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What are the Common Effects?

Stimulants such as cocaine and methamphetamine can produce euphoric effects. Smoking or injecting these drugs cause an intense, immediate "rush" that lasts just a few minutes. Snorting or swallowing these drugs produces a high that is less intense but lasts longer. [2] [4]

Stimulants can cause the heart to beat faster and blood pressure and metabolism to increase. They also can cause users to become more talkative, energetic, and anxious. [4]

Repeated use of stimulants can lead to feelings of hostility or paranoia in some users. Single high doses can produce dangerously high body temperatures and an irregular heartbeat. [11]

Cocaine causes the body's blood vessels to become narrow, constricting the flow of blood. This forces the heart to work harder to pump blood through the body. The heart may work so hard that it temporarily loses its natural rhythm. This is called fibrillation, and it can be very dangerous because it stops the flow of blood through the body. [1] Physical symptoms of cocaine overdose may include chest pain, nausea, blurred vision, fever, muscle spasms, convulsions, and coma. [2]

Methamphetamine can also cause a variety of heart problems, including rapid heart rate, irregular heartbeat, and irreversible, stroke-producing damage to small blood vessels in the brain. [4] It can also cause high blood pressure, shortness of breath, nausea, vomiting, and diarrhea. Methamphetamine can also increase body temperature, which can be lethal if not treated rapidly. [3]

How Stimulants Produce Euphoria

Stimulants change the way the brain works by changing the way nerve cells communicate. Nerve cells, called neurons, send messages to each other by releasing special chemicals called neurotransmitters. Neurotransmitters work by attaching to key sites on neurons called receptors. [3] Click here (http://teens.drugabuse.gov/facts/facts_brain1.asp#communicate) for more information on how the brain communicates (neurotransmission).

There are many types of neurotransmitters, but the transmitter dopamine is