Amphetamines: dependence, symptoms and treatment

Amphetamines can be used in the form of tablets, injections, by inhalation and smoking. Amphetamines can cause an increase in mood, wakefulness, alertness, concentration, increase physical activity and cause a sense of well-being. Prolonged use can cause dependence.

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

Methamphetamine, sometimes used for medical purposes (with attention deficit hyperactivity disorder, obesity and narcolepsy), is easily produced illegally and has become widespread in the Netherlands, the United Kingdom, and North America. Illegal methamphetamine use is the main type of abuse of amphetamines in North America.

[1], [2]

Symptoms of dependence on amphetamines

Acute use

The psychological effects of using amphetamines are similar to those of cocaine and include cheerfulness, euphoria, a sense of confidence and strength. Amphetamines usually 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

It is shown that repeated use of amphetamines leads to the death of a large number of nerve cells. Prolonged use also leads to the development of dependence. Tolerance grows slowly, but in the end the amount of consumed matter can increase several hundred times. Tolerance to various effects develops unevenly, so that tachycardia and increased alertness are minimized, and at the same time, hallucinations and delusions can occur. However, even large doses are rarely lethal. There is evidence that long-term patients injected up to 15,000 mg of amphetamine in 24 hours without any acute disorders.

Abusers of amphetamines are prone to accidents, as these drugs cause the excitation and reassessment of their strengths, followed by excessive fatigue and drowsiness. With intravenous use, amphetamines can lead to severe antisocial behavior, as well as provoke the development of an attack of schizophrenia.

As a result of prolonged use of large intravenous or oral doses, paranoid psychosis may develop. More rarely, psychosis is provoked by a single use of a large dose or repeated use of moderate amounts of a substance. Typical features include delirium of persecution, ideas of attitude and a sense of omnipotence. People who use high intravenous doses often agree that eventually they will develop paranoia, and change their behavior. Despite this, those who use amphetamines very intensively or take them continuously for about a week, the criticality may decrease and they react according to the delusional plot. Recovery usually occurs even after protracted amphetamine psychoses. Patients with severe disorganization and paranoid phenomena recover slowly, but completely. More vivid symptoms disappear gradually, in a few days or weeks, but some confusion, memory disorders and delusions often persist for months.

The exhaustion syndrome observed with repeated use of methamphetamines manifests itself in severe fatigue and the need for sleep after the stimulation phase. Methamphetamines can also cause psychosis, in which the patient mistakenly interprets the actions of others, hallucinates and becomes unreasonably suspicious. Some consumers develop prolonged depression, during which suicide is possible. The use of matamfetamines can lead to death due to severe dehydration, disseminated intravascular coagulation and kidney failure. Patients often break down teeth due to reduced 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 changes in the EEG that meet the criteria for physical dependence. A sudden cessation of consumption can expose a latent depression or provoke a pronounced depressive reaction. Following the withdrawal status, 2-3 days of severe fatigue or drowsiness and depression are usually observed.

[3], [4], [5], [6], [7], [8], [9],

Treatment of dependence on amphetamines

Acute use

Patients in a state of acute psychotic stimulation, with paranoid delusions, auditory and visual hallucinations react well to phenothiazines; Chlorpromazine in a dose of 25-50 mg intramuscularly quickly reduces this condition, but can cause severe postural hypotension. Effective haloperidol 2.5-5 mg intramuscularly; it rarely causes hypotension, but can lead to the development of an acute extrapyramidal reaction. As a rule, persuasion and a calm, safe environment contribute to recovery, and usually this is enough. Ammonium chloride 1 g every 2-4 h for acidification of urine enhances the excretion of amphetamines.

Chronic use

In some patients, cognitive-behavioral therapy is effective. Observed with discontinuation of amphetamines, depression may be stopped by antidepressants if depressive symptoms persist for weeks.

[10], [11], [12], [13], [14], [15]