Dextroamphetamine (Encyclopedia of Drugs and Addictive Substances)
- How Is It Taken?
- Usage Trends
- Finding the Right Treatment
- Treatment for Habitual Users
- The Law
- For More Information
What Kind of Drug Is It?
Dextroamphetamines are stimulantsubstances that increase the activity of a living organism or one of its parts. Stimulants create a temporary "" that elevates users' moods, but these effects do not last long. A "low," which can sometimes be overwhelming, follows once the drug's effects wear off.
Like other amphetaminesPronounced am-FETT-uh-meens; stimulant drugs that increase mental alertness, reduce appetite, and help keep users awake., dextroamphetamines also give people more energy, allowing them to do more and stay awake longer without getting tired. This effect of "speeding up" people's actions explains how the drugs came to be known by the street names "go-pills," "pep pills," "speed," and "uppers."
Dextroamphetamines are addictive drugs that have a high rate of abuse. The prefix "dextro" in the drug name dextroamphetamine refers to dextrose, a type of sugar. Dextroamphetamines are simply amphetamines that contain sugar molecules. (An entry on amphetamines is also available in this encyclopedia.)
The history of amphetamines stretches back to the late nineteenth century. The drug was first synthesized, or made in a laboratory, in 1887. However, it was not used until 1932 when the drug manufacturer Smith, Kline and French introduced Benzedrine. Packaged as an over-the-counter inhaler, the amphetamine drug Benzedrine helped relieve nasal congestion.
Dextroamphetamine: The Drug with Multiple Uses
Throughout the 1930s, doctors in Europe prescribed amphetamines to treat colds, hay fever, and asthma. That same decade, amphetamines became available in tablet form for the treatment of the daytime sleeping disorder known as , a fairly rare condition that causes people to fall asleep quickly and unexpectedly. Later, many Americans became hooked on amphetaminespecifically the dextroamphetamine sulfate Dexedrinefter finding that users could lose weight quickly and effortlessly. Only then did researchers begin to realize that these drugs could be dangerous and addictive.
During World War II (1939945), amphetamines were distributed among soldiers from the United States, the United Kingdom, Germany, and Japan to keep them awake and alert on the battlefield. Back on the home front, people who worked in factories manufacturing goods for the war effort were also using the drug to boost their productivity. After the war, use of the drug continued, both in the United States and abroad.
Access to Amphetamines Is Restricted
Amphetamines and dextroamphetamines became the drug of choice for people who needed a lift or who needed to stay alert. Night-shift workers, students cramming for exams, and truck drivers on long hauls were among the most common users. The addictive nature of the drugs contributed to the growing demand for them. In 1970, drug companies in the United States produced about 12 million amphetamine tablets. A large percentage of these drugs fell into the wrong hands and made their way to the black marketThe illegal sale or trade of goods; drug dealers are said to carry out their business on the black market.. That year, the U.S. Congress passed the Controlled Substances Act (CSA) in an effort to stop the huge increase in drug use. The new law restricted the use of amphetamines and classified them as Schedule II drugsrugs with genuine medical uses that nevertheless possess a high potential for abuse and dependency.
What Is It Made Of?
All amphetamines are , or manufactured, substances. They cannot be grown in a garden or dug up from the ground. The composition of amphetamine pills or capsules is actually a combination of various types of crystalline compounds called amphetamine salts. The difference between amphetamine and dextroamphetamine is a few molecules of dextrose, which is a type of sugar.
The chemical formula for dextroamphetamine is (C9H13N)2. The chemical formula for dextroamphetamine sulfate is C18H28N2O4S.
How Is It Taken?
Dextroamphetamine sulfate is manufactured in capsule and tablet form and is usually swallowed. Dexedrine capsules have one brown end and one clear end and are filled with two types of tiny drug pellets. One type of pellet dissolves shortly after the capsule is ingested. The other type is time-released, allowing for a gradual release of the rest of the medication throughout the day. The capsules are available in 5-milligram, 10-milligram, and 15-milligram doses. Dexedrine also comes in tablet form. The 5-milligram pills are triangular and orange. DextroStat, another dextroamphetamine sulfate, is only available in 5-milligram and 10-milligram tablets. The pills are yellow and round.
For the treatment of narcolepsy, patients are typically prescribed 5 milligrams to 60 milligrams of dextroamphetamine per day. Patients age six or older with (ADHD) usually take 5 milligrams to 40 milligrams per day, depending on their age and response to the drug. The youngest ADHD patientsges three to fiveay be given half of a 5-milligram tablet.
Are There Any Medical Reasons for Taking This Substance?
