Stimulant Addiction: Symptoms, Risks, and Treatment Resources

What is a Stimulant?

Stimulants are a class of drugs that increase activity in the central nervous system (CNS), enhancing alertness, attention, and energy. They include both prescription medications, which are used to treat conditions like ADHD and narcolepsy, and illicit substances with no medical use. They also tend to be highly addictive, with Adderall, meth, and crack cocaine being among the most commonly abused stimulants.

Stimulants provide a wide range of experiences, from extreme focus and alertness to euphoria, hyperfixation, aggression, and depression. The U.S. Drug Enforcement Agency (DEA) classifies drugs with a high potential for abuse that have recognized medical uses as Schedule II substances. This includes certain stimulants like Adderall and methamphetamine prescribed under specific conditions, as well as cocaine, which is used for certain medical purposes despite its high abuse potential.[1]. There are also unscheduled stimulants, like caffeine, which have a lower potential for abuse than cocaine and methamphetamine.

Stimulant Quick Reference

How do Stimulants Work?

Stimulants trigger increased central nervous system activity by promoting the production of two key neurotransmitters  — dopamine and norepinephrine. Dopamine is linked to feelings of happiness and satisfaction. Norepinephrine is connected to memory formation and learned behavior, which helps reinforce addictive behaviors[2].

What are the Effects of Stimulants?

Stimulants provide an initial surge of warmth, energy, euphoria, and hyperfocus. This is followed by an abrupt come down during which users report feeling heavy, exhausted, depressed, irritable, and subject to intense cravings for more of the stimulant drug.

The high’s duration and intensity depend on multiple factors, including the substance, how it’s consumed, and the person’s tolerance. Crack cocaine tends to have the shortest high, followed by meth and then Adderall.

The Desirable Effects of Stimulant Drugs

Although the way it is taken may vary (such as inhaling for cocaine or consuming/injecting for methamphetamine), addiction to stimulants has similar addictive patterns and potential detrimental results as addiction to inhalants.

People who use stimulants like crack cocaine, meth, and Adderall often report enjoyable short-term effects like:

• A ‘euphoric’ feeling is described as a flood of warmth across the body
• Intense happiness and confidence
• A boost of energy and sociability
• Improved focus and motivation
• The sensation of ‘breathing easier
• Decreased appetite
• Increased heart rate, blood pressure, and blood sugar

The Negative Effects of Stimulant Drugs

Users of stimulant drugs may find themselves facing negative and sometimes life-threatening effects. This risk increases with dosage size, duration of use, and purchasing stimulants illegally, as they may be cut with other drugs and/or household supplies to increase their potency or volume.

Documented negative effects of stimulants[3] include but are not limited to:

• Headaches and cerebrovascular events
• Anxiety, paranoia, and psychosis
• Jitteriness and sweating
• Weight loss
• High blood pressure (hypertension)
• Insomnia and sleep disturbances
• Chest pain
• Heart palpitations, irregular heartbeat (arrhythmias), and/or a racing heart (tachycardia)
• EKG abnormalities: inappropriate sinus tachycardia, sinus arrhythmia, prolonged QT, premature ventricular contractions, ventricular tachycardia
• Sudden cardiac death
• Seizures

Stimulants and Overdoses

Deaths related to stimulant overdoses are on the rise and have more than tripled between 2010 and 2017[4]. Some factors behind this include a rise in stimulant drug use and an increase in dangerously potent opioids, such as fentanyl, contaminating most drug supplies. Recognizing the signs is key to helping someone overdosing on a stimulant.

Recognizing the Signs of a Stimulant Overdose

Depending on the substance taken, the dosage, purity of the drug, and other underlying medical symptoms, the signs and symptoms of a stimulant overdose may vary. However, some common indicators of a sublethal stimulant overdose may include:

• Dizziness
• Confusion
• Flushed skin
• Heart palpitations and irregular heartbeat (arrhythmias)
• Hallucinations and delirium
• Panic and anxiety
• Mood swings
• Vomiting
• Cramps
• Excessive Sweating
• Pupil dilation

A life-threatening overdose on stimulant drugs presents with ‘bigger symptoms,’ which may include:

• High temperature and fever
• Cardiac Arrest
• Convulsions
• Severely high blood pressure
• Irregular breathing

All signs and symptoms of either a sublethal or life-threatening stimulant drug overdose require immediate medical treatment.

