History & Facts about Amphetamines:

  • While they are very similar, and have the same historical and pharmacological origin, there are some differences between amphetamines and methamphetamine.  Surprising fact: During the early 1900’s, methampetamines were sold and/or prescribed, similarly to amphetamines, sometimes even over the counter!  Currently, however, methamphetamine is very rarely given by prescription, rather it is typically manufactured illicitly as a “street drug”.  Today, the medical community is aware of the inherent dangers associated with use of methamphetamine.  This page will focus on information about prescription amphetamines.  If you would like more information about the “street drug” methamphetamine CLICK HERE
  • Amphetamines were first developed in the early 1900’s.  Pharmacological scientists found that a class of drugs they had developed (amphetamines), had the ability to treat a variety of ailments (Heal, Smith,  Gosden, & Nutt, 2013).  For example, the drug could be used to treat breathing disorders, because it had the ability to widen the airways in the lungs.  An asthma inhaler, containing amphetamines, was designed and commonly sold, over the counter, as the Benzedrine Inhaler (AMA, 1933).

 

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  • During the late 1930’s, Benzedrine tablets were invented, and were extensively prescribed, as a treatment for depression.  The drug’s ability to suppress the appetite, also made it a sought after treatment for obesity.  Amphetamines, in tablet form, started becoming very profitable for the pharmaceutical companies.  At the same time, the new Benzedrine (amphetamine) tablets rapidly gained plausibility, among psychiatrists, as a possible antidepressant medication (Goodman & Gilman, 1937).  During this time there were already, scattered reports of abuse, and episodes of psychosis among chronic users.

 

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  • In 1937, a medical professional by the name of Bradley, was the first to report some beneficial effects, when children with severe behavioral problems, were treated with amphetamines (Bradley, 1937). Today, these same “behavioral problems” may be diagnosed as (ADHD) attention deficit/hyperactivity disorder, and are still often treated with amphetamines.
  • It was soon realized that the main effects of the amphetamines, was their ability to increase focus, alertness, energy, wakefulness, and had the potential to increase a persons sense of well-being.  All of theses qualities were precisely what people with depression were looking for. Amphetamines (Benzedrine tablets), seemed to be the “magic pill” for depression, and has been referred to as the “first antidepressant” (Goodman & Gilman, 1937).
  • Amphetamines were also used by several countries, during World War II, to enhance the performance of their soldiers.  After the war, much of the drugs unused surplus ended up on the black market.  Amphetamines were quickly becoming a widespread drug of abuse (Connell, 1966).

