Dextroamphetamine

What Kind of Drug Is It?

Dextroamphetamines are stimulants—substances that increase the activity of a living organism or one of its parts. Stimulants create a temporary "high" that elevates users' moods, but these effects do not last long. A "low," which can sometimes be overwhelming, follows once the drug's effects wear off.

Like other amphetamines, dextroamphetamines also give people more energy, allowing them to do more and stay awake longer without getting tired. This effect of "speeding up" people's actions explains how the drugs came to be known by the street names "go-pills," "pep pills," "speed," and "uppers."

Overview

Dextroamphetamines are addictive drugs that have a high rate of abuse. The prefix "dextro" in the drug name dextroamphetamine refers to dextrose, a type of sugar. Dextroamphetamines are simply amphetamines that contain sugar molecules. (An entry on amphetamines is also available in this encyclopedia.)

The history of amphetamines stretches back to the late nineteenth century. The drug was first synthesized, or made in a laboratory, in 1887. However, it was not used until 1932 when the drug manufacturer Smith, Kline and French introduced Benzedrine. Packaged as an over-the-counter inhaler, the amphetamine drug Benzedrine helped relieve nasal congestion.

Official Drug Name: Dextroamphetamine (DEKS-troh-am-FETT-uh-meen), D-amphetamine, dextroamphetamine sulfate (Dexedrine [DEKS-uh-dreen], DextroStat [DEKS-troh-statt])

Also Known As: Copilots, dexies, go-pills, pep pills, speed, uppers

Drug Classifications: Schedule II, stimulant

Dextroamphetamine: The Drug with Multiple Uses

Throughout the 1930s, doctors in Europe prescribed amphetamines to treat colds, hay fever, and asthma. That same decade, amphetamines became available in tablet form for the treatment of the daytime sleeping disorder known as narcolepsy, a fairly rare condition that causes people to fall asleep quickly and unexpectedly. Later, many Americans became hooked on amphetamines—specifically the dextroamphetamine sulfate Dexedrine—after finding that users could lose weight quickly and effortlessly. Only then did researchers begin to realize that these drugs could be dangerous and addictive.

During World War II (1939–1945), amphetamines were distributed among soldiers from the United States, the United Kingdom, Germany, and Japan to keep them awake and alert on the battlefield. Back on the home front, people who worked in factories manufacturing goods for the war effort were also using the drug to boost their productivity. After the war, use of the drug continued, both in the United States and abroad.

Access to Amphetamines Is Restricted

Amphetamines and dextroamphetamines became the drug of choice for people who needed a lift or who needed to stay alert. Night-shift workers, students cramming for exams, and truck drivers on long hauls were among the most common users. The addictive nature of the drugs contributed to the growing demand for them. In 1970, drug companies in the United States produced about 12 million amphetamine tablets. A large percentage of these drugs fell into the wrong hands and made their way to the black market. That year, the U.S. Congress passed the Controlled Substances Act (CSA) in an effort to stop the huge increase in drug use. The new law restricted the use of amphetamines and classified them as Schedule II drugs—drugs with genuine medical uses that nevertheless possess a high potential for abuse and dependency.

What Is It Made Of?

All amphetamines are synthetic, or manufactured, substances. They cannot be grown in a garden or dug up from the ground. The composition of amphetamine pills or capsules is actually a combination of various types of crystalline compounds called amphetamine salts. The difference between amphetamine and dextroamphetamine is a few molecules of dextrose, which is a type of sugar.

The chemical formula for dextroamphetamine is (C₉H₁₃N)₂. The chemical formula for dextroamphetamine sulfate is C₁₈H₂₈N₂O₄S.

How Is It Taken?

Dextroamphetamine sulfate is manufactured in capsule and tablet form and is usually swallowed. Dexedrine capsules have one brown end and one clear end and are filled with two types of tiny drug pellets. One type of pellet dissolves shortly after the capsule is ingested. The other type is time-released, allowing for a gradual release of the rest of the medication throughout the day. The capsules are available in 5-milligram, 10-milligram, and 15-milligram doses. Dexedrine also comes in tablet form. The 5-milligram pills are triangular and orange. DextroStat, another dextroamphetamine sulfate, is only available in 5-milligram and 10-milligram tablets. The pills are yellow and round.

For the treatment of narcolepsy, patients are typically prescribed 5 milligrams to 60 milligrams of dextroamphetamine per day. Patients age six or older with attention-deficit/hyperactivity disorder (adhd) usually take 5 milligrams to 40 milligrams per day, depending on their age and response to the drug. The youngest ADHD patients—ages three to five—may be given half of a 5-milligram tablet.

