Amphetamines (Forensic Science)
In the United States, the use of controlled substances is governed at the federal level by the Controlled Substances Act of 1970. The most strongly controlled substances are listed in Schedule I of the act, and those under the least control are listed in Schedule V. Amphetamines, along with cocaine, morphine, and phencyclidine (PCP), are listed in Schedule II. Drugs in this class have a high potential for abuse and also have accepted medical uses within the United States (with severe restrictions). Abuse of Schedule II drugs may lead to severe psychological dependence, physical dependence, or both.
Amphetamines are easy to produce, are cheap to buy, and cause effects in the body similar to those of cocaine. Most illicit, or “street,” amphetamines are actually methamphetamine, which is particularly potent and has long-lasting effects. Street names for amphetamines and methamphetamine include meth, crank, krank, crystal, glass, ice, pep pills, speed, uppers, peanut brittle, and tweak. These names often reflect particular ways the drugs appear; for example, ice is a very pure form, whereas peanut brittle is less so. The street price for one gram of methamphetamine ranges from twenty to three hundred dollars.
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Manufacture (Forensic Science)
The high demand for methamphetamine, along with significant profit potential, has resulted in the production of the drug in thousands of clandestine laboratories, or “clan labs.” “Super labs” are clan labs that are capable of producing seventy-five to one hundred pounds of methamphetamine in each production cycle. In comparison, “stove-top labs” typically produce only one to four ounces per batch. Production of one pound of the drug can result in from five to seven pounds of hazardous waste. Most of this waste ends up dumped on the ground or flushed into streams or sewage systems.
The synthetic route by which methamphetamine is prepared is widely known, and the required chemicals are readily available. The three most common production routes are the P2P (phenyl-2-propanone) amalgam method, the hydroiodic acid and red phosphorus reduction method, and the Birch reduction method. Ephedrine and pseudoephedrine, which can be found in many over-the-counter cold remedies, are key starting materials in the production of methamphetamine. Depending on the synthetic pathway, other important materials include iodine, red phosphorus, hydrogen chloride gas, and anhydrous ammonia. The U.S. government has regulated the sale and use of some of these chemicals in an effort to curb production of methamphetamine.
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Routes of Ingestion (Forensic Science)
Amphetamines may be smoked, snorted, injected, or taken orally in pill form. Methamphetamine is often smoked; the drug is placed in a glass pipe, heat is applied to the bowl, and the vapors are inhaled through the stem. Snorting the drug tends to cause irritation to the nasal lining. Heavy, long-term users generally prefer to inject the drug. Like cocaine, amphetamine can be dissolved in water and cooked to prepare it for injection.
The route of ingestion determines the onset of the drug’s effects. Effects from oral ingestion are felt within thirty to sixty minutes. When snorted, the drug produces effects within five to twenty minutes. Injecting and smoking the drug both result in an intense “rush” within seconds of ingestion. The intensity of the effects, which can last from six to twelve hours, is related to both the dose of the drug and its purity. Regardless of the route of ingestion, tolerance to the drug may develop quickly, so that the user requires larger and larger doses of amphetamines to produce the desired effect. Whereas medical doses of amphetamines rarely exceed 100 milligrams per day, a super user on a binge may ingest more than 15,000 milligrams every twenty-four hours.
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Forms (Forensic Science)
The appearance of amphetamine and methamphetamine depends on the synthetic process and quality control used in their production. High-quality street meth is generally a white crystalline powder. The color of lower-quality meth may range from dark yellow to brown. The drug may be crystalline, granular, or solid block, and it may have a sticky consistency. It may be packaged in plastic bags, paper bindles, or glass vials.
Ice is a very pure form of methamphetamine with an appearance similar to that of broken glass. It is usually ingested by smoking, and the effects can last up to fourteen hours. The price of one gram of ice ranges from two hundred to four hundred dollars.
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Effects (Forensic Science)
As stimulants that act on the central nervous system, amphetamines reduce fatigue and the need to sleep, increase confidence and energy levels, and in general cause psychological and physical exhilaration. These effects are identical to those of cocaine, but the effects of cocaine last from twenty to eighty minutes, whereas those of amphetamines last for four to twelve hours. New users can rapidly develop psychological dependence on amphetamines.
Common effects displayed by people under the influence of amphetamines include alertness, anxiety, euphoria, reduced appetite, talkativeness, and teeth grinding. Chronic abuse of the drug can produce severe mental and physical problems, including delusions, visual and auditory hallucinations, and violent behavior. Long-term high-dose users of amphetamines may experience formication, which is the feeling that bugs are crawling under the skin. People in this state can severely injure themselves while trying to dig or cut the imagined bugs from their skin.
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Further Reading (Forensic Science)
Gano, Lila. Hazardous Waste. San Diego, Calif.: Lucent Books, 1991. Provides a good discussion of the health risks of the hazardous wastes generated by clandestine labs in the production of methamphetamine.
Hicks, John. Drug Addiction: “No Way I’m an Addict.” Brookfield, Conn.: Millbrook Press, 1997. Focuses on drug-abuse treatment strategies, with an emphasis on amphetamine addiction.
Laci, Miklos. Illegal Drugs: America’s Anguish. Detroit: Thomson/Gale, 2004. Comprehensive guide to illegal drugs in the United States includes discussion of the origins, uses, and effects of drug abuse. Of particular interest is the section on drug trafficking.
Menhard, Francha Roffé. Drugs: Facts About Amphetamines. Tarrytown, N.J.: Marshall Cavendish, 2006. Provides information on the characteristics, legal status, history, abuse, and treatment of addiction to amphetamines and methamphetamine.
Pellowski, Michael. Amphetamine Drug Dangers. Berkeley Heights, N.J.: Enslow, 2000. Discusses stimulant drugs in general and amphetamines in particular. Topics of interest include the signs and symptoms of amphetamine abuse.
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Amphetamines (Encyclopedia of Mental Disorders)
Amphetamines are a group of drugs that stimulate the central nervous system. Some of the brand names of amphetamines sold in the United States are Dexedrine, Biphetamine, Das, Dexampex, Ferndex, Oxydess II, Spancap No 1, Desoxyn, and Methampex. Some generic names of amphetamines include amphetamine, dextroamphetamine, and methamphetamine.
