From Chapter One of the book
How to Quit Drugs for Good
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Amphetamines and Other Stimulants
Amphetamines, diet pills, methylphenidate (Ritalin), and phenylpropanolamine are products of the laboratory. All have been synthesized within the past 125 years. Other stimulants that occur naturally in plants have been used by indigenous peoples for thousands of years. These organic stimulants include cathinone, found in the leaves of the khat plant; ephedrine, found in Chinese ephedra shrubs; caffeine, found in coffee beans, tea leaves, cola nuts, and yerba mate; and nicotine, found in tobacco. (Cocaine is also a stimulant and is covered in a separate section in this chapter.)
Amphetamines. Amphetamine (or amphetamine sulfate) was first available as an over-the-counter inhaler in the 1930s. Called the Benzedrine inhaler, it was recommended for treatment of nasal congestion. Benzedrine was later marketed, in the form of a pill, for the treatment of narcolepsy and for “minimal brain dysfunction” (MBD), which is now called “attention deficit hyperactive disorder” (ADHD). Trade name: Benzedrine. AKA: Uppers, Bennies, Peaches, Whites.
Dextroamphetamine (or dextroamphetamine sulfate) is marketed under the trade name Dexedrine (AKA: Dexies, Co-pilots, Oranges, Footballs). It’s also available in combination with amphetamine under the trade name Biphetamine (AKA: Black Beauties, Black Mollies, Blackbirds).
Methamphetamine hydrochloride, the pharmaceutical product, comes in tablet form (trade name: Desoxyn). The methamphetamine appearing on the street is most often the product of clandestine chemical laboratories. It comes in the form of a crystalline powder (AKA: Speed, Crank, Meth, Crystal Meth, Crystal). Operators of clandestine labs have also produced a crystallized version of methamphetamine hydrochloride that can be smoked (AKA: Ice, Quartz).
Methcathinone is the structural analog of methamphetamine and cathinone, the psychoactive stimulant found in the khat plant. This compound is also the product of clandestine labs. AKA: Cat, Khat, Goob, Crank.
Diet pills. Pharmaceutical companies have developed amphetamine congeners (chemicals that are similar in nature) into today’s prescription diet pills. They are milder than the amphetamines yet stronger than caffeine. These include (along with trade names): benzphetamine (Didrex), diethylpropion (Tenuate, Tepanil), fenfluramine (Pondimin), mazindol (Mazanor, Sanorex), phendimetrazine (Bontril, Plegine, Prelu-2, Trimstat), phenmetrazine (Preludin), and phentermine (Adipex-P, Ionamin, Fastin).
Methylphenidate. Manufactured under the trade names Ritalin and Methylphenidate Hydrochloride, this synthetic stimulant has a lower potential for abuse than the amphetamines. Although similar in action to the amphetamines, it packs a weaker punch. Currently, this medication is prescribed for ADHD and for the treatment of narcolepsy.
Phenylpropanolamine. This mild stimulant can be found in many prescription and over-the-counter medications. It’s a common ingredient, sometimes in combination with caffeine, in over-the-counter diet pills (trade names: Acutrim, Appendrine, Dexatrim, Ordinex). It also appears in various over-the-counter cough, cold, and allergy remedies (trade names: Alka Seltzer Plus, Contac, Coricidin-D, Naldecon, Sinarest).
Khat. For centuries, people in Arabia and East Africa have cultivated the shrub Catha edulis for the production of khat. This product consists of the fresh, young leaves of the khat plant. These are chewed to produce a mild stimulant effect. For the full effect, the leaves must be consumed quickly, usually within 48 hours of picking, because the psychoactive stimulant cathinone converts to a significantly milder stimulant (cathine) as the leaves dry.
Ephedrine. This mild stimulant derives from Chinese ephedras. It has been used for centuries in China for the treatment of hay fever, asthma, and nasal congestion. In recent years, this herbal stimulant has become available through legal, over-the-counter markets in the United States.
Caffeine. This psychoactive chemical occurs naturally in many plants all over the world. It’s both legal and widely available. Served in coffees, teas, and carbonated soft drinks as well as chocolate and cocoa concoctions, this mild stimulant acts as a social lubricant or “alertness booster” in low doses. In higher doses, it can turn anyone into a nervous wreck. What’s a low dose? One to two cups of coffee, two to three cups of tea, or two to three caffeinated sodas per day—a little more if you’re younger, a little less if you’re older.
But there’s a problem. Caffeine is highly addicting. It’s not easy to curtail our consumption. We tend to press ourselves to our personal limit, to get that caffeine buzzing deep inside yet managing to hold the high just short of nervous frenzy. However, some of us can’t hold it there and repeatedly overconsume, venturing fitfully into the fray of nervous system overstimulation. This is the group of us who become flat-out caffeine addicts. It’s primarily to this group that other caffeine products appeal, such as over-the-counter caffeine tablets (trade names: NoDoz, Vivarin), diet pills, headache remedies and cold medications, and prescription headache remedies.
Nicotine. This popular, widely available substance acts as a mild stimulant. It might very well be the single most addicting drug in the world. Few people can use it in moderation. For example, not many can limit their smoking to just a couple of cigarettes a week. In fact, more than 90% of people who use this drug use it addictively, and using tobacco addictively can be a major undertaking. Smokers light up a cigarette anywhere from five to 80 times a day and, with each one, draw in anywhere from 15 to 30 lungfuls of smoke. So that’s doing anywhere from 75 to 3,200 “hits” a day. What power this drug has to control our behavior!