Are There Any Medical Reasons for Taking This Substance?

Amphetamines such as Dexedrine and DextroStat (dextroamphetamine sulfate) and Adderall (a combination of amphetamine and dextroamphetamine sulfate referred to as a "mixed amphetamine") are used to treat ADHD and narcolepsy. (An entry on Adderall is also available in this encyclopedia.) Dextroamphetamines are useful in the treatment of ADHD because they improve the user's ability to concentrate. The drug helps patients with narcolepsy by speeding up bodily functions and increasing alertness.

In the 1970s, dextroamphetamines were approved for use as antiobesity drugs. Because they decrease feelings of hunger in people who

take them, dextroamphetamines and other amphetamines have often been abused by dieters. This is exactly what happened with Dexedrine. By the start of the twenty-first century, research was underway on a variety of different diet pills. Dextroamphetamines like Dexedrine, however, were no longer being prescribed for weight loss in the United States.

Usage Trends

Problems undoubtedly develop when dextroamphetamine pills and capsules are taken by individuals who have no medical need for the drug. All amphetamines are psychostimulants, meaning that they act primarily on the brain. Amphetamines are extremely addictive, and high doses can affect the brain in negative ways. Regardless of the dangers, their power to increase concentration and decrease the need for sleep has led to a new trend known as stimulant "sharing." (See separate entries in this encyclopedia on "Adderall" and "Ritalin and Other Methylphenidates.")

Reports from the United States, Canada, and the United Kingdom in the first five years of the twenty-first century indicate that prescription dextroamphetamines are being shared—or sold—among adolescents and college students. illicit drug users claim they receive the stimulants from other young people who use them for medical purposes. In some cases, the drugs are stolen or simply lifted from the family medicine cabinet.

The reasons for the abuse of dextroamphetamines at the high school and college levels vary. Nicholas Zamiska commented in the Wall Street Journal that the "unapproved use" of drugs like Adderall seem to stem from increased pressure on students to perform well on standardized tests. Illicit recreational drug use occurs as well.

Major Studies on Amphetamine Use and Abuse

DAWN and NSDUH:

The Drug Abuse Warning Network (DAWN) operates through the Substance Abuse and Mental Health Services Administration (SAMHSA), a division of the U.S. Department of Health and Human Services. DAWN monitors drug-related visits to hospital emergency departments (EDs). In the last two quarters of 2003, the DAWN report estimated that the use of stimulants resulted in 42,538 emergency department visits in 260 hospitals across the United States. Of those visits, 18,129 of them were attributed directly to amphetamines and dextroamphetamines.

SAMHSA's own annual study, known as the National Survey on Drug Use and Health (NSDUH), tracks nonmedical drug use among Americans of all ages. The latest statistics available from SAMHSA as of mid-2005 were from 2003. That year, 4 percent of all youths age twelve to seventeen reported using prescription-type drugs, including stimulants. The percentage was higher among eighteen- to twenty-five-year-olds. Six percent of this age group admitted to using prescription drugs for nonmedical reasons. About 1.9 percent of adults age twenty-six and older reported illicit prescription drug use.

Generation Rx?:

On April 21, 2005, the Partnership for a Drug-Free America (PDFA) released the findings of its 2004 study on the abuse of drugs among U.S. teenagers. The PDFA's Partnership Attitude Tracking Study, better known as PATS, indicated that the trend in teen drug use in the early part of the twenty-first century involves prescription (Rx) and over-the-counter (OTC) medications. The authors of the study see this as a sign that "Rx and OTC medicine abuse has penetrated teen culture."

Millions of teens are using prescription drugs without a doctor's order, prompting the media to dub these young adults "Generation Rx." According to PATS, 10 percent of American teenagers, or 2.3 million young people, have tried prescription stimulants like Adderall without a doctor's prescription. The teens in the study reported that they obtained the stimulants from fellow classmates or from their own home medicine cabinets.

Monitoring the Future … and Beyond:

The PATS statistics mirror the results of the 2004 Monitoring the Future (MTF) study. An annual survey of drug use among eighth, tenth, and twelfth-grade students, the MTF is performed by the University of Michigan and funded by the National Institute on Drug Abuse (NIDA). Although amphetamine use was down slightly among eighth and tenth graders, about 10 percent of high school seniors reported recreational use of the drug in 2004.