Amphetamines such as Dexedrine and DextroStat (dextroamphetamine sulfate) and Adderall (a combination of amphetamine and dextroamphetamine sulfate referred to as a "mixed amphetamine") are used to treat ADHD and narcolepsy. (An entry on Adderall is also available in this encyclopedia.) Dextroamphetamines are useful in the treatment of ADHD because they improve the user's ability to concentrate. The drug helps patients with narcolepsy by speeding up bodily functions and increasing alertness.
In the 1970s, dextroamphetamines were approved for use as antiobesity drugs. Because they decrease feelings of hunger in people who
take them, dextroamphetamines and other amphetamines have often been abused by dieters. This is exactly what happened with Dexedrine. By the start of the twenty-first century, research was underway on a variety of different diet pills. Dextroamphetamines like Dexedrine, however, were no longer being prescribed for weight loss in the United States.
Problems undoubtedly develop when dextroamphetamine pills and capsules are taken by individuals who have no medical need for the drug. All amphetamines are , meaning that they act primarily on the brain. Amphetamines are extremely addictive, and high doses can affect the brain in negative ways. Regardless of the dangers, their power to increase concentration and decrease the need for sleep has led to a new trend known as stimulant "sharing." (See separate entries in this encyclopedia on "Adderall" and "Ritalin and Other Methylphenidates.")
Reports from the United States, Canada, and the United Kingdom in the first five years of the twenty-first century indicate that prescription dextroamphetamines are being sharedr soldmong adolescents and college students. illicitUnlawful. drug users claim they receive the stimulants from other young people who use them for medical purposes. In some cases, the drugs are stolen or simply lifted from the family medicine cabinet.
The reasons for the abuse of dextroamphetamines at the high school and college levels vary. Nicholas Zamiska commented in the Wall Street Journal that the "unapproved use" of drugs like Adderall seem to stem from increased pressure on students to perform well on standardized tests. Illicit occurs as well.
Major Studies on Amphetamine Use and Abuse
DAWN and NSDUH:
The Drug Abuse Warning Network (DAWN) operates through the Substance Abuse and Mental Health Services Administration (SAMHSA), a division of the U.S. Department of Health and Human Services. DAWN monitors drug-related visits to hospital emergency departments (EDs). In the last two quarters of 2003, the DAWN report estimated that the use of stimulants resulted in 42,538 emergency department visits in 260 hospitals across the United States. Of those visits, 18,129 of them were attributed directly to amphetamines and dextroamphetamines.
SAMHSA's own annual study, known as the National Survey on Drug Use and Health (NSDUH), tracks nonmedical drug use among Americans of all ages. The latest statistics available from SAMHSA as of mid-2005 were from 2003. That year, 4 percent of all youths age twelve to seventeen reported using prescription-type drugs, including stimulants. The percentage was higher among eighteen- to twenty-five-year-olds. Six percent of this age group admitted to using prescription drugs for nonmedical reasons. About 1.9 percent of adults age twenty-six and older reported illicit prescription drug use.
On April 21, 2005, the Partnership for a Drug-Free America (PDFA) released the findings of its 2004 study on the abuse of drugs among U.S. teenagers. The PDFA's Partnership Attitude Tracking Study, better known as PATS, indicated that the trend in teen drug use in the early part of the twenty-first century involves prescription (Rx) and over-the-counter (OTC) medications. The authors of the study see this as a sign that "Rx and OTC medicine abuse has penetrated teen culture."
Millions of teens are using prescription drugs without a doctor's order, prompting the media to dub these young adults "Generation Rx." According to PATS, 10 percent of American teenagers, or 2.3 million young people, have tried prescription stimulants like Adderall without a doctor's prescription. The teens in the study reported that they obtained the stimulants from fellow classmates or from their own home medicine cabinets.
Monitoring the Future and Beyond:
The PATS statistics mirror the results of the 2004 Monitoring the Future (MTF) study. An annual survey of drug use among eighth, tenth, and twelfth-grade students, the MTF is performed by the University of Michigan and funded by the National Institute on Drug Abuse (NIDA). Although amphetamine use was down slightly among eighth and tenth graders, about 10 percent of high school seniors reported recreational use of the drug in 2004.
A study conducted by University of Michigan Substance Abuse Research Center scientists, detailed in the journal Addiction in 2005, tracked the usage of amphetamines beyond high school. Of nearly 11,000 randomly selected college students, 6.9 percent of them reported nonmedical prescription stimulant use at least once in their lives. About 4.1 percent admitted using prescription stimulants in the past year, and 2.1 percent used them in the past month. The authors of the study concluded that "high-risk behavior" such as this "should be monitored further." They added, "intervention efforts are needed to curb this form of drug abuse."
Effects on the Body
Common side effects of dextroamphetamine use include dry mouth, headache, nausea, dizziness, restlessness, increased blood pressure and pulse rate, loss of appetite, difficulty sleeping, and either diarrhea or constipation. Higher doses can result in fever, an unusually fast heartbeat, chest pain, blurred vision, , tremors, moodiness, and even aggression.
