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Amphetamines 101:

Everything You Need to Know

Amphetamines 101:

Everything You Need to Know

Amphetamines or stimulants are medications or illegal drugs that speed up the central nervous system. While the drugs have legal uses, they also have potential for abuse.

This article will examine the history of amphetamines in the United States as it relates to the origins of the epidemic. It will also explore how amphetamines are abused recreationally as well as their long-term effects on the body if misused. Detoxification and treatment options for those addicted to amphetamines are also reviewed.

History of Amphetamines

In 1929, a biochemist named Gordon Alles discovered beta-phenyl-isopropylamine (later called amphetamine) that could dilate the airways and act as a decongestant. He published his clinical results in 1929, and pharmaceutical manufacturers started clinical development trials on the compound.

Over the Counter Availability

Americans could first purchase amphetamines in an over-the-counter form in the 1930s when the drugs were marketed as Benzedrine.1 People would inhale Benzedrine to reduce the incidence of nasal congestion. Doctors also prescribed amphetamines in tablet form to treat medical conditions such as narcolepsy and minor depression based on Alles’ work.2

The tablets grew popular in use, and in 1941, Benzedrine’s total sales were estimated at $500,000, according to an article in the American Journal of Public Health. In 1945, pharmaceutical manufacturer Smith, Kline, and French (SKF) started selling dextroamphetamine tablets marketed as “Dexedrine.”

World War II saw the increase of amphetamines on both sides of the war. The United States military supplied Benzedrine tablets to pilots while German and Japanese militaries supplied methamphetamine as a means to keep soldiers awake longer. People at this time also began to realize Benzedrine’s effects in promoting weight loss. A pharmaceutical manufacturer called Clark & Clark combined Benzedrine with thyroid hormones and marketed the pills as diet pills.

Realizing Addictive Effects

Doctors started to realize the addictive effects of amphetamines in the late 1940s. Researchers in a military prison started to note a significant number of patients who were hallucinating and agitated. They discovered patients were consuming the amphetamine base of the inhalers and found an estimated 33 percent of inhaler abusers had begun using amphetamines in the military.

Amphetamines vs. Tranquilizers

In the late 1950s, SKF introduced a new medication called Dexamyl, which was a blend of dextroamphetamine and amobarbital, a barbiturate sedative. They marketed it as a weight-loss remedy as well as for those who had anxieties and experienced emotional distress. According to the American Journal of Public Health, the United States was producing an estimated 80,000 kilograms of amphetamine salts a year in 1962. People in the United States used amphetamines significantly more than tranquilizers, although the 1960s are often remembered as a time when people used a significant amount of tranquilizers. In the 1960s, the average person was using 65 doses of amphetamines a year while the average tranquilizer consumption was 14 standard doses a year.

Public Awareness

Public Awareness

The increased amount of prescriptions led to the increased awareness of the side effects of amphetamines. Researchers started to describe side effects such as paranoia and psychosis. In the 1970s, there was an emergence of newer antidepressants as well as increased laws that restricted prescribing amphetamines. In 1971, Congress passed the Comprehensive Drug Abuse Prevention and Control Act. This act classified both amphetamines and methamphetamines as Schedule II drugs, meaning they have medical uses but also high potential for abuse. However, greater regulations resulted in greater incidences of diversion.

The 1970s were the first initial peak in amphetamine use. New designer drugs and the increasing popularity of methamphetamines and cocaine in the 1980s meant that amphetamine use decreased. At its peak in the 1970s, an estimated 3.8 million people in the United States were past-year, non-medical amphetamines users. In 2004, an estimated 3 million Americans used amphetamines for non-medical purposes.

Identifying Amphetamines

Other Names for Amphetamines

Amphetamines are sold on the street under names such as bennies, black beauties, crank, ice, speed, and uppers. Drug dealers may sell them as pills or as substances to smoke or inject. Prescription amphetamines include:

  • Amphetamine
  • Dextroamphetamine (Adderall, Dexedrine)
  • Methylphenidate (Ritalin, Ritalin SR)

What Amphetamines Look Like

Illegally produced amphetamines may appear like crystals, fine powder, coarse powder or chunks of material that may be slightly off-white or yellow. They are sometimes sold in plastic bags or in aluminum foil. They are also sold as capsules or tablets.

Medical Use of Amphetamines

Currently the U.S. Food and Drug Administration classifies amphetamines as Schedule II stimulants. This means the substances have potential for abuse, but also medical use. Doctors currently prescribe amphetamines to treat conditions such as attention deficit hyperactivity disorder (ADHD), narcolepsy, or obesity.3

High School Popularity

One of the most significant categories of amphetamine abusers and recreational users is young people. According to the National Institute on Drug Abuse (NIDA), Adderall is the most commonly abused drug by high school seniors other than alcohol or tobacco.4 An estimated 7.4 percent of high school seniors using drugs that aren’t prescribed to them are using Adderall.

