Author: Anjali Talcherkar, PhD

Stimulants are a group of drugs that can have a wide range of effects on the body and mind. Classified by the Drug Enforcement Administration as Schedule II, stimulants have a high potential for misuse, potentially leading to severe psychological or physical dependence.¹ Some stimulants like caffeine are common, while others can lead to severe health problems, including stimulant use disorder or addiction.^2,3

In this Article:

• What Are Stimulants and How Are They Used?
• What Are the Side Effects of Stimulant Drugs?
• What Are the Risks of Stimulants?
• What Are Treatment Options for Stimulant Addiction?

What Are Stimulants and How Are They Used?

Stimulants are a class of drugs that activate the central nervous system and speed up communication between the brain and body. All stimulants affect the body by increasing your heart rate, blood pressure, and body temperature. By increasing brain activity, stimulant drug effects cause you to be more alert, less tired, and more physically active.

Also known as “uppers,” stimulants can improve your mood and increase self-confidence.² This happens due to the drug increasing levels of dopamine and norepinephrine in the brain.²

Stimulants range from substances found in everyday food and drinks to prescription drugs and illegal substances. Caffeine is one of the most widely used stimulants in the world. Coffee, tea, soda, energy drinks, and chocolate all contain caffeine.² Small amounts of caffeine can increase alertness and help you stay awake, but only for a limited time. Large amounts of caffeine can cause insomnia, restlessness, and cardiac arrest.

Prescribed stimulants are most often in pill form. Illicit stimulants usually are smoked, snorted, swallowed, or injected.⁴ The use of stimulant medications without a prescription is illegal.

While stimulant medications can be used safely, they can be dangerous if not taken correctly.² Common prescription stimulants include: ^1,6

• Amphetamines (Adderall and Dexedrine), used to treat attention-deficit hyperactivity disorder (ADHD), narcolepsy, and obesity
• Methylphenidate (Concerta and Ritalin), also used to treat ADHD and narcolepsy
• Diet aids (Didrex, Bontril, Preludin, Fastin, Adipex, Ionamin, and Meridia)

Common illicit stimulants include: ^1,6

• Methamphetamine
• Cocaine
• Methcathinone
• Synthetic Cathinones (“Bath Salts”)

What Are the Side Effects of Stimulant Drugs?

Stimulant drug effects on the body vary depending on the type of stimulant, as well as individual factors. Stimulants affect everyone differently, based on:⁶

• Size, weight, and health
• If the person is used to taking it
• If other drugs are taken around the same time
• The amount taken
• The strength of the stimulant drug

In small to low doses, you may experience the following stimulant effects:⁴

• Euphoria
• Heightened feelings of well-being
• Increased heart rate and blood pressure
• Increased alertness
• Talkativeness
• Reduced appetite

Higher doses may cause the following stimulant drug effects:⁴

• Anxiety
• Tension
• Increased body temperature
• Nausea
• Tremors
• Seizures
• Coma
• Death

What Are the Risks of Stimulants?

Excessive use of stimulants can be dangerous, even life-threatening. You may experience restlessness, anxiety, and insomnia when coming down from the drug. Stimulants like cocaine and methamphetamine are highly addictive and can cause uncomfortable withdrawal effects such as depression, mood swings, paranoia, and hallucinations.⁴

Stimulant effects can also cause cognitive and physiological damage.^2,6,8 Long-term or heavy use of methamphetamines may cause inflammation of the heart lining and long-lasting reduction of neurotransmitter levels, specifically dopamine and serotonin.⁷

Neurological effects of stimulants can include:^2,3,6

• Increased blood pressure
• Irregular heartbeat
• Dangerously high body temperatures
• Decreased sleep
• Lack of interest in eating and no appetite
• Intense anger or paranoia
• Risk for seizures and stroke at high doses

College students are using prescription stimulants for better academic performance.² In addition to the health and legal risks associated with prescription stimulant misuse, stimulant use is often regarded as “cheating” by university honor codes, similar to steroid use in competitive sports.²

Eventually, and with repeated use, a person may need more of a stimulant to get the same drug-induced effects, known as tolerance. A person becomes at risk of stimulant use disorder when tolerance, dependence, and withdrawal symptoms are present.