High-dose dextroamphetamine abusers can develop "amphetamine psychosis" after a week or so of continuous use. Amphetamine psychosisPronounced sy-KOH-sis; a severe mental disorder that often causes hallucinations and makes it difficult for people to distinguish what is real from what is imagined. affects the way the mind functions, causing feelings of severe , and all kinds of hallucinationsisual, auditory, and tactile. Tactile hallucinations make the user feel as if bugs, worms, or snakes are crawling on their skin. Such sensations are very real, and therefore extremely frightening, to the individual who is experiencing them. As a result, violent reactions sometimes occur during amphetamine psychosis. Once the amphetamine abuser is free of the drug, however, the psychosis goes away. Symptoms such as mental confusion and memory problems may linger, however.
When used for medical purposes, dextroamphetamines are prescribed at the lowest possible dosage. The dosage is then raised gradually by a doctor until the desired action is achieved. All amphetamines are highly addictive. According to the 59th edition of the Physicians' Desk Reference: "There are reports of patients who have increased the dosage to many times that recommended," leading to "tolerance, extreme psychological dependenceThe belief that a person needs to take a certain substance in order to function, whether that person really does or not., and severe social disability."
Tolerance occurs when it takes more and more of the drug to achieve the effect or high originally produced by smaller doses. Tolerance to amphetamines can occur quickly and often leads to overdose. Symptoms of dextroamphetamine overdose include extreme confusion and anxiety, hallucinations, severe tics or shaking, an irregular heartbeat, extremely high blood pressure, vomiting, stomach cramps, convulsions, and coma. An overdose of dextroamphetaminer any other amphetamine, for that matteran be fatal.
Dextroamphetamine as a Treatment for ADHD
Amphetamines and dextroamphetamines typically give the user a boost of energy. In people with attention-deficit/hyperactivity disorder (ADHD), however, these very same drugs help to calm them down, allowing them to better focus their energy. Individuals with ADHD typically have a short attention span, and they tend to get distracted quite easily. They may also show signs of hyperactivity, impulsive behavior, and emotional instability. It can be a challenge for people with untreated ADHD to concentrate their attention and control their behavior. Drugs like Dexedrine, a dextroamphetamine sulfate, and Adderall, a combination of amphetamine and dextroamphetamine salts, help manage the symptoms of ADHD by acting on the part of the brain that decides when and how to act.
According to an article in Phi Delta Kappan, it is essential that parents or caregivers of children and teens with ADHD: 1) be informed about the effects of the drugs that have been prescribed for treatment; 2) know the consequences that might arise if these drugs are discontinued; and 3) accept the responsibility to stay in close touch with the child's doctor and therapist. In most cases, drug treatment for ADHD must be combined with some sort of counseling or therapy to achieve the highest success rates. One of the most popular and successful therapeutic methods as of 2005 was (CBT), or "talk" therapy. Cognitive behavioral therapy helps patients develop better coping skills and change their negative patterns of thinking and behavior into positive ones.
Reactions with Other Drugs or Substances
The stimulating effects of dextroamphetamine can be intensified when the drug is combined with other stimulants such as cocaine or nicotine. (Entries on cocaine and nicotine are also available in this encyclopedia.) Dextroamphetamines should never be mixed with alcohol or other depressants.
Some medications can cause severe reactions in the user when mixed with stimulants. In addition, people with certain medical conditions should stay away from these drugs. Specifically, dextroamphetamines should not be taken by pregnant women, nursing mothers, or individuals with any of the following conditions:
- heart disease
- high blood pressure
- tourett's syndromeA severe tic disorder that causes distress and significant impairment to those affected by it., or any other tic disorder
- a history of drug abuse
- depression that is being treated with prescription drugs
- severe pain that is being treated with the prescription drug meperidine. (A separate entry on meperidine is available in this encyclopedia.)
Treatment for Habitual Users
from amphetamines can be a long and difficult process for many users. Psychological dependence is made even worse by the intense cravings for the drug that users experience. Unpleasant and sometimes frightening symptoms develop as the body tries to adjust to the absence of the stimulant. The withdrawal process causes depression and may also bring on fatigue, vivid dreams, irregular sleep patterns, and increased appetite.
Experts in the treatment of substance abuse and addiction report that behavioral therapy and emotional support are essential for the successful rehabilitation of amphetamine abusers. An individual recovering from drug addiction must avoid all psychoactive drugs, including alcohol. Amphetamine and dextroamphetamine cravings can be extremely powerful and may last for years after a former user has kicked the habit.
