Stimulants
Stimulants are sometimes referred to as uppers and reverse the
effects of fatigue on both mental and physical tasks. Two
commonly used stimulants are nicotine, found in tobacco
products, and caffeine, an active ingredient in coffee, tea,
some soft drinks, and many non-prescription medicines. Used in
moderation, these substances tend to relieve malaise and
increase alertness. Although the use of these products has been
an accepted part of U.S. culture, the recognition of their
adverse effects has resulted in a proliferation of caffeine-free
products and efforts to discourage cigarette smoking.
A number of stimulants, however, are under the regulatory
control of the CSA. Some of these controlled substances are
available by prescription for legitimate medical use in the
treatment of obesity, narcolepsy, and attention deficit
disorders. As drugs of abuse, stimulants are frequently taken to
produce a sense of exhilaration, enhance self esteem, improve
mental and physical performance, increase activity, reduce
appetite, produce prolonged wakefulness, and to "get high." They
are recognized as among the most potent agents of reward and
reinforcement that underlie the problem of dependence.
Stimulants are diverted from legitimate channels and
clandestinely manufactured exclusively for the illicit market.
They are taken orally; sniffed, smoked, and injected. Smoking,
snorting, or injecting stimulants produces a sudden sensation
known as a "rush" or a "flash." Abuse is often associated with a
pattern of binge use-sporadically consuming large doses of
stimulants over a short period of time. Heavy users may inject
themselves every few hours, continuing until they have depleted
their drug supply or reached a point of delirium, psychosis, and
physical exhaustion. During this period of heavy use, all other
interests become secondary to recreating the initial euphoric
rush. Tolerance can develop rapidly; and both physical and
psychological dependence occur. Abrupt cessation, even after a
brief two or three-day binge, is commonly followed by
depression, anxiety, drug craving, and extreme fatigue known as
a "crash."
Therapeutic levels of stimulants can produce exhilaration,
extended wakefulness, and loss of appetite. These effects are
greatly intensified when large doses of stimulants are taken.
Physical side effects, including dizziness, tremor; headache,
flushed skin, chest pain with palpitations, excessive sweating,
vomiting, and abdominal cramps, may occur as a result of taking
too large a dose at one time or taking large doses over an
extended period of time. Psychological effects include
agitation, hostility, panic, aggression, and suicidal or
homicidal tendencies. Paranoia, sometimes accompanied by both
auditory and visual hallucinations, may also occur. In overdose,
unless there is medical intervention, high fever, convulsions,
and cardiovascular collapse may precede death. Because
accidental death is partially due to the effects of stimulants
on the body's cardiovascular and temperature-regulating systems,
physical exertion increases the hazards of stimulant use.
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