphoria.
- To lose weight.
- To feel more alert or stay awake.
- To focus and think more clearly.
- To boost libido.
- To improve performance at work, school, or in sports.
Who Abuses Stimulants?
When it comes to prescription stimulants, these were historically given to people with obesity, asthma, and narcolepsy. However, once doctors became aware of the addictive properties of stimulants, they have largely restricted these prescriptions to children and young adults with ADHD.
In recent years, high school and college students have been known to abuse stimulants such as Adderall or Ritalin for study purposes. However, teens and young college students are not the only ones using them. According to a study by the U.S. Department of Health and Human Services, an estimated 5 million U.S. adults have reported misusing stimulants.
Are Stimulants Addictive?
Stimulants are addictive for physical and psychological reasons. The severity of dependency varies according to the particular type of stimulant, as well as how much and how often the drug is taken. For example, crack cocaine and crystal meth are highly potent and unregulated stimulants that can produce a physical addiction almost immediately. Prescription stimulants such as Adderall, on the other hand, can become physically addictive if they’re taken regularly and for long periods.
The other reason that stimulants are addictive is that the body builds up a tolerance, causing the person to take higher doses to achieve the desired effects. The build-up of a tolerance level leads to withdrawal symptoms if the drug is discontinued. These withdrawal effects occur when dopamine levels drop in the brain.
Stimulants are also psychologically addictive. If a person is taking these drugs to feel more confident and/or to enhance their performance, they may rely on them to feel normal. This can prompt a psychological attachment to stimulants that can be difficult to break. This is where treatment can be effective for helping individuals wean off the drug while dealing with the underlying causes of their addiction.
Statistical Overview of Prevalence of Abuse
Below are some statistics surrounding stimulant abuse in the U.S.:
- According to a 2019 SAMSHA (Substance Use and Mental Health Services Administration) survey, 1 million people aged 12 and older had an addiction to cocaine in the previous year.
- In 2018, 1 million people were addicted to methamphetamine, while roughly 550,000 people were addicted to prescription stimulants.
- Roughly 40% of all overdose deaths in 2018 were due to stimulants. More than half of those involved a combination of opioids.
- According to the National Survey on Drug Use and Health, 8.6 million Americans aged 12 and older have reported using crack.
- SAMHSA reports that more than 18 million Americans aged 12 and older reported using ecstasy in 2016.
- According to a study by Addiction, 25% of students have reported using Adderall to help them cram for exams.
- In 2019, 16,167 deaths were caused by psychostimulants, primarily methamphetamine. In that same year, 15,883 deaths were caused by cocaine use.
Physical and Neurological Effects of Stimulants
Stimulants affect the central nervous system, resulting in an array of physical and neurological effects. Some of the most common are:
- Decreased appetite
- Increased concentration
- Difficulty sleeping
- Increased pulse and blood pressure
Stimulants are commonly abused with other substances, especially alcohol. Below are the effects and consequences of these combinations.
While alcohol and stimulants are commonly combined, the risk of sudden death from mixing these is 20 times higher than it is with either substance on its own. This combination can also lead to alcohol poisoning because stimulants mask the effects of alcohol, causing a person to drink more than they normally would.
Mixing alcohol and cocaine can also increase the risk of cardiac problems, stroke, or seizures. Whether it’s cocaine, amphetamines, or prescription drugs, mixing alcohol with stimulants can be dangerous and lead to symptoms such as vomiting and dizziness. Meth, in particular, can lead to violent and unpredictable behavior if it is mixed with alcohol. It can also worsen the comedown or “crash” period, triggering depression or suicidal thoughts.
Combining stimulants with other stimulants is also hazardous. Cocaine and ecstasy, for example, are sometimes combined to enhance the high. However, as both drugs affect the cardiovascular system, they can increase the risk of heart attack, stroke, or seizures. Generally, mixing any two stimulants can lead to these effects, as they all influence the same bodily systems.