Amphetamines stimulate the nervous system and are used in the treatment of depression, attention-deficit disorder, obesity, and narcolepsy, a disorder that causes individuals to fall asleep at inappropriate times during the day. Amphetamines produce considerable side effects and are especially toxic in large quantities. Amphetamines are commonly abused recreational drugs and are highly addictive.
Amphetamines are usually given orally and their effects can last for hours. Amphetamines produce their effects by altering chemicals that transmit nerve messages in the body.
The typical dose for amphetamines in the treatment of narcolepsy in adults ranges from 5 mg to 60 mg per...
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Amphetamines (Encyclopedia of Drugs and Addictive Substances)
- What Is It Made Of?
- How Is It Taken?
- Usage Trends
- Reactions with Other Drugs or Substances
- For More Information
What Kind of Drug Is It?
Amphetamines are stimulant drugs that improve concentration, reduce appetite, and help keep users awake. Stimulants heighten the activity of a living being. In the 2003 edition of their book Drugs 101: An Overview for Teens, Margaret O. Hyde and John F. Setaro defined stimulants as "drugs used to increase alertness, relieve fatigue, [and make users] feel stronger and more decisive." Caffeine, nicotine, cocaine, ecstasy (MDMA), and steroids are all stimulants. (An entry for each of these substances is available in this encyclopedia.) However, amphetamines have a great potential for abuse. The "" created by stimulants makes people feel good, but only temporarily. "They may elevate mood," wrote John B. Murray in the Journal of Psychology, but "their effects are short-lived."
Although they were discovered late in the nineteenth century, amphetamines did not receive much attention in the medical community until 1927, when a University of California researcher named Gordon Alles began studying their effects. Alles found that the drugs gave people a lot of energy, allowing them to do more and stay awake longer without getting tired. This effect of "speeding up" people's actions explains how amphetamines eventually came to be known by the street names "speed" and "uppers."
There are several different types of amphetamines. (For more information, see individual entries on Adderall, dextroamphetamine, and methamphetamine in this encyclopedia.) Generally, all amphetamines act the same way: as stimulants.
Early Amphetamines Treat Breathing Problems
The first amphetamine was made in a laboratory by a German chemist in the late 1880s. The drug was not used for medical purposes, however, until more than forty years later. By that time, scientists were looking to create a drug that would mimic the effects of ephedra, a natural Chinese remedy for . When boiled in water, stems from the ephedra bush produce a tea that helps dilate, or open up, the small sacs of the lungs. The active ingredient in this tea apparently eases breathing in asthmatics who drink it. (An entry on ephedra is also available in this encyclopedia.)
Research on asthma medications led to the manufacture of Benzedrine, the earliest and most basic form of amphetamine. In 1931, the pharmaceutical company Smith, Kline, and French introduced the Benzedrine inhaler to relieve the discomfort of nasal congestion due to colds, allergies, and asthma. As Murray pointed out, these first Benzedrine users reported trouble sleeping when they were on the drug. This sparked yet another branch of research on the effects of amphetamines. By 1935, drug companies were marketing amphetamines for the treatment of a daytime sleeping disorder known as narcolepsyA sleep disorder characterized by daytime tiredness and sudden attacks of sleep.. Researchers did not yet realize that amphetamine use could be dangerous.
The ADHD Connection
As far back as 1937, doctors were looking for ways to help children who had problems concentrating. At the time, the condition that is now referred to as (ADHD) was called "minimal brain dysfunction." Little was known about the disorder, and it was believed to affect only children. Since then, the misleading name "minimal brain dysfunction" has been dropped, and medical researchers have learned more about ADHD and its effects.
ADHD is a disorder that begins during childhood, although in many cases it goes undiagnosed until adulthood. It is very difficult for people with ADHD to focus their attention and control their behavior. Children with ADHD are easily distracted and have difficulty concentrating, especially on schoolwork. They may also talk excessively, interrupt conversations, and have trouble waiting their turn. In many cases, people diagnosed with ADHD display impulsive behavior(sometimes called impulsivity) Acting quickly, often without thinking about the consequences of one's actions., which frequently persists into adulthood.
According to the Schaffer Library of Drug Policy's 1972 entry on amphetamines, early use of amphetamines in young patients with ADHD produced surprising results. "Instead of making them even more jittery, as might be expected, the amphetamines calm many of these children and noticeably improve their concentration and performance," commented the authors of the article. The use of amphetamines for ADHD in children and adults continues into the twenty-first century.
Usage Spikes after World War II
During World War II (1939945), soldiers used amphetamines to maintain alertness during combat. In the years following the war, many service personnel had trouble functioning without the drug. One major instance of widespread amphetamine abuse occurred in Japan after the war. Much of the country was devastated by bombs dropped during World War II, and the Japanese had to work long hours to rebuild their country. Japanese men who had been soldiers recalled how amphetamines had helped them face one battle after another when the war was in full swing. Demand for the drug increased, and amphetamines were released for sale in Japan without a prescription. This led to a decade of abuse throughout the nation. In the mid-1950s, though, the Japanese government restricted access to amphetamines and passed stricter laws against illegal amphetamine use.
Around the same time, Americans were becoming hooked on amphetamines, too. Users found they could lose weight quickly and effortlessly. Amphetamines quickly earned a reputation as a "wonder drug" that allowed users to work harder without feeling tired. "Pharmaceutical companies encouraged doctors to prescribe amphetamines to depressed housewives in the 1960s," wrote Andrew Weil and Winifred Rosen in From Chocolate to Morphine. The drugs were even given to racehorses, since it was thought the drug would make them run faster. Throughout the decade, public health authorities noted a new and disturbing trend in amphetamine use among drug users in San Francisco, California. Individuals, soon to be known as "speed freaks," were injecting liquefied amphetamines into their veins.
Amphetamine use also went up dramatically in the United Kingdom in the 1960s. According to Hilary Klee in the Journal of Drug Issues, "the 'Swinging Sixties' was a period of revolutionary social change and experimentation with psychoactive drugs 'Pop idols' became majorinfluences on British youth. The role models in the United Kingdom wereyoung and working class, like many of their fans. Amphetamine was popular among them because it provided the energy to perform all night and survive periods on tour."