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  • By the 1960’s, it became apparent to the medical community that amphetamines were very addictive, and had the potential to induce psychosis, that was comparable to the psychopathology seen with schizophrenia.
  • At the same time, that this awareness regarding the dangers of amphetamines was increasing, the monoamine oxidase inhibitors (MAOI’s) and tricyclic antidepressants were being introduced.  These newly developed medications began to replace amphetamines, by psychiatrists, as a safer treatment option for depression.  These cutting edge antidepressants were not believed to carry the same risk for addiction and abuse.  However, some medical professionals disagreed. Many general practitioners discordantly stuck to the “old stand by”, and continued to liberally prescribe amphetamines, for treatment of depression. There was much disagreement, in the medical community, about the effectiveness of the newer antidepressants.
  • Drug abuse, overall, became of crucial importance in the political arena during the later 1960’s. Lawmakers, alongside concerned citizens, became increasingly distressed about the far reaching amphetamine abuse across the country.  People abusing the drug had begun displaying psychotic, violent, and aggressive behaviors.  All social classes seemed to be affected by the drug, from the housewife in the suburbs, to war veterans, professionals, and young people (Jackson, 1966). Anyone seemed vulnerable to the enslaving qualities of amphetamines, the drug did not discriminate.
  • Furthermore, it was not until the 1970’s, that the United States began to recognize the magnitude of the dangers, associated with amphetamines, and enacted new laws that restricted prescribing. The prescriptions, written for amphetamines, began to decline somewhat after these laws were put in to place (Dunlap, 1970).  However, amphetamine abuse has not disappeared.  It still exists in our generation.
  • National surveys, as of 2005, indicated that approximately 3 million Americans used amphetamines, non-medically, during the past year.  Furthermore, roughly 350,000 of those people surveyed, indicated they were also addicted to the drug (SAMHSA, 2006).
  • Currently, legal amphetamines are available by prescription only.  In addition, more tamper-deterrent drug formulations, to reduce the potential for abuse, have been created. Today, amphetamine formulations, such as Adderall and Ritalin, among others, are most commonly used to treat symptoms of ADHD and narcolepsy (Heal, Smith,  Gosden, & Nutt, 2013).
  • Less commonly, amphetamines are still used for treatment resistant depression (depression that does not respond to the typical antidepressants). The drug does have considerable medical benefits for some people. However, it is no longer used as a widespread “cure all” for depression, due to the high risk of addiction, abuse, and diversion of the drug to the “black market”.  Furthermore, we now have expanded treatment options for depression, that often work better for some people, than the traditional MAOI’s and trycyclic antidepressants.
  • Currently, the most commonly used medications to treat depression are the selective serotonin re-uptake inhibitors or selective serotonin norepinephrine re-uptake inhibitors (SSRI’s and SNRI’s).  These medications can work very well for some people.  However, since my blog is dedicated to reducing stigma surrounding mental illness AND improving treatment for mental disorders, I would like to make note that these medications do not work well for all people.  It seems that it is difficult for some medical professionals to break from routine, when the common antidepressants (SSRI’s & SNRI’s) are not relieving a person’s symptoms.  I feel the mental health community needs to be more open-minded to the fact that some people may need alternative treatments. It’s understandable, in the era of prescription medication abuse, that medical professionals do not want to take risks with medications that can be misused.  However, amphetamines may be one of the few drugs that certain individuals, with severe depression, respond to.  People are individuals, with possible differences in brain chemistry, and should not be denied a treatment that would relieve their depression, simply because others may misuse the drug.
  • The drug does still needs to be monitored closely and prescribed with care.  There are many practices a medical professional can put in place, when it seems that prescribing a medication with risk for abuse, may be the best option for the patient.  For example, prescribing small doses and checking in with the patient frequently. Another option could be to call the patient into the office randomly, for a “pill count”, to make sure medications are being taken as prescribed, and not being diverted.  These medications do have risk, but if monitored closely, can be life changing for some patients. The bottom line is that these medications do have benefits, despite abuse potential.  The risk versus benefit should be examined, and the patient should always be given the best treatment available.
  • It is important to find a medical professional who you feel comfortable with, and who will take the time to really listen to, and hear, you.  You deserve to be treated as an individual, and not be discriminated against, based on value judgement’s, or the behavior of others.  Unfortunately, in our current culture, this seems to be a common issue with any medication that has potential for misuse.
  • High school and college students are often considered to be at high risk for abuse of amphetamines.  These drugs are often abused to stay alert and awake, which can be a quality students are looking for when overwhelmed with classwork, jobs, and other obligations.  As a young student all these new responsibilities can be overwhelming.  People in the truck driving and transportation industries, air traffic control, security positions, and other stressful jobs, that require long hours of wakefulness, are also often at risk for amphetamine abuse.
  • Methamphetamine is a derivative of amphetamine. When first developed, in the 1950’s, it was given to people to treat things such as Parkinson’s disease, depression, and even alcoholism (Bett, 1946).  Methamphetamine is a much stronger form of the amphetamines, the effects of the drug are felt more quickly, it is highly addictive, and associated with serious health risks.  Today, methamphetamine is typically known as a “street drug”.
  • Desoxyn (methamphetamine hydrochloride) tablets is an example of a methamphetamine that may be prescribed, in very rare situations, mainly to treat morbid obesity.  It is only given when other treatments have failed, and benefit versus risk is weighed carefully, because the drug is associated with serious risks.  The medication comes with a special “black box” warning that indicates: “MISUSE OF METHAMPHETAMINE MAY CAUSE SUDDEN DEATH AND SERIOUS CARDIOVASCULAR ADVERSE EVENTS”.
  • Amphetamines can look like pills or powder.  In addition, “fake” amphetamines are also sold on the street.  It is never a good idea to purchase anything from an unknown source, or off the street.  You really have no idea what is in the drug you are buying.  Additionally, amphetamines can be dangerous, and addictive, and should only be taken under the supervision of a medical professional.

