The United Nations (UN) estimates that the number of amphetamine abusers to be between 13-53 million globally and most of them are between 15-64 years old. Amphetamines are a group of psychoactive drugs that induce a stimulant effect on users. However, they are associated with a high level of psychological dependence and potential for both mental and physical toxicity-related problems (Sevak, William, and Rush).
Being body stimulants, amphetamine's abuse has potential for adverse effects on the abuser. Amphetamines elicit both mental and physical symptoms in active users and those on withdrawal/rehabilitation. Some of the side effects of amphetamine abuse include behavioral derangements, mood disorders, tremors, confusion, anxiety related disorders, and stroke among others. These adverse effects even get worse when there is concomitant amphetamine use with cocaine and alcohol. This not only predisposes the individual to dangerous neuro-toxic effects but also exposes the individual to health risks as transmission of hepatitis C, HIV, and sexually transmitted infections (STIs).
Amphetamines exist in circulation as methamphetamine, dextroamphetamine, and levoamphetamine (Martínez-Quintana et al.) Amphetamine group of drugs can be manufactured anywhere and apparently there are no restrictions to production and supply of these potentially abusive drugs. Now the only way to deal with the menace is to track down abusers of this stimulant. As a measure to curb this vice, the United States has decided to restrict the distribution and sale of medication containing pseudoephedrine. However, amphetamine-based components have been used in the treatment medications for conditions like obesity, narcolepsy, and attention deficit-hyperactivity disorder (London, McCracken, Kuczenski, and Berman).
Abuse of amphetamines is also more common in western Asia and larger parts of Europe. However, there is also a high trend of amphetamine abusers especially in the United States. Martínez-Quintana et al. (2013) estimate that more than 12 million 15-64 years old Europeans abuse amphetamines. These statistics indicate a prevalence of amphetamine abuse among the productive individuals of Asia, Europe, West Africa, and United States. This is not only a public health concern, but also a socio-economic issue since most amphetamine abusers are in the age bracket, 15-64 years.
The aim of this manuscript is to examine the prevalence of amphetamines abuse in the United States and the rest of the world. This paper further explores the advantages and disadvantages of amphetamine use and misuse respectively among the populations.
Epidemiology and context of amphetamine abuse
Abuse of amphetamines and related derivatives especially methamphetamine is increasing in the United States and globally. However, this vice has been reported to be more prevalent in Europe, Western parts of Asia, West Africa, United States, and Central Africa (Meredith, Jaffe, Saxon, and Ang-Lee). Chronic and wide spread abuse of amphetamines has predisposed users to both physical and neuropsychological disorders. According to Rasmussen (2008), this drug is commonly abused among people from age 15 -65 years.
According to Foundation for a Drug-Free World (2014), by the end of 2008, about 13 million United States citizens above 12 years old had used methamphetamine (amphetamine type stimulant) and more than 500,000 were regular users. This indicates that use and abuse of amphetamine stimulants starts at teen-age and extends up to the aging group of persons. Rasmussen (2008) argues that there has been an increased abuse of amphetamines and its derivatives in the United States because of technological advancements that have enable increased production and covert distribution into the world markets. Similarly, by 2008 about 500,000 cases of amphetamine abuse had been reported among Australians (Greene, Braitberg, and Kerr). Consequently, legal, environmental, social, and public health problems arise with an increased proportion of abusers.
Misuse of amphetamines takes many forms and effects of abuse affect victims at varying degrees. Meredith et al. (2005) indicate that there are three levels of amphetamine abuse. One of them is the low intensity abuse where abusers inhale or swallow methamphetamine and other derivatives in order to experience the amphetamine stimulation. Metamphetamine is a derivative of amphetamine and is commonly available form of the stimulant. This makes them to remain awake with extra energy needed to complete a certain task. Others engage in low intensity abuse in order to lose weight. The other level of misuse is binge abuse where abusers inject themselves with amphetamine formulations or smoke in order to have a more extreme experience and extra energy. Dependence is more common at this level. The last category of misuse is the high intensity amphetamine abuse. At this level, the person is already addicted and the aim is to continue taking the drug in order to maintain the intense feeling (rush). Thus, the person is prompted to take more and more of amphetamine leading to more and intense addiction.
Short term effects of amphetamines use and abuse
The amphetamine derivate, metamphetamine (MA) is the widely available form of Amphetamine. Metamphetamine (MA) is more potent and penetrates the central nervous system much faster than the parent form (amphetamine). In the nervous system, MA stimulates release of catecholamines while preventing the reuptake of neurotransmitters like dopamine and norepinephrine. Abuse of amphetamine has both short term and long term socio-economic and health effects. These effects not only affect the individual but also the family and society at large.