The massive increase in drug use in the 1960s prompted countries throughout the world to pass new anti-drug laws and regulations. In the United States, Congress passed the Controlled Substances Act (CSA) of 1970, which cut down considerably on the production, importation, and prescription of amphetamines. Many forms of amphetamine, particularly diet pills, were removed from the over-the-counter market. But this crackdown on amphetamines led to the development of illegal labs in many countries. By the 1990s, amphetamine production had emerged worldwide, with large numbers of illegal labs being reported especially in the western United States, the United Kingdom, and eastern Europe. The problem persisted into the early twenty-first century, especially among unemployed youth.
What Is It Made Of?
Amphetamines do not occur naturally; they cannot be grown in a garden or dug up from the ground. Rather, amphetamines are synthetic, or manufactured, substances that consist of the elements carbon, hydrogen, and nitrogen.
The chemical structure of amphetamines is related to two natural substances known to boost energy within the human body. Those substances are and adrenalinePronounced uh-DREN-uh-linn; a natural stimulant produced by the human body; also known as epinephrine (epp-ih-NEFF-run).. Ephedrine is a
natural stimulant found in the ephedra bush. It is the active ingredient in a Chinese herbal drug that relieves the symptoms of asthma. Adrenaline is a natural stimulant that the human body produces all by itself. It sets off the body's "fight or flight" reaction in times of emergency. When adrenaline is released, heart rate and blood pressure increase, the muscles that control breathing relax, and the pupils of the eyes dilate.
How Is It Taken?
Amphetamines come in both tablets and capsules and are usually swallowed. However, drug abusers sometimes crack open the capsule to get to the flecks of the drug inside it, or they grind the tablets into a fine powder. Amphetamine powder obtained from either method is then inhaled or "snorted." Users also mix it with tobacco or marijuana and then smoke it.
Beginning in the 1960s, some hardcore drug abusers started mixing the amphetamine powder into a liquid and then injecting it. This is called , or IV, drug abuse. When injected, the amphetamine high occurs almost immediately, increasing the danger of addiction. Weil and Rosen described the physical and mental effects of a few weeks of continued intravenous use. Addicts "became emaciatedPronounced ee-MASE-ee-ate-ed; very thin and sickly looking. and generally unhealthy," the authors reported. "They stayed up for days on end, then 'crashed' into stupors. They became jumpy, paranoid, and even psychotic."
Many high-dose amphetamine abusers become psychotic, or mentally deranged, after a week or so of continuous use. A disruption occurs in the way their minds function, making it difficult for people suffering from a psychotic episode to distinguish between what is real and what is imagined. Users who increase "their dose rapidly to enormous levelsswallowing whole handfuls of amphetamine tablets" can develop an "amphetamine ." According to the Schaffer Library of Drug Policy, this condition makes them feel as if "ants, insects, or snakes [are] crawling over or under the skin."
Are There Any Medical Reasons for Taking This Substance?
Historically, amphetamines have been prescribed by doctors as an appetite suppressant and as a treatment for both ADHD and an unusual sleep disorder called narcolepsy.
Amphetamines tend to decrease feelings of hunger in people who take them, making them an often-abused drug among dieters. Although the use of amphetamines for weight control was popular in the 1950s and again in the 1980s and part of the 1990s, this practice is no longer common. Amphetamine use for weight loss can be very dangerous. Most doctors agree that the best way to regulate weight is through moderate exercise and a healthy diet.
As of 2005, amphetamines were most commonly prescribed to treat ADHD and narcolepsy. Amphetamines are successful in the treatment of ADHD because they help improve the user's ability to concentrate. In prescription form, amphetamines also have been found to be helpful in treating narcolepsy, a fairly rare condition that causes people to fall asleep quickly and unexpectedly. Amphetamines speed up bodily functions, producing a much-desired feeling of alertness in people with narcolepsy.
Amphetamine abuse is very widespread and often unintended. Cynthia Kuhn and her coauthors summarized the dangers of amphetamines in their book Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy. In a word, the buzz from
amphetamines is "pleasurable." Overuse typically stems from the drug's effects. Amphetamines make most users feel good, at least in the short term. Experimentation with amphetamines can get out of hand quite easily, though. Even legal usershose individuals taking the drug with a doctor's prescriptionan get hooked.
Not Just a Nasal Spray
Generations ago, over-the-counter nasal inhalers contained amphetamines. The reasoning behind amphetamine treatment for nasal congestions was quite simple: stimulants are known to constrict blood vessels. Constricting the blood vessels in the nose and sinuses cuts down on congestion because it shrinks the nasal tissues, allowing air to flow more freely through the nose. This effect is only temporary, though, and when it wears off, a "rebound effect" occurs. The nasal passages actually end up more severely blocked than they were before the amphetamine was inhaled.
The first users of any new drug are a bit like human guinea pigs. "Because of the incredible complexity of the brain," explained Kuhn, "most drugs that affect it have actions in addition to those for which they were developed." Aside from the problems with the rebound effect, some users of early nasal inhalers "experienced general stimulation from them" as well, wrote Weil and Rosen. "Some got high, and some became dependent." Because of their side effects and the potential for abuse, amphetamines are no longer dispensed in over-the-counter decongestants.
Who's Using Amphetamines?
The results of the 2004 Monitoring the Future (MTF) study were released to the public on December 21, 2004. Conducted by the University of Michigan (U of M), it was sponsored by research grants from the National Institute on Drug Abuse (NIDA). Since 1991, U of M has tracked patterns of drug use and attitudes toward drugs among students in the eighth, tenth, and twelfth grades. (Prior to that, from 1975 to 1990, the MTF survey was limited to twelfth graders.)
The 2004 MTF survey results indicate that nonprescription amphetamine use among students in the eighth and tenth grades had fallen. Researchers noted "a steady decline among eighth graders since 1996; in fact, their annualuse has fallen by almost half since then," from 9.1 to 4.9 percent. Amphetamine use was also down among tenth graders, "but not among twelfth graders, whoremain near their recent peak levels of use." According to MTF charts for 2003 to 2004, about one in every ten high school seniors reported using amphetamines "in the last twelve months." The ease with which seniors said they would be able to get the drug held steady. More than half of the twelfth graders surveyed said it would be "fairly easy" or "very easy" to obtain amphetamines.
