Mental health articles

Stimulant drugs include a mphetamine, cocaine and crack cocaine. Some amphetamine and amphetamine-like drugs are legally produced and used therapeutically. For example, dexamphetamine (dexedrine) and methylphenidate (ritalin) are, somewhat controversially, used for the management of children with attention deficit disorder. In the past amphetamine was prescribed as an appetite suppressant and in the treatment of depression but such use is no longer recommended. Amphetamine sulphate (‘speed’, ‘whizz’, ‘sulphate’) is illicitly produced amphetamine. It is a whitish (pink/grey) powder that can be snorted, swallowed or injected.

Other forms of amphetamine are amphetamine base, which usually comes as a paste which is swallowed or smoked, and methylamphetamine (or methamphetamine), ‘ice’, a crystalline form, which is usually smoked in a pipe designed for the purpose. Amphetamines cause arousal (increasing heart and respiratory rate), and dilate the pupils. Users seek the feelings of alertness, energy, confidence, exhilaration and reduced fatigue which the drug brings. To the observer they are likely to appear excitable, speak rapidly and have poor concentration. Appetite will be diminished. The effects of amphetamine last 3–4 hours. Following repeated use, tolerance and psychological dependence may develop. Cocaine (‘coke’, ‘charlie’) is a white powder that is usually snorted but can also be injected, swallowed or smoked. When cocaine powder is dissolved in water and heated with baking soda small crystals of crack cocaine (‘rocks’ or ‘stones’) about the size of a raisin are produced. Crack is usually smoked using a crack pipe where the rock is heated and the vapours inhaled. It can also be injected. Like amphetamine, crack and cocaine produce physiological arousal and feelings of well-being, alertness and exhilaration. The effects, however, are much shorter than those of amphetamine. The psychological peak is reached after about 20–30 minutes for cocaine and is almost immediate for crack. This means that it must be used frequently to sustain the effect. A range of psychological and psychiatric complications are associated with stimulant use. In contrast to the desired effects, users may experience feelings of anxiety, agitation, irritability and restlessness. After a period of regular, repeated use a ‘come down’ or ‘crash’, typified by feelings of lethargy, sleepiness and depression, is common as the body adjusts to the absence of the drug. The depression can be severe and suicide is a risk. Webster (1999) found that in a sample of 288 crack users 64 per cent had experienced suicidal thoughts and 37 per cent had attempted suicide. A drug-induced psychosis may be precipitated; this usually follows high levels of use over several days. This is characterized by hallucinations, feelings of paranoia and delusions. Symptoms resolve as the drug is eliminated from the body. Crack users who are smoking are prone to respiratory problems due to the build-up of fluids in the lungs. Wheezing, shortness of breath, coughing and chest pains are common, a condition known as ‘crack lung’. Cardiovascular problems such as high blood pressure, irregular heartbeat and strokes can occur with both cocaine and crack. Long-term cocaine use can result in damage to the septum of the nose.

Prolonged use of any stimulants can have detrimental effects on the user’s general physical health due to lack of food and sleep. When injected the problems associated with intravenous drug use can occur. Use during pregnancy may bring complications for mother and child. For further information about the effect of substance misuse during pregnancy see Siney. Significant amounts of money may be required to sustain use, particularly of cocaine or crack, and people may engage in a variety of unscrupulous or illegal ways of raising money, such as those described for heroin users.

Tags: side-effects, stimulants