Stimulants Abuse

Medically reviewed by:
Dr. Conor Sheehy, PharmD., BCPS

What is Stimulant Abuse?

Stimulant abuse is the compulsive use of and addiction to stimulant drugs like methamphetamine, Adderall, and cocaine. The first time an individual uses a stimulant, they experience euphoria and increased energy. With continued use, they build up a tolerance to these effects, so that they need to increase how much or how often they take the drug, or consume it in a new way (such as switching from taking a pill to crushing and snorting it) in order to experience the high they felt the first few times they took the drug.

Taking higher doses more often tends to lead to compulsive binging that lasts from hours to days, with users barely eating or sleeping, and often exhibiting extreme and uncharacteristic behavior. After a stimulant binge, an individual will crash or come down, experiencing irritability and jitteriness which is worsened by lack of sleep. As they come down further, users experience depression, fatigue, lethargy and insomnia, usually followed by excessive sleeping that shifts into extreme hunger upon awakening.

Acute withdrawal symptoms can last as long as a week, but few individuals are able to withstand these without professional addiction treatment. Individuals attempting to detox on their own are compelled to seek out more stimulant drugs to relieve withdrawal suffering and therefore repeat the cycle again.

Most Common Types of Stimulants Abused

The stimulant class of drugs includes both prescription and illicit stimulants. Prescription stimulants are medications used in the treatment of attention-deficit hyperactivity disorder (ADHD) and narcolepsy. Commonly prescribed stimulants are amphetamine salts (Adderall) and methylphenidate (Ritalin and Concerta). Although methamphetamine (Desoxyn) is also available by prescription for ADHD and obesity, it is rarely ever prescribed due to a very high risk of misuse and addiction.

While prescription stimulants can be extremely beneficial for patients with a legitimate medical need, anyone taking them without a prescription, or in ways other than indicated by a medical professional, is misusing or abusing the drug, putting themselves at risk of tolerance, dependence and addiction.

Prescription stimulants most often come in tablet or capsule form but may be formulated as a liquid as well. Common methods of misuse include crushing into a powder for snorting, dissolving in liquid to subvert delayed-release mechanisms, or injecting for faster onset.

Illegal or recreational stimulants include cocaine and crystal meth, the crystalline form of the drug methamphetamine. are a significant public health concern in the United States. In 2015, almost 6,000 people died from stimulant use, primarily the use of crystal meth, which was 255% higher than it was ten years earlier, in 2005.

Crystal meth appears like glass or white rocks, and is also referred to as ice, speed, meth, glass, and blue. It creates an intense euphoric high and energy that persists despite lack of sleep. Although there have been massive crack-downs on meth production in the United States, and the number of meth labs has decreased overall, there is more meth available on the streets today than ever, due to an influx of the drug smuggled in from Mexico.

People who use meth take it by swallowing, snorting, smoking, and injecting the substance after dissolving it in liquid. The high caused by methamphetamine begins fast and lasts 8 to 12 hours. Users often take additional doses in a “binge and crash” fashion.

Cocaine is a stimulant that can be used as a legal topical anesthetic agent for small wounds like nose bleeds or oral injuries, but is most often used recreationally. On the street, cocaine appears as a white or off-white crystalline powder that can be “cut” with other substances such as caffeine, hydroxyzine, and lidocaine by dealers wanting to maximize profits by either bulking up a small amount of cocaine, or increasing the potency of their product. Cocaine is commonly referred to as, blow or coke, and it has a crystalline form known as crack or rock. People use cocaine by snorting, smoking (crack), or by injection.

In the brain, cocaine increases concentrations of dopamine by preventing its reuptake and degradation. It also increases levels of norepinephrine, which constricts blood vessels. At these unnaturally high levels, these two neurotransmitters produce addictive levels of high energy and euphoria.

What are the Side Effects of Stimulant Abuse?

Stimulants work by increasing the amount of dopamine and norepinephrine in the brain. Dopamine is a neurotransmitter involved in reward and reinforcement behavior, while norepinephrine affects blood pressure, heart rate, and mood. Individuals taking prescription stimulants as recommended by their doctors benefit from the way these effects treat the symptoms of conditions like narcolepsy or ADHD.