The MTF survey does not track drug use among people after their high school years. However, amphetamine use in the general population can be determined by other data. Experts in the field of drug research periodically gather together all of the information available on certain drugs to create a profile, or description, of a typical user. Based on these studies, the typical amphetamine user of the 1960s, 1970s, 1980s, and part of the 1990s was young, white, male, single, and often unemployed. More recent findings cited in the Journal of Psychology in 1998 indicate that the population of amphetamine users is becoming broader and now includes:
- more women
- more married, divorced, and widowed people
- fewer whites
- people of all age groups, from middle school students to retirees.
In mid-2003, Alcoholism & Drug Abuse Weekly reported the results of the Quest Diagnostics 2002 Drug Testing Index, a measure of drug use among American workers. Based on 7 million urine tests performed by the lab throughout 2002, the overall use of drugs in the workplace apparently decreased. The incidence of amphetamine usage, however, went up significantly. According to Quest, positive test results among U.S. workers "increased 70 percent over the past five years" from 1998 through 2002.
The use and abuse of amphetamine-like stimulants is a growing global problem that poses "a serious threat to the health, social and economic fabric of families, communities and nations," according to the World Health Organization Web site. The United Nations estimated that in the year 2000, 29 million people around the world had abused various types of amphetamine stimulants in the previous decade.
Effects on the Body
Amphetamines are . As a prescription drug for the treatment of ADHD, amphetamines have been shown to increase performance accuracy, improve short-term memory, improve reaction time, aid in solving mathematical problems, increase problem-solving abilities in games, and help individuals concentrate.
"If stimulants simply increased energy and alertness," commented Kuhn, "they indeed would be [a] miracle medicine.How ever, these drugs also cause an unmistakable euphoria and sense of well-being that is the basis of addiction." The effect of amphetamines is similar to the effect of cocaine, another widely abused psychostimulant. However, amphetamine highs are generally longer lasting.
Amphetamine users often feel that the drug puts them in a better mood and increases their level of confidence. "It gives me a lot of energy," remarked one user in an interview with Klee. "I can get out and do things, meet people, things like that. And you don't let anything get to you. You're on top of the world."
Amphetamines are often abused by people who want to boost their energy and enhance their physical performance. Athletes on amphetamines may find that they can play longer, harder, and better. Students on speed can endure longer studying sessions and remain focused on their homework for hours, sometimes without even taking a break to eat. Truck drivers who take amphetamines are able to cover more miles without falling asleep at the wheel. But the high generated by amphetamines eventually wears off.
After the Buzz
"A single oral dose of amphetamine usually stimulates the body for at least four hours," wrote Weil and Rosen. After that, more of the drug is needed to maintain the high. Once the buzz of uppers has worn off, users who felt awake, energized, and full find themselves very tired, grumpy, and extremely hungry. A person coming down from an amphetamine high may sleep an entire day away before the drug leaves his or her system entirely.
"Irritability and/or aggression is common when 'coming down' off the drug, when using [it] heavily, and when [it is] combined with alcohol," reported Klee. "You get to the point where you're shouting at people and causing trouble and the amphetamine gives you the energy to do itwhich is a problem," noted one of the users Klee quoted. Such behavior can ruin longstanding relationships and, in some cases, result in social rejection for users.
Addiction and Other Dangers
Long-term amphetamine use can result in a psychological addiction or psychological dependenceThe belief that a person needs to take a certain substance in order to function, whether that person really does or not.. Psychological dependence can develop quickly, especially in people who already show signs of depression. As Kuhn put it, "We know that the drive to use cocaine or amphetamine is considerably stronger than that for any of the other addictive drugs."
The use of amphetamines can cause an upset stomach, diarrhea, headache, dizziness, nervousness, weight loss, and insomnia. The drug can also lead users to perform bizarre, repetitive actions. "Assembling and disassembling radios, cars, and gadgets is common amongusers. [They] are aware that their activity is meaningless but report not being able to stop," noted Murray. Higher doses result in fever, an unusually fast heartbeat, chest pain, blurred vision, tics, tremors, and antisocial behavior.
Amphetamines can kill. Prolonged abuse of amphetamines can lead to . Taking greater quantities of amphetamines increases the chance of an overdose. Signs of an overdose include convulsions, followed by coma, and then possibly death. The cause of death may be from the bursting of blood vessels in the brain, a heart attack, or an extremely high fever.
The National Academy of Sciences revealed in 2003 that exposure to amphetamines can reduce "the ability of certain brain cells to change in response to life experiences." With funding provided by the National Institute on Drug Abuse (NIDA), drug researchers from the University of Lethbridge in Canada and U of M-Ann Arbor worked together, conducting experiments with amphetamines on lab rats.
Amphetamine-treated rats seemed confused by changes that were introduced to their surroundings during the course of the testing. Rats that were not given amphetamines, however, had no problems maneuvering around ramps, bridges, tunnels, and toys that had been relocated in their cages. Even after three and a half months, the amphetamine-treated rats were unable to adjust to changes in their environment. Analysis of the brains of both treated and untreated rats showed definite differences in their physical appearance.
These findings correspond with drug experiments conducted by three researchers on human volunteers in 1969. Those experiments, according to Murray, indicated that high doses of amphetamines affect the brain. The volunteers, who were hospitalized for the six-week-long study, experienced wide mood swings that began with euphoria, or a feeling of great happiness, and ended with deep depression. They also went for days without eating or sleeping well, talked nonstop for hours at a time, and showed signs of paranoiaAbnormal feelings of suspicion and fear. before the experiment was concluded.
Reactions with Other Drugs or Substances
Amphetamines are dangerous drugs. The dangers increase when they are taken with other addictive substances. Amphetamines are frequently combined with other drugs to prolong or add to the high they produce alone. Caffeine is one substance that is known to add to the effects of amphetamines. When combined with alcohol, "amphetamines have the potential to produce unprovoked, random, and often senseless violence," noted Murray. Amphetamines raise blood pressure, so they should not be taken by people who are on medication to reduce their blood pressure. In addition, the drug should not be taken with over-thecounter cold medications or with certain antidepressant medications.