Amphetamine Use Around the World

The United States isn’t the only country affected by amphetamine use and abuse. According to the BBC, prescriptions for methylphenidate (Ritalin and other drugs) increased from 420,000 in 2007 to 657,000 in 2012.5 The increase in prescriptions can result in an increase for abuse as many people who obtain amphetamines do so from friends or family. The drugs are often prescribed in the treatment of ADHD, which some experts contend is over-treated across the world.

Misconceptions About Amphetamines

Myth: Amphetamines Act Like Cocaine

A common misconception about amphetamines is that they work in a similar way to cocaine. While cocaine is a stimulant, the body quickly metabolizes cocaine. By contrast, amphetamines remain in the body for a longer time period, particularly in the central nervous system. This effect is what makes amphetamines last longer in the body than cocaine.

Myth: They’re Safe Because They’re Legal

Another common misconception is that because amphetamines are legally prescribed in the United States, they aren’t dangerous or addictive. Some people may combine amphetamines with other drugs as a means to increase their high, and this practice can result in overdose. According to NIDA, an estimated 93,562 emergency room visits in 2009 were related to the use of stimulants, including methamphetamines and amphetamines.6

The United States Drug Enforcement Agency list amphetamines as a Schedule II drug for a reason. They have the potential to cause addiction and harmful side effects if misused and taken other than as prescribed.

Myth: All Amphetamines are Pharmaceutically Manufactured

Another misconception is that because amphetamines are prescription pills, all amphetamines (even those sold on the street) are made by a pharmaceutical manufacturer. Illegal laboratories may produce amphetamines that contain mixtures far from the original chemical structure. For example, amphetamines produced illegally may contain caffeine, sugar, and other binding agents. Some illegal manufacturers also add other drugs and psychoactive substances to try and increase the pill’s effects.

If a person buys amphetamines on the street, they cannot be sure of what they are getting. Amphetamines may be only a small component. This increases the risks for adverse health effects and reactions from pills or powders.

Effects of Amphetamines

Physical Effects

Amphetamines have three major effects on the body: stimulate the central nervous system, suppress appetite, and speed up the body’s heart rate. By stimulating the central nervous system, amphetamines can have the following effects:

  • Appetite Loss
  • Exhaustion
  • Faster Heart Rate
  • Higher Blood Pressure
  • Insomnia

Large Dose Effects

People who take large doses of amphetamines may experience the following symptoms:

  • Blurred Vision
  • Dizziness
  • Fever
  • Headache
  • Sweating

Overdose Effects

If a person takes too much or overdoses on amphetamines, a person can experience symptoms that include:

  • Agitation
  • Convulsions
  • Hallucinations
  • Higher Body Temperatures

These symptoms can also lead to death if a person takes too much. Very high body temperatures can cause brain and organ damage a person cannot recover from.

How Amphetamines are Consumed

How fast a person experiences any of the above effects depends upon the method they use it. Examples include:

Smoking or injecting:

The effects are almost immediate and intense. However, they are often the shortest-lasting.

Snorting:

Snorting amphetamines can cause a high in anywhere from three to five minutes. The effects usually last about 15 to 30 minutes. However, the high is usually less intense than when injecting amphetamines.

Taken orally:

When a person takes amphetamines via pill form, a person usually starts to feel high in about 15 to 20 minutes. The sensations are usually longer lasting than when snorting, smoking, or injecting amphetamines.

Regardless of the route used, there is no safe level of illegal amphetamine use, and there are many risks to its use on the body.

Long-Term Effects of Amphetamines

Psychosis

Long-term amphetamine abuse can cause a condition called psychosis. This condition causes symptoms that include:

  • Auditory hallucinations
  • Paranoia
  • Repetitive thoughts
  • Skin picking
  • Visual hallucinations

Those who abuse amphetamines chronically may also experience erratic or unusual behavior as well as violent behaviors. People may also experience suicidal thoughts and depression related to their use.

Nutritional Deficiencies

In addition, amphetamines can be an appetite suppressant. Those who abuse them long-term are vulnerable to nutritional deficiencies and malnutrition. As a result, they are also subject to more illnesses as their body doesn’t have the nutrients it needs to maintain a healthy immune system.

Higher Risk for Medical Conditions

Those who abuse amphetamines via injection are at increased risks for IV-related medical conditions. Examples include HIV, hepatitis B, and hepatitis C. They are also at greater risk for endocarditis, a serious heart infection that can prove deadly.

What is Detox from Amphetamines Like?