For people to be considered addicted to stimulants, they must meet at least 2 of 11 criteria within a 12-month period, as outlined by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5): ⁸

• You have cravings or a strong desire to use a stimulant.
• You take the stimulant in larger amounts or over a longer period of time than intended.
• You spend a lot of time and effort trying to obtain the stimulant, use it, or recover from its use.
• You are unsuccessful in trying to reduce or control your use of a stimulant.
• You have persistent or recurrent social or interpersonal problems caused or exacerbated by ongoing stimulant use.
• You’re not able to fulfill major obligations at work, school, or home due to stimulant use.
• You give up or reduce important social, occupational, or recreational activities because of stimulant use.
• You use stimulants repeatedly in situations where it is physically hazardous to do so.
• You continue to use stimulants despite having a physical or psychological problem that is likely to have been caused or exacerbated by stimulant use
• You develop tolerance to the stimulant.
• You experience withdrawal symptoms or continue taking the stimulant to avoid withdrawal symptoms.

What Are Treatment Options for Stimulant Addiction?

Although stimulant use disorder is a severe health issue and relapse rates are high, professional treatment can help address the underlying issues to promote long-term sobriety.⁷ With many treatment options available, recovery is possible.

You may or may not need detox when coming off of stimulants. Currently, there are no approved drugs to treat stimulant withdrawal symptoms.⁶ It is best to seek medical advice to understand what the best method of treatment is for you.

A few stimulant drug treatment options include:⁹

• Inpatient residential. These rehab programs provide a 24-hour structured routine, generally in a non-hospital setting. The length of stay can range from 30 days to 12 months, depending on the individual treatment recommendations.
• Intensive outpatient programs (IOPs). These programs vary in structure and intensity, generally cost less than residential inpatient treatment, and are more suitable for people with jobs and strong social support.
• Partial hospitalization programs (PHPs). These programs take place in hospital settings and are a form of intensive outpatient treatment. Most insurance providers cover PHPs.
• Executive rehabs. These programs cater to busy entrepreneurs or high-profile individuals, are usually more expensive than other programs, and allow clients to participate in their work duties while in treatment.
• Youth rehabs. These programs cater to adolescents and young adult populations with substance use, mental health, and/or addiction issues. Both inpatient and outpatient rehabs for youth are available.

Treatment followed by aftercare and ongoing support improves abstinence rates, reduces the chance of relapse, and enhances long-term recovery outcomes.⁹

Aftercare and long-term care options include:¹⁰

• Psychotherapy and counseling. Behavioral therapy is recognized as the most effective treatment for stimulant use disorder.⁶ Contingency management is a type of behavioral therapy that rewards positive behaviors. Cognitive-behavioral therapy (CBT) can help you identify and change harmful thinking and behavior patterns into healthy ones. Working one-on-one with a therapist can help you process underlying issues, such as trauma, that may have been contributing to the drug misuse.
• Recovery support groups. There are a variety of groups to choose from, including Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and Pills Anonymous (PA), offered nationally and globally. Some of these programs are based on the 12 Steps.
• Group therapy. This is a social therapy that involves meeting with other people in recovery from substance use disorders. It may occur in a community setting or private practice.

Whatever your situation, if you need help locating treatment options, call 800-934-1582(Who Answers?) for 24/7 support.

References

1. Department of Justice/Drug Enforcement Administration. (2020). Stimulants.
2. Weyandt, L. L., Oster, D. R., Marraccini, M. E., Gudmundsdottir, B. G., Munro, B. A., Rathkey, E. S., & McCallum, A. (2016). Prescription stimulant medication misuse: Where are we and where do we go from here?. Experimental and Clinical Psychopharmacology, 24(5).
3. National Institute on Drug Abuse for Teens. (2017). Prescription Stimulant Medications (Amphetamines).
4. Alcohol and Drug Foundation. (2021, July 16). Stimulants.
5. National Institute on Drug Abuse. (2018). Mind Matters: The Body’s Response to Prescription Stimulants.
6. Yale Medicine. (2021). Stimulant use disorder.
7. Substance Abuse and Mental Health Services Administration. (1999). Treatment for Stimulant Use Disorders.
8. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition).
9. National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).
10. Laudet, A. B., Savage, R., & Mahmood, D. (2011, September 6). Pathways to long-term recovery: a preliminary investigation. Journal of Psychoactive Drugs, 34(3), 305–311.