Treatment for Habitual Users
Tolerance to amphetamines occurs quickly. In an attempt to sustain the high that results from amphetamine use, users often begin taking more of the drug than they should. They then find themselves unable to stop on their own. The process can last days or weeks. Besides feeling intense cravings for the drug, longtime users who attempt to kick their habit experience other unpleasant effects. These include extreme anxiety, abdominal pain, shortness of breath, vivid or unpleasant dreams, fever, decreased energy, and depression. Even "long after the withdrawal period, past users may experience urgings and cravings," added Murray. Addiction experts consider behavioral therapy and emotional support essential for the successful treatment and rehabilitation of amphetamine abusers.
Amphetamines can be extremely toxic. When uppers are "used without medical supervision, they are potentially dangerous, even for first-time users," warned Murray. People who are high on amphetamines are more likely to take chances and engage in riskier behavior than they would if they were not high. This increases the danger of becoming infected with HIV (the human immunodeficiency virus), which can lead to AIDS (acquired immunodeficiency syndrome), either through unsafe sex or by sharing needles.
Drug abuse among young people is associated with early sexual activity, increased involvement in criminal activities, and higher
school dropout rates. Amphetamine users often take other drugs along with uppers. This can increase the likelihood of becoming involved in accidents. It can also contribute to the development of physical, mental, and emotional problems, including high rates of infection, , depression, and suicidal tendencies.
Infants born to mothers dependent on amphetamines have an increased risk of premature delivery and low birth weight. The infants may actually experience symptoms of drug withdrawal. Mothers taking the drug should not breast-feed their babies, since amphetamine is excreted in human milk. A number of studies using rodents as test animals indicate that women should not take amphetamines at all when pregnant.
Amphetamines are controlled substances: their use is regulated by certain federal laws. The Controlled Substances Act (CSA) of 1970 called for the assignment of all controlled drug substances into one of five categories called schedules. These schedules are based on a substance's medicinal value, harmfulness, and potential for abuse and addiction. Schedule I is reserved for the most dangerous drugs that have no recognized medical use. Amphetamines fall under Schedule II: dangerous drugs with genuine medical uses that also have a high potential for abuse and addiction.
Possessing amphetamines without a medical doctor's prescription is against the law and can result in imprisonment and stiff fines. The length of the jail sentence and the amount of the fine are increased when a person is convicted of a second or third offense of amphetamine possession. People convicted of distributing amphetamineselling or giving away prescribed drugsace lengthy prison terms and fines of up to $2 million.
For More Information
Bayer, Linda. Amphetamines and Other Uppers. Broomall, PA: Chelsea House Publishers, 2000.
Clayton, Lawrence. Amphetamines and Other Stimulants. New York: Rosen Publishing Group, 1994.
Gahlinger, Paul M. Illegal Drugs: A Complete Guide to Their History, Chemistry, Use, and Abuse. Las Vegas, NV: Sagebrush Press, 2001.
Hyde, Margaret O., and John F. Setaro. Drugs 101: An Overview for Teens. Brookfield, CT: Twenty-first Century Books, 2003.
Kuhn, Cynthia, Scott Swartzwelder, Wilkie Wilson, and others. Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy, 2nd ed. New York: W.W. Norton, 2003.
Pellowski, Michael J. Amphetamine Drug Dangers. Berkeley Heights, NJ: Enslow Publishers, Inc., 2001.
Schull, Patricia Dwyer. Nursing Spectrum Drug Handbook. King of Prussia, PA: Nursing Spectrum, 2005.
Weil, Andrew, and Winifred Rosen. From Chocolate to Morphine. New York: Houghton Mifflin, 1993, rev. 2004.
Westcott, Patsy. Why Do People Take Drugs? Austin, TX, and New York: Raintree Steck-Vaughn Publishers, 2001.
Klee, Hilary. "The Love of Speed." Journal of Drug Issues (Winter, 1998): pp. 33-55.
Murray, John B. "Psychophysiological Aspects of Amphetamine-Methamphetamine Abuse." Journal of Psychology (March, 1998): pp. 227-237.
"Workplace Drug Use Declines, Amphetamine Use Increases." Alcoholism & Drug Abuse Weekly (June 16, 2003): p. 8.
"The Amphetamines." Schaffer Library of Drug Policy. http://www.druglibrary.org/schaffer/ (accessed June 16, 2005).
"Amphetamine-Type Stimulants." World Health Organization. http://www.who.int/substance_abuse/facts/ATS/en/ (accessed June 16, 2005).
"Mind over Matter: Stimulants." NIDA for Teens: The Science behind Drug Abuse. http://teens.drugabuse.gov/mom/mom_stim2.asp (accessed June 16, 2005).
Monitoring the Future. http://www.monitoringthefuture.org/ and http://www.nida.nih.gov/Newsroom/04/2004MTFDrug.pdf (both accessed June 16, 2005).
Proceedings of the National Academy of Sciences of the United States of America. http://www.pnas.org/ (accessed June 16, 2005).
See also: Adderall; Cocaine; Dextroamphetamine; Diet pills; Ephedra; Methamphetamine
Amphetamines (World of Forensic Science)
Amphetamines are a family of chemical compounds that are indirect stimulants of the central nervous system (CNS). Amphetamines cause the increased release into the brain of dopamine and norepinephrine, two endogenous (produced by the body) chemical messengers, which in turn stimulate the nervous system. Many drug abusers seeking a boost of physical energy and mental stimulation consume amphetamines due to their cocaine-like behavioral effects. Determining the presence or absence of amphetamines in the blood is included in most forensic drug screening tests.
Effects of amphetamines that may be experienced include: increased alertness, appetite inhibition, insomnia, decreased fatigue, and emotional euphoria. In high doses, amphetamines can induce delirium, panic attacks, confusion, aggressiveness, and suicidal tendencies. Chronic users sometimes develop a state of amphetamine-induced psychosis that shares similarities with an acute schizophrenic crisis. Drug abusers usually inject amphetamines intravenously or inhale them by smoking.
MDMA (Methylenedioxymethamphetamine), an amphetamine derivative also known as Ecstasy, is swallowed in tablets or capsules, in doses ranging from 6020 milligrams, usually in association with alcoholic drinks. Drug abusers in general tend to consume these stimulants together with alcohol or marijuana, whose alkaloids further enhance the effects of amphetamines. The amphetamine-induced euphoric state lasts an average of 4 hours, which is more than twice the time of cocaine effects.
