Definition - CNS stimulant:
A type of drug that increases the levels of certain chemicals in the brain and increases alertness, attention, energy, and physical activity. CNS stimulants also raise blood pressure and increase heart rate and breathing rate. They are used to treat depression, attention deficit hyperactivity disorder (a disorder in which a person has problems paying attention, controlling actions, and remaining still or quiet), and narcolepsy (a sleep disorder). Also called central nervous system stimulant.
Think about what happens in the morning after you've consumed your first cup of coffee. You feel an increase in energy, alertness, and your ability to focus. And what happens on mornings when you skip that cup of coffee? You likely feel more tired or maybe find it harder to concentrate. This is because coffee contains caffeine, which is a stimulant drug. Some stimulants, like coffee, are used every day by people who want to stay awake or increase their alertness. While stimulants can be used safely, they can be dangerous if not taken correctly. Some stimulants are available only through prescription, and others are illegal. Let's discuss stimulants in more detail.
Stimulants are drugs that 'stimulate' the central nervous system. In other words, they increase the activity in your brain. Though each stimulant has unique effects, all stimulants increase your heart rate, blood pressure, and body temperature. By increasing the electrical activity in your brain, stimulants cause you to be more alert, decrease fatigue, and prolong physical activity. Stimulants can also improve your mood and increase self-confidence. For these reasons, stimulants are also referred to as 'uppers.'
What is their legal status in the United States?
A number of stimulants have no medical use in the United States but have a high potential for abuse. These stimulants are controlled in Schedule I. Some prescription stimulants are not controlled, and some stimulants like tobacco and caffeine don't require a prescription - though society's recognition of their adverse effects has resulted in a proliferation of caffeine-free products and efforts to discourage cigarette smoking.
Stimulants are drugs that increase the body's natural functions. They impact the nervous system and make the body release more natural chemicals like dopamine that sharpen a person's alertness, attention and energy. Stimulants are often called "uppers," because they increase a person's blood pressure and heart rate.
Stimulants are usually prescribed by doctors to help patients facing sleep disorders, hyperactivity disorders and severe cases of depression. They are habit-forming drugs, so they must be taken carefully as prescribed. When taken responsibly, stimulants can be safe and effective to use.
Teenagers often get a hold of them by stealing or buying the pills from a friend or relative who has a prescription. Recreational users are much more likely to become addicted to the drug. Most stimulants are available in pill form, although some may also be available as an injectable liquid or a patch that's put on the skin. Abusers typically take the drugs in pill form (by swallowing whole, chewing or crushing and snorting the powder), or by injection if the drug is liquid. The latter methods hasten the high. Discontinuing use can lead to withdrawal symptoms such as headaches, dizziness and insomnia.
Nonfatal Overdoses: All Stimulants:
CDC has analyzed data from syndromic surveillance of suspected drug overdoses. Data presented here include percent change estimates in rates of suspected all stimulant overdoses per 10,000 ED visits. The map provides annual percent change estimates in rates of all stimulant overdoses per 10,000 ED visits for the most recent month of data.
Abuse is often associated with a pattern of binge use:
Sporadically consuming large doses of stimulants over a short period of time. Heavy users may inject themselves every few hours, continuing until they have depleted their drug supply or reached a point of delirium, psychosis, and physical exhaustion. During heavy use, all other interests become secondary to recreating the initial euphoric rush.
In overdose:
Unless there is medical intervention, high fever, convulsions, and cardiovascular collapse may precede death. Because accidental death is partially due to the effects of stimulants on the body's cardiovascular and temperature-regulating systems, physical exertion increases the hazards of stimulant use.
Schedule I:
A number of stimulants have no medical use in the United States but have a high potential for abuse. These stimulants are controlled in Schedule I. Some prescription stimulants are not controlled, and some stimulants like tobacco and caffeine don't require a prescription - though society's recognition of their adverse effects has resulted in a proliferation of caffeine-free products and efforts to discourage cigarette smoking.
Dependence and Tolerance:
People who use stimulants regularly can develop dependence and tolerance to them. Tolerance means they need to take larger amounts of stimulants to get the same effect. Dependence on stimulants can be psychological, physical, or both. People who are dependent on stimulants find that using the drug becomes far more important than other activities in their life. They crave them and find it very difficult to stop using them. People who are psychologically dependent on stimulants may find they feel an urge to use them when they are in specific surroundings or socialising with friends. Physical dependence occurs when a person's body adapts to the stimulants and gets used to functioning with the stimulant present.
How is stimulant use disorder treated?
Behavioral therapy is the most effective treatment for stimulant use disorder. One such method, contingency management, gives patients tangible rewards for positive behaviors, aiding their efforts to stop using stimulants. Cognitive behavioral therapy, which helps to identify and modify damaging thinking and behavior, can also help people overcome their addiction. For early or less severe use disorder, motivational interviews can be effective: These help to turn ambivalence about quitting into motivation to quit and can help patients fight the urge to use stimulants. While stimulant withdrawal is not typically medically dangerous, as with alcohol or heroin withdrawal, the resulting depression, especially in amphetamine withdrawal, may be quite severe. People going through treatment should be monitored for suicidal signs. Recovering users with other mental disorders are especially at risk.
There are no approved medications to treat stimulant dependence. Treatment is a process that requires long-term attentiveness. For all substance use disorders, detoxification by itself, without follow-up care, is a waste of time and money, says Yale Medicine psychiatrist Kathleen Carroll, PhD.
