Amphetamines: addiction, symptoms and treatment

Amphetamines can be taken as pills, injected, snorted, or smoked. Amphetamines can cause an increase in mood, alertness, concentration, physical activity, and a sense of well-being. Long-term use can lead to dependence.

Among the substances related to amphetamines are amphetamines and methamphetamines, known in slang as "ice", "crystal", "speed", "crank" or "glass".

Methamphetamine, sometimes used for medical purposes (for ADHD, obesity, and narcolepsy), is easily produced illegally and is widely used in the Netherlands, the United Kingdom, and North America. Illicit methamphetamine use is the primary form of amphetamine abuse in North America.

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Symptoms of Amphetamine Addiction

Acute use

The psychological effects of amphetamines are similar to those of cocaine and include alertness, euphoria, confidence, and strength. Amphetamines commonly cause erectile dysfunction in men, but also increase sexual desire. Their use is associated with unsafe sexual practices, and amphetamine users have a higher risk of contracting sexually transmitted infections, including HIV.

Chronic use

Repeated use of amphetamines has been shown to cause the death of large numbers of nerve cells. Long-term use also leads to dependence. Tolerance builds slowly, but eventually the amount of substance consumed can increase several hundredfold. Tolerance to various effects develops unevenly, so that tachycardia and increased alertness are minimized, while hallucinations and delirium may occur. However, even large doses are rarely lethal. There are reports of long-term users injecting up to 15,000 mg of amphetamine in 24 hours without any acute disturbances.

Amphetamine abusers are prone to accidents because the drugs cause excitement and overestimation of one's own strength, followed by extreme fatigue and drowsiness. When used intravenously, amphetamines can lead to severe antisocial behavior and can also trigger an attack of schizophrenia.

Paranoid psychosis may develop as a result of prolonged use of large intravenous or oral doses. Less commonly, psychosis is triggered by a single large dose or repeated use of moderate amounts of the substance. Typical symptoms include delusions of persecution, ideas of reference, and a sense of omnipotence. People who use high intravenous doses often accept that they will eventually become paranoid and change their behavior. However, those who use amphetamines very heavily or who take them continuously for about a week may become less critical and react in accordance with the delusional plot. Recovery usually occurs even after prolonged amphetamine psychoses. Patients with severe disorganization and paranoid symptoms recover slowly but completely. The more severe symptoms disappear gradually over days or weeks, but some confusion, memory impairment, and delusional ideas often persist for months.

The wasting syndrome seen with repeated methamphetamine use is marked fatigue and a need for sleep after the stimulation phase. Methamphetamines can also cause psychosis, in which the patient misinterprets the actions of others, hallucinates, and becomes unreasonably suspicious. Some users develop prolonged depression, during which suicide is possible. Methamphetamine use can result in death due to severe dehydration, disseminated intravascular coagulation, and renal failure. Patients often suffer from tooth decay due to decreased salivation, acidic metabolic products, and poor oral hygiene.

Although there is no typical withdrawal syndrome after stopping the use of methamphetamines or other amphetamines, there are EEG changes that meet the criteria for physical dependence. Abrupt cessation of use may reveal underlying depression or provoke a pronounced depressive reaction. The withdrawal state is usually followed by 2-3 days of marked fatigue or drowsiness and depression.

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Treatment of amphetamine addiction

Acute use

Patients in acute psychotic excitement, with paranoid delusions and auditory and visual hallucinations, respond well to phenothiazines; chlorpromazine 25-50 mg intramuscularly rapidly relieves this condition but may cause severe postural hypotension. Haloperidol 2.5-5 mg intramuscularly is effective; it rarely causes hypotension but may lead to the development of an acute extrapyramidal reaction. As a rule, reassurance and a calm, safe environment promote recovery and are usually sufficient. Ammonium chloride 1 g orally every 2-4 hours to acidify the urine enhances the excretion of amphetamines.

Chronic use

Cognitive behavioral therapy is effective in some patients. Depression that occurs with amphetamine withdrawal may be treated with antidepressants if depressive symptoms persist for weeks.

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