In one broad-spectrum study, people rated the difficulty they had quitting various drugs. When the scores were averaged, nicotine ranked the highest, beating out alcohol, heroin, cocaine, and all the other drugs of abuse.
(Note: Although the methods in this book will help you quit smoking, the book was not intended for that purpose. The entry for nicotine has been included here so you’ll know that it’s a mild stimulant and a powerfully addicting drug. You’ll find more on nicotine in Chapter 6, “How to Break a Habit,” and Chapter 7, “Healing Through Diet.”)
Combinations. Some users inject methamphetamine with heroin in a variation of a speedball. Some smoke ice with other smokables: tobacco, marijuana, or opium. Some use amphetamines in combination with cocaine. However, the most typical combination is the upper-downer combo, pairing stimulants with depressants or analgesics or using the stimulants throughout the day and the depressants in the evening to help with sleep.
How They’re Used
Amphetamines can be taken orally, snorted, injected, or, in the case of ice, smoked. The effects of amphetamines—especially the two illegally manufactured powders methamphetamine and methcathinone—are similar to that of cocaine, but the high lasts much longer. The amphetamine high lasts four to five hours and the coke high only 15 to 30 minutes.
The pharmaceuticals—diet pills, methylphenidate, and phenylpropanolamine—are almost always taken in their manufactured form: pills, capsules, or liquids. All these drugs create a pick-me-up that lasts a few hours.
It’s rare to find fresh khat leaves on U.S. streets, but it’s becoming more common to find its psychoactive constituent cathinone. Users usually snort cathinone, although some inject it and some take it orally. Users who go for the herbal stimulant ephedrine usually take it orally in powders or capsules, although many sip it in the form of tea.
People go for the caffeine buzz by pounding cup after cup of coffee, tea, or soda. Heavy users sometimes add various over-the-counter pills and preparations to their menu of caffeine delights.
About 4.7% of us have used illicit stimulants at some time in our lives. About 0.9% have used illicit stimulants within the past year, and 0.4% have used within the past month. That’s 763,000 who are current users. These figures don’t include legally prescribed stimulants, over-the-counter stimulants, and caffeine.
The Joy of It
Stimulants give us energy. They keep us alert. Even the mild stimulants can keep us awake all night. This makes them favorites among truckers hauling overnight loads and students pulling pre-exam all-nighters.
All stimulants decrease our appetite. Mild to moderate stimulants, when used over a period of time, can cause weight loss, thus the market for diet pills. Mild to moderate stimulants can also boost our mental concentration. Methylphenidate helps many people with ADHD to become more focused, in other words, to have an increased capacity for paying attention.
The stronger stimulants pack too much of a wallop to help us pay attention in any sustained sort of way. They get us buzzing with intense sensations of pleasure. They make us feel more like partying than applying our minds to a single task. Like cocaine, the powerful stimulants boost our sense of confidence around others and our feelings of potency within.
Also like cocaine, methamphetamine and methcathinone, when injected, provide a rush. It’s blast-off time. Many users describe the rush as a “total body orgasm.” In fact, males can experience spontaneous ejaculation during liftoff. Ice, like crack, produces an overwhelming rush of pleasure shortly after the smoke fills the lungs. The rush from ice compares to what we experience from methamphetamine injection.
The Problems They Cause
The problems caused by amphetamines compare nearly identically to those caused by cocaine. (see the subsection “The Problems It Causes” under the “Cocaine” section).
Other stimulants cause the same problems, but the milder the stimulant, the less severe the effect. For example, caffeine causes a rise in blood pressure and heart rate, but to a lesser extent than methamphetamine. And, although overdosing on mild stimulants is rare, some people have done it simply by taking too much on a given occasion.
More on caffeine: I’ve counseled dozens of clients with severe caffeine addictions, people who down between 12 and 30 caffeine beverages a day. Most of them had been previously addicted to other drugs or alcohol, and this is their “one remaining addiction…well, along with nicotine.” Most of them had never, or rarely, used harder stimulants. For those who had been addicted to harder stimulants (such as cocaine, amphetamines, or prescription diet pills), excessive use of caffeine would replicate, to some extent, the high they used to experience from the harder stuff. Some of them continue their excessive caffeine use, some have gradually reduced their caffeine consumption to a manageable level, and others have quit the caffeine altogether. Those who don’t give up their excessive caffeine consumption relapse more often on the harder stimulants. A couple of years ago, one of my clients overdosed on caffeine and diet pills and spent a week recovering in the hospital. That was her “big crash.” After that scare, she quit all stimulants, including caffeine.
When coming off stimulants, you can expect to feel tired, depressed, and hungry. You might also have little patience, become easily irritated, have a negative outlook on life, or become mentally sluggish. You’ll want to sleep, although sleep might not come easily.
When withdrawing from strong stimulants, nothing will seem pleasurable. Things that you would normally enjoy won’t be enjoyable, and depression might rule your world.
Most people find that their cravings remain intense for months, even for the mild stimulants. Some people get occasional cravings, even after years of abstinence.