Substance use - amphetamines

There are different kinds of street amphetamines. Common ones and some of their slang terms are:

• Amphetamine: goey, louee, speed, uppers, whiz
• Dextroamphetamine (ADHD medicine used illegally): dexies, kiddie-speed, pep pills, uppers; black beauty (when combined with amphetamine)
• Methamphetamine (crystal solid form): base, crystal, d-meth, fast, glass, ice, meth, speed, whiz, pure, wax
• Methamphetamine (liquid form): leopard's blood, liquid red, ox blood, red speed

Illegal amphetamines come in different forms:

• Pills and capsules
• Powder and paste
• Crystal
• Liquid

They can be used in different ways:

• Swallowed
• Dabbed onto the gums
• Inhaled through the nose (snorted)
• Injected into a vein (shooting up)
• Smoked

Amphetamines are stimulant drugs. They make the messages between your brain and body move faster. As a result, you are more alert and physically active. Some people use amphetamines to help them stay awake on the job or to study for a test. Others use them to boost their performance in sports.

Amphetamines also cause the brain to release dopamine. Dopamine is a chemical that is involved with mood, thinking, and movement. It is also called the feel-good brain chemical. Using amphetamines may cause pleasurable effects such as:

• Feeling a sudden sense of euphoria (joy), called a "flash" or "rush"
• Having less inhibition, similar to being drunk
• Feeling as if your thinking is extremely clear
• Feeling more in control, self-confident
• Wanting to be with and talk to people (more sociable)
• Having increased energy

How fast you feel the effects of amphetamines depends on how they are used:

• Smoking or injecting into a vein (shooting up): Effects (the "rush") start right away and are intense and last a few minutes.
• Snorting: Effects (the "high") start in 3 to 5 minutes, are less intense than smoking or injecting, and last 15 to 30 minutes.
• Taken by mouth: Effects (the "high") start in 15 to 20 minutes and last longer than smoking, injecting, or snorting, depending on how much is taken.

Amphetamines can harm the body in many ways, and lead to:

• Appetite decrease and weight loss
• Heart problems such as fast heart rate, irregular heartbeat, increased blood pressure, and heart attack
• High body temperature and skin flushing
• Memory loss, problems thinking clearly, and stroke
• Mood and emotional problems such as aggressive or violent behavior, depression, and suicide
• Ongoing hallucinations and inability to tell what is real
• Restlessness and tremors
• Skin sores
• Sleep problems
• Tooth decay (meth mouth)
• Death

People who use these drugs, especially methamphetamine, have a high chance of getting HIV and hepatitis B and C. This is from activities such as sharing used needles with someone who is already infected with one of these diseases. Other risky behaviors that can be linked to drug use, such as having unsafe sex, can also increase the chance of becoming infected with one of these diseases.

Amphetamines can cause birth defects when taken during pregnancy. Also, street drugs are not safe during breastfeeding.

You usually do not get addicted to prescription amphetamines when you take them at the right dosage to treat your health condition.

Addiction happens when you use amphetamines to get high or improve performance. Addiction means your body and mind are dependent on the drug. You are not able to control your use of it and you need it to get through daily life.

Addiction can lead to tolerance. Tolerance means you need more and more of the drug to get the same high feeling. And if you try to stop using the drug, your mind and body may have reactions. These are called withdrawal symptoms, and may include:

• Strong craving for the drug
• Having mood swings that range from feeling depressed to agitated to anxious
• Feeling tired all day
• Not able to concentrate
• Seeing or hearing things that are not there (hallucinations)
• Physical reactions may include headaches, aches and pains, increased appetite, not sleeping well

Treatment begins with recognizing there is a problem. Once you decide you want to do something about your drug use, the next step is to get help and support.

Treatment programs use behavior change techniques through counseling (talk therapy). The goal is to help you understand your behaviors and why you use amphetamines. Involving family and friends during counseling can help support you and keep you from going back to using (relapsing).

If you have severe withdrawal symptoms, you may need to stay at a live-in treatment program. There, your health and safety can be monitored as you recover.

At this time, there is no medicine that can help reduce the use of amphetamines by blocking their effects. But, scientists are researching such medicines.

As you recover, focus on the following to help prevent relapse:

• Keep going to your treatment sessions.
• Find new activities and goals to replace the ones that involved your drug use.
• Spend more time with family and friends you lost touch with while you were using. Consider not seeing friends who are still using.
• Exercise and eat healthy foods. Taking care of your body helps it heal from the harmful effects of drug use. You will feel better, too.
• Avoid triggers. These can be people you used drugs with. They can also be places, things, or emotions that can make you want to use again.

Resources that may help you on your road to recovery include:

• The Partnership for Drug-free Kids -- drugfree.org/
• LifeRing -- www.lifering.org/
• SMART Recovery -- www.smartrecovery.org/
• Narcotics Anonymous -- www.na.org/

Your workplace employee assistance program (EAP) is also a good resource.

Contact your provider if you or someone you know is addicted to amphetamines and needs help to stop using. Also contact your provider if you are having withdrawal symptoms that concern you.

If you are thinking about hurting yourself or others, call or text 988 or chat 988lifeline.org. You can also call 1-800-273-8255 (1-800-273-TALK). The 988 Suicide and Crisis Lifeline provides free and confidential support 24/7, anytime day or night.

You can also call 911 or the local emergency number or go to the hospital emergency room. DO NOT delay.

If someone you know has attempted suicide, call 911 or the local emergency number right away. DO NOT leave the person alone, even after you have called for help.

Substance abuse - amphetamines; Drug abuse - amphetamines; Drug use - amphetamines

Kowalchuk A, Reed BC. Substance use disorders. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 50.

National Institute on Drug Abuse website. What is methamphetamine? nida.nih.gov/publications/research-reports/methamphetamine/what-methamphetamine. Updated October 2019. Accessed May 22, 2024.

United States Drug Enforcement Administration website. Department of Justice/Drug Enforcement Administration Drug Fact Sheet. Stimulants. www.dea.gov/sites/default/files/2020-06/Stimulants-2020.pdf. Updated April 2020. Accessed June 12, 2024.

Weiss RD, Liebschutz JM. Drug use disorders. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 365.

Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.