Current treatment options:
Addicts who want to quit using cocaine or other stimulants face a formidable task. Psychotherapy remains a foundation for treatment of addiction to cocaine or other stimulants. In addition, clinicians may prescribe medications marketed for other health problems. As yet, no medication is FDA-approved for cocaine or stimulant addiction, although new compounds are always being tested. Behavioral therapies. Various psychosocial interventions offer techniques to help addicts "unlearn" an addiction, learn ways to resist cravings, and slowly build a drug-free life. Options include:
Cognitive behavioral therapy, which helps patients to recognize and avoid drug triggers, and then learn new ways of coping without drugs
Contingency management, which uses tangible rewards and incentives - such as vouchers that can be exchanged for movies or dinner - to encourage abstinence
The Matrix Model, which combines behavioral therapy, family education, individual counseling, a 12-step self-help program, and drug testing.
Prescription stimulants are medicines used to treat ADHD and narcolepsy.
Most prescription stimulants come in tablet, capsule, or liquid form, which a person takes by mouth. When misusing a prescription stimulant, a person can swallow, snort, smoke, or inject the drug.
Prescription stimulants increase the activity of the brain chemicals dopamine and norepinephrine.
Prescription stimulants increase alertness, attention, and energy. Their misuse, including overdose, can also lead to psychosis, anger, paranoia, heart, nerve, and stomach problems. These issues could lead to a heart attack or seizures.
Prescription stimulant misuse can lead to a substance use disorder, which takes the form of addiction in severe cases, even when used as prescribed by a doctor.
Withdrawal symptoms include fatigue, depression, and sleep problems. Concerns about use should be discussed with a health care provider.
Behavioral therapies can be effective in helping people stop prescription stimulant misuse, including cognitive-behavioral therapy and contingency management.
Prescription stimulants come in tablets or capsules. When abused, they are swallowed, injected in liquid form or crushed and snorted.
Short Term Effects:
The short-term effects of stimulants include exhaustion, apathy and depression - the "down" that follows the "up." It is this immediate and lasting exhaustion that quickly leads the stimulant user to want the drug again. Soon he is not trying to get "high," he is only trying to get "well" - to feel any energy at all.
Long Term Effects:
Stimulants can be addictive. Repeated high doses of some stimulants over a short period can lead to feelings of hostility or paranoia. Such doses may also result in dangerously high body temperatures and an irregular heartbeat.
Contraindications:
There are numerous relative contraindications to the use of stimulants. Patients with advanced arteriosclerosis should use minimal stimulants given the elevated risk of myocardial infarction, as stimulants elevate cardiac demand. Also, patients with severe hypertension will exacerbate their existing elevated high blood pressure when using stimulants and, therefore, should minimize their use. Untreated hyperthyroidism, glaucoma, and a recent stroke are also relative contraindications to stimulant use. Cardiac arrhythmias are also known to worsen and even result from the use of certain stimulants, and hence individuals so affected should avoid stimulant use.
Younger patients under the age of 12 and pregnant patients should avoid using stimulants. From a general perspective, some patients are highly sensitive to stimulants and should either avoid using or minimize their dose.
Toxicity:
Treatment of a stimulant overdose depends on the specific agent used, the ongoing adverse effects, and the potential risk for further adverse effects. The generally available options for treating stimulant toxicity are benzodiazepines, beta-blockers, antiarrhythmics medications, and antihypertensive medications. Certain medications under these classes of drugs may be contraindicated depending on the specific drug used. Benzodiazepines lower the associated anxiety of stimulant toxicity and may improve the patient's vital signs. They are also the primary option if the patient is experiencing seizures. Beta-blockers are useful for lowering the heart rate of the patient, given that tachycardia is a very common symptom of stimulant overdose. As well, they can improve the patient's hypertensive state. Antiarrhythmic medications are generally reserved for ventricular arrhythmias that result from stimulant toxicity.
It is critical to confirm the specific drug that induces the stimulant toxicity given the potential treatment contraindications. For example, cocaine overdoses are a frequent cause of stimulant toxicity. While they induce tachycardia, chest pain, and hypertension, the use of beta-blockers may potentially be cardiotoxic to a patient who has overdosed on cocaine.
Amphetamine-Type Stimulants (ATS):
In the past 15 years, many parts of the world - both developing and developed - havewitnessed a significant increase in the availability and use of ATS. Regions experienc-ing the greatest increase are North America, Europe, South-East Asia and Australia. Of an estimated 200 million people who use drugs worldwide, some 35 million peopleare said to use ATS. This is more than those reported to use cocaine (13 million) andopiates (16 million) combined.
Stimulants enhance the activity of the central and peripheral nervous systems
Common effects may include increased alertness, awareness, wakefulness, endurance, productivity, and motivation, arousal, locomotion, heart rate, and blood pressure, and a diminished desire for food and sleep.
Use of stimulants may cause the body to reduce significantly its production of natural body chemicals that fulfill similar functions. Until the body reestablishes its normal state, once the effect of the ingested stimulant has worn off the user may feel depressed, lethargic, confused, and miserable. This is referred to as a "crash", and may provoke reuse of the stimulant.
Stimulants are Prescription medicines or are without a prescription (legally or illicitly)
It was estimated in 2015 that the percentage of the world population that had used cocaine during a year was 0.4%. For the category "Amphetamines and prescription stimulants" (with "amphetamines" including Amphetamine and Methamphetamine) the value was 0.7%, and for Ecstasy 0.4%
Stimulants in therapeutic doses, increases ability to focus, vigor, sociability, libido and may elevate mood. However, in higher doses stimulants may actually decrease the ability to focus. In higher doses stimulants may also produce euphoria, vigor, and decrease need for sleep.
