A Discussion of Stimulants

A Discussion of Stimulants

A stimulant is a type of drug that is supposed to increase your feeling of happiness, contentment and even euphoria while at the same time it increases your energy and alertness. (While alcohol and opioids may also produce a feeling of happiness, contentment and euphoria, these are central nervous system depressants and don't normally increase energy or alertness.) EXAMPLES Some of the most common stimulants are:
  • Caffeine
  • Nicotine
  • Cocaine
  • Crack cocaine
  • Amphetamines
  • Methamphetamine
  • Methylphenidate (Ritalin)
  • Ecstasy

In this article, we are going to discuss cocaine, crack cocaine and methamphetamine (“meth”).

COCAINE Cocaine is processed from the coca plant. The Spanish conquistadores saw South American Indians chewing the coca leaf to give them energy. (Some people confuse the coca plant with the cacao tree from which cocoa and chocolate are derived but one is a leafy plant and the other a tree.) Chewing coca leaves gave some stimulation but was not popular with Europeans until the middle of the nineteenth century, when German chemist Albert Niemann found that you could greatly increase the stimulant effect by extracting the cocaine from the leaves. In a process that is still similar to that used today, the coca leaves were soaked in an alcohol solvent. The resulting liquid is further refined into hydrochloride salt, an odorless, white crystalline powder. This powder is snorted or it can be dissolved in water and injected. Cocaine then became a popular stimulant in Europe. Its use and its harmful effects were dramatized by Arthur Conan Doyle’s famous detective--Sherlock Holmes. Cocaine is most often snorted, smoked or mixed with water and injected. The duration of cocaine’s immediate euphoric effects depends upon the route of administration. The faster the absorption, the more intense the high. Also, the faster the absorption, the shorter the duration of action. The high from snorting is relatively slow in onset, and may last 15 to 30 minutes, while that from smoking may last 5 to 10 minutes. “Coke,” “C,” “snow,” “flake,” “blow,” “bump,” “candy,” “Charlie,” “rock,” and “toot” are common names for cocaine. A “speedball” is the street name given to combining cocaine or crack with heroin.

CRACK COCAINE Crack cocaine is cocaine that has not been refined into the hydrochloride salt but remains in a more solid form. Crack cocaine is a rock crystal that can be heated and its vapors smoked. The sound made when the rock crystal is heated is a crackling sound and hence the name crack. Because it requires less processing, crack is less expensive than cocaine powder and because it is smoked, it can produce a “high” in less than 10 seconds.

METHAMPHETAMINE Meth is a crystal-like powdered substance that often is in rock-like chunks of powder. Sometimes meth is grown into crystals which is more concentrated. Meth is usually white or slightly yellow, depending on the purity. One of the main reasons for the explosion of illicit production of meth is that it is simple and inexpensive and uses ingredients that are easy to obtain. However, the process gives off very caustic and flammable fumes and is very dangerous. Meth is taken orally, snorted, injected or smoked. Abusers may become addicted quickly, needing higher doses more often. Methamphetamine is commonly known as “speed,” “meth,” “chalk, and “tina.” In its smokable form, it’s often called “ice,” “crystal,” “crank,” “glass,” “fire,” and “go fast.”

HOW STIMULANTS PRODUCE PLEASURE AND EUPHORIA In the brain, there are literally billions of neurons (nerve cells) which communicate with each other by means of electrical impulses which create sensations and carry instructions throughout the body. A neuron’s electrical impulse causes the release of a chemical named a neurotransmitter. The neurotransmitter goes to another neuron which has a receptor that accepts only that neurotransmitter. One neurotransmitter named dopamine is believed to stimulate receptors in the brain that create the feeling of pleasure and euphoria. When we do things that we consider to be pleasurable, more dopamine is released which stimulates the dopamine receptors, producing pleasure, and then is returned back into the transmitting neuron by a specialized protein called the dopamine transporter. (Of course, many people find pleasure in things like eating a fine meal or drinking a nice wine that do not bring the same amount of pleasure to others. This means that dopamine seems to be released based on each person’s conception of pleasure.) Stimulants change the way the brain works by changing the way nerve cells communicate. Cocaine and meth both artificially increase the actions of dopamine neurotransmitters but in different ways. Cocaine attaches to the dopamine transporter and blocks the normal recycling process, which increases the length of time (an estimated 50% longer) dopamine continues to stimulate the receptors. This increases the feelings of pleasure and euphoria for a short time. Meth increases the concentration of dopamine by increasing the number of dopamine neurotransmitters that are released into the brain. This increased amount of dopamine results in more stimulation of the receptors and increases the feelings of pleasure and euphoria. Generally, the faster the absorption of a drug, the shorter is the duration of action. The high from snorting may last 15 to 30 minutes, while that from smoking may last five to 10 minutes. Because of the short time of the “high”, many users increase their stimulant use and this increases their risk of addiction.