 

How amphetamines affect the brain & body:

  • Our brains contain special nerve cells, called neurons.  Neurotransmitters (chemical messengers), can be thought of as the messengers, that transmit signals, between the brains’s nerve cells.  When a neurotransmitter (messenger) attaches to a receptor on a nerve cell, it causes changes inside the nerve cell, that enable the nerve cell to carry out it’s individualized function.  Amphetamines affect two main neurotransmitters in the body: norepinephrine and dopamine.
  • Norepinephrine is a neurotransmitter that is part of the bodies natural “fight or flight system”. When the bodies levels of norepinephrine are increased, it causes an increased sense of energy.  The second neurotransmitter affected is dopamine.  Dopamine is one of the brains natural “feel good” neurotransmitters.  It is what allows us to feel pleasure from normal life events.  When this chemical is increased artificially by a drug, it causes the feeling of euphoria or “high”, that is often sought after by people who are looking to abuse a drug.  However, when a chemical artificially causes a surplus of dopamine in the brain, the dopamine levels become “depleted”, and it becomes harder for a person to feel happy without the drug. This leads to addiction.  The person feels as if they need the drug to feel “normal”.
toomuchandtoolittleneurotransmitters
When using drugs that increase dopamine, the dopamine builds up in the synapse (the gap between the nerve cells). This basically causes an “overload” of this feel good chemical (dopamine), leading to euphoria.  After using the drug there is less dopamine available.  This makes it hard for the person to feel happy “normally”, without the extra stimulation of the drug, which can lead to addiction.  The person now “needs” the drug to feel “normal”.
  • If the amphetamines are taken as prescribed, and in low doses, people generally do not feel the euphoria, that can lead to addiction.  However, the drug may still need to be discontinued slowly, to avoid uncomfortable withdrawal symptoms.  This is why it is especially important to take medications with a potential for abuse, exactly as prescribed, and never share your medications with others.
  • Physical effects of amphetamine use on the body can also include increased blood pressure and pulse rates, insomnia, loss of appetite, and physical exhaustion (DEA, 2017).
  • Signs of overdose can include: agitation, increased body temperature, hallucinations, convulsions, and possible death.  Chronic abuse produces a psychosis that resembles schizophrenia and is characterized by: Paranoia, picking at the skin, preoccupation with one’s own thoughts, along with auditory and visual hallucinations. Violent and erratic behavior is frequently seen among those who are abusing amphetamines (DEA, 2017).  Again, it is so important to take these medications under the close supervision of a medical professional, for a legitimate medical condition, and always according to the dosing schedule that is provided.

Comments and discussion are welcomed.  I would like to hear your opinions, thoughts, and experiences in the comment section below.  Sharing stories of strength and hope brings us together, and we can help each other.

Support is essential to mental health!

If you or a loved one is struggling with drug addiction.  Please reach out for help.  Taking the first step is often hard, but worth it.  The whole process of changing a habit, such as drug dependence, seems impossible at first.  Don’t look too far into the future. Just take the first step and reach out for help. Then with help you can take baby steps towards your goal. The amazing goal of being free from the chains of substance abuse is worth it!  Below are some resources to help you find substance use professionals to help you, or a loved one, find treatment.

 

References

AMA Council on Pharmacy and Chemistry. (1933). Benzedrine. Journal of the American Medical Association. (101) p. 1315.

Bett, WR. (1946). Benzedrine sulphate in clinical medicine: A survey of the literature. Postgraduate Medical Journal 22: p. 205–218

Bradley, C. (1937). Behavior of children receiving Benzedrine. American Journal of Psychiatry 94: p. 577–585.

Connell, P. (1966). Clinical manifestations and treatment of amphetamine type of dependence. JAMA 196: p. 718–723.

Dunlop, D. (1970). The Use and Abuse of Psychotropic Drugs.  Proceedings of the Royal Society of Medicine. (63) p. 1279–1282.

Drug Enforcement Administration [DEA]. (2017).  Drug fact sheet: Amphetamines. Retrieved from https://www.dea.gov/druginfo/drug_data_sheets/Amphetamines.pdf

Goodman, L., & Gilman. A. (1937) Benzedrine Sulfate ‘pep pills’ [editorial].  Journal of the American Medical Association. (108) p. 1973–1974.

Heal, D., Smith, S., Gosden, J., & Nutt, D. (2013). Amphetamine, past and present: a pharmacological and clinical perspective.  Journal of Psychopharmacology: Jun; 27(6): p. 479–496. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666194/

Jackson, B. (1966). White-Collar pill party. Atlantic Monthly 218 (August 1966): p. 35–40.

Substance Abuse and Mental Health Services Administration (SAMHSA). (2006).  Results From the 2005 National Survey on Drug Use and Health: National Findings. Retrieved from http://oas.samhsa.gov/NSDUH/2k5NSDUH/2k5results.htm

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