Stimulants are a class of psychoactive substances that increase excitatory effects in the nervous system. They often cause alertness, wakefulness, increased focus, heightened mood, and an energized feeling. Some stimulants can also increase your heart rate and blood pressure. Stimulant drugs cover a wide range of effects and uses. Some are used for medicinal purposes while others are primarily used recreationally for their euphoric effects.
Most stimulants work by interacting with a naturally occurring neurochemical in the body called dopamine. They can also, to a lesser extent, affect serotonin and norepinephrine. Dopamine is responsible for several vital functions in the brain including roles that relate to executive functions, motor control, motivation, arousal, and reward.
Under normal circumstances, dopamine is released into the nervous system to bind to dopamine receptors. Any excessive dopamine is reabsorbed into the nerve cells that sent them. However, stimulants like meth and cocaine block the reuptake process, leaving large amounts of the chemical to bind to more receptors.
When used recreationally, stimulants can cause feelings of arousal, excitement, elevated mood, anxiety, irritability, and euphoria. In some cases, abuse can lead to serious consequences such as paranoia, panic disorders, depression, suicidal thoughts, and a condition called stimulant psychosis, which is stimulant-induced hallucinations, paranoia, and delusions that follow a high dose. Treatment usually can lead to recovery from stimulant psychosis.
Some stimulants, like meth, can flood the dopamine receptors to the point where it causes damage. Damaged receptors will not be as efficient, which can lead to a chemical imbalance that causes an inability to feel pleasure from any source besides stimulant abuse. This can lead to continued abuse, dependence, addiction, depression, and thoughts of suicide.
The most commonly used stimulant is found in coffee, energy drinks, and other snacks and beverages. Though caffeine isn’t often thought of as a drug, dependence on this psychoactive substance is culturally accepted. However, for most people, its effects are relatively mild.
Drugs like Ritalin and Adderall are commonly used to treat attention deficit hyperactivity disorders. Stimulants can increase focus and alertness for people who have trouble staying on task, letting their mind wander, or have some sleep disorders like narcolepsy. These prescription drugs aren’t often used as a recreational drug, but they can be abused as an academic performance-enhancing substance. College students often use them to study longer and more effectively to increase test scores. Abuse can lead to health and dependence issues.
Cocaine is one of the most popular illicit stimulants, and it was used in epidemic proportions during the 1980s. This powerful stimulant can elevate your mood, make you feel powerful, and increase your overall excitability. Crack is cocaine in its free-base form, and it can be smoked, offering a brief and intense high. Cocaine is highly addictive, and it can lead to mental and physical health problems when abused. It’s also relatively expensive, and addiction often leads to financial problems.
Meth is a powerful stimulant that can come in pills, powder, and crystalline form. Like crack, meth offers a short but intense, euphoric high that can be extremely addictive. Unlike other stimulants, it increases the amount of dopamine you produce and floods dopamine receptors so much that it can damage them, leading to long-lasting consequences.
Drugs like bath salts and flakka (α-PVP) are designed in clandestine labs to mimic the effects of MDMA or cocaine while circumventing existing drug laws. Synthetic cathinones are often powerful and unpredictable. They have been known to lead to anxiety, panic, terrifying hallucinations, and aggressive outbursts.
Certain stimulants can be incredibly addictive, leading to severe substance use disorders. However, they can come with some warning signs that can let you know that you need to seek help. Illicit stimulants like cocaine and meth have the highest addiction liabilities. Repeated recreational use can lead to physical dependence and addiction. Tolerance is often the first sign of a substance use disorder. Drugs that interact with dopamine often cause tolerance to build up quickly after several hits in one sitting because your body needs time to produce more of the chemicals. However, if you notice that the same dose is less effective when you retake the drug a few days or weeks after your last hit, you may be developing a tolerance.
If you continue to use, you can start to develop a physical dependence. This occurs when your body starts to rely on the drug to produce excitatory effects. When meth is involved, damaged receptors can cause your body to rely on the drug to feel any pleasure at all.
If you are worried about someone else in your life that you believe may be using an addictive stimulant, you may notice these behavioral signs of addiction:
Addiction, or severe substance use disorders, are ultimately defined by compulsive use of a drug despite serious consequences. For instance, if you are struggling at work because of substance use and your boss fires you and you continue to use, you may be addicted.
Stimulant addiction is a disease that is complicated and can have various contributing factors. If you’ve become addicted to a stimulant like cocaine or meth, you will need complex treatment solutions to achieve long-lasting recovery. Addiction is difficult to overcome, and there is no known cure, but it can be treated with the right therapies and professionals by your side.
For treatment to be effective, it’s important that it is tailored to your individual needs, lasts long enough, and uses evidence-based treatment options.
Stimulant withdrawal can be uncomfortable, but it’s not usually dangerous. In many cases, it causes emotional symptoms like apathy, depression, or anxiety. In some cases, especially when meth is involved, you can experience a condition called anhedonia, which is the inability to feel pleasure. Meth can damage dopamine receptors, which can contribute to this severe psychological symptom, and it may take a while to recover.
In the worst cases, emotional symptoms can lead to suicidal thoughts and actions. If you experience deep depression or thoughts of suicide after using stimulant drugs, it’s critical to seek help as soon as possible. Medication and treatment can lead to relief of depressive symptoms.
In severe cases, medical detox can help alleviate symptoms and guide you to sobriety safely. Detox involves 24-hour medically managed care every day for about a week, depending on your specific needs and the existence of other medical concerns. Some injuries, diseases, and other ailments that need immediate care can also be addressed in medical detox. After your condition improves, you can advance to the level of care that’s appropriate for your needs.
Clinicians will help assess your needs and concerns, and your therapist will sit down with you to create an addiction treatment program that fits you. If you have ongoing medical or psychological conditions that need more intensive care, an inpatient program can offer 24-hour medical or clinical monitoring that will help you avoid serious complications.
Once you can live on your own without a significant threat of relapse or other medical concerns, you may continue to outpatient services, which is separated into intensive outpatient and standard outpatient services.
Intensive outpatient involves more than nine hours of clinical services every week and may include as much as several hours every day. Outpatient treatment involves fewer than nine hours and acts as an ideal step between more intensive treatment independent living after treatment.
American Psychiatric Association. (2017, January). What Is Addiction? from https://www.psychiatry.org/patients-families/addiction/what-is-addiction
American Society of Addiction Medicine. (n.d.). What is the ASAM Criteria? from https://www.asam.org/resources/the-asam-criteria/about
ScienceDirect. (n.d.). Stimulant psychosis. from https://www.sciencedirect.com/topics/neuroscience/stimulant-psychosis