Addiction vs. Dependence

As a general rule, people who take amphetamines as prescribed and at the right dosages do not get addicted. There is a difference between addiction (when a person loses control over their use of a substance) and being dependent on the medication to treat a medical condition.

However, some people abuse amphetamines as a means to achieve a high, improve their performance in school or work, or to lose weight. Using amphetamines for these purposes can lead to addiction. A person who is addicted to amphetamines may feel like they need them to navigate through their daily life.

Withdrawal Symptoms

If a person’s body is reliant on the drug, they will experience withdrawal symptoms associated with not using the drug anymore. Examples of these symptoms include:

  • Body aches and pains
  • Difficulty concentrating
  • Experiencing hallucinations (seeing or hearing)
  • Extreme fatigue
  • Headaches
  • Increased appetite
  • Problems sleeping
  • Strong physical cravings for the drug when not using it

Medications for Detox

While there is no FDA-approved drug to treat these symptoms, there are medications a doctor can prescribe to help minimize some of these effects. Examples can include anti-nausea medications and over-the-counter pain relievers. The duration of withdrawal can depend on the type of medication a person is abusing as well as if the medicine is an extended release. The longer the medication acts, the longer the medicine can take to leave the body. As a general rule, most people experience a reduction in withdrawal symptoms after about two to four days after a person takes their last amphetamine.

Therapy and Counseling

After a person completes the withdrawal process, a doctor will usually recommend participating in some type of rehabilitation treatment. This usually includes participating in therapy or counseling. Sometimes, a person’s family or friends will also participate in counseling sessions. Family therapy can help a family understand how they can better help their loved one as well as start to rebuild their family relationships.

What are Common Barriers to Getting Sober from Amphetamines?

Polysubstance Abuse

One common struggle with amphetamine sobriety is that amphetamines aren’t always the only substance a person abuses. According to the Alcohol and Drug Foundation, many people will abuse amphetamines along with other drugs, such as alcohol, cannabis, or benzodiazepines. These substances of abuse cause a frequent swing in a person’s symptoms. They may use amphetamines to feel more alert after using central nervous system depressants like alcohol or cannabis or vice-versa. Polysubstance abuse means a person not only withdraws from amphetamines, but also other substances as well. Also, a person has to work to break not one, but other addictions. While this is certainly possible, it often requires professional help to do so.

Lingering Withdrawal Symptoms

Another common struggle for those addicted to amphetamines who are now pursuing sobriety is that a person may think just because they have detoxed from amphetamines that they will no longer have any lingering symptoms. According to the Alcohol and Drug Foundation, amphetamine withdrawal symptoms can last a month or more. After the most acute withdrawal symptoms, a person can experience other effects, including:

  • Anxiety
  • Depression
  • Irritability
  • Lingering cravings
  • Physical exhaustion
  • Problems sleeping well

Having these low feelings can make it difficult for a person to continue their sobriety. This is why continued help is important after a person has gone through the initial detox process.

Finding Help for Amphetamine Addiction

Prescribing Physician

If a person struggles with amphetamine addiction, there are several places they can seek help. A person can talk to their prescribing physician if they feel their prescription use of amphetamines has gotten out of control. Their physician can recommend treatment centers in a person’s area or choose to treat the addiction if they are well-versed in addiction medicine.

If a person is illegally abusing amphetamines or simply isn’t sure where to start, they can call the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Helpline at 1-800-662 HELP (4357). This is a free and confidential service open 24 hours a day on a year-round basis to help those struggling with addiction. Helpline operators can help with referrals to treatment facilities and support groups as well as free publications and information on drugs, medications, and how to get sober. The service is free of charge to anyone who calls. Family members and loved ones can also call the helpline to receive information on how to help a loved one.

Community Resources

In addition, there are often resources in or near one’s own community. These include rehabilitation centers, mental health facilities, and community groups who help those who are struggling with addiction. A person can find these through Internet searches, discussions with their primary care physician, or by reaching out to community groups such as Narcotics Anonymous. Even though amphetamines are not a narcotic, these groups are often connected with community resources that can help a person seek treatment.

Conclusion

Amphetamine addiction can be devastating to the person experiencing it as well as their family. Addiction can cause a person to lose control over their life and harm their relationships with friends and family. Amphetamine addiction in particular can also cause long-term health effects if a person continues their patterns of abuse. Therefore, it is best that a person seek help to find the support they need to achieve and maintain their sobriety.

 


References

  1. https://www.dea.gov/sites/default/files/2018-06/drug_of_abuse.pdf
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2377281/
  3. https://medlineplus.gov/ency/patientinstructions/00079htm
  4. https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions/what-drugs-are-most-frequently-used-by-adolescents
  5. https://www.bbc.com/news/health-23674235
  6. https://adf.org.au/drug-facts/amphetamines/