dextroamphetamine, methamphetamine, and their various salts, are
collectively referred to as amphetamines. In fact, their chemical
properties and actions are so similar that even experienced users have
difficulty knowing which drug they have taken.
Amphetamine was first marketed in the 1930s as Benzedrine® in an
over-the-counter inhaler to treat nasal congestion. By 1937, amphetamine
was available by prescription in tablet form and was used in the
treatment of the sleeping disorder, narcolepsy, and the behavioral
syndrome called minimal brain dysfunction, which today is called
attention deficit hyperactivity disorder (ADHD). During World War II,
amphetamine was widely used to keep the fighting men going and both
dextroamphetamine (Dexedrine®) and methamphetamine (Methedrine®) were
use of amphetamines spread, so did their abuse. In the 1960s,
amphetamines became a perceived remedy for helping truckers to complete
their long routes without falling asleep, for weight control, for
helping athletes to perform better and train longer, and for treating
mild depression. Intravenous amphetamines, primarily methamphetamine,
were abused by a subculture known as "speed freaks." With experience, it
became evident that the dangers of abuse of these drugs outweighed most
of their therapeutic uses.
Increased control measures were initiated in 1965 with amendments to the
federal food and drug laws to curb the black market in amphetamines.
Many pharmaceutical amphetamine products were removed from the market
including all injectable formulations, and doctors prescribed those that
remained less freely. Recent increases in medical use of these drugs can
be attributed to their use in the treatment of ADHD. Amphetamine
products presently marketed include generic and brand name amphetamine (Adderall®,
Dexedrine®, Dextrostat®) and brand name methamphetamine (Desoxyn®).
Amphetamines are all controlled in Schedule II of the CSA.
meet the ever-increasing black market demand for amphetamines,
clandestine laboratory production has mushroomed. Today, most
amphetamines distributed to the black market are produced in clandestine
laboratories. Methamphetamine laboratories are, by far, the most
frequently encountered clandestine laboratories in the United States.
The ease of clandestine synthesis, combined with tremendous profits, has
resulted in significant availability of illicit methamphetamine,
especially on the West Coast, where abuse of this drug has increased
dramatically in recent years. Large amounts of methamphetamine are also
illicitly smuggled into the United States from Mexico.
Amphetamines are generally taken orally or injected. However, the
addition of "ice," the slang name for crystallized methamphetamine
hydrochloride, has promoted smoking as another mode of administration.
Just as "crack" is smokable cocaine, "ice" is smokable methamphetamine.
Methamphetamine, in all its forms, is highly addictive and toxic.
effects of amphetamines, especially methamphetamine, are similar to
cocaine, but their onset is slower and their duration is longer. In
contrast to cocaine, which is quickly removed from the brain and is
almost completely metabolized, methamphetamine remains in the central
nervous system longer, and a larger percentage of the drug remains
unchanged in the body, producing prolonged stimulant effects. Chronic
abuse produces a psychosis that resembles schizophrenia and is
characterized by paranoia, picking at the skin, preoccupation with one's
own thoughts, and auditory and visual hallucinations. These psychotic
symptoms can persist for months and even years after use of these drugs
has ceased and may be related to their neurotoxic effects. Violent and
erratic behavior is frequently seen among chronic abusers of
amphetamines, especially methamphetamine.
referred to as "uppers," reverse the effects of fatigue on both mental
and physical tasks. Two commonly used stimulants are nicotine, which is
found in tobacco products, and caffeine, an active ingredient in coffee,
tea, some soft drinks, and many non-prescription medicines. Used in
moderation, these substances tend to relieve malaise and increase
alertness. Although the use of these products has been an accepted part
of U.S. culture, the recognition of their adverse effects has resulted
in a proliferation of caffeine-free products and efforts to discourage
number of stimulants, however, are under the regulatory control of the
CSA. Some of these controlled substances are available by prescription
for legitimate medical use in the treatment of obesity, narcolepsy, and
attention deficit disorders. As drugs of abuse, stimulants are
frequently taken to produce a sense of exhilaration, enhance self
esteem, improve mental and physical performance, increase activity,
reduce appetite, produce prolonged wakefulness, and to "get high." They
are among the most potent agents of reward and reinforcement that
underlie the problem of dependence.
Stimulants are diverted from legitimate channels and clandestinely
manufactured exclusively for the illicit market. They are taken orally,
sniffed, smoked, and injected. Smoking, snorting, or injecting
stimulants produce a sudden sensation known as a "rush" or a "flash."
Abuse is often associated with a pattern of binge use--sporadically
consuming large doses of stimulants over a short period of time. Heavy
users may inject themselves every few hours, continuing until they have
depleted their drug supply or reached a point of delirium, psychosis,
and physical exhaustion. During this period of heavy use, all other
interests become secondary to recreating the initial euphoric rush.
Tolerance can develop rapidly, and both physical and psychological
dependence occur. Abrupt cessation, even after a brief two- or three-day
binge, is commonly followed by depression, anxiety, drug craving, and
extreme fatigue known as a "crash."
Therapeutic levels of stimulants can produce exhilaration, extended
wakefulness, and loss of appetite. These effects are greatly intensified
when large doses of stimulants are taken. Physical side effects,
including dizziness, tremor, headache, flushed skin, chest pain with
palpitations, excessive sweating, vomiting, and abdominal cramps, may
occur as a result of taking too large a dose at one time or taking large
doses over an extended period of time. Psychological effects include
agitation, hostility, panic, aggression, and suicidal or homicidal
tendencies. Paranoia, sometimes accompanied by both auditory and visual
hallucinations, may also occur. Overdose is often associated with high
fever, convulsions, and cardiovascular collapse. Because accidental
death is partially due to the effects of stimulants on the body's
cardiovascular and temperature-regulating systems, physical exertion
increases the hazards of stimulant use.