Amphetamine Use Disorder

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KEY POINTS

• Amphetamine use disorder is a pattern of using amphetamines that leads to serious personal, family, and health problems. Amphetamines are a type of medicine, called stimulants, that can increase your alertness and energy.
• Amphetamine use disorder can be treated. For any treatment to be successful, you must want to stop using amphetamines. Your healthcare provider may prescribe a medicine that will help you get through withdrawal symptoms. Self-help groups such as Narcotics Anonymous, support groups, and therapy may be helpful.
• The best way to help yourself is to see your healthcare provider and make plans to stop using amphetamines.

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What is amphetamine use disorder?

Amphetamines are a type of medicine called stimulants. Stimulants can increase your alertness and energy. They might be prescribed by a healthcare provider to treat sleep problems, obesity, ADHD, depression, or other health problems. They may also be sold illegally as "speed" or "uppers."

Amphetamine use disorder is a pattern of using amphetamines that leads to serious personal, family, and health problems. The more of these statements that apply to you, the more severe your amphetamine use disorder is.

1. You use more or use amphetamines for longer than you planned.
2. You want to cut down or quit, but are not able to do so.
3. You spend a lot of time and energy getting drugs, using drugs, and getting over the effects.
4. You crave amphetamines so much that you have trouble thinking about anything else.
5. You have problems at work or school, or stop taking care of people who depend on you.
6. You have relationship problems because you don’t keep your promises, or you argue or get violent with other people.
7. You stop doing things that used to matter to you, such as sports, hobbies, or spending time with friends or family, because of your substance use.
8. You use amphetamines even when it is dangerous, such as while driving or operating machinery.
9. You keep using amphetamines even though you know that it is hurting your physical or mental health.
10. You need to use more and more of the drug, or use it more often to get the same effects. This is called tolerance.
11. You have withdrawal symptoms when you stop using.

Amphetamine use disorder may also be called drug abuse, substance abuse, dependence, or addiction.

You may be abusing prescription amphetamines if you:

• Take them for reasons other than why they were prescribed
• Take more than the prescribed dose
• Continue to use them when you no longer have a need for them

Not everyone who uses amphetamines will become addicted. However, it is not uncommon for someone to start out using amphetamines to treat a health problem and then becoming addicted.

What is the cause?

The brain makes chemicals that affect thoughts, emotions, and actions. Amphetamines change the balance of these chemicals in your brain. When you use amphetamines regularly, your brain starts to get used to them. As a result you don't feel good unless you use them. When you stop using them suddenly, the balance of chemicals in your brain changes, which causes the symptoms of withdrawal.

You have a higher risk of becoming dependent on drugs if you:

• Have a family history of drug or alcohol abuse
• Have abused alcohol or drugs in the past
• Are easily frustrated, have trouble dealing with stress, or feel like you aren’t good enough
• Are regularly around people who use alcohol or drugs
• Have a mental health problem
• Have constant pain

What are the symptoms?

The symptoms of amphetamine use disorder depend on how much and how often you take the drug. The symptoms can be mild to severe, such as:

• Being nervous and overexcited
• Losing weight
• Talking and thinking fast, called "speeding"
• Having a fast or irregular heartbeat or sweating
• Nausea and vomiting
• Large, dilated pupils
• Seeing, hearing, or feeling something that is not there
• Thinking that others are out to get you when they are not
• Being less aware of what is going on around you, loss of memory, or depression

You may also have symptoms of new or worse health problems caused by long-term amphetamine use such as

• Problems with your teeth and gums
• Chronic constipation
• Eating and sleeping disorders
• Depression, anxiety, or panic disorder
• Chest pain or cardiac arrest (the heart suddenly stops beating)
• Kidney failure
• Stroke
• Trouble breathing or stopping breathing

The symptoms of amphetamine withdrawal can be mild to severe. You may have some of these symptoms when you stop taking amphetamines:

• Shakiness and jumpiness followed by no energy
• Too much or too little sleep, or bad dreams
• Seizures
• Cravings for amphetamines
• Depression that can last many months

How is it diagnosed?

A healthcare provider will ask how much and how often you use amphetamines. Be honest about your drug use. Your provider needs this information to give you the right treatment. He or she will also ask about symptoms, your medical history and give you a physical exam. You may have blood and urine tests.

How is it treated?

Amphetamine use disorder can be treated. For any treatment to be successful, you must want to stop using amphetamines. When you stop using amphetamines, your healthcare provider may prescribe medicine to help you get through withdrawal symptoms. You may also need to stop taking all stimulants, including caffeine and tobacco.

If you want to quit, get help.

Self-help groups such as Narcotics Anonymous, support groups, and therapy may be helpful. Kinds of therapy may include:

• Cognitive-Behavioral Therapy (CBT). CBT helps you look at your thoughts, beliefs, and actions, and understand which ones cause problems for you. Then you learn to change unhealthy ways of thinking and acting.
• Family therapy. Often people with substance use disorders don’t realize they have a problem or aren’t ready to accept treatment. This leaves loved ones frustrated and confused. Family therapy treats all members of the family rather than working with one person alone. It helps the whole family understand each other better and make changes.
• Substance use disorder treatment programs. Your healthcare providers and counselors will work with you to develop a treatment program. You may be able to go to therapy a few times a week (outpatient therapy). Or you may need treatment in a hospital or rehab center. You may need to stay there for several weeks, or you may be able to go to a clinic or hospital each day.
• Recovery is a long-term process. Many people with substance use disorders try to quit more than once before they finally succeed. Don't give up. You can quit and quit for good. Get help and try again. Follow-up treatment is very important so that you don’t go back to using amphetamines.

If you have overdosed, or are having severe withdrawal symptoms you will need to be treated in a hospital. You will also be treated for any health problems such as a heart attack, stroke, or other life-threatening problems.

How can I take care of myself?

The best way to help yourself is to see your healthcare provider and make plans to stop taking amphetamines. If you are already seeing a healthcare provider, it is important to take the full course of treatment he or she prescribes.

• Get support. Talk with family and friends. Consider joining a support group in your area.
• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. Don’t use alcohol or drugs. Exercise according to your healthcare provider's instructions.
• Avoid situations where people are likely to use alcohol or drugs.
• Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all the medicines, natural remedies, vitamins, and other supplements that you take.
• Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.

People and resources in your community that can help you include your healthcare providers, therapists, support groups, mental health centers, and alcohol or substance abuse treatment programs. You may want to contact:

• Narcotics Anonymous
  818-773-9999
  http://www.na.org