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You Are Here: Home > Essay Topics > Health Essays and Research Papers > Drugs and Drug Abuse  > Essay on Amphetamines Abuse Effects and Treatment

  Drugs and Drug Abuse

Essay on Amphetamines Abuse Effects and Treatment

Amphetamines are a form of central nervous system stimulants that may be prescribed by a physician and that are sometimes obtained illegally for the purpose of abuse or addiction. When they are lawfully prescribed, amphetamines may be used to treat Attention Deficit Hyperactivity Disorder (ADHD), narcolepsy, and treatment-resistant depression. In the past, amphetamines were used by physicians for appetite suppression among overweight and obese individuals, but with the exception of phentermine (Fastin), this use is no longer medically recognized.

In addition, Methylenedioxymethamphetamine (MDMA/Ecstasy), an illegal drug, is sometimes classified as a form of amphetamine by experts. The current brand names of amphetamine that are legally prescribed as of this writing are Adderall, Adderall XR, Dexedrine, Dextrostat, and Desoxyn. Amphetamines increase the level of dopamine as well as that of norephinephrine, two key brain chemicals.

When abused, amphetamines are usually used to produce a state of euphoria. Once an individual develops an addiction to the amphetamine, the drug is needed to avoid the symptoms of withdrawal. According to the United Nations Office on Drugs and Crime, an estimated 29.6 million people worldwide abused amphetamines in 2003, primarily amphetamine and methamphetamine, a form of amphetamine that is an illegal drug that is usually produced in clandestine laboratories. (This entry concentrates on non-methamphetamine drugs that are amphetamines.)

Amphetamines are Schedule II drugs under the Controlled Substances Act. They are taken orally or through injection.

Because of their considerable addictive potential, most physicians do not prescribe amphetamines to those patients who have a current or past history of substance abuse. In addition, amphetamine should not be prescribed to patients who have Bipolar Disorder because the drug could exacerbate or trigger a manic state. Patients who have Tourette's syndrome or other tic disorders should not use amphetamines because the drug may worsen their existing tics. Patients who are highly anxious should also avoid amphetamines. Excessive stimulation may occur if amphetamine is taken with large doses of Propoxyphene (Darvon, Darvocet), a medication given for pain.

Amphetamines have also been shown to worsen the psychotic symptoms in individuals diagnosed with delusional disorders and schizophrenia.

According to Charles Levinthal, author of Drugs, Society, and Criminal Justice, the origin of amphetamines can be traced back to ma huang, a medicinal herb that was used by the Chinese 5,000 years ago to treat respiratory disorders. In 1887, German chemists isolated the active ingredient in ma huang, naming it ephedrine. Then in 1927, Los Angeles, California, research chemist Gordon Alles created a synthetic form of ephedrine, which he named amphetamine.

Amphetamine was first sold in 1932 as Benzedrine, a brand name product that was included in over-the-counter inhalers that were used to treat asthma. In 1937, amphetamine was available in a prescription tablet that was used to treat narcolepsy, excessive sleeping, and "minimal brain dysfunction" (now called Attention Deficit Hyperactivity Disorder). The drug was also included in an inhaler to treat nasal congestion.

Amphetamine was often given to military service members in both the United States and Germany during World War II in the form of dextroamphetamine (Dexedrine) and methamphetamine (Methedrine) so that they could stay awake under battle conditions. Suicide pilots (kamikaze) in Japan also used amphetamines.

According to the Drug Enforcement Administration (DEA), amphetamines have been used for multiple purposes through the years; for example, in the 1960s, truckers used amphetamines to stay awake over long hauls. The drug was also used to treat depression and to help athletes improve their performance. In the case of inhalers used for nasal congestion and asthma, some individuals abused the drug by withdrawing the amphetamine from the inhaler and injecting it or drinking it.

This abuse potential of amphetamines was eventually discovered and noted by federal and state authorities, and in 1965, federal food and drug laws were amended to limit the supply of amphetamine. However, abuse of the drug continued, and amphetamine abuse reached a peak in the early 1980s. Abuse fell off after that time among all age levels, as cocaine and crack cocaine became the dominant drugs of abuse.