A study conducted by University of Michigan Substance Abuse Research Center scientists, detailed in the journal Addiction in 2005, tracked the usage of amphetamines beyond high school. Of nearly 11,000 randomly selected college students, 6.9 percent of them reported nonmedical prescription stimulant use at least once in their lives. About 4.1 percent admitted using prescription stimulants in the past year, and 2.1 percent used them in the past month. The authors of the study concluded that "high-risk behavior" such as this "should be monitored further." They added, "intervention efforts are needed to curb this form of drug abuse."

Effects on the Body

Common side effects of dextroamphetamine use include dry mouth, headache, nausea, dizziness, restlessness, increased blood pressure and pulse rate, loss of appetite, difficulty sleeping, and either diarrhea or constipation. Higher doses can result in fever, an unusually fast heartbeat, chest pain, blurred vision, tics, tremors, moodiness, and even aggression.

Amphetamine Psychosis

High-dose dextroamphetamine abusers can develop "amphetamine psychosis" after a week or so of continuous use. Amphetamine psychosis affects the way the mind functions, causing feelings of severe paranoia, and all kinds of hallucinations—visual, auditory, and tactile. Tactile hallucinations make the user feel as if bugs, worms, or snakes are crawling on their skin. Such sensations are very real, and therefore extremely frightening, to the individual who is experiencing them. As a result, violent reactions sometimes occur during amphetamine psychosis. Once the amphetamine abuser is free of the drug, however, the psychosis goes away. Symptoms such as mental confusion and memory problems may linger, however.

Monitoring Dosage

When used for medical purposes, dextroamphetamines are prescribed at the lowest possible dosage. The dosage is then raised gradually by a doctor until the desired action is achieved. All amphetamines are highly addictive. According to the 59th edition of the Physicians' Desk Reference: "There are reports of patients who have increased the dosage to many times that recommended," leading to "tolerance, extreme psychological dependence, and severe social disability."

Tolerance occurs when it takes more and more of the drug to achieve the effect or high originally produced by smaller doses. Tolerance to amphetamines can occur quickly and often leads to overdose. Symptoms of dextroamphetamine overdose include extreme confusion and anxiety, hallucinations, severe tics or shaking, an irregular heartbeat, extremely high blood pressure, vomiting, stomach cramps, convulsions, and coma. An overdose of dextroamphetamine—or any other amphetamine, for that matter—can be fatal.

Finding the Right Treatment

Dextroamphetamines such as Dexedrine and amphetamine/dextroamphetamine mixtures such as Adderall are commonly prescribed by physicians to treat ADHD. Finding the right drug to treat a child or an adult with ADHD is often a process of "trial and error." Doctors try one drug, observe the effects, and decide whether an alternate form of treatment is advisable.

Establishing a safe and effective drug treatment can be especially difficult when it comes to children. Some evidence indicates that children experiencing ADHD-like symptoms may actually be suffering from severe anxiety, or a severe state of fear or worry, which is worsened by the use of stimulants. In these very rare cases, amphetamines and dextroamphetamines can cause overstimulation in the child.

In one case reported in the May 2004, issue of Pediatrics, doctors raised the question about whether dextroamphetamines may have contributed to psychotic behavior in a seven-year-old ADHD patient. His symptoms, including extreme agitation, an elevated temperature, ranting and raving, and hallucinations, all disappeared when the stimulant prescription was discontinued and an anti-anxiety drug was administered. Results such as these suggest that the child was suffering from severe anxiety rather than ADHD, even though his symptoms mirrored those of a typical ADHD patient.

Dextroamphetamine as a Treatment for ADHD

Amphetamines and dextroamphetamines typically give the user a boost of energy. In people with attention-deficit/hyperactivity disorder (ADHD), however, these very same drugs help to calm them down, allowing them to better focus their energy. Individuals with ADHD typically have a short attention span, and they tend to get distracted quite easily. They may also show signs of hyperactivity, impulsive behavior, and emotional instability. It can be a challenge for people with untreated ADHD to concentrate their attention and control their behavior. Drugs like Dexedrine, a dextroamphetamine sulfate, and Adderall, a combination of amphetamine and dextroamphetamine salts, help manage the symptoms of ADHD by acting on the part of the brain that decides when and how to act.

According to an article in Phi Delta Kappan, it is essential that parents or caregivers of children and teens with ADHD: 1) be informed about the effects of the drugs that have been prescribed for treatment; 2) know the consequences that might arise if these drugs are discontinued; and 3) accept the responsibility to stay in close touch with the child's doctor and therapist. In most cases, drug treatment for ADHD must be combined with some sort of counseling or therapy to achieve the highest success rates. One of the most popular and successful therapeutic methods as of 2005 was cognitive behavioral therapy (cbt), or "talk" therapy. Cognitive behavioral therapy helps patients develop better coping skills and change their negative patterns of thinking and behavior into positive ones.

Reactions with Other Drugs or Substances

The stimulating effects of dextroamphetamine can be intensified when the drug is combined with other stimulants such as cocaine or nicotine. (Entries on cocaine and nicotine are also available in this encyclopedia.) Dextroamphetamines should never be mixed with alcohol or other depressants.

Some medications can cause severe reactions in the user when mixed with stimulants. In addition, people with certain medical conditions should stay away from these drugs. Specifically, dextroamphetamines should not be taken by pregnant women, nursing mothers, or individuals with any of the following conditions:

• heart disease
• high blood pressure
• thyroid disease
• tourette's syndrome, or any other tic disorder
• a history of drug abuse
• depression that is being treated with prescription drugs
• severe pain that is being treated with the prescription drug meperidine. (A separate entry on meperidine is available in this encyclopedia.)

Treatment for Habitual Users

withdrawal from amphetamines can be a long and difficult process for many users. Psychological dependence is made even worse by the intense cravings for the drug that users experience. Unpleasant and sometimes frightening symptoms develop as the body tries to adjust to the absence of the stimulant. The withdrawal process causes depression and may also bring on fatigue, vivid dreams, irregular sleep patterns, and increased appetite.

Experts in the treatment of substance abuse and addiction report that behavioral therapy and emotional support are essential for the successful rehabilitation of amphetamine abusers. An individual recovering from drug addiction must avoid all psychoactive drugs, including alcohol. Amphetamine and dextroamphetamine cravings can be extremely powerful and may last for years after a former user has kicked the habit.

Patti Davis, daughter of former U.S. President Ronald Reagan and his wife, Nancy, talked about her past drug addiction in the article "Dope: A Love Story" in Time magazine. In the article, Davis wrote that she often wondered "why the world is so hard for some people" that they "run for the refuge of drugs." This observation shows why an effective drug rehabilitation program must help patients identify and deal with the underlying emotional issues surrounding their drug use.

The reasons for drug use are numerous. The Merck Manual of Medical Information noted that "some amphetamine abusers are depressed and seek the mood-elevating effects of these stimulants to temporarily relieve the depression." Davis pointed out that some people are afraid of the world. Drugs "take you away—far away; they let you hide, which is what frightened people do," she commented. Recovering drug abusers need a solid support system to remain drug free.

Consequences

Amphetamine addicts frequently allow their need for the drug to take over their lives. Users can become so obsessed with satisfying their drug habit that they ignore the most important people in their lives. Relationships with family and friends frequently deteriorate, and money problems may begin to develop as the addiction grows. In general, substance abuse is associated with increased rates of school failure, theft (usually to fund the drug habit), domestic violence, sexual assault, unemployment, and homelessness. People who are high on amphetamines are more likely to engage in risky behavior than people who do not take drugs. This can contribute to the spread of sexually transmitted diseases, including HIV (the human immunodeficiency virus, which can lead to acquired immunodeficiency syndrome [AIDS]).

The Law

Abuse of any amphetamine can have serious legal consequences. Amphetamines are controlled substances, meaning their use is regulated by certain federal laws. Under the terms of the Controlled Substances Act (CSA) of 1970, amphetamines are classified as Schedule II drugs. Schedule II drugs are prescription medications that have genuine medical uses but also pose a high risk for abuse and addiction. Schedule II drugs like dextroamphetamines require a doctor's prescription and carry a warning that states they "should be prescribed or dispensed sparingly." Pharmacies and hospitals that dispense Schedule II drugs must register with the U.S. Drug Enforcement Administration. In addition, limits are placed on the amount of dextroamphetamine produced by manufacturers for the United States each year.

Since the passage of the CSA, according to Andrew Weil and Winifred Rosen in From Chocolate to Morphine, "most cases of amphetamine abuse have involved legally manufactured and prescribed drugs." Most of the illicit dextroamphetamine supply, then, comes from actual prescriptions that are obtained, used, and sold illegally.

"Go-Pills" and the Military

Dextroamphetamines have a long history of use by the military and were even given to astronauts to fight motion sickness and fatigue during space flights. The drug's routine use by air force pilots has given new meaning to the term "copilot," one of several street names for dextroamphetamine.

The U.S. Air Force has used Dexedrine, known in military circles as "go-pills," since 1960. A 1995 report from Langley Air Force Base revealed widespread amphetamine use in Operation Desert Storm. Gene Collier, writing in the Post-Gazette, reported that 60 percent of U.S. pilots in the Gulf War said they took Dexedrine during their missions. In a study performed by the U.S. Army Aeromedical Research Laboratory in 2000, one pilot was able to stay awake for sixty-four hours straight by taking Dexedrine.

Dextroamphetamine reportedly improves alertness and flight performance by fighting fatigue, confusion, and air sickness in the cockpit. It has been shown to increase accuracy, improve short-term memory, and speed up reaction time. But Dexedrine, like all amphetamines, is a habit-forming drug with potentially serious side effects. A tragic incident occurred in 2002 involving two American pilots who were taking the drug. This incident called the use of Dexedrine by the military into serious question.

Deadly Consequences

The two pilots, Major Harry Schmidt and Major William Umbach, were flying separate F-16s back from a mission in Afghanistan. On the night of April 17, 2002, twelve Canadian soldiers in Afghanistan were hit by a quarter-ton bomb dropped by Major Schmidt from his F-16. Four of the soldiers were killed, the other eight were wounded. The Canadians had been conducting a live-fire exercise with anti-tank guns that night—an exercise that U.S. Air Force officials apparently had been told about earlier. According to the Canadian inquiry report on the case, as reported by CBC News, "Until the moment the bombs struck, Canadian forces had no knowledge of impending danger."

Both U.S. pilots stated that they believed they were under attack when they saw the flashes of gunfire on the ground below. Schmidt wanted

to return fire, but, according to the Post-Gazette, was told by Umbach, "Let's just make sure that it's not friendlies, that's all." By "friendlies," Umbach was referring to soldiers fighting on the same side as the Americans. Cockpit voice recordings indicate that Major Schmidt was instructed to hold his fire, but he remained convinced that he was under attack and responded, "I am rolling in in self-defense."

The American pilot who dropped the 500-pound bomb had taken a 20-milligram dose of Dexedrine about an hour before the incident. Some observers felt that the drug "may have been a factor in the decision to drop a bomb on allied soldiers," noted CBC News. American Air Force officials argued that hundreds of earlier patrols had been flown safely and successfully over Afghanistan by pilots on Dexedrine.

The outcome of the so-called "friendly fire" case was decided on July 6, 2004. According to CBC News, the text of the U.S. Air Force verdict stated that Schmidt exhibited "arrogance and a lack of flight discipline" for not taking "a series of evasive actions and remain[ing] at a safe distance to await further instructions." Instead, he "closed on the target and blatantly disobeyed the direction to 'hold fire."' Schmidt's actions were deemed "inexcusable," and he was found guilty of dereliction of duty—abandoning duty or showing negligence—for his actions.

The use of Dexedrine by the military remains a hot topic of debate.

Anyone convicted of transporting or dealing in dextroamphetamine in the United States faces up to twenty years in prison and a hefty fine for a first offense. Repeat offenders face even stiffer penalties. In the United Kingdom, amphetamines are designated a class B drug under the 1971 Misuse of Drugs Act. Possession carries a penalty of imprisonment for three months to five years, and dealing carries a sentence of six months to fourteen years, along with a possible fine.

For More Information

Books

Beers, Mark H., and others. The Merck Manual of Medical Information, 2nd home ed. New York: Pocket Books, 2003.

Brecher, Edward M., and others. The Consumers Union Report on Licit and Illicit Drugs. Boston: Little Brown & Co., 1972.

Clayton, Lawrence. Amphetamines and Other Stimulants. New York: Rosen Publishing Group, 1994.

Gahlinger, Paul M. Illegal Drugs: A Complete Guide to Their History, Chemistry, Use, and Abuse. Las Vegas, NV: Sagebrush Press, 2001.

Kuhn, Cynthia, Scott Swartzwelder, Wilkie Wilson, and others. Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy, 2nd ed. New York: W.W. Norton, 2003.

Physicians' Desk Reference, 59th ed. Montvale, NJ: Thomson PDR, 2004.

Weil, Andrew, and Winifred Rosen. From Chocolate to Morphine. New York: Houghton Mifflin, 1993, rev. 2004.

Periodicals

"Attention Deficit Disorder: Generic Dexedrine Spansule Capsules Approved." Medical Letter on the CDC & FDA (February 17, 2002): p. 6.

Calello, Diane P., and Kevin C. Osterhoudt. "Acute Psychosis Associated with Therapeutic Use of Dextroamphetamine." Pediatrics (May, 2004): p. 1466.

Collier, Gene. "Pilots on the Go Might Not Know When to Stop." Post-Gazette (January 19, 2003).

Davis, Patti. "Dope: A Love Story." Time (May 7, 2001): p. 55.

Emonson, D., and R. Vanderbeek. "The Use of Amphetamines in U.S. Air Force Tactical Operations during Desert Shield and Storm." Aviation Space and Environmental Medicine, volume 66, number 3 (1995): p. 802.

Grady, Denise. "History Counsels Caution on Diet Pills." New York Times (May 25, 1999).

Hewitt, Bill. "Clipped Wings." People (February 3, 2003): pp. 103-104.

Jurgensen, John. "Military Researchers Focus on Pilot Fatigue." Detroit News (January 25, 2003).

McCabe, S. E., and others. "Non-medical Use of Prescription Stimulants among U.S. College Students." Addiction (January, 2005): pp. 96-106.

"Negligence Is a Two-Way Street." Phi Delta Kappan (November, 1995): pp. 259-260.

"Sex, Drugs, and Rock 'n' Roll." Independent (January 28, 1996): p. 8.

Shute, Nancy, and others. "The Perils of Pills: The Psychiatric Medication of Children Is Dangerously Haphazard." U.S. News & World Report (March 6, 2000): p. 44.

Zamiska, Nicholas. "Pressed to Do Well on Admissions Tests, Students Take Drugs; Stimulants Prescribed for Attention Disorders Find New Unapproved Use." Wall Street Journal (November 8, 2004): p. A1.

Web Sites

"2003 National Survey on Drug Use and Health (NSDUH)." U.S. Department of Health and Human Services, Substance Abuse and MentalHealth Services Administration.http://www.oas.samhsa.gov/nhsda.htm (accessed June 30, 2005).

"Drug Abuse Warning Network, 2003: Interim National Estimates of Drug-Related Emergency Department Visits." DAWN, 2003: Office of Applied Studies, Substance Abuse and Mental Health Services Administration. http://DAWNinfo.samhsa.gov/ (accessed June 30, 2005).

"Generation Rx: National Study Reveals New Category of Substance Abuse Emerging: Teens Abusing Rx and OTC Medications Intentionally to Get High." Partnership for a Drug-Free America.http://www.drugfree.org/ (accessed June 30, 2005).

"Grieving Canadians Stunned U.S. Pilots Took Drugs." CBC News, December 21, 2002. http://www.cbc.ca/stories/2002/12/21/clooney_021221 (accessed June 30, 2005).

"Indepth: Go-Pills, Bombs & Friendly Fire." CBC News, November 17, 2004. http://www.cbc.ca/news/background/friendlyfire/gopills.html (accessed June 30, 2005).

"Indepth: The 'Friendly Fire' Reports." CBC News, October 22, 2003. http://www.cbc.ca/news/background/friendlyfire/reports.html (accessed June 30, 2005).

"Indepth: U.S. Air Force Verdict." CBC News, July 6, 2004. http://www.cbc.ca/news/background/friendlyfire/verdict.html (accessed June 30, 2005).

Monitoring the Future.http://www.monitoringthefuture.org/ and http://www.nida.nih.gov/Newsroom/04/2004MTFDrug.pdf (both accessed June 30, 2005).

National Institute on Drug Abuse.http://www.nida.nih.gov/ and http://www.drugabuse.gov (both accessed June 30, 2005).

"Shepperd: 'Go-Pills' Common for Pilots." CNN.com, January 3, 2003. http://www.cnn.com/2003/US/01/03/cnna.shepperd/index.html (accessed June 30, 2005).

"Teens Becoming 'Generation Rx'." CNN.com. http://www.cnn.com/2005/HEALTH/parenting/04/21/drug.survey.ap/index.html (accessed June 30, 2005).

"U.S. Pilots Took Amphetamines before 'Friendly Fire' Incident." CBC News, December 21, 2002. http://www.cbc.ca/story/world/national/2002/12/20/friendlyfire021220.html (accessed June 30, 2005).

See also: Adderall; Amphetamines; Methamphetamine; Ritalin and Other Methylphenidates