Individuals taking prescription or recreational stimulants for the first time may experience euphoria, high blood pressure, fast and irregular heartbeat, hyperthermia, rapid breathing, decreased appetite, and hyperglycemia. The ability of stimulant drugs to quickly release large amounts of dopamine and norepinephrine in the reward areas of the brain reinforces drug-seeking behavior, which essentially trains people to repeat the experience.

Chronic use of meth leads to long term side effects such as paranoia, memory loss, weight loss, hallucinations, and rotten and lost teeth (meth mouth). Users who inject methamphetamine are more susceptible to contracting blood-borne pathogens like HIV, Hep B, and Hep C.

The high caused by cocaine generally lasts 15 to 30 minutes. The immediate short term-effects of cocaine abuse include euphoria, hypersensitivity to light, sound, and touch, paranoia, increased mental alertness, dilated pupils, hypertension, tremors, and restlessness. People who use cocaine, especially crack cocaine, can become addicted after their first time.

Long-term consequences of cocaine addiction depend on the method of use. Smoking crack can result in respiratory distress, asthma, and higher rates of a respiratory infection such as pneumonia. Snorting cocaine over time can cause a loss of smell, frequent runny nose, and difficulty swallowing. Ingesting cocaine orally can result in bowel necrosis resulting from a lack of blood flow to the intestines. Injecting cocaine is associated with higher risks of contracting hepatitis, HIV, and the development of an abscess.

The abuse of any stimulant drug has been shown to lower inhibitions and increase risky and uncharacteristic behavior, which can increase the risk of sexually transmitted infections (STIs), accidents, relationship problems, and legal trouble.

Abusing stimulants leads to tolerance and physical dependency, so that individuals suffer from withdrawal symptoms when they attempt to quit or cut down.

The symptoms of withdrawal can develop just hours after the last use, with acute symptoms lasting up to a week, and some symptoms lasting for months. The common signs and symptoms of stimulant withdrawal are both physiological and psychological:

What are the Signs of a Stimulant Overdose?

Whether intentionally or unintentionally, taking too many prescription or recreational substances can cause a stimulant overdose. The signs and symptoms that occur when individuals overdose are tremors, restlessness, confusion, panic, fever, muscle pain, and weakness. Additionally, they may experience an irregular heartbeat that can progress to arrhythmia, hypotension, hypertension, nausea, vomiting, and diarrhea. Currently, there is no medication available to treat stimulant overdose, but there are supportive treatments that can address the symptoms present. As the most common cause of death in a fatal stimulant overdose is heart attack, stroke, or seizure, individuals overdosing on any type of stimulant require emergency medical treatment to restore blood flow to the brain and heart.

Treatment Options for Stimulant Abuse

While there are no stimulant-specific drugs to treat stimulant withdrawal or stimulant abuse, there are medications that can relieve individual withdrawal symptoms, such as pain relievers and anti-convulsant and anti-seizure medications. Antidepressants may be given to help heal patients’ imbalanced brain chemistry. Nutritional and supportive care help with both detox and long-term recovery, providing the building blocks needed for patients’ bodies and brains to heal and get stronger.

There are many different kinds of addiction treatment programs available, but all of them should involve a treatment program designed to address each patient’s unique needs, from the severity and duration of addiction to co-occurring disorders. Although there are some programs lasting only 30 days, research has shown that programs of 90 or more days are needed in most cases.

Behavioral therapy is the cornerstone of treatment for most individuals in recovery. This kind of therapy addresses the patient’s mindset and habits, providing new perspectives and approaches, and teaching new ways of coping with stress and drug use triggers. Individual, family, and group counseling is also needed to uncover and address underlying issues, to improve communication and interpersonal relationships, and to forge supportive connections with other people in recovery.

Stimulant addiction recovery isn’t something that can be accomplished and left behind in a short period of time, but rather is an ongoing journey of growth that allows individuals to create a life that supports their continued freedom from stimulant abuse.