Opioid and stimulant combinations such as heroin and cocaine are known as “speedballing.” This toxic combination greatly enhances the high of each drug, while causing unique sensations that cannot be achieved from taking each drug independently.
However, speedballing is notoriously dangerous and can lead to an overdose because the drugs are antagonistic. As one is a stimulant and the other a depressant, they cancel each other out, which can lead a person to mistakenly think they are more sober than they actually are. Another dangerous consequence is that heroin is longer lasting and can cause respiratory failure when the cocaine wears off.
Negative Health Consequences
When taken in excess and for long periods, stimulants can lead to serious health consequences. These include:
- Anger or aggression
- Violent behavior
- Extreme weight loss
- Chronic high blood pressure
- Increased risk of stroke
- Increased risk of heart damage
- Memory problems
- Lung damage (if stimulants are smoked)
- Infertility and difficulty with sexual performance
- Decreased immunity
- Increased risk of skin infections
- Risk of contracting HIV, hepatitis, and sexually transmitted diseases from sharing needles and unsafe sexual behaviors
- “Meth mouth:” severe dental decay, gum disease, and loss of teeth
- Chronic respiratory system inflammation and/or damage to nasal passages (if stimulants are snorted)
It’s also important to be aware of the signs and symptoms of a stimulant overdose, which can include:
- Overactive reflexes
- Rapid breathing
- Panic attacks
- Abnormally high fever
- Muscle pains
- Heart problems (irregular heartbeat)
- Abnormally high or low blood pressure
- Circulation failure
- Nausea, vomiting, diarrhea, and abdominal cramps
Signs & Symptoms of Stimulant Abuse
People who are addicted to stimulants can begin to exhibit the following signs of abuse:
Physical Signs of Abuse
- High blood pressure
- Talking fast or rambling
- Excessive weight loss
- Frequently dilated pupils
- Fast heart rate
- Fast breathing
- Irregular heartbeat
- High body temperature
- Poor diet
- Abdominal pain
Behavioral Signs of Abuse
Stimulant addiction tends to lead to specific behavioral signs. While some of these are specific to particular drugs, they include:
- A strange odor on a person’s breath, hair, or clothing.
- Sudden behavior changes.
- Mood swings.
- Using substances in a pattern that lasts hours or days, followed by long periods of sleep.
- Psychotic behavior such as hallucinations and paranoia.
- Risky sexual behavior.
- Hallucinations: “meth mites;” compulsively scratching the skin.
- “Tweaking:” rapid eye movements, lack of coordination, and fast, incomprehensible speech.
- Engaging in repetitive behaviors that don’t seem to serve a purpose.
- Teeth grinding, jaw clenching.
- Running out of prescription stimulants early or faking symptoms to get a prescription.
- “Doctor shopping” to acquire multiple prescriptions.
- Hiding or lying about stimulant use.
- Isolating from family and friends.
- Loss of interest in activities or hobbies.
- Insomnia or over-sleeping.
- Suspicious behaviors.
- Abusing other substances (“poly-substance use”).
- Ongoing debts, loss of jobs, or financial problems.
- Relationship issues.
Stimulant Withdrawal Symptoms
Chronic stimulant abuse can lead to tolerance and subsequent withdrawal symptoms. Some of the most common symptoms include:
- Jittery reactions
- Dulled senses
- Loss of interest
- Slowed movements
- Slow heart rate
- Increased appetite
- Impaired memory
- Weight loss or gaunt appearance
- Insomnia or hypersomnia
- Body aches
- Drug cravings
- Unpleasant dreams
- Disturbances to sleep patterns
- Sensitivity to touch
Treatment for Stimulant Addiction
If you find yourself struggling with a stimulant addiction, help is available. Below are some of the recommended treatment options for this kind of substance abuse. These therapies are often most effective when combined with other treatments, and are accessible through a doctor or by speaking directly to a rehab facility. You may also want to enroll in a rehab program that offers inpatient or outpatient options, depending on your needs.