It’s important to note that the risk of overdose on a stimulant increases when mixed with other substances. If you are considering mixing stimulants with other substances, make a plan not to use them alone.

Learn More About Specific Stimulant Drugs

There are various kinds of stimulant drugs, some prescription and some illicit. While they impact the central nervous system similarly, each has unique effects and health risks. Click on the links below to learn more about specific stimulants.

• Adderall Addiction
• Crack Addiction
• Meth Addiction

What is Stimulant Drug Abuse?

Stimulant drug abuse encompasses the misuse of prescription stimulants, such as taking pharmaceutical amphetamines like Adderall without a prescription or not as prescribed, as well as the use of illicit stimulants like cocaine, crack, and meth. Misuse can indicate a risk of developing Stimulant Use Disorder.

Understanding Stimulant Addiction

Addiction to a stimulant drug can happen to any individual or family. According to the 2020 National Survey on Drug Use and Health[5], 10.3 million people aged 12 or older reported stimulant drug abuse during the previous 12-month period. This includes a wide range of substances, including crack cocaine, powder cocaine, meth, Adderall, and Ritalin.

In 2021, over 5,400 New Jersey residents were admitted to emergency services due to stimulant use or abuse. Over 800 of those admits were first-time participants in substance abuse treatment.[6]

Tennessee ranks in the top three for states with the highest rate of prescription drug abuse. The percentage of fatal drug overdoses that involved stimulants in this state numbered 44% of all fatal drug overdose deaths in 2019.[7]

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), categorizes patterns of stimulant misuse that lead to significant impairment or distress as Stimulant Use Disorder. This includes a range of behaviors from abuse to dependence on stimulants. Stimulant Use Disorder requires the presence of 2 or more of the following criteria in the last 12 months:

1. The stimulant is often taken in larger amounts or over a longer period than was intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control stimulant use.
3. Much time is spent on activities necessary to obtain the stimulant, use it, or recover from its effects.
4. Craving, or a strong desire or urge to use the stimulant.
5. Recurrent stimulant use results in a failure to fulfill major role obligations at work, school, or home.
6. Continued stimulant use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the stimulant
7. Important social, occupational, or recreational activities are given up or reduced because of stimulant use.
8. Recurrent stimulant use in situations in which it is physically hazardous.
9. Stimulant use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the stimulant.

An increase in tolerance, characterized by a need for markedly increased amounts of the stimulant to achieve intoxication or the desired effect or a markedly diminished effect with continued use of the same amount, is a criterion for Stimulant Use Disorder in both prescribed and illicit stimulant use.

Treating Stimulant Use Disorder

Recovery from Stimulant Use Disorder is possible, and there is a large selection of medical, therapeutic, and peer-led tools and resources available to help. Every recovery journey is different but typically involves three key stages — withdrawal management, therapeutic treatment, and long-term lifestyle maintenance.

Managing Stimulant Withdrawal

Individuals will begin to notice withdrawal symptoms almost immediately after their last dose. Symptoms of withdrawal will vary based on the substance used but commonly include anxiety, restlessness, agitation, exhaustion, severe but temporary depression, and suicidal ideation.

These symptoms may last for 96 hours to a few weeks and may be lessened by support from your physician. For this reason, some Stimulant Use Disorder treatment programs recommend in-patient support for this portion of recovery.

Therapies Used in Stimulant Use Disorder Treatment

The second stage of Stimulant Use Disorder recovery involves the support of caring psychologists and therapists who understand that addiction is a disease. Typically, this stage involves a combination of one-on-one talk therapy, behavior skills groups, and peer-facilitated support groups. In some cases, therapies such as psychodrama therapy, or experiential therapy might also be used.

Lifestyle Maintenance for Stimulant Use Disorder

The last stage of recovery from Stimulant Use Disorder involves cultivating a lifestyle designed to optimize physical and mental health, interpersonal and community connections, and lasting sobriety.

This may include continued attendance at peer-led support groups, relationship counseling, vocational guidance and training, new recreational activities, and a solid social network.[8]

Counseling may continue for months or years, depending on what works best for the individual in recovery.