What most of us know as amphetamines is the general term for the chemical name alpha-methylphenethylamine.1 Amphetamines are central nervous system (CNS) stimulant drugs that are often used to treat disorders such as ADHD and narcolepsy. Some people use them to promote wakefulness or as diet aids because amphetamine use results in decreased appetite and weight loss.1,2 Despite their legitimate medicinal uses, they also carry a high abuse potential.
The World Health Organization (WHO) reports that the highest levels of abuse for amphetamines occur in East Asia. While amphetamine abuse continues to be a significant problem in the United States, its use has declined compared to other drugs, such as prescription painkillers.2,3
Amphetamine abuse is associated with the development of physical dependence and the potential for addiction (a moderate-to-severe substance use disorder4). And a variety of people abuse amphetamines for different reasons.
For instance, certain stimulants designed for medicinal purposes, such as Ritalin and Adderall, have recently gained popularity as drugs of abuse and potential learning and memory aids in adolescents and college students. Other frequently abused stimulant drugs are ephedrine, methylphenidate, and MDMA (ecstasy).4
People with amphetamine use disorders often have a combination of both physical and psychological symptoms that may need to be treated by a professional substance use disorder treatment program.
Signs and Symptoms of Abuse
In some circles, the terms addiction and substance abuse have been replaced with substance use disorder to define the two concepts.4 The term stimulant use disorder may also be used as a blanket term that describes substance use disorders with all types of stimulant drugs, including amphetamines and cocaine.
The signs of an amphetamine addiction (or stimulant use disorder) include:4,5
- Continuing to use amphetamine drugs despite their negative consequences, such as:
- Inability to fulfill major life obligations.
- Detrimental effects to a person’s physical health, occupation, personal relationships, school, or other important areas of life.
- Inability to cut down or stop using amphetamines despite a desire to do so.
- Repeated cravings for amphetamines.
- Spending substantial time using amphetamines or recovering from their use.
- Obtaining amphetamines illegally, or if they have a prescription for amphetamines, using the drugs in higher amounts or more often than prescribed.
- “Doctor shopping” to obtain multiple prescriptions for amphetamines from different doctors.
- Using amphetamines when it is dangerous to do so, such as while driving, mixing amphetamines with alcohol or other drugs, and using amphetamines at work.
- Demonstrating significant tolerance to amphetamines.
- Demonstrating withdrawal symptoms after periods of abstinence.
- Experiencing a number of negative side effects associated with amphetamine usage that can include delusions, extreme suspiciousness or paranoia, and hallucinations.
- Losing interest in facets of life that used to be important to the person.
- Legal, financial, or relationship problems directly related to amphetamine use.
Effects of Use and Abuse
There are a number of potentially harmful effects associated with amphetamine use and abuse, including:5,6
- High blood pressure.
- Increased or irregular heartbeat.
- Increased risk of heart attack or stroke.
- Dry mouth.
- Bloodshot eyes.
- Dilated pupils.
- Appetite loss.
- Weight loss.
- Poor attention.
- Memory problems.
- Poor problem-solving.
- Paranoid delusions.
- Higher risk of seizures.
- Higher risk of addiction/stimulant use disorder.
- Higher risk of overdose.
People who develop significant psychiatric symptoms, such as delusions and hallucinations, may receive an additional diagnosis of a substance-induced psychotic disorder.4 Unfortunately, it is not uncommon for someone with an amphetamine addiction to have some sort of co-occurring psychological disorder that further complicates their substance use disorder. But a competent, trained professional can guide you down the road to recovery, beginning with detox.
Count Your Pills
A surprising number of young men and women are able to obtain doctor-prescribed ADHD stimulants even though they don’t have a doctor’s recommendation. This is a big problem that can result in widespread abuse. But where do people get ahold of their prescription drugs? In 2016, Recovery Brands found that a surprising majority of young individuals between the ages of 18 and 28 get their prescription stimulant medications to treat ADHD through their friends. More than 20% acquire them through their family members; more than 18% via schoolmates; and only 14.8% from an illicit dealer. Those with doctor approval for these medications should keep tabs on their medications to treat ADHD in order to protect at-risk college-age people from substance abuse and the consequences of it.
Detoxification, or detox, technically refers to a natural cleansing process that the body uses to rid itself of foreign substances and impurities.5 Any drugs in the system, including amphetamines, are metabolized by the liver and eliminated from the body. This process occurs whether or not the person actively uses drugs. However, in addiction treatment circles, detox is colloquially known as the first line of treatment in getting clean from a given substance.
