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Amphetamines

Amphetamines and amphetamine-related drugs are central nervous system stimulants whose actions resemble those of adrenaline, one of the body's natural hormones.

The most important of these stimulants are the original drug, amphetamine, and its close chemical relations, methamphetamine and dextroamphetamine. Only the latter, under the trade name Dexedrine, is legally manufactured today. Everything else is synthesized in illicit "basement" laboratories.

Amphetamine was first introduced in the 1930s as a remedy for nasal congestion. Later, all three drugs were found to be effective in treating such other conditions as hyperactivity in children and narcolepsy (uncontrollable sleeping fits). Although they were also prescribed to control obesity and depression, their use for these disorders has been discontinued because patients became quickly and seriously dependent.

The amphetamines have long been taken for their stimulant and euphoric effects. When they were easily available, truck drivers, students, and athletes were among those who used them extensively to prolong their normal periods of wakefulness and endurance.

Among street drug users, injectable methamphetamine, usually called "speed," has been the most popular of this group of drugs because the "high" is more rapid and intense than when the drug is taken orally. There are reports of a smokable form of methamphetamine, known on the street as "ice."

Other street names for these drugs are bennies, glass, crystal, crank, pep pills, and uppers.

Amphetamine misuse has declined dramatically since the near epidemic between 1950 and 1970. At the same time, however, there has been a marked increase in the use of such other stimulants as cocaine. As well, drugs related to amphetamine - such as MDA, PMA, TMA, and STP - have appeared on the street.

Appearance:

Illicit amphetamine appears as crystals, chunks, and fine to coarse powders, off-white to yellow in color, and supplied loose (in plastic or foil bags) or in capsules or tablets of various sizes and colors. The drug may be sniffed, smoked, injected, or taken orally in tablet or capsule form.

Effects

The effects of any drug depend on several factors:

Amphetamines, like adrenaline, affect not only the brain but also the heart, lungs, and many other organs. Short-term effects appear soon after a single dose and disappear within a few hours or days.

At low doses, such as those prescribed medically, physical effects include loss of appetite, rapid breathing and heartbeat, high blood pressure, and dilated pupils. Larger doses may produce fever, sweating, headache, blurred vision, and dizziness. And very high doses may cause flushing, pallor, very rapid or irregular heartbeat, tremors, loss of coordination, and collapse. Deaths have been reported as a direct result of amphetamine use. Some have occurred as a consequence of burst blood vessels in the brain, heart failure, or very high fever. The psychological effects of short-term use include a feeling of well-being and great alertness and energy. With increased doses, users may become talkative, restless, and excited, and may feel a sense of power and superiority. They may also behave in a bizarre, repetitive fashion. Many become hostile and aggressive. Paradoxically, in children these drugs frequently produce a calming effect and were often prescribed for hyperactivity.

Long-term effects appear soon after repeated use over a long period. With prolonged amphetamine use, the short-term effects are exaggerated. Because amphetamines specifically suppress appetite, chronic heavy users generally fail to eat properly and thus develop various illnesses related to vitamin deficiencies and malnutrition.

Users may also be more prone to illness because they are generally run down, lack sleep, and live in an unhealthy environment. Chronic heavy users may also develop amphetamine psychosis - a mental disturbance very similar to paranoid schizophrenia. The psychosis condition is an exaggeration of the short-term effects of high doses; the symptoms usually disappear within a few days or weeks after drug use is stopped.

Heavy users of amphetamines may be prone to sudden, violent, and irrational acts. These result from drug-induced self-centredness, distortions of perception, and delusions that other people are threatening or persecuting them. The deviant lifestyle of many users may increase the likelihood of such behavior.

In one Canadian study, violence (either accidental, self -inflicted, or perpetrated by others) was the leading cause of amphetamine-related deaths. Violent death was at least four times as common among regular users of amphetamines as among non-users of the same age and sex.

As a way of coping with undesired amphetamine effects, users may turn to other dependence-producing drugs. Depressant drugs, particularly barbiturates, alcohol, and opiates, may be used to aid sleep or compensate for overdose. Thus users risk, in turn, addiction to these drugs as well.

Infections from unsterile needles are not unusual among users who inject the drug. Some infections are passed from user to user via shared needles. Hepatitis, for example, is common among speed users who regularly employ a needle; AIDS (acquired immune deficiency syndrome) may spread in the same way.

Amphetamine products often contain substances that do not easily dissolve in water. When users inject the drug, these particles can pass into the body and block small blood vessels or weaken the blood vessel walls. Kidney damage, lung problems, strokes, or other tissue injury may result.

Tolerance and dependence

Regular use of amphetamines induces tolerance to some effects, which means that more and more of the drug is required to produce the desired effects. Tolerance does not develop to all effects at the same rate, however; indeed, there may be increased sensitivity to some of them.

Chronic users may also become psychologically dependent on amphetamines. Psychological dependence exists when a drug is so central to a person's thoughts, emotions, and activities that the need to continue its use becomes a craving or compulsion. Experiments have shown that animals, when given a free choice, will readily operate pumps that inject them with cocaine or amphetamine. Animals dependent on amphetamines will work hard to get more of the drug.

Physical dependence occurs when the body has adapted to the presence of the drug, and withdrawal symptoms occur if its use is stopped abruptly. The most common symptoms of withdrawal among heavy amphetamine users are fatigue, long but troubled sleep, irritability, intense hunger, and moderate to severe depression, which may lead to suicidal behavior. Fits of violence may also occur. These disturbances can be temporarily reversed if the drug is taken again.

Amphetamines and pregnancy

Little research has been done in humans into the effects of amphetamine use on pregnancy and fetal growth. Experiments with animals suggest, however, that use during pregnancy may produce adverse behavioral effects, such as hyperexcitability, in offspring. And among humans, several cases have been documented of withdrawal symptoms among newborn infants of mothers using amphetamines.

Other Stimulants

In the past few years, there has been increasing use of nasal decongestants for their relatively mild stimulant properties. Various combinations of ephedrine, phenylpropanolamine (PPA), and caffeine are often misrepresented as "speed" or are sold in capsules that resemble those of legally manufactured amphetamines; these are called "look-alike" stimulants. Taken in doses high enough to stimulate the central nervous system, these drugs (especially when used in combinations) can produce such side effects as high blood pressure, irregular heartbeat, and agitation. Deaths due to stroke have been reported following massive doses of look-alike combinations or of a related decongestant, propylhexadrine.

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Copyright (c) 1972 Revised January 1991 Alcoholism and Drug Addiction Research Foundation, Toronto Canada
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