SAGE Reference

Encyclopedia of Substance Abuse Prevention,

Treatment, & Recovery
Amphetamines

Contributors: Edited by: Gary L. Fisher & Nancy A. Roget

Edited by: Gary L. Fisher & Nancy A. Roget
Book Title: Encyclopedia of Substance Abuse Prevention, Treatment, & Recovery
Chapter Title: "Amphetamines"
Pub. Date: 2009
Access Date: October 17, 2021
Publishing Company: SAGE Publications, Inc.
City: Thousand Oaks
Print ISBN: 9781412950848
Online ISBN: 9781412964500
DOI: http://dx.doi.org/10.4135/9781412964500.n24
Print pages: 70-71
© 2009 SAGE Publications, Inc. All Rights Reserved.
This PDF has been generated from SAGE Knowledge. Please note that the pagination of the online
version will vary from the pagination of the print book.
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Amphetamines, including methamphetamine and dextroamphetamine, are psychomotor stimulants that affect
the serotonin, epinephrine, norepinephrine, and dopamine levels in the brain. Amphetamines are prescribed
to treat various disorders, but they are also illegally manufactured for recreational use. Pharmacotherapies
and cognitive behavioral therapies are used to treat amphetamine addictions, and to date, the only empirically
validated treatment is the Matrix Model.

Amphetamines closely resemble adrenaline, a naturally produced hormone in the body. Amphetamines cause
vasodilation and bronchodilation, as well as an increase in heart rate and blood pressure. Physiological
effects of amphetamines vary depending on the dose and method of administration, but include decreased
appetite, muscular weakness, respiratory depression, chest pain, hyperactivity, nausea, increased sex drive,
dry mouth, headaches, sweating, dizziness, and punding (the repeated performance of some pointless
act for an extended time). Psychological effects of amphetamines include euphoria, insomnia, increased
concentration and alertness, anxiety, increased sociability or talkativeness, aggression, and antisocial
behavior. High doses or continued use of amphetamines can cause a syndrome known as "amphetamine
psychosis," characterized by psychotic behavior including paranoia, delusions, and auditory and visual
hallucinations. Routes of administration for amphetamines include oral ingestion, smoking
(methamphetamine), intranasal, and intravenous (methamphetamine). Khat, the only organically derived
amphetamine, is made from the leaves of the Qat tree in East Africa. The leaves are chewed and produce
similar feelings of euphoria, as well as having anesthetic effects.

Amphetamines are commonly used to treat attention deficit hyperactivity disorder and are used to treat
narcolepsy and other sleeping disorders. However, because amphetamines are so widely prescribed, they are
readily, available for recreational use, and recently, public awareness has increased regarding the potential
for amphetamines abuse. In addition to amphetamines that are medically prescribed, illegally manufactured
amphetamines (e.g., methamphetamine) are commonly abused as well. The National Institute on Drug Abuse
estimated that 4.3% of the U.S. population age 12 and older have used methamphetamines at some point in
their lives. The prevalence of amphetamine abuse on college campuses in the United States is approximately
10% given that stimulants are often used to stay awake in order to study for extended periods.

Tolerance to amphetamines develops quickly with habitual use; thus, the dose needs to be continually
increased to achieve the desired effects. Withdrawal symptoms from amphetamines include intense cravings
for the drug, dysphoria, vivid and unpleasant dreams, depression, increased anxiety, decreased energy
levels, increased appetite, irritability, and an inability to reach REM (rapid eye movement) sleep cycles.
Withdrawal from amphetamines is not medically dangerous and does not usually require inpatient
detoxification. However, observation of depressive symptoms and for suicidality is recommended, as the
severity of depression is associated with the length of abuse.

According to the U.S. Department of Health and Human Services, the rate of treatment admissions for
primary methamphetamine or amphetamine abuse from 1993 to 2003 increased from 13 to 56 admissions per
100,000 patients age 12 or older. In addition, the proportion of primary methamphetamine or amphetamine
admissions referred to treatment by the criminal justice system increased from 36% in 1993 to 51% in 2003.

Antidepressant drugs, which affect serotonin levels, are used to treat the depression that occurs when
stopping amphetamine use. Sedatives are occasionally used on a short-term basis to treat the anxiety and
sleep problems that may occur. An antipsychotic drug may be used to relieve psychotic symptoms such as
delusions, paranoia, and hallucinations and also helps to balance dopamine levels.