Like cocaine, some amphetamines also cause addiction and progressive tolerance within a few weeks of use, leading its users to increase doses to achieve the same initial effects. Other physical effects of amphetamine abuse are cardiac arrhythmias, dangerously high blood pressure, chest pain, circulatory collapse, chills, excessive perspiration, and headaches. Nausea, anorexia, diarrhea, vomiting and abdominal cramps, and coma may also occur. A national survey by the Drug Abuse Warning Network under commission of the Substance and Mental Health Services Administration, reported that between 1999 and 2001, more than 86% of all life-threatening cases of intoxication recorded by hospital emergency services in the U.S. were associated with the use of MDMA in combination with either alcohol, marijuana, cocaine, or heroin.
The U.S. Department of Justice, Drug Enforcement Administration (DEA), classifies both illegal and controlled substances under five levels of Schedules, I to V. Most amphetamines are categorized in Schedule I, along with other substances such as LSD, marijuana, peyote, mescaline, heroin, etc. A drug or substance scheduled at level I is thus classified because the drug has a high potential for abuse, has no currently accepted medical use in treatment in the United States, and there is a lack of accepted safety for use of the drug. Therefore, amphetamine parent chemicals scheduled under level I cannot be prescribed by physicians in the United States.
Other amphetamine derivatives such as methamphetamine, phenmetrazine, and methylphenidate are under Schedule II, along with cocaine. Schedule II drugs are described as drugs with a high potential for abuse and physical or psychological dependence, but with currently accepted medical uses in the United States with severe restrictions. Schedule II drugs are tightly regulated and require a written prescription from a licensed physician.
Schedule III amphetamines also require prescription by a physician, but their manufacture and supply are less controlled and the potential for abuse is less. Therapeutic drugs such as some appetite suppressants and some drugs prescribed for attention deficit disorder fall into this category. Some amphetamines are approved by the Food and Drug Administration either as ingredients of pharmaceutical drugs or as a one-salt drug, such as methylphenidate, used in the treatment of narcolepsy, a clinical condition that induces patients to an uncontrollable state of sleepiness that leads to suddenly falling asleep anywhere and at any time.
SEE ALSO FDA (United States Food and Drug Administration; Illicit drugs; Narcotic; Nervous system overview; Neurotransmitters.
Amphetamine (Encyclopedia of Drugs, Alcohol, and Addictive Behavior)
Amphetamine was first synthesized in 1887, but its central nervous system (CNS) stimulant effects were not noted at that time. After rediscovery, in the early 1930s, its use as a respiratory stimulant was established and its properties as a central nervous system stimulant were described. Reports of abuse soon followed. As had occurred with cocaine products when they were first introduced in the 1880s, amphetamine was promoted as being an effective cure for a wide range of ills without any risk of addiction. The medical profession enthusiastically explored the potentials of amphetamine, recommending it as a cure for everything from alcohol hangover and depression to the vomiting of pregnancy and weight reduction. These claims that it was a miracle drug contributed to public interest in the amphetamines, and they rapidly became the stimulant of choiceince they were inexpensive, readily available, and had a long duration of action.
Derivatives of amphetamine, such as METHAMPHETAMINE, were soon developed and both oral and intravenous preparations became available for therapeutic uses. Despite early reports of an occasional adverse reaction, enormous quantities were consumed in the 1940s and 1950s, and their liability for abuse was not recognized. During World War II, the amphetamines, including methamphetamine, were widely used as stimulants by the military in the United States, Great Britain, Germany, and Japan, to counteract fatigue, to increase alertness during battle and night watches, to increase endurance, and to elevate mood. It has been estimated that approximately 200 million Benzedrine (amphetamine) tablets were dispensed to the U.S. armed forces during World War II. In fact, much of the research on performance effects of the amphetamines was carried out on enlisted personnel during this period, as the various countries sought ways of maintaining an alert and productive armed force. Although amphetamine was found to increase alertness, little data were collected supporting its ability to enhance performance.
Since 1945, use of the amphetamines and CO-CAINE appears to have alternated in popularity, with several stimulant epidemics occurring in the United States. There was a major epidemic of amphetamine and methamphetamine abuse (both oral and intravenous) in Japan right after the war. The epidemic was reported to have involved, at its peak, some half-million users and was related to the release with minimal regulatory controls of huge quantities of surplus amphetamines that had been made for use by the Japanese military. Despite this experience, there were special regulations governing their manufacture, sale, or prescription in the United States until 1964 (Kalant, 1973).
The first major amphetamine epidemic in the United States peaked in the mid-1960s, with approximately 13.5 percent of the university population estimated, in 1969, to have used amphetamines at least once. By 1978, use of the amphetamines had declined substantially, contrasting with the increase of cocaine use by that time. The major amphetamine of concern in the United States in the 1990s is methamphetamine, with pockets of "ice" (smoked methamphetamine) abuse.
Amphetamines are now controlled under Schedule II of the CONTROLLED SUBSTANCES ACT. Substances classified within this schedule are found to have a high potential for abuse as well as currently accepted medical use within the United States. Amphetamine, methamphetamine, cocaine, METHYLPHENIDATE, and phenmetrazine are all stimulants included in this schedule.
Amphetamines are frequently prescribed for the treatment of narcolepsy, obesity, and for childhood ATTENTION DEFICIT DISORDER. They are clearly efficacious in the treatment of narcolepsy, one of the first conditions to be successfully treated with these drugs. Although patients with this disorder can require large doses of amphetamine for prolonged periods of time, attacks of sleep can generally be prevented. Interestingly, tolerance does not seem to develop to the therapeutic effects of these drugs, and most patients can be maintained on the same dose for years.
