Stimulants and Substance Misuse

Stimulants Overview

• Ancient cultures used CNS stimulants before scientific understanding.

• Key topics:

  • Medical uses of CNS stimulants.

  • Complications from misuse.

Medical Uses of CNS Stimulants

• Amphetamines:

  • Used for asthma, myasthenia gravis, depression, and ADHD.

  • Side effects: anxiety, insomnia, heart palpitations.

  • Risks include dependence, severe psychological effects, and physical health issues.

Pharmacology of Stimulants

• Ephedrine: potent vasoconstrictor, short-term use recommended due to tolerance.

• Amphetamines influence dopamine, norepinephrine.

• Withdrawal symptoms include depression, fatigue, and increased appetite.

Stimulant Misuse Consequences

• Serious neurological and physical impacts:

  • Brain damage and significant reductions in gray matter.

  • Cardiovascular issues, risk of myocardial infarction.

  • Gastrointestinal issues such as ulcers and “meth mouth.”

DSM-5 Diagnostic Criteria for Stimulant Use Disorder

• Includes:

  • Increased quantity or duration of use.

  • Unsuccessful efforts to reduce.

  • Significant time spent on stimulant-related activities.

  • Tolerance and withdrawal symptoms.

Severity Specifiers

• Mild: 2-3 symptoms.

• Moderate: 4-5 symptoms.

• Severe: 6+ symptoms.

Cocaine Overview

• Historical use in South America; transformed into crack for smoking.

• Current medical uses limited to topical anesthetics in medical settings.

Caffeine as a Stimulant

• Commonly consumed globally, less addictive than other stimulants.

• Moderate use is generally safe; excessive consumption can lead to negative health effects.