Amphetamine abuse

Figure 11.14 Analysis of amphetamines by GC-NPD following HS-SPME exti action from human hair (a) Normal hair (b) normal hair after addition of amphetamine (1.5 ng) and methamphetamine (16.1 ng) (c) hair of an amphetamine abuser. Peak identification is as follows 1, a-phenethylamine (internal standard) 2, amphetamine 3, methamphetamine 4, N-propyl-/3-phenethyamine (internal standard). Reprinted from Journal of Chronatography, B 707,1. Koide et ai, Determination of amphetamine and methamphetamine in human hair by headspace solid-phase microextraction and gas cliromatography with niti ogen-phosphoms detection, pp. 99 -104, copyright 1998, with permission from Elsevier Science.

The development of effective pharmacotherapy has lagged behind progress in understanding the reward mechanisms and chronic impairments underlying stimulant abuse. Pharmacological and behavioral treatment approaches that have been used for cocaine abuse have not been as widely tested for the treatment of amphetamine abuse, limiting what can be offered for treatment of this disorder. No treatment agents are approved by the FDA for treatment of cocaine or amphetamine dependence. 

Ahmad K Asia grapples with spreading amphetamine abuse. Lancet 361 1878—1879,2003 Almodovar-Fabregas LJ, Segarra O, Colon N, et al Effects of cocaine administration on VTA cell activity in response to prefrontal cortex stimulation. Ann N Y Acad... 

Ellinwood EH Jr Assault and homicide associated with amphetamine abuse. Am J Psychiatry 127 1170-1175, 1971... 

Kramer JC Introduction to amphetamine abuse. J Psychedelic Drugs 2 1, 1969... 

Sato M Psychotoxic manifestations in amphetamine abuse. Psychopharmacol Bull 22 751-756, 1986... 

Andrews. J.S., and Holtzman, S.G. The interaction of ti-amphetamine and naloxone differs for rats trained on separate fixed-interval or fixed-ratio schedules of reinforcement. Pharmacol Biochem Behav 26 167-171, 1987. Angrist, B.M., and Gershon, S. Amphetamine abuse in New York City, 1966-1968. Semin Psychiatry 1 195-207, 1969. 

Ellinwood, E.H. Amphetamine psychosis Individuals, settings, and sequences. In Ellinwood, E.H., and Cohen, S., eds. Current Conceprs on Amphetamine Abuse. Rockville, MD National Institute on Mental Health, 1972. pp. 143-157. 

Siomopoulos, V. Violence The ugly face of amphetamine abuse. IMJ... 

Kramer, J.C. Fischman, V.S. and Littlefield, D.C. Amphetamine abuse. Pattern and effects of high doses taken intravenously. JAMA 201 305-309, 1967. 

Long-term amphetamine abuse results in many damaging effects, not least of which is addiction. Chronic abusers exhibit symptoms that can include violent behavior, anxiety, confusion, and insomnia. They also can display a number of psychotic features, including paranoia, auditory hallucinations, mood disturbances, and delusions (for example, the sensation of insects creeping on the skin). The paranoia can result in homicidal as well as suicidal thoughts. 

Alcohol Abuse, Alcohol Dependence Amphetamine Abuse, Amphetamine Dependence Cannabis Abuse, Cannabis Dependence Cocaine Abuse, Cocaine Dependence Hallucinogen Abuse, Hallucinogen Dependence Inhalant Abuse, Inhalant Dependence Nicotine Dependence Opiate Abuse, Opiate Dependence Phencyclidine Abuse, Phencyclidine Dependence... 

In the aftermath of World War II, problems with amphetamine abuse began to arise. An epidemic of amphetamine abuse and related cases of amphetamine-induced psychosis arose first in Japan and later in the United States. Since that time, use of amphetamines and other stimulants has been greatly curtailed and as a class are more tightly regulated than virtually any other psychotropic agents, with the exception of narcotic analgesics. 