Amphetamine abuse is no longer a major problem today, with the glaring exception of the illegal manufacture and use of methamphetamine, which is an increasing problem in the United States. However, some data suggest that with the restriction of access to pseudoephedrine, an ingredient in the manufacture of methamphetamine that is available in over-the-counter drugs, abuse of this drug is beginning to decrease.

Today, amphetamines are legally prescribed by physicians to treat some patients who have attention deficit hyperactivity disorder (ADHD) or to treat narcolepsy. However, if there is a recent past history or current history of substance abuse, most physicians will avoid prescribing amphetamines or other stimulants to individuals with ADHD, preferring to prescribe nonstimulants such as atomoxetine (Strattera), a medication that is specifically approved for the treatment of ADHD, or bupropion (Wellbutrin), an antidepressant medication with some psychostimulant effects.

Even under the care of a physician, the termination of amphetamine use may lead to the development of (or the unmasking of an existing) depression. Additionally, excessive fatigue is almost always noted during amphetamine withdrawal. Nonetheless, there are no clear life-threatening consequences of the abrupt discontinuation of amphetamines, so tapering and slow discontinuation are not usually done.

Side Effects of Amphetamines

Common side effects that may occur with the lawful use of amphetamine may include the following:

- dry mouth

- constipation

- weight loss

- insomnia

- headache

- dizziness

In some cases, beta blocker medications may be used to counteract these side effects of amphetamines.

Serious side effects from abuse

Amphetamines can cause serious side effects when they are abused, including such symptoms as a rapid heartbeat, hyperthermia (high fever), high blood pressure, seizures, mania, and suicidal thoughts. In the most extreme cases, the user can experience an amphetamine psychosis, and accidental overdose deaths have occurred.

Amphetamine psychosis

Symptoms of amphetamine psychosis, a condition that is difficult to distinguish from schizophrenia, may include both auditory (heard) and visual (seen) hallucinations, paranoid ideas, and picking at the skin. These psychotic symptoms may resolve eventually, but they may also persist for months or years, well after the drug was abused and the use was discontinued. Patients who have amphetamine psychosis may also exhibit violent behavior.

Abusers of Amphetamines

According to the Monitoring the Future study for 2004, high school seniors had a prevalence rate of 15.0 percent of having ever used amphetamines, compared to young adults (15.9 percent). The highest rate was 18.0 percent for non-college students.

Treatment for Amphetamine Abuse

Of those individuals who were admitted for treatment for abuse of an amphetamine (not methamphetamine), 1.0 percent, or 19,133 individuals, reported amphetamine as their primary substance of abuse in 2004 in the United States, according to information from the Office of Applied Studies of the Substance Abuse and Mental Health Services Administration (SAMHSA).

Individuals who are dependent on amphetamines should undergo detoxification in a treatment facility. Withdrawal from amphetamines can be difficult and is best undertaken in a treatment facility that has experience working with withdrawal procedures or treatment should occur under the care of a physician. In the first hours of withdrawal, the addict may feel depressed, anxious, and agitated. Withdrawal from amphetamines can take from six to 18 weeks.

 

References:

1)         Johnston, Lloyd D., et al. Monitoring the Future: National Survey Results on Drug Use, 1975-2004. Vol. 2, College Students and Adults Ages 19-45. Bethesda, Md.: National Institute on Drug Abuse, National Institutes of Health, 2005.

2)         Joseph, Donald E., et al., eds. Drug Drugs of Abuse. Washington, D.C.: U.S. Department of Justice, 2005.

3)         Levinthal, Charles F. Drugs, Society, and Criminal Justice. New York: Pearson Education, 2006.

4)         Office of Applied Studies, Substance Abuse and Mental Health Services Administration. Treatment Episode Data Set (TEDS) Highlights-2003: National Admissions to Substance Abuse Treatment Services. Rockville, Md.: Department of Health and Human Services, June 2005.

5)         Stahl, Stephen M. Essential Psychopharmacology: The Prescriber's Guide. Cambridge: Cambridge University Press, 2005.

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