Amphetamines/ Stimulants

What is it?

Often, amphetamines and other stimulants like methylphenidate look like prescription medications that come from a pharmacy.

Methamphetamine, Ecstasy (3,4-methylenedioxymethamphetamine (MDMA)), methylphenidate and various forms of amphetamine are psychoactive (mind altering) drugs that affects how we think and behave. They are stimulants that speed up our breathing, heart rate, thoughts and actions. MDMA is also sometimes considered a hallucinogen since it can alter our senses and perceptions.

Most methamphetamine and MDMA available today is manufactured in uncontrolled labs using chemicals and other ingredients that may be toxic. They come in different forms:
• Pills or capsules sometimes with pictures or letters on the tablet/capsule (usually swallowed or crushed up and sniffed up the nostril or "snorted") They can also be inserted (in the vagina or the rectum)
• Powder (a white, pink or yellow substance that can be snorted, or dissolved in water and injected))
• Crystalline chunks, commonly known as 'crystal meth' (whitish, translucent shards that look like ice, and are normally smoked in a pipe)

How does it work?

Since the 1930s, people have been using amphetamines and related stimulants for a wide range of reasons. Some people were prescribed these drugs to treat conditions such as asthma, depression or obesity. Others have used it to increase their alertness and energy level. For instance, some military personnel and shift workers have used methamphetamine to stay awake and perform well on the job. Some people continue to use amphetamine and related stimulants for fun, to heighten their sexual experiences or to increase their concentration. But like any drug, amphetamines and related stimulants can be harmful.

Stimulants
When used to help increase our focus and attention, a small amount of stimulant may be helpful. But when you use the drug repeatedly, you may start needing an increasing amount in order to feel its positive effects. And while methamphetamine or MDMA may help you feel more energized in a social situation, continuing to use it as a tool can affect how you engage with others and build relationships.

Amphetamines and stimulants work by increasing the activity of the brain chemicals (neurotransmitters) called dopamine, and to a lesser extent, norepinephrine. These medications activate areas of the brain that control impulsive actions, attention and body movements and help improve symptoms of attention deficit/hyperactivity disorder (AD/HD). Stimulant effects usually start within an hour. Some medications wear off within 3-4 hours, and others may last for up to 16 hours.

Methamphetamine
Methamphetamine increases three brain chemicals (neurotransmitters): dopamine, norepinephrine and serotonin. These activate a series of nerve cells in the brain's "pleasure pathway". Methamphetamine speeds up your breathing and heart rate. You may feel happy and alert at first. Afterward, you usually feel drained and may become tired and miserable.

When methamphetamine is smoked or injected, the drug moves quickly into your bloodstream and goes directly to your brain. When ingested or inserted, the drug is absorbed through membranes in the body and takes up to 20 minutes to take effect. You may experience an intense high followed by several hours of energy and contentment. But the effects of methamphetamine can be different for different people. Instead of feeling content, you may feel anxious or restless. Some of the factors that can influence how methamphetamine will affect you include your past experiences with the drug, present mood and surroundings, and mental and physical health condition. Crystal methamphetamine is usually more highly concentrated than other forms of the drug and produces the most intense effects.

MDMA
MDMA increases the activity of the brain chemical (neurotransmitter) serotonin. Mild hallucinogenic effects include feelings of peacefulness, acceptance, and empathy. People who use the drug claim they experience feelings of closeness with other people and want to touch or hug others. MDMA takes effect 20 to 40 minutes after taking a tablet. 60 to 90 minutes after taking the drug the user feels the peak effects. The effects of 'real' MDMA usually subside after about 3-5 hours.

When swallowed, MDMA is absorbed into the bloodstream through the small intestine and stomach. When snorted, the drug is absorbed into your bloodstream through the membranes in the nose, and when injected, it goes directly into your bloodstream and travels to your brain. MDMA increases the release of naturally occurring chemicals in our brain that play a role in regulating our mood and energy level. We may feel energetic and exhilarated, peaceful and loving. But the effects of MDMA can be different for different people. Instead of feeling happy and content, you may feel anxious or nervous. Some of the factors that can influence how MDMA will affect us include your past experiences with the drug, present mood and surroundings, and mental and physical health condition.

