Large doses can lead to cardiovascular and respiratory dysfunctions, including hyperthermia, arrhythmias (irregular heartbeat), high blood pressure, and possibly death (NCBI, 2021; NIDA, 2016a). However, different routes of use may lead to higher concentrations in the blood, indicating a greater effect and greater potential for overdose. Healthcare service providers need to learn the medical signs, symptoms, and consequences of stimulant use to understand how best to medically manage patients with stimulant use disorders. Behavioral health service providers should also learn the medical aspects of stimulant use disorders so they can refer patients for medical intervention quickly and appropriately.
Co-Occurring Disorders and Conditions
The financial burdens can be severe for these patients and, if the patients lack insurance, hospitals’ costs of https://ecosoberhouse.com/ care may be unrecoverable. Collaborative arrangements between hospitals and local treatment facilities can allow for door-to-door SUD treatment. “Chemsex,” or the use of multiple substances to enhance sexual pleasure, is a potential health threat in polysubstance use with stimulant use (Giorgetti et al., 2017; Hammoud et al., 2018; Stevens et al., 2020; Torres et al., 2020). In particular, concomitant use of gamma-hydroxybutyric acid, alcohol, amyl nitrates, erectile dysfunction medications, and/or ketamine may be popular enhancements to the sexual experience, and each contributes differently to the potential for emergency intervention for patients.
Amphetamine psychosis
- Improved access to treatment of HIV infection and prevention efforts can help address the elevated risk of HIV infection among people who use stimulants.
- There is also disagreement about the role of sensitization in deepening postwithdrawal depression.
- Since over 95% of pharmaceutical amphetamines are either d-amphetamine or a mixture of d- and l-amphetamine salts, this review concentrates on these compounds.
- A growing body of research has linked cocaine use to increased odds of developing venous insufficiency and venous thrombosis (Griffin & Cha, 2019; T. Sharma et al., 2019).
This enthusiasm about “discoveries” changes, with time and increasing doses, from “watching the world” to feelings of being watched. Behaviors become more fixed and stereotypic, culminating in intense suspiciousness and, in psychotic reactions, paranoid thinking and persecutory perceptions that misinterpret environmental cues. Visual hallucinations may be overreactions to barely glimpsed and recognizable objects in one’s peripheral vision or may be described as shadows of people or things. Auditory hallucinations similarly begin with hearing simple noises and usually progress to hearing others speak about oneself, typically derogatorily. In later stages of psychosis, the individual may have a persistently altered perception of reality and overwhelming feelings of being unsafe.
Stimulant-Induced Psychosis
The mechanisms underlying neurotoxicity remain speculative, however; and some evidence suggests marked species differences in vulnerability to stimulant-induced neurotoxicity (see 65 for a review). Given the potential for profound species differences in susceptibility to stimulant-induced neurotoxicity, preclinical approaches may have limited utility in addressing questions relevant to clinical practice. Rather, systematic longitudinal and cross-sectional studies of the effects of prolonged human stimulant exposure are required. Whenever a person seeks treatment for substance abuse, there are many things to consider. For instance, depending on the severity of the abuse, a person may need inpatient care in a hospital or rehabilitation center, which can be costly.
Damage to cardiac and vascular tissue, such as the endothelial cells, by molecular mechanisms triggered by MA causes aortic dissection, dilated cardiomyopathy, arrythmia, and pulmonary hypertension (Kevil et al., 2019). Inflammation triggered by MA contributes to functional and structural changes in drug addiction treatment the cardiovascular system, such as fibrosis and atherosclerotic plaque formation (Kevil at al., 2019; Paulus & Stewart, 2020). Physical exertion and an overheated room can increase the likelihood of adverse effects because stimulants affect the body’s heat-regulating mechanism at the same time that blood vessel constriction conserves heat.
Adoption and twin studies estimate that 60−80% of the risk for ADHD is heritable, likely reflecting a polygenic or oligogenic risk mechanism 30. The prescription of chronic stimulant medication for maintenance therapy has long been the most effective treatment for ADHD 31, and stimulant use has continued to increase over the last decade. Despite this increase, estimates suggest that roughly half of children and adolescents with ADHD do not receive medical treatment for the disorder 29, and even fewer adults with ADHD receive any intervention directed at its amelioration.
Seeking Help and Treatment
- High-dose and high frequent-use patterns often lead to even more compulsive bingeing over a few hours to days that ceases only when the individual is totally exhausted or the stimulant supply runs out.
- Methamphetamine may induce psychosis through inhibition of the dopamine transporter, resulting in increased dopamine within the synaptic cleft.
- The task of developing and encouraging these linkages among treatment components cannot fall to hospital staff alone; all providers and staff should be encouraged to cooperate in the effort.
- Factors such as a person’s weight, individual brain chemistry, pre-existing conditions, when they started using, how much they use, and how frequently they use will also directly affect the severity of the side effects they experience from long term amphetamine use.
Although these rates are low, FDA added a warning label to these medications in 2007 that reads “stimulants may cause treatment-emergent psychotic or manic symptoms in patients with no prior history” (Moran et al., 2019, p. 1,129). Cocaine has been linked with many forms of heart disease, including different forms of arrhythmias, hypertension, coronary vasospasm, arteriosclerosis, myocardial infarction, hypertrophic cardiomyopathy, and sudden cardiac death (Kim & Park, 2019). Arteriosclerosis is seen in younger-age individuals who take cocaine, as well as in individuals how long do amphetamines stay in urine with co-occurring cardiovascular risk factors (Kim & Park, 2019). Myocardial infarction can occur with both low-dose and high-dose cocaine use (Kim & Park, 2019).
Brain damage from abuse
Hitting a nerve causes intense electric or burning pain both above and below the injection site (Dunn & Gauthier, 2020). After the injury, pain and abnormal sensations like burning or neuropathy (pins and needles) in the area served by the nerve can persist. Other forms of nerve damage also may occur with cocaine or MA use (e.g., nerve compression; Dunn & Gauthier, 2020). In a sample of more than 900 people with injection drug use (Colledge et al., 2020), nerve damage was the most commonly reported injection-related injury and disease, occurring in 19 percent of the sample. For patients who may use substances adulterated with levamisole, there is an elevated risk of levamisole-induced vasculitis (Abdul-Karim et al., 2013; George et al., 2019).