The Matrix Model, an empirically validated outpatient treatment for stimulant abuse, was developed in the
1980s and has been used in the treatment of more than 1,000 methamphetamine users. The therapist
develops a positive relationship with the patient, promoting self-esteem, dignity, and self-worth. Therapists
are nonconfrontational, yet realistic and direct in their interactions with patients. The Matrix Model draws from
several other empirically validated treatment approaches for drug addictions; thus, it includes information on
relapse prevention, family and group involvement, drug education, and information regarding support groups.
A treatment manual has been developed, and several studies funded by the National Institute on Drug Abuse
have found treatment to be associated with significant reductions in stimulant use.
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Numerous drugs have been investigated for the treatment of amphetamine use, including fluoxetine,
amlodipine, imipramine, desipramine, and dexam-phetamine (used as a substitution treatment), yet none has
demonstrated significant levels of efficacy in treating amphetamine abuse. Recently, opioid antagonists (e.g.,
naltrexone), used for the treatment of opioid dependence, have been investigated for treating amphetamine
dependence. Naltrexone blocks the rewarding effects of amphetamines by affecting dopamine levels in the
brain. Several studies have reported that naltrexone decreased patients' reports of cravings, consumption,
and the feeling of being "high." Opioid blockers have been shown to attenuate specific effects of
amphetamines in animal studies and have recently proved effective in decreasing several subjective effects
of amphetamines in studies with healthy, human volunteers. One study, which measured the feasibility of
using naltrexone as a pharma-cotherapy in amphetamine-dependent participants, found that compliance with
treatment (naltrexone plus relapse prevention therapy) was 69%. In this study, naltrexone led to a reduction
in the quantity of use and a reduction in the subjective feeling of being "high."

Psychosocial treatments for amphetamine dependence, such as cognitive behavioral therapy (CBT) are
currently being utilized, though CBT is not a universally agreed upon treatment for amphetamine dependence.
CBT for amphetamine use consists of training in coping skills, self-efficacy and refusal skills, problem-solving
skills, self-monitoring, coping with cravings, modeling, planning for relapse prevention, role playing, and
behavioral reversal. One study used CBT in combination with motivational interviewing, which is known to be
effective in addiction treatment. Results indicated that CBT significantly increased amphetamine refusal self-
efficacy ratings posttreatment and was associated with improvements in general health and psychological
domains, such as somatic symptoms, anxiety, social dysfunction, and depression. Another study combining
CBT with motivational interviewing examined whether there were differences between two sessions and four
sessions of CBT in reducing amphetamine use in regular users. Results showed that there was a significant,
overall reduction of amphetamine use in both groups, but there was no significant difference in effectiveness
between the two- and four-session interventions.

Interpersonal Psychotherapy (IPT), originally used in the treatment of depression, was modified for
interventions with cocaine- and stimulant-dependant people in a study conducted with alcohol- and/or
stimulant-dependant participants. IPT was used to identify the role of interpersonal relationships in the
development and maintenance of stimulant dependence and how these factors could increase or decrease
abstinence. Results indicated that IPT did not significantly decrease stimulant use. However, more intense
treatment was associated with a better outcome, regardless of the substance that was targeted in the IPT.

Meggan M. Bucossi & , and Gregory L. Stuart

http://dx.doi.org/10.4135/9781412964500.n24
See also

• Central Nervous System Stimulants

• Illicit and Illegal Drugs
• Methamphetamine

Further Readings

Baker, A., Boggs, T. G., and Lewin, T. J.Randomized controlled trial of brief cognitive-behavioral interventions
among regular users of amphetamine. Addiction96 (2001) 1279–1287http://dx.doi.org/10.1046/
j.1360-0443.2001.96912797.x
Feeney, G. F. X., Connor, J. P., Young, R. M., Tucker, J., and McPherson, A.Improvement in measures of
psychological distress amongst amphetamine misusers treated with brief cognitive-behavioral therapy (CBT).
Addictive Behaviors31 (2006) 1833–1843http://dx.doi.org/10.1016/j.addbeh.2005.12.026
Jayaram-Lindstrom, N., Wennberg, R., Beck, O., and Franck, J.An open clinical trial of naltrexone for
amphetamine dependence: Compliance and tolerability. Nordic Journal of Psychiatry59 (2005)
167–171http://dx.doi.org/10.1080/08039480510023052
U.S. Department of Health and Human Services. (2006). Trends in methamphetamine/amphetamine
admissions to treatment: 1993–2003. The DASIS Report, Issue 9. Retrieved May 20, 2008, from
http://www.drugabusestatistics.samhsa.gov/2k6/methTx/methTX.htm

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