What are the associated risks and health effects?

Using stimulants, methamphetamine or MDMA is a problem when it negatively affects our life or the lives of others. Many of us may think this refers only to people who regularly use large amounts, but even a single occasion of use can lead to a problem. For instance, we may make a poor decision that results in problems with relationships or the law. What’s important to recognize is the potential for adverse consequences of use in any context and over time.

Using stimulants, MDMA or methamphetamine can also be both beneficial and harmful to your social life. Small amounts of stimulant, MDMA or methamphetamine may help you feel more confident and outgoing when socializing. But increased openness and affection may lead you to take risks such as having unprotected sex. Using more than moderate amounts can make you feel anxious, affecting your interactions with others and may lead to agitation and irritability or overdose.

Stimulants
Stimulants, especially when taken in high doses can cause you to have side effects such as nausea, vomiting, stomach ache, loss of appetite, trouble sleeping, faster heart beat, irritability, agitated behavior, nervousness, excited speech, dry mouth, headaches, making abnormal movements or sounds (tics) and rarely, seeing, hearing or feeling things that aren’t there; these are called hallucinations.

Methamphetamine
Methamphetamine use is risky because there's no way to know what's mixed in with the drug. People who make the drug in uncontrolled labs sometimes add things that don't belong there. Injecting the drug increases your risk of dependence. And if you inject or smoke the drug, you are at risk of infections as well as HIV and hepatitis, if you share needles or pipes.

Regular use of methamphetamine may lead to temporary psychotic symptoms such as seeing things that aren’t there. If you have a family history of psychosis, or are living with a psychotic disorder, you may be more vulnerable to experience long lasting effects. Frequent use of methamphetamine over time can also increase your risk of heart disease and stroke, especially if you have a cardiac condition. If you use the drug when pregnant, you may give birth to a baby with a low body weight.

Sometimes people use large amounts of methamphetamine over a short period of time because they want to get very high quickly. When a person gets very high one day, they usually end up ‘crashing’ hard the next day. Crashing means feeling very depressed, tired and physically ill. People who experiment with methamphetamine can get hooked on trying to reach the high they originally achieved. The more they try, the more they use. The more they use, the more tolerant their body becomes and the greater their risk of developing dependence. People who develop a dependence on methamphetamine may experience signs of withdrawal, including tiredness, disturbed sleep, headaches, anxiety and depression.

When a person uses large amounts of crystal methamphetamine repeatedly, the original benefits turn into negative experiences. The high turns into feelings of depression. Improved social skills turn into isolation and paranoia. Wakefulness becomes memory loss and a shortened attention span. And better sexual experiences end in sexual problems. A long-term heavy user may suffer brain and organ damage. They may also become mentally ill and develop schizophrenia-like behaviour and hallucinations, repetitive behaviour patterns (picking at their skin or pulling their hair), delusions of parasites or insects on the skin, aggressive behaviour and homicidal or suicidal thoughts.

MDMA
MDMA use can have positive effects but it can also be harmful to your well-being. For instance, many people who use MDMA say it helps them dance for a long time. But combining MDMA with dancing in a hot room may lead to a dangerous increase in your body temperature and loss of body fluids. The consequences can be life-threatening and include cardiovascular, kidney and liver damage. And since it is not possible to know the purity and content of the drug, you can accidentally use too much or ingest another dangerous substance. Like other psychoactive drugs, MDMA can interfere with normal brain development.

Some users may grind their teeth after using MDMA. There have been deaths associated with MDMA use, usually as a result of heatstroke from dancing for long periods of time in hot clubs without replenishing lost body fluids.

Studies on the effects of MDMA over time are inconclusive. MDMA use is associated with negative effects on memory. But some researchers suggest the impact may be minimal. Research suggests a link between MDMA use and depression. But it is not clear how much of the association is based on MDMA use and how much is due to other factors such as vulnerability to depression.

Acknowledgments

[2014] This fact sheet was produced by the Centre for Addictions Research of BC on behalf of the BC Partners for Mental Health and Addictions Information. An excerpt has been reproduced here with permission. To read the full fact sheet and for more helpful substance use and mental health resources, please visit www.heretohelp.bc.ca