WHAT IS TOLERANCE? Our nervous systems work hard to maintain a constant degree of cell activity in spite of the presence of chemicals (drugs) in the brain stimulating the dopamine receptors (homeostasis). Tolerance is the situation where a person needs higher doses and more frequent use of a drug in order to receive the same sensation that was experienced in the initial use. This is because the receptors are now not as sensitive to the drugs-they become desensitized. While generally receptors don't become desensitized after only a single exposure to a drug, it can happen. It depends on the individual’s DNA and metabolism.

COCAINE AND METH CAN DAMAGE THE WAY THE BRAIN WORKS Research suggests that long-term cocaine use may reduce the amount of dopamine produced and the number of dopamine receptors in the brain, thus reducing the ability to feel pleasure. When this happens, nerve cells must have cocaine to communicate properly. Without the drug, the brain can't send enough dopamine into the receptors to create a feeling of pleasure. If a long-term user of cocaine or crack stops taking the drug, the memory of the euphoria associated with cocaine use can trigger tremendous craving and relapse to drug use. Animal research going back more than 30 years shows that high doses of meth damage dopamine-producing neuron cell endings. Nerve ending damage is associated with reduced motor speed and impaired verbal learning. Other studies of chronic meth abusers indicate structural and functional changes in areas of the brain associated with emotion and memory. It is thought that this explains some of the emotional and cognitive problems seen in chronic meth abusers. Long-term stimulant abuse can result in addiction, a chronic, relapsing disease characterized by compulsive drug-seeking and drug use.

WHAT DO USERS FEEL? Cocaine users report:

  • Panic attacks
  • Feelings of restlessness
  • Irritability
  • Anxiety
  • Losing touch with reality
  • Hearing voices that are not there
  • Decreased appetite leading to malnourishment
  • If snorted — loss of the sense of smell, nosebleeds, hoarseness, and a chronically runny nose
Meth users report:
  • Violent behavior
  • Anxiety
  • Confusion
  • Insomnia
  • Paranoia
  • Hearing voices that are not there
  • Mood disturbances
  • Delusions (insects creeping on the skin)
  • Homicidal thoughts
  • Suicidal thoughts
  • Decreased sexual functioning
  • Decreased appetite leading to malnourishment
  • Cerebral edema (excessive fluid in the brain)
  • Brain hemorrhage
  • High blood pressure
  • Chest pain
  • Shortness of breath
  • Nausea
  • Vomiting
  • Diarrhea
  • Increased body temperature (can be lethal)
  • Severe dental problems
  • Symptoms of Parkinson’s disease

ALCOHOL AND COCAINE National Institute on Drug Abuse researchers have found that the human liver combines cocaine and alcohol and manufactures a third substance, cocaethylene. Cocaethylene intensifies cocaine’s euphoric effects, while potentially increasing the risk of sudden death. The mixture of cocaine and alcohol is the most common two-drug combination that results in drug-related death.

HEALTH RISKS In addition to the reduction of dopamine production and dopamine receptors, stimulants cause the body’s blood vessels to become narrow, constricting the flow of blood and causing the heart to work harder. This may cause the heart to temporarily lose its natural rhythm. This is called fibrillation, and it can be very dangerous because it stops the flow of blood through the body. Other physical symptoms may include chest pain, nausea, blurred vision, fever, muscle spasms, convulsions, and coma. Hyperthermia (elevated body temperature) and convulsions occur with methamphetamine and cocaine overdoses, and if not treated immediately can result in death. Cocaine and meth related deaths are often a result of cardiac arrest or seizures followed by respiratory arrest.

WITHDRAWAL SYMPTOMS The withdrawal symptoms of cocaine and meth are not as dramatic as the symptoms of opiates and alcohol. Some cocaine withdrawal symptoms are:

  • Fatigue
  • Lack of pleasure
  • Anxiety
  • Irritability
  • Sleepiness
  • Agitation
  • Extreme suspicion
  • Cravings
  • Exhaustion
  • Depression
  • Insomnia
Some meth withdrawal symptoms are:
  • Fatigue
  • Long, disturbed periods of sleep
  • Irritability
  • Intense hunger
  • Moderate to severe depression
  • Psychotic reactions
  • Anxiety
  • Cravings
  • Exhaustion
  • Mental confusion
  • Insomnia
  • Restlessness
METH AND COCAINE MEDICAL DETOX Most people don't think that they need to come to Novus for medical detox from cocaine or meth because the withdrawal symptoms are normally not as painful as withdrawal from heroin, methadone, Xanax, painkillers or alcohol. However, chronic cocaine or meth users are likely seriously dehydrated, undernourished and very prone to feelings of paranoia. When they come to Novus they are given IV’s that hydrate them, they eat well and they feel safe. After a few days they are relaxed and ready for their next step on the road to recovery. At Novus we don't get rave success stories by accident. We get them because we have and apply the correct technology.

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