A stimulant is a psychoactive drug that operates by blocking the reuptake of dopamine, norepinephrine, and serotonin in the synapses of the CNS. Because more of these neurotransmitters remain active in the brain, the result is an increase in the activity of the sympathetic division of the autonomic nervous system (ANS). Effects of stimulants include increased heart and breathing rates, pupil dilation, and increases in blood sugar accompanied by decreases in appetite. For these reasons, stimulants are frequently used to help people stay awake and to control weight.
Used in moderation, some stimulants may increase alertness, but used in an irresponsible fashion they can quickly create dependency. A major problem is the “crash” that results when the drug loses its effectiveness and the activity of the neurotransmitters returns to normal. The withdrawal from stimulants can create profound depression and lead to an intense desire to repeat the high.
Caffeine is a bitter psychoactive drug found in the beans, leaves, and fruits of plants, where it acts as a natural pesticide. It is found in a wide variety of products, including coffee, tea, soft drinks, candy, and desserts. In North America, more than 80% of adults consume caffeine daily (Lovett, 2005). 1 Caffeine acts as a mood enhancer and provides energy. Although the U.S. Food and Drug Administration lists caffeine as a safe food substance, it has at least some characteristics of dependence. People who reduce their caffeine intake often report being irritable, restless, and drowsy, as well as experiencing strong headaches, and these withdrawal symptoms may last up to a week. Most experts feel that using small amounts of caffeine during pregnancy is safe, but larger amounts of caffeine can be harmful to the fetus (U.S. Food and Drug Administration, 2007). 2
Nicotine is a psychoactive drug found in the nightshade family of plants, where it acts as a natural pesticide. Nicotine is the main cause for the dependence-forming properties of tobacco use, and tobacco use is a major health threat. Nicotine creates both psychological and physical addiction, and it is one of the hardest addictions to break. Nicotine content in cigarettes has slowly increased over the years, making quitting smoking more and more difficult. Nicotine is also found in smokeless (chewing) tobacco.
People who want to quit smoking sometimes use other drugs to help them. For instance, the prescription drug Chantix acts as an antagonist, binding to nicotine receptors in the synapse, which prevents users from receiving the normal stimulant effect when they smoke. At the same time, the drug also releases dopamine, the reward neurotransmitter. In this way Chantix dampens nicotine withdrawal symptoms and cravings. In many cases people are able to get past the physical dependence, allowing them to quit smoking at least temporarily. In the long run, however, the psychological enjoyment of smoking may lead to relapse.
Cocaine is an addictive drug obtained from the leaves of the coca plant. In the late 19th and early 20th centuries, it was a primary constituent in many popular tonics and elixirs and, although it was removed in 1905, was one of the original ingredients in Coca-Cola. Today cocaine is taken illegally as recreational drug.
Cocaine has a variety of adverse effects on the body. It constricts blood vessels, dilates pupils, and increases body temperature, heart rate, and blood pressure. It can cause headaches, abdominal pain, and nausea. Since cocaine also tends to decrease appetite, chronic users may also become malnourished. The intensity and duration of cocaine’s effects, which include increased energy and reduced fatigue, depend on how the drug is taken. The faster the drug is absorbed into the bloodstream and delivered to the brain, the more intense the high. Injecting or smoking cocaine produces a faster, stronger high than snorting it. However, the faster the drug is absorbed, the faster the effects subside. The high from snorting cocaine may last 30 minutes, whereas the high from smoking “crack” cocaine may last only 10 minutes. In order to sustain the high, the user must administer the drug again, which may lead to frequent use, often in higher doses, over a short period of time (National Institute on Drug Abuse, 2009). 3 Cocaine has a safety ratio of 15, making it a very dangerous recreational drug.
Amphetamine is a stimulant that produces increased wakefulness and focus, along with decreased fatigue and appetite. Amphetamine is used in prescription medications to treat attention deficit disorder (ADD) and narcolepsy, and to control appetite. Some brand names of amphetamines are Adderall, Benzedrine, Dexedrine, and Vyvanse. But amphetamine (“speed”) is also used illegally as a recreational drug. The methylated version of amphetamine, methamphetamine (“meth” or “crank”), is currently favored by users, partly because it is available in ampoules ready for use by injection (Csaky & Barnes, 1984). 4 Meth is a highly dangerous drug with a safety ratio of only 10.
Amphetamines may produce a very high level of tolerance, leading users to increase their intake, often in “jolts” taken every half hour or so. Although the level of physical dependency is small, amphetamines may produce very strong psychological dependence, effectively amounting to addiction. Continued use of stimulants may result in severe psychological depression. The effects of the stimulant methylenedioxymethamphetamine (MDMA), also known as “Ecstasy,” provide a good example. MDMA is a very strong stimulant that very successfully prevents the reuptake of serotonin, dopamine, and norepinephrine. It is so effective that when used repeatedly it can seriously deplete the amount of neurotransmitters available in the brain, producing a catastrophic mental and physical “crash” resulting in serious, long-lasting depression. MDMA also affects the temperature-regulating mechanisms of the brain, so in high doses, and especially when combined with vigorous physical activity like dancing, it can cause the body to become so drastically overheated that users can literally “burn up” and die from hyperthermia and dehydration.