Stimulants are a large class of drugs that work by stimulating the central nervous system (CNS). These drugs can promote wakefulness, alertness and concentration. Stimulants include illicit drugs like methamphetamine, prescription drugs like Adderall and over-the-counter drugs like caffeine and nicotine. Stimulant drugs can be natural or synthetic. Because the drug class is so large, there is a range of risks that are associated with different types of stimulants. Many types of stimulants can cause the development of tolerance, dependence, and addiction. Prescription and illicit stimulants also have additional risks associated with use. Stimulant drug abuse is widespread, and “study drugs” like Ritalin and Adderall have been a source of concern recently. High school and college students are at high risk for misusing these drugs, which can lead to potentially negative outcomes. Before getting into the details of stimulant addiction, it may be helpful to understand a few terms: Important TermsToleranceA physical process that occurs when the brain adapts to a drug and becomes less responsive to its presence. Essentially, a person will need to take a higher dose to receive the same effects. DependenceIt indicates that the brain has become dependent on a drug’s presence and needs it in order to maintain “normal” function. For example, many people are dependent on the caffeine in their morning coffee. If they don’t have their coffee, they may experience symptoms like lethargy, lack of motivation or a headache. Dependence on more potent stimulants may lead to addiction. AddictionAn extension of dependence. While dependence is manageable, addiction is characterized by compulsive drug-seeking behavior despite serious adverse consequences. Many prescription stimulants are not associated with addiction, but illicit drugs like cocaine and methamphetamine are highly addictive. The various classes of amphetamines are chemically diverse, and each type of amphetamine can have very different effects on the brain. One amphetamine may lead to only mild dependence, but another may lead to significant dependence or addiction. If dependence or addiction occurs, a person would need constant drug administration and ever-increasing doses to prevent withdrawal symptoms. Are Stimulants Addictive? In most cases, legal stimulants are associated with a risk for dependence. When taken as prescribed, stimulant medication for ADHD treatment has a relatively low risk for addiction. However, tolerance to stimulants develops rapidly when they are taken regularly, even as directed. Chronic misuse of legal stimulants increases the risk that dependence will progress into an addiction. Commonly abused prescription stimulants include: Commonly Abused Prescription StimulantsDexedrine (dextroamphetamine) Adderall (amphetamine salts) Ritalin, Concerta (methylphenidate) Focalin (dexmethylphenidate) Vyvanse (lisdexamfetamine) Many illegal stimulants have a high risk for addiction. For example, cocaine and methamphetamine are notoriously addictive. People who have developed a serious addiction to these drugs may behave uncharacteristically in order to obtain more of their drug of choice. For example, someone struggling with addiction may steal from loved ones to purchase more drugs. Commonly abused illicit stimulants include: Commonly Abused Illegal StimulantsCocaine Methamphetamine Synthetic cathinones (bath salts) 3,4-Methylenedioxymethamphetamine (MDMA) Stimulant effects often include: Stimulant Side EffectsHigh energy levels Increased ability to focus Elevated mood Increased sociability Elevated heart rate Paranoia Increased body temperature Insomnia Loss of appetite Large doses of potent stimulants like methamphetamine may reduce the ability to focus. It can also cause paranoia, aggression and abnormal or repetitive behaviors (toe-tapping, pacing). Some people may compulsively perform mechanical tasks like organizing or sorting objects. Stimulant Addiction Statistics Data from the National Institute on Drug Abuse (NIDA) shows that prescription drugs were misused by 2.1% of American adults, and 0.2% met the criteria for having a stimulant use disorder. According to the 2018 National Survey on Drug Use and Health (NSDUH), 2.2% of American adults reported having used cocaine within the previous year, and 0.7% had used methamphetamine. The group with the highest rate of prescription stimulant abuse is college students. In 2018, 2.5% of students reported that they had misused prescription stimulants within the past year. Compared to students, only 1.1% of people aged 18 to 22 who were not enrolled in college reported misusing stimulants. However, college students were less likely to use methamphetamine (0.1%) than people of the same age who were not enrolled in college (0.3%). Young people have the highest risk for long-term adverse consequences associated with stimulant misuse. Studies have shown that chronic stimulant misuse is associated with worse academic performance and increased risk for future substance use disorders. How Are Stimulants Abused? Stimulants can be misused in many ways. In most cases of stimulant misuse, someone with a legitimate prescription will take more stimulant pills than they are directed to take. In addition, people may crush and snort the powder, dissolve the pills in liquid or even inject the dissolved stimulant into a vein. When