From 2011 to 2017, the number of people seeking opioid treatment who reported past-month MA use increased from nearly 19 percent in 2011 to 43 percent in 2017 (M. S. Ellis et al., 2018). From 2015 to 2017, the number of people with past-month heroin use who reported also using MA tripled from 9 to 30 percent, reflecting what some have termed a “twin epidemic” of opioid and MA addiction (Strickland et al., 2019). Cocaine use has been similarly linked to multiple psychiatric disorders, including ADHD, PTSD, bipolar disorder, antisocial personality disorder, eating disorders, insomnia disorder, and anxiety disorders (Butler et al., 2017; SAMHSA, 2020l). Typically, uncomplicated psychosis induced by stimulants resolves rapidly unless more of the drug is taken. However, observational studies from Japan and Thailand suggest that MA-induced psychosis can persist well beyond the 1-month cutoff in DSM-5 and may become a more chronic condition, even in individuals without a previous psychiatric history (Glasner-Edwards & Mooney, 2014). For MA, withdrawal symptoms seem to be most severe in the initial days following cessation of use (UNODC, 2019b).

Hitting a nerve causes intense electric or burning pain both above and below the injection site (Dunn & Gauthier, 2020). After the injury, pain and abnormal sensations like burning or neuropathy (pins and needles) in the area served by the nerve can persist. Other forms of nerve damage also may occur with cocaine or MA use (e.g., nerve compression; Dunn & Gauthier, how long do amphetamines stay in your system 2020). In a sample of more than 900 people with injection drug use (Colledge et al., 2020), nerve damage was the most commonly reported injection-related injury and disease, occurring in 19 percent of the sample. The potential increased risk of Parkinson’s disease specifically has not been observed among people taking cocaine (Lappin et al., 2018).

Chapter 3—Medical Aspects of Stimulant Use Disorders

To some extent, the dangerous consequences and addictive potential of stimulants also reflect the route of drug administration. Routes that facilitate more rapid drug delivery are more strongly linked to addiction and worse severity of addiction (Allain et al., 2015). Inhalation and intravenous injection of cocaine or MA are more strongly linked to addiction than oral, intranasal, and transdermal routes and in some cases are https://ecosoberhouse.com/ also linked to other harms, such as increased risk of overdose and more frequent drug use (Allain et al., 2015). Intravenous use produces the greatest click here effect with the greatest risk for negative side effects compared to intranasal or oral routes. The information in this chapter may also be useful to nonmedical treatment providers to help them recognize physical symptoms that would warrant medical attention and follow-up.

The alpha-blocker phentolamine also may be used to manage hypertension but is not effective for tachycardia (Richards & Le, 2020). Beta-blockers are generally discouraged in the treatment of stimulant-induced hypertension (and particularly for cocaine), although this is an unresolved matter with some guidelines offering mixed advice on their use or avoidance. As tolerance develops to the euphoric effects, people tend to increase doses and frequency of stimulant administration in an attempt to recapture the original and most intense sensations. During this phase, intermittent consumption is prolonged with the discovery that higher doses produce greater effects and more frequent doses prolong those effects. The effects of stimulant use also reflect the temporal pattern of drug administration and the individual’s experience history or chronicity of use. Some people use stimulants only periodically, although most discover that tolerance builds rapidly to many of the desired effects, particularly euphoria, so increasing doses and increasing frequency are needed to achieve similar effects.

What should I know about storage and disposal of this medication?

Another emphasis is the need for establishing and ensuring linkages between medical facilities and appropriate, comprehensive SUD treatment/rehabilitation programs. The Journal of the American Medical Association’s Council on Drugs announced the introduction of methylphenidate (Ritalin) in its “New and Nonofficial Drugs” section in 1957 (Kautz, 1957). Intravenous methylphenidate (10–30 mg, three times daily) improved the majority of 164 patients manifesting a variety of symptoms including sleepiness, tremors, drooling, and nasal congestion (Ferguson et al., 1956). Methylphenidate (50 mg i.v.) was also used to increase blood pressure in a comatose woman who had attempted suicide by overdose on the sedative hypnotics ethchlorvynol (Placidyl) and methyprylon (Noludar) mixed with alcohol (Ivey, 1958). Methylphenidate (0.4 mg/kg i.m.) was also injected into newborn infants with “depression,” describing poor breathing, resulting in a “marked increase in respiratory activity” and “increased crying and bodily activity” (Gale, 1959).