Stopping on Your Own
While it can be tempting to try to detox from stimulants on your own, it is not recommended. Stimulant withdrawal symptoms are very uncomfortable, and while they are less dangerous than opioid detoxes, medical complications can still arise. Recovery from stimulant abuse should be done under medical supervision, where doctors and clinicians can keep you safe and comfortable.
Treatment programs that deal with both addiction and mental health conditions can be highly beneficial, especially if you have an underlying condition such as depression or anxiety. Rehab facilities that offer dual diagnosis are often staffed with psychiatrists or clinical therapists that are qualified to diagnose and treat concurrent mental health conditions. This allows clinicians to safely address these conditions alongside withdrawal from the drug itself.
Cognitive-Behavioral Therapy (CBT)
Cognitive-behavioral therapy (CBT) is one of the most highly recommended and widely used therapies for substance abuse and mental health conditions. CBT helps individuals identify automatic and negative thinking patterns and change them into more positive ones. Another benefit of this type of therapy is that it can teach clients how to deal with stress, cope with cravings, identify triggers, and deal with situations that encourage stimulant use.
The Matrix Model
The Matrix Model is another form of therapy that has shown to be effective in treating addictions to stimulants like cocaine and methamphetamines. This 16-week approach is comprehensive and consists of a mixture of behavioral therapy, individual counseling, 12-step support, family education, drug testing, and encouraging non-drug-related activities. Through guided therapy, patients learn about issues connected to addiction and relapse. These sessions are designed to promote self-esteem and self-worth while the patient and therapist work together to reinforce positive behavioral changes.
Motivational interventions such as contingency management are useful counseling techniques for addiction. These approaches are based on a reward system, and they use motivational techniques to help individuals commit to change and remain abstinent. Individuals who receive motivational interventions learn that it is possible to achieve sobriety using self-control and they are often given rewards or incentives as a guide.
Support groups such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and 12-Step programs can also be beneficial. These groups are well established and recognized for their ability to provide ongoing support and help individuals reduce the risk of relapses.
There are a few medications used for treating stimulant addiction. Some of these can prevent relapse and minimize withdrawal symptoms:
While research is in the early stages, anticonvulsant drugs may reduce cravings and prevent relapse by blocking the euphoric effects of stimulants. Some of the promising ones include Baclofen, Tiagabine, and Topiramate.
Beta-blockers like Propranolol are known to help with anxiety and restless leg syndrome during stimulant detoxing. Like anticonvulsants, these drugs may also reduce the euphoric effects of stimulants, discouraging future use.
Disulfiram is currently used to treat alcohol addiction. However, it is showing promise as a treatment for stimulant addiction, particularly because it blocks the enzymatic breakdown of dopamine. This leads to an unpleasant high and can prevent relapses.
Wellness & Holistic Activity Programs
Programs that encourage healthy activities such as yoga, social outings, outdoor adventures, etc. can be highly beneficial for individuals who are recovering from substance abuse and mental health conditions. These types of programs are great for encouraging calmness, emotional expression, improving physical health, and teaching valuable skills.
If you or a loved one are struggling with stimulant abuse or addiction, you are not alone. Treatment and support are readily available. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment.
You can also find a list of treatment centers near you on our website to help get you on the path to recovery.
Ciccarone, D. (2011). Stimulant Abuse: Pharmacology, Cocaine, Methamphetamine, Treatment, Attempts at Pharmacotherapy. Prim Care. 38(1), 41–58. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056348.
National Institute on Drug Abuse. (2021). Overdose Death Rates. Drugabuse.gov. https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates.
National Institute on Drug Abuse. (2018). What are Prescription Stimulants? Drugabuse.gov. https://www.drugabuse.gov/publications/drugfacts/prescription-stimulants.
National Institute on Drug Abuse. (2018). Five million American adults misusing prescription stimulants. Drugabuse.gov. https://www.drugabuse.gov/news-events/news-releases/2018/04/five-million-american-adults-misusing-prescription-stimulants.
Substance Abuse and Mental Health Services Administration (SAMHSA). (2020). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf
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