Drug withdrawal, on the other hand, refers to a cluster of symptoms that can arise in people after developing physical dependence to a substance. The person’s body has learned to operate “normally” only when the drug is present at a certain level in its tissues. So when the person stops using drugs, the person’s system is thrown out of balance and he or she experiences any number of negative physical, emotional, psychological, and cognitive symptoms.4,5
Medication is often helpful to ease the discomfort associated with withdrawal symptoms—something known as withdrawal management.5 The actual severity and length of the symptoms that a person experiences depends on many factors, including:5
- How long he took amphetamines.
- The typical amount amphetamines he took.
- The method he took them (e.g., injecting, smoking, snorting, pill form).
- Individual differences in metabolism and psychological makeup.
In general, the American Psychiatric Association (APA) recognizes several diagnostic criteria associated with amphetamines withdrawal:4
- Dysphoria (depression, apathy, sadness, anxiety) and 2 or more of the following symptoms:
- Fatigue and lethargy
- Insomnia or hypersomnia (sleeping too much)
- Significantly increased appetite
- Extreme restlessness
- Difficulty initiating movements
- Difficulty moving
- Feeling as if you are moving in slow motion
- The emotional, psychological, and physical symptoms of amphetamines withdrawal are believed to be a result of extremely depleted levels of neurotransmitters, such as dopamine and serotonin. Amphetamines raise these neurotransmitter levels extremely high, so when you stop using the drug, these levels drop drastically and you feel terrible.5, 6
- Though amphetamine withdrawal symptoms are not considered physically dangerous, there may still be danger to the user in terms of poor judgment, psychotic behaviors, or dehydration. So choosing to detox under a physician’s supervision is usually the wisest choice. 5,6
Available Options for Rehab
When receiving treatment for an amphetamine addiction, the first step is going through a withdrawal management program, or detox, as it’s more commonly known. Here, a physician trained in addiction medicine carefully supervises the person, perhaps administering specific medications to help ease withdrawal syndromes.
Withdrawal medications may include very mild stimulants, such as Provigil, to reduce lethargy and sleepiness, medications for depression (although many antidepressant medications don’t work best until you’ve taken them a while), and medications for psychotic symptoms or seizures.5,6
Depending on the person, withdrawal management may mean inpatient admission (for individuals with severe issues, such as psychosis, or who may live in conditions that would foster relapse, such as being homeless) or outpatient care. It is important to discuss your treatment options with your treatment providers and choose an option based on their recommendations, as well as your personal needs, affordability, and comfort level. In addition, after following the withdrawal management program, getting involved in an aftercare program increases your odds of sustaining sobriety long-term.
Treating Co-Occurring Disorders
In addition to co-occurring amphetamine addiction and mental health disorders, many people also have co-occurring substance use disorders that involve sedatives. The reason for this is that the person uses the sedatives to dampen the stimulant side effects of the amphetamines, such as nervousness, hyperactivity, and insomnia.4 People with more than one substance use disorder need special consideration during the withdrawal management process, and most likely would be best served in an inpatient program.
Other common co-occurring disorders for people with amphetamine addictions are personality disorders (particularly antisocial personality disorder); attention deficit hyperactivity disorder (ADHD); post-traumatic stress disorder (PTSD); and gambling disorders.4 These co-occurring disorders also need to be treated at the same time as the person’s stimulant use disorder.5,6
To get this comprehensive treatment, seek out programs that involve:5,6
- A general treatment outline.
- Specific additions and alterations to that general outline that address that person’s needs.
- Intensive therapy (group therapy or individual therapy or a combination of the two) that is designed to identify and address the factors that drove the substance abuse to begin with; help the person learn and apply new coping skills; and prepare the person for long-term recovery with a relapse prevention plan.
- Strong social support through family therapy, family involvement in the individual’s case, becoming involved in social support groups such as 12-step groups, getting involved in volunteer work, and other potential means to develop a strong social support network that fosters the individual’s recovery.
- Continued treatment of any co-occurring psychological or psychiatric disorders or other conditions, as well as any co-occurring medical conditions.
- Any other special interventions that apply to the individual case.
Simply quitting amphetamines and going through withdrawal without attending to these deeper issues may dramatically increase the risk of relapse.5,6 While relapse also occurs in individuals who receive treatment, these rates are far lower for people who go to a formal treatment program compared to people who do not.
- Heal, D. J., Smith, S. L., Gosden, J. & Nutt, D. J. (2013). Amphetamine, past and present–a pharmacological and clinical perspective. Journal of Psychopharmacology, 27(6), 479–496.
- World Health Organization. (2016). Amphetamine-type stimulants.
- National Institute on Drug Abuse. (2014). What is prescription drug abuse?.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition. Arlington, VA: American Psychiatric Publishing.
- Ries, R. K., Fiellin, D. A., Miller, S. C. & Saitz, R. (2014). The ASAM Principles of Addiction Medicine. New York: Lippincott Williams & Wilkins.
- Doweiko, H. (2011). Concepts of Chemical Dependency. Stanford, CT: Nelson Education.