George S Braithwaite RA (2000). Using amphetamine isomer ratios to determine the compliance of amphetamine abusers prescribed Dexedrine. Journal of Analytical Toxicology, 24, 223-7... 

Long-term cocaine or amphetamine abuse leads to a deterioration of the nervous system. The body recognizes the excessive stimulatory actions produced by these drugs. To deal with the overstimulation, the body creates more depressant receptor sites for neurotransmitters that inhibit nerve transmission. A tolerance for the drugs therefore develops. Then, to receive the same stimulatory effect, the abuser is forced to increase the dose, which induces the body to create even more depressant receptor sites. The end result over the long term is that the abusers natural levels of dopamine and norepinephrine are insufficient to compensate for the excessive number of depressant sites. Lasting personality changes are thus often observed. 

During World War II, soldiers on both sides of the war used amphetamines to maintain alertness and increase stamina. Historians speculate that overuse produced states of uncontrolled aggression that may have contributed to berserker charges by soldiers on both sides during many battles. Historians have said that from 1942 until his suicide, Hitler received daily methamphetamine (MAP), a kind of amphetamine, injections from his doctor. Many historians believe that the amphetamine abuse corrupted Hitler s judgement, undermined his health, and probably influenced the course of the war. 

Current research has demonstrated that there are no medical treatments effective for treating amphetamine abuse. This means that other drugs cannot be substituted to assist in the weaning process. However, thousands of individuals have successfully gone through withdrawal and continue to abstain from amphetamine use despite the long and uncomfortable process. Twelve-step programs are helpful for many substance abusers in recovery. 

Early onset of drug abuse is associated with early sexual activity, crime, and educational failure. Young amphetamine users risk exploitation by adults and are more likely to become involved in criminal or violent behavior and prostitution—having to resort to sex for survival. Consequently, they are also more likely to become infected with HIV or other sexually transmitted diseases and by tuberculosis or other bacterial, fungal, or viral infections. Chronic amphetamine abusers are also more at risk for mental and emotional disorders including anxiety, phobias, and depression. They are at higher risk of suicide. 

Amphetamine abuse among teenagers is not just a problem faced by the United States and western countries. In Thailand, every day more teenagers become addicted to amphetamines. The number of youths arrested on drug-related charges sharply escalated in 1996, reportedly the year that the popularity of amphetamines among young people surpassed that of heroin. 

AMPHETAMINE PSYCHOSIS A delusional state of mind caused by severe amphetamine abuse. Paranoia, hallucinations, and unfounded feelings of persecution are common features. 

Amphetamine psychosis causes feelings of severe paranoia and auditory and visual hallucinations. The amphetamine addict who is psychotic typically experiences delusions of persecution, believing someone, or everyone, is out to get them. Because of these paranoid delusions, violence can frequently occur during amphetamine psychosis. Once the amphetamine abuser is free of the drug, psychosis fades quickly. However, symptoms such as mental confusion, memory problems, and delusional thoughts may last up to several months or longer. 

Animal studies show that amphetamine abuse may cause birth defects. There are no controlled studies of this effect in humans however it is known that pregnant women who are amphetamine-dependent may give birth prematurely and are more likely to have infants with a low birth weight. Amphetamines cross the placenta, so a baby bom to an amphetamine abuser may experience withdrawal symptoms once the drug begins to leave the infant s system. 

Withdrawal from chronic amphetamine abuse can be long and difficult. Also, it results in depression and at least two of the following symptoms fatigue, vivid dreams, irregular sleep patterns, increased appetite, and psychomotor problems. 

Once an amphetamine abuser stops taking the drug, withdrawal symptoms begin as the body tries to adjust to the absence of the stimulant. This results in very uncomfortable and potentially life-threatening physical symptoms, called withdrawal syndrome. According to the World Health Organization (WHO), withdrawal is experienced by 87% of amphetamine users who stop the drug. 

---