Greene, Braitberg, and Kerr (2008) indicates that intake of amphetamine based products stimulates the body system creating a false sense of energy and wellbeing. Thus, after the amphetamine effects dwindle, the individual may experience severe mental and physical breakdown since also the body was pushed too far and faster than normal. Use of amphetamines reduces one’s appetite and hunger pangs. It gives the individual a feeling of stomach fullness. As a result, the individual does not eat and may experience extreme malnutrition and loss of weight (London, McCracken, Kuczenski, and Berman). Besides, abuse of these drugs can cause intense feeling of nausea and vomiting with loss of essential body fluid and electrolytes.
Amphetamines are associated with distorted sleep patterns and may consequently cause insomnia. They also lead to mental derangements like irritability, aggressiveness, and delusions of power. Martínez-Quintana et al. (2013) argue that amphetamines can cause persistent hallucinations, confusion, anxiety related disorders, convulsions, and even death.
Sevak, William, and Rush (2010) add that the short term effect of methamphetamine abuse may include but not limited to anorexia(lack of appetite for food), increased size of pupils, bizarre and violent behavior, acute psychosis, seizures and even death especially on intake of high doses. MA abuse is also associated with high body temperature, excessive sweating, tachycardia (increased heart rate), clenching of jaws, and headaches. According to Meredith, Jaffe, Saxon, and Ang-Lee (2005), high amphetamine abuse leads to sharing of intravenous instruments among users. This behavior predisposes such individuals to HIV and hepatitis C infection among other blood borne diseases. This, therefore, leads to further spread of sexually transmitted infections including HIV since there is also a tendency to engage in unprotected sex.
However, some authors have established that amphetamines may still have some beneficial effects to the user. One of them is increased alertness and attentiveness. Thus, a person becomes more interested in external stimuli. For this reason, amphetamines have been prescribed for the treatment of the attention deficit-hyperactivity disorder (ADHD). Moreover, since amphetamines induce severe loss of appetite and weight loss, these drugs have been prescribed for the treatment of overweight and obesity. However, other scholars have gone ahead to question the risks and benefit associated with amphetamine prescription in obesity, narcolepsy, Parkinson’s disease, and ADHD treatment. Amphetamines and its derivatives have been administered as prescription drugs to treat the social, mental, and psychological derangements in ADHD. Children with ADHD are given daily doses of 2.5mg of amphetamine and gradually increased until there is clinical improvement in the disease.
Similarly, individuals with progressive and increased episodes of sleep (narcolepsy) have also been prescribed 5-60mg of amphetamines on a daily basis because the drug stimulates the central nervous system causing attentiveness and alertness. However, precaution is taken among patients with high blood pressure, cardiac conditions, glaucoma, history of drug abuse, and cerebrovascular disease (Foundation for a Drug-Free World).
Long term effects of amphetamines use and abuse
According to Sevak, William, and Rush (2010), chronic abuse of amphetamines can lead to long term physical and mental effects including cerebrovascular injury, irregular heart rate, hypertension, and organ damage. Amphetamine abuse has been associated with rupture and collapse of blood vessels, and this can lead to cerebrovascular accidents (stroke), high blood pressure, tachycardia (increased heart rate), and damage of visceral organs like the liver, brain, lungs, and kidneys.
Moreover, victims of abuse often suffer memory loss (both short term and long term). Most of the users have difficulty in comprehending abstract ideas and concepts. Besides, intense mood swings are common. Foundation for a Drug-Free World (2014) further indicates that amphetamines misuse subjects the individual to long term physical effects like severe weight loss, tooth decay, psychological dependence, internal organ damage and risk for infections. Moreover, a person can suffer long term mental effects like depression, un-resolving psychosis, brain damage, and paranoia. Besides, amphetamine intoxication often affects transmission of catecholamines leading to chronic neurotoxicity.
As a social and public health concern, amphetamine abuse leads to poor social interactions and aggressive behavior among other behavioral problems. Among school going ages, amphetamine abuse has been associated with exposure to other forms of abuse including alcohol, nicotine, and cocaine abuse. Teenagers and young adults in high school and college often experience memory deficits and this affects learning, performance and career advancement. Chronic use of MA often leads to depletion of catecholamines and withdrawal syndrome may ensue. MA withdrawal syndrome usually manifests with a severe sense of dysphoria, anergia, and suicidal tendencies.
Treatment of MA abuse and withdrawal syndrome is not only costly but takes a long period of valuable time (4-12 months) that could have been invested in more economically beneficial activities. This vice not only exposes the abusers to risk of infection with STIs and blood borne diseases but also the general population. Furthermore, the abuser suffers both physical and mental dysfunctions that could lead to death. However, despite being abused amphetamines have been used therapeutically to treat some conditions like obesity, attention deficit with hyperactivity, and chronic sleep episodes.
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