Patti Davis, daughter of former U.S. President Ronald Reagan and his wife, Nancy, talked about her past drug addiction in the article "Dope: A Love Story" in Time magazine. In the article, Davis wrote that she often wondered "why the world is so hard for some people" that they "run for the refuge of drugs." This observation shows why an effective drug rehabilitation program must help patients identify and deal with the underlying emotional issues surrounding their drug use.
The reasons for drug use are numerous. The Merck Manual of Medical Information noted that "some amphetamine abusers are depressed and seek the mood-elevating effects of these stimulants to temporarily relieve the depression." Davis pointed out that some people are afraid of the world. Drugs "take you awayar away; they let you hide, which is what frightened people do," she commented. Recovering drug abusers need a solid support system to remain drug free.
Amphetamine addicts frequently allow their need for the drug to take over their lives. Users can become so obsessed with satisfying their drug habit that they ignore the most important people in their lives. Relationships with family and friends frequently deteriorate, and money problems may begin to develop as the addiction grows. In general, substance abuse is associated with increased rates of school failure, theft (usually to fund the drug habit), domestic violence, sexual assault, unemployment, and homelessness. People who are high on amphetamines are more likely to engage in risky behavior than people who do not take drugs. This can contribute to the spread of sexually transmitted diseases, including HIV (the human immunodeficiency virus, which can lead to acquired immunodeficiency syndrome [AIDS]).
Abuse of any amphetamine can have serious legal consequences. Amphetamines are controlled substances, meaning their use is regulated by certain federal laws. Under the terms of the Controlled Substances Act (CSA) of 1970, amphetamines are classified as Schedule II drugs. Schedule II drugs are prescription medications that have genuine medical uses but also pose a high risk for abuse and addiction. Schedule II drugs like dextroamphetamines require a doctor's prescription and carry a warning that states they "should be prescribed or dispensed sparingly." Pharmacies and hospitals that dispense Schedule II drugs must register with the U.S. Drug Enforcement Administration. In addition, limits are placed on the amount of dextroamphetamine produced by manufacturers for the United States each year.
Since the passage of the CSA, according to Andrew Weil and Winifred Rosen in From Chocolate to Morphine, "most cases of amphetamine abuse have involved legally manufactured and prescribed drugs." Most of the illicit dextroamphetamine supply, then, comes from actual prescriptions that are obtained, used, and sold illegally.
Anyone convicted of transporting or dealing in dextroamphetamine in the United States faces up to twenty years in prison and a hefty fine for a first offense. Repeat offenders face even stiffer penalties. In the United Kingdom, amphetamines are designated a class B drug under the 1971 Misuse of Drugs Act. Possession carries a penalty of imprisonment for three months to five years, and dealing carries a sentence of six months to fourteen years, along with a possible fine.
For More Information
Beers, Mark H., and others. The Merck Manual of Medical Information, 2nd home ed. New York: Pocket Books, 2003.
Brecher, Edward M., and others. The Consumers Union Report on Licit and Illicit Drugs. Boston: Little Brown & Co., 1972.
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.
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.
Physicians' Desk Reference, 59th ed. Montvale, NJ: Thomson PDR, 2004.
Weil, Andrew, and Winifred Rosen. From Chocolate to Morphine. New York: Houghton Mifflin, 1993, rev. 2004.
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Calello, Diane P., and Kevin C. Osterhoudt. "Acute Psychosis Associated with Therapeutic Use of Dextroamphetamine." Pediatrics (May, 2004): p. 1466.
Collier, Gene. "Pilots on the Go Might Not Know When to Stop." Post-Gazette (January 19, 2003).
Davis, Patti. "Dope: A Love Story." Time (May 7, 2001): p. 55.
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See also: Adderall; Amphetamines; Methamphetamine; Ritalin and Other Methylphenidates
Dextroamphetamine (Encyclopedia of Drugs, Alcohol, and Addictive Behavior)
This is the d-isomer of AMPHETAMINE. It is classified as a PSY-CHOMOTOR STIMULANT drug and is three to four times as potent as the l-isomer in eliciting central nervous system (CNS) excitatory effects. It is also more potent than the l-isomer in its ANORECTIC (appetite suppressant) activity, but slightly less potent in its cardiovascular actions. It is prescribed in the treatment of narcolepsy and OBESITY, although care must be taken in such prescribing because of the substantial ABUSE LIABILITY.
High-dose chronic use of dextroamphetamine can lead to the development of a toxic psychosis as well as to other physiological and behavioral problems. This toxicity became a problem in the United States in the 1960s, when substantial amounts of the drug were being taken for nonmedical reasons. Although still abused by some, dextroamphetamine is no longer the stimulant of choice for most psychomotor stimulant abusers.
(SEE ALSO: Amphetamine Epidemics; Cocaine)
MARIAN W. FISCHMAN