Although the amphetamines have been used extensively in the treatment of obesity, considerable evidence exists for a rapid development of tolerance to the anorectic (appetite loss) effects of this drug, with continued use having little therapeutic effect. These drugs are extremely effective appetite suppressants, but after several weeks of use the dose must be increased to achieve the same appetite-suppressant effect. People remaining on the amphetamines for prolonged periods of time to decrease food intake can reach substantial doses, resulting in toxic side effects (e.g., insomnia, irritability, increased heart rate and blood pressure, and tremulousness). Therefore, these drugs should only be taken for relatively short periods of time (4-6 weeks). In addition, long-term follow-up studies of patients who were prescribed amphetamines for weight loss have not found any advantage in using this medication to maintain weight loss. Data indicate that weight lost under amphetamine maintenance is rapidly gained when amphetamine use is discontinued. In addition to the lack of long-term efficacy, the dependence-producing effects of amphetamines make them a poor choice of maintenance medication for this problem.
The use of amphetamines in the treatment of attention deficit disorders in children, remains extremely controversial. It has been found that the amphetamines have a dramatic effect in reducing restlessness and distractibility as well as lengthening attention span, but there are side effects. These include reports of growth impairment in children, insomnia, and increases in heart rate. Those promoting their use point to their potential benefits and they advocate care in limiting treatment dose and duration. Opponents of their use, while agreeing that they provide some short-term benefits, conclude that these do not outweigh their disadvantages. Amphetamine therapy has also been attempted, but with little success, in the treatment of Parkinson's disease, and both amphetamine and cocaine have been suggested for the treatment of depression, although the evidence to support their efficacy does not meet current standards demanded by the U.S. Food and Drug Administration.
The amphetamines act by increasing concentrations of the neurotransmitters DOPAMINE and NOREPINEPHRINE at the neuronal synapse, thereby augmenting release and blocking uptake. It is the augmentation of release that differentiates amphetamines from cocaine, which also blocks uptake of these transmitters. Humans given a single moderate dose of amphetamine generally show an increase in activity and talkativeness, and they report euphoria, a general sense of well-being, and a decrease in both food intake and fatigue. At higher doses repetitive motor activity (i.e., stereotyped behavior) is often seen, and further increases in dose can lead to convulsions, coma, and death. This class of drugs increases heart rate, respiration, diastolic and systolic blood pressure, and high doses can cause cardiac arrhythmias. In addition, the amphetamines have a suppressant effect on both rapid eye movement sleep (REM)he stage of sleep associated with dreamingnd total sleep. The half-life of amphetamine is about ten hours, quite long when compared to a stimulant like cocaine, which has a half-life of approximately one hour, or even methamphetamine which has a half-life of about five hours.
The amphetamine molecule has two isomers: the d-(+) and l-(-) isomers. There is marked stereo-selectivity in their biological actions, with the d-isomer (dextroamphetamine) considerably more potent. For example, it is more potent as a locomotor stimulant, in inducing stereotyped behavior patterns, and in eliciting central nervous system excitatory effects. The isomers appear to be equipotent as cardiovascular stimulants. The basic amphetamine molecule has been modified in a number of ways to accentuate various of its actions. For example, in an effort to obtain appetite suppressants with reduced cardiovascular and central nervous system effects, structural modifications yielded such medications as diethylproprion and fenfluramine, while other structural modifications have enhanced the central nervous system stimulant effects and reduced the cardiovascular and anorectic actions, yielding medications such as methylphenidate and phenmetrazine. These substances share, to a greater or lesser degree, the properties of amphetamine.
A major toxic effect of amphetamine in humans is the development of a schizophrenia-like psychosis after repeated long-term use. The first report of an amphetamine psychosis occurred in 1938, but the condition was considered rare. Administration of amphetamine to normal volunteers with no histories of psychosis (Griffith et al., 1968) resulted in a clear-cut paranoid psychosis in five of the six subjects who received d-amphetamine for one to five days (120-220 mg/day), which cleared when the drug was discontinued. Unless the user continues to take the drug, the psychosis usually clears within a week, although the possibility exists for prolonged symptomology. This amphetamine psychosis has been thought to represent a reasonably accurate model of schizophrenia, including symptoms of persecution, hyperactivity and excitation, visual and auditory hallucinations, and changes in body image. In addition, it has been suggested that there is sensitization to the development of a stimulant psychosisnce an individual has experienced this toxic effect, it is readily reinitiated, sometimes at lower doses and even following long drug-free periods.
Amphetamine abusers taking repeated doses of the drug can develop repetitive behavior patterns which persist for hours at a time. These can take the form of cleaning, the repeated dismantling of small appliances, or the endless picking at wounds on the extremities. Such repetitive stereotyped patterns of behavior are also seen in nonhumans administered repeated doses of amphetamines and other stimulant drugs, and they appear to be related to dopaminergic facilitation. Cessation of amphetamine use after high-dose chronic intake is generally accompanied by lethargy, depression, and abnormal sleep patterns. This pattern of behavior, opposite to the direct effects of amphetamine, does not appear to be a classical abstinence syndrome. The symptoms may be related to the long-term lack of sleep and food intake that accompany chronic stimulant use as well as to the catecholamine depletion that occurs as a result of chronic use.
Animals given unlimited access to amphetamine will self-administer it reliably, alternating days of high intake with days of low intake. They become restless, tremulous, and ataxic, eating and sleeping little. If allowed to continue self-administering the drug, most will take it until they die. Animals maintained on high doses of amphetamines develop tolerance to many of the physically and behaviorally debilitating effects, but they also develop irreversible damage in some parts of the brain, including long-lasting depletion of dopamine. It has been suggested that the prolonged anhedonia seen after long-term human amphetamine use may be related to this, although the evidence for this is not very strong.
As with all PSYCHOMOTOR STIMULANT drugs, at low doses animals are active and alert, showing increases in responding maintained by other reinforcers, but often decreasing food intake. Higher doses produce species-specific repetitive behavior patterns (stereotyped behavior), and further increases in dose are followed, as in humans, by convulsions, hyperthermia, and death. Tolerance (loss of response to a certain dose) develops to many of amphetamine's central effects, and cross-tolerance among the stimulants has been demonstrated in rats. Thus, for example, animals tolerant to the anorectic effects of amphetamine also show tolerance to cocaine's anorectic effects. Although there is tolerance development to many of amphetamine's effects, sensitization develops to amphetamine's effects on locomotor activity. Thus, with repeated administration, doses of amphetamine that initially did not result in hyperactivity or stereotypy can, with repeated use, begin to induce those behaviors when injected daily for several weeks. In addition, there is cross-sensitization to this effect, such that administration of one stimulant can induce sensitization to another one. In contrast to cocaine, however (in which an increased sensitivity to its convulsant effects develops with repeated use), amphetamines have an anticonvulsive effect.