someone abuses stimulants, they put themselves at risk for serious adverse short- and long-term health consequences. These include high blood pressure, heart damage and increased risk for mental health disorders and addiction. Signs of Stimulant Addiction There are a few signs of stimulant abuse and addiction that can be observed by friends or family members. Common signs of stimulant abuse include: Symptoms of Stimulant AddictionAbnormally high energy levels Talking more than normal Increased focus or an inability to focus Erratic or evasive behavior Mood swings Anxiety or paranoia Altered sleep patterns Rapid weight loss Unusual irresponsibility or failure to meet deadlines Missing school or work Loss of interest in hobbies Side Effects of Stimulant Addiction Legal and illegal stimulants often have overlapping short- and long-term side effects: Short-Term EffectsLong-Term EffectsPolysubstance Abuse Side EffectsShort-term effects associated with stimulant misuse include positive effects like high energy levels, reduced need for sleep, increased motivation and improved ability to focus. Negative effects include anxiety, jitteriness, rapid heart rate, increased blood pressure, increased body temperature, excessive sweating, and headache. Long-term side effects may not be present in all cases of stimulant misuse. When they are present, they typically include prolonged depression, loss of pleasure, high blood pressure and manic episodes. In rare cases, chronic stimulant misuse can lead to stimulant-induced psychosis and hallucinations. Combining stimulants with other drugs or alcohol can be very dangerous and even lethal. Many people enjoy combining stimulants and depressants like alcohol because stimulants can enhance the effects of other drugs and increase the amount of time that someone can use other drugs. This is incredibly dangerous, however, and many drug overdoses are associated with polysubstance abuse. Can You Overdose on Stimulants? It is possible to overdose on stimulants, including legal, over-the-counter drugs like caffeine. Signs of a stimulant overdose include: Stimulant Overdose SymptomsPanic or paranoia Altered mental state Hallucinations Nausea or vomiting Trouble breathing Severe trembling Lack of coordination Fever Excessive sweating Discolored urine Muscle spasms Seizures Chest pain Stoke Heart attack Stimulant overdoses can be life-threatening. If an overdose is suspected, call 911 immediately. Overdose treatment should be done in a hospital setting where medical professionals can administer sedatives to limit the risk of a stroke or heart attack. Stimulant Withdrawal and Addiction Treatment Stimulant withdrawal symptoms set in when someone reduces the dose or quits taking the drug altogether. Withdrawal symptoms can be very uncomfortable, but these symptoms typically vary from person to person. Withdrawal symptom severity is typically related to the amount used, frequency of use and the level of dependence or addiction. Withdrawal symptoms usually set in within 12–24 hours after the last dose. People often experience anxiety, restlessness and drug cravings. In the next couple of days, fatigue and long periods of sleep are common. After the first few days, insomnia, depression, irritability and mood swings are common. These symptoms may last for a week or more, depending on the severity of withdrawal. For people who are struggling to quit using stimulants, professional treatment may be the best course of action. In addition to providing a safe and supportive environment, professional rehab facilities help to minimize triggers that can derail the early recovery. Our Drug Detox and Inpatient Rehab Center The Recovery Village Palm Beach at Baptist Health 4905 Lantana Rd Lake Worth, FL 33463 561-340-7269 Key Points: Stimulant Addiction Here are some important points to remember about stimulant addiction: The stimulant family is a broad drug category that includes over-the-counter drugs like caffeine, prescription stimulants like Adderall and illegal drugs like methamphetamine Commonly misused stimulants all have some risk for the development of dependence or addiction Stimulant misuse is associated with negative physical and psychological consequences Stimulant overdose can be lethal Professional treatment and rehab can help people overcome stimulant use disorders Stimulant misuse is associated with serious negative consequences. If you or someone you love is struggling with stimulant misuse, The Recovery Village Palm Beach at Baptist Health can help. Contact us today to learn more about treatment plans and programs that can help you regain control of your life. SourcesNational Institute on Drug Abuse. “Five million American adults misusing prescription stimulants.” April 2018. Accessed December 22, 2019. Substance Abuse and Mental Health Services Administration. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health; Stimulant Misuse.” 2019. Accessed December 22, 2019. Substance Abuse and Mental Health Services Administration. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health; Stimulant Misuse; Table 6.22B.” 2019. Accessed December 22, 2019. Lakhan, Shaheen E.; Kirchgessner, Annette . “Prescription stimulants in individuals with and without attention deficit hyperactivity disorder: misuse, cognitive impact, and adverse effects.” Brain and Behavior, September 2012. Accessed December 22, 2019.