Amphetamines

Amphetamines are a group of nervous system stimulants that includes amphetamine, dextroamphetamine, and methamphetamine. They are used to induce a state of alert wakefulness and euphoria, and since they inhibit appetite, they also serve as diet pills. After World War II, they were widely prescribed by physicians as diet pills, but they are generally no longer recommended for weight loss programs since there are too many hazards in the prolonged use of amphetamines. Prolonged exposure may result in organ impairment, affecting particularly the kidneys. Amphetamines are addictive and may lead to compulsive behavior , hallucinations, paranoia, and suicidal actions. Their medical use has currently been narrowed to treating only two disorders. One is a condition known as attention-deficit hyperactivity disorder (ADHD) in children. When used to treat overactive children, amphetamines are carefully administered under controlled situations as part of a larger program. The other condition for which amphetamines are prescribed is a sleep disorder known as narcolepsy, the sudden uncontrollable urge to sleep during the hours of wakefulness.

In street language, amphetamines are known as pep pills, as speed (when injected), and as ice (when smoked in a crystalline form). The popularity of amphetamines as a street drug appears to have been facilitated originally by pilfering from the drug companies manufacturing the pills. They are now also illegally manufactured in secret laboratories.

History

Amphetamines were first synthesized in 1887 by the drug company Smith, Kline and French. They were not marketed until 1932, however, as Benzedrine inhalers for relief from nasal congestion due to hay fever, colds, or asthma . In 1935, after noting its stimulant effects, the drug company encouraged prescription of the drug for the chronic sleep disorder narcolepsy. Clinical enthusiasm for the drug led to its misapplication for the treatment of various conditions, including addiction to opiates. The harmful effects of the drug were first noted by the British press, and in 1939 amphetamines were placed on a list of toxic substances for the United Kingdom.

The early abuse of Benzedrine inhalers involved the removal of the strip containing the amphetamines from the casing of the inhaler. The strips were then either chewed or placed in coffee to produce an intense stimulant reaction. Since the inhalers were inexpensive and easily obtainable at local drug stores, they were purchased by young people searching for ways of getting "high." But amphetamines became particularly popular in World War II. Soldiers on both sides were given large amounts of amphetamines as a way of fighting fatigue and boosting morale. The British issued 72 million tablets to the armed forces. Records also show that kamikaze pilots and German panzer troops were given large doses of the drug to motivate their fighting spirit. Hitler's own medical records show that he received eight injections a day of methamphetamine, a drug known to create paranoia and unpredictable behavior when administered in large dosages.

The demand for amphetamines was high in the 1950s and early 1960s. They were used by people who had to stay awake for long periods of time. Truck drivers who had to make long hauls used them to drive through the night. Those who had long tours of duty in the armed forces relied on them to stay awake. High school and college students cramming for tests took them to study through the nights before their examinations. Athletes looked to amphetamines for more energy , while English and American popular musicians structured their lives and music around them. The Food and Drug Administration (FDA) estimated that there were well over 200 million amphetamine pills in circulation by 1962 in the United States alone.

During that period of time about half of the quantity of amphetamines produced were used outside of the medically prescribed purposes mandated by the legal system. Of the 19 companies producing amphetamines then, nine were not required to show their registry of buyers to the FDA. It is believed that these nine companies supplied much of the illegal traffic in amphetamines for that period.

By 1975 a large number of street preparations were being passed off as amphetamine tablets. Tests indicated that only about 10% of the street drugs represented as amphetamines contained any amphetamine substance at all. The false amphetamines were in fact mixtures of caffeine and other drugs that resembled amphetamine, such as phenethylamine, an over-the-counter drug used to relieve coughs and asthma or to inhibit appetite. Other false amphetamine tablets contained such over-thecounter drugs as ephedrine and pseudoephedrine. These bootleg preparations came under such names as Black Beauty, Hustler, and Penthouse, and they were promoted in magazines that catered to counterculture sentiment.

The use of amphetamines and drugs like amphetamine showed a sharp decrease in the 1980s. The decrease was probably due to the increasing use of cocaine , which was introduced in the mid-1970s and continues to be a major street drug at the present time. Another reason was the introduction of newer types of appetite suppressants and stimulants on the pharmacological market and then to the street trade. Still, a survey done in 1987 showed that a large number of high school seniors (12%) had used drugs of the amphetamine type during the previous year.

Ice

Illegal users of methamphetamine originally took the drug in pill form or prepared it for injection. More recently, however, a crystalline form of the drug that is smoked like crack cocaine has appeared on the market. The practice of smoking methamphetamine began in Hawaii and then spread to California. Various names are given to smokable methamphetamine, such as Ice, LA Ice, and Crank. Ice is much cheaper than crack because it is made from easily available chemicals and does not require complicated equipment for its production. An illegal drug manufacturer can produce ice at a much lower cost than cocaine and therefore realize a much greater profit margin. Like cocaine, amphetamine reaches the brain faster when it is smoked. Users have begun to prefer ice over crack because the high lasts much longer, persisting for well over 14 hours. The side effects of an ice high can be quite severe, however. Side effects such as paranoia, hallucinations, impulsive behavior, and other psychotic effects may last for several days after a prolonged high from ice.

Action

Amphetamines, according to recent research, act on the neurotransmitters of the brain to produce their mood-altering effects. The two main neurotransmitters affected are dopamine and norepinephrine, produced by cells in the brain. Amphetamines appear to stimulate the production of these two neurotransmitters and then prevent their uptake by other cells. They further increase the amount of surplus neurotransmitters by inhibiting the action of enzymes that help to absorb them into the nervous system. It is believed that the excess amount of neurotransmitters caused by the amphetamines are also responsible for the behavioral changes that follow a high.

Drugs that pose a high risk of addiction like amphetamines, opiates, and cocaine all seem to arouse the centers of the brain that control the urge to seek out pleasurable sensations. Addictive drugs overcome those centers and displace the urge to find pleasure in food, sex, or sleep, or other types of activity that motivate people not addicted to drugs. The drug addict's primary concern is to relive the pleasure of the drug high, even at the risk of "crashing" (coming down from the high in a painful way) and in the face of the social disapproval the habit inevitably entails. Laboratory experiments have shown that animals self-administering amphetamines will reject food and water in favor of the drug. They eventually perish in order to keep up their supply of the drug.

Withdrawal symptoms for chronic users include depression , anxiety , and the need for prolonged periods of sleep.

Physical and psychological effects

Amphetamines inhibit appetite and stimulate respiration as a result. On an oral dose of 10-15 mg daily an individual feels more alert and more confident in performing both physical and mental work and is able to show an increase in levels of activity. It has not been determined how the drug affects the quality of work done under its influence. The drug also results in a rise in blood pressure and an increased, though sometimes irregular, heart rate .

Psychological dependency arises from the desire to continue and heighten the euphoric effects of the drug. During an amphetamine euphoria, the individual feels an enlargement of physical, mental, and sexual powers along with the absence of the urge to eat or sleep. Those who inject the drug feel a "rush" of the euphoric effect moments after the injection. They will feel energized and focused in an unusual way.

Depending on the user's medical history, the dosage, and the manner in which the drug was delivered to the body, a number of toxic effects can accompany amphetamine abuse. Large intravenous dosages can lead to delirium, seizures, restlessness, the acting out of paranoic fantasies, and hallucinations. In hot weather there is a danger of heat stroke, since amphetamines raise the body temperature . The increased blood pressure can lead to stroke. Heart conditions such as arrhythmia (irregular heartbeat) can develop and become fatal, especially for those with heart disease . Since the dosage levels of street drugs are not reliable, it is possible to overdose unknowingly when using the drug intravenously. The results can be coma and death. Chronic users will show much weight loss and chronic skin lesions. Those who are "shooting up" (injecting) street versions of amphetamine face the further dangers from contaminated substances, adulterations in the chemicals used, and a lack of sterilized needles. These conditions carry the same risks associated with heroin use, such as hepatitis and infections to vital organs, along with irreversible damage to blood vessels. Contaminated needles may also transmit the HIV virus that causes AIDS .

Treatment

It takes several days to help a person recover from an acute amphetamine reaction. It is important to control body temperature and to reassure a person undergoing the psychological effects of the drug. In order to control violent behavior, tranquilizers are administered to quiet the patient. Treatment of the depression which is an after-effect of heavy usage is also required. Patients will seek to deal with the fatigue that comes after the body has eliminated the drug by resuming its use. A long-term program for maintaining abstinence from the drug has to be adhered to. Just as in the case of recovery from alcoholism and other forms of drug abuse, recovering addicts benefit from support groups.

Resources

books

Clayton, Lawrence. Amphetamines and Other Stimulants. New York: Rosen Publishing Group, 1998.

Conolly, Sean. Amphetamines (Just the Facts). Oxford: Heinemann Library, 2000.

Klaassen, Curtis D. Casarett and Doull's Toxicology. 6th ed. Columbus: McGraw-Hill, Inc., 2001.

O'Neil, Maryadele J. Merck Index: An Encyclopedia of Chemicals, Drugs, & Biologicals. 13th ed. Whitehouse Station, NJ: Merck & Co., 2001.

Shapiro, Harry. Waiting for the Man. New York: William Morrow, 1988.

Stimmel, Barry. The Facts About Drug Use. New York: Haworth Medical Press, 1991.

periodicals

Chan, Paul, et al. "Fatal and Nonfatal Methamphetamine Intoxication in the Intensive Care Unit." Journal of Toxicology: Clinical Toxicology 32 (June 1994): 147-56.

Kiefer, D.M. "Chemistry Chronicles: Miracle Medicines." Today's Chemist 10, no. 6 (June 2001): 59-60.

Steele, M.T. "Screening for Stimulant Use in Adult Emergency Department Seizure Cases." Journal of Toxocology 38, no.6 (2001): 609-613.

Jordan Richman

KEY TERMS

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AIDS

—Acquired immunodeficiency syndrome; a fatal viral disease contracted by a virus transmitted through the blood or body fluids.

Attention-deficit hyperactivity disorder (ADHD)

—A childhood condition marked by extreme restlessness and the inability to concentrate, which is sometimes treated with amphetamines.

Crashing

—Coming down from a prolonged drug high such as that produced by amphetamines.

Euphoria

—Feelings of elation and well being produced by drugs like amphetamines.

HIV

—Human immunodeficiency virus, which leads to AIDS.

Ice

—Crystalline methamphetamine that is smoked to produce a high.

Neurotransmitters

—Chemicals produced in the brain, which are responsible for different emotional states.

Paranoia

—Delusions of persecution; one of the main psychotic conditions produced by an excess use of amphetamines.

Speed

—An injectable form of methamphetamine.

Tranquilizers

—Drugs used to pacify anxiety attacks.