Learned behaviors, typically generated by operant schedules of reinforcement, are generally affected by the amphetamines in a rate-dependent fashion. Thus, behaviors that occur at relatively low rates in the absence of the drug tend to be increased at low-to-moderate doses of amphetamine, while behaviors occurring at relatively high frequencies tend to be suppressed by those doses of amphetamine. In addition, with high doses most behaviors tend to be suppressed. As is seen with other stimulants, such as cocaine, environmental variables and behavioral context can play a role in modulating these effects. For example, behavior under strong stimulus control shows tolerance to repeated amphetamine administration much more rapidly than does behavior under weak stimulus control. In addition, if the amphetamine-induced behavioral disruption has the effect of interfering with reinforcement delivery, tolerance to that effect develops rapidly. Tolerance does not develop to the amphetamine-induced disruptions when reinforcement density is increased or remains the same.
Amphetamines can serve as reinforcers in nonhumans and, as described above, can produce severely toxic consequences when available in an unlimited fashion. However, when available for a few hours a day, animals will take them in a regular fashion, showing little or no tolerance to their reinforcing effects.
A substantial number of studies have been carried out evaluating the effects of amphetamines on learning, cognition, and other aspects of performance. The data indicate that under most conditions the amphetamines are not general performance enhancers. When there is improvement in performance associated with amphetamine administration, it can usually be attributed to a reduction in the deterioration of performance due to fatigue or boredom. Attention lapses that impair performance after sleep deprivation appear to be reduced by amphetamine administration; however, as sleep deprivation is prolonged, this effect is reduced. A careful review of the literature in this area (Laties & Weiss, 1981) concluded that improvement is more obvious with complex, as compared with simple, tasks.
In addition, in trained athletes, whose behavior shows little variability, only very small improvements can be seen. Laties and Weiss have argued persuasively, however, that the small changes in performance induced by amphetamines can result in the 1 to 2 percent improvement that may make the difference in a close athletic competition. Although the facilitation in performance after amphetamine does not appear to be substantial, it is sufficient to "spell the difference between a gold medal" and any other. Unfortunately, such data have led athletes to take stimulants prior to athletic events, particularly those in which strenuous activity is required over prolonged periods (e.g., bicycle racing), leading to hyperthermia, collapse, and even death in some cases.
The mood-elevating effects of the amphetamines are generally believed to be related to their abuse. Their use is accompanied by reports of increased self-confidence, elation, frequently euphoria, friendliness, and positive mood. When amphetamine is administered repeatedly, tolerance develops rapidly to many of its subjective effects (such that the same dose no longer exerts much of an effect). This means that the user must take increasingly larger amounts of amphetamine to achieve the same effect. As with nonhuman research subjects, there is however, little or no evidence for the development of tolerance to amphetamine's reinforcing effects.
Experienced stimulant users, given a variety of stimulant drugs, often cannot differentiate among cocaine, amphetamine, methamphetamine, and methlyphenidatell of which appear to have similar profiles of action. Since these drugs have different durations of action, however, it becomes easier to make this differentiation over time.
In the United States in the 1950s, nonmedical amphetamine use was prevalent among college students, athletes, truck drivers, and housewives. The drug was widely publicized by the media when very little evidence of amphetamine toxicity was available. Pills were the first form to be widely abused. Use of the drug expanded as production of amphetamine and methamphetamine increased significantly, and abusers began to inject it. An extensive black market in amphetamines developed, and it has been estimated that 50 to 90 percent of the quantity commercially produced was diverted into illicit channels. In the 1970s, manufacture of amphetamines was substantially curtailed, amphetamines were placed in Schedule II of the Controlled Substances Act, and abuse of these substances was substantially reduced. Perhaps only by coincidence, as amphetamine use declined, cocaine use increased.
The amphetamines, as with other stimulants, are generally abused in multiple-dose cycles (i.e., binges), in which people take the drug repeatedly for some period of time, followed by a period in which they take no drug. Amphetamines are often taken every three or four hours for periods as long as three or four days, and dosage can escalate dramatically as tolerance develops. Like cocaine binges, these amphetamine-taking occasions are followed by a "crash" period in which the user sleeps, eats, and does not use the drug. Abrupt cessation from amphetamine use is usually accompanied by depression. Mood generally returns to normal within a week, although craving for the drug can last for months.
There is little evidence for the development of physical dependence to the amphetamines. Although some experts view the "crash" (with lethargy, depression, exhaustion, and increased appetite) that can follow a few days of moderate-to-high dose use as meeting the criteria for a withdrawal syndrome, others believe that the symptoms can also be related to the effects of chronic stimulant use. When using stimulants people do not eat or sleep very much and, as well, catecholamine depletion may well be contributing to these behavioral changes.
As of the mid-1990s, little information is available about the treatment of amphetamine abusers, and no reports of successful pharmacological interventions exist in the treatment literature. As with cocaine abuse, the most promising nonpharmacological approaches include behavioral therapy, RELAPSE PREVENTION, rehabilitation (e.g., vocational, educational, and social-skills training), and supportive psychotherapy. Unlike cocaine, however, minimal clinical trials with potential treatment medications for amphetamine abuse have been carried out. The few that have been attempted report no success in reducing a return to amphetamine use.
(SEE ALSO: Amphetamine Epidemics; ; Treatment)
ANGRIST, B., & SUDILOVSKY, A. (1978). Central nervous system stimulants: Historical aspects and clinical effects. In L. L. Iversen, S. D. Iverson, & S. H. Snyder (Eds.), Handbook of psychopharmacology. New York: Plenum.
GRIFFITH, J. D., ET AL. (1970). E. Costa and S. Garattini (Eds.), Amphetamines and related compounds. New York: Raven Press.
GRILLY, D. M. (1989). Drugs and human behavior. Needham, MA: Allyn & Bacon.
KALANT, O. J. (1973). The amphetamines: Toxicity and addiction. Springfield, IL: Charles C. Thomas.
LATIES, V.G., & WEISS, B. (1981). Federation proceedings, 40, 2689-2692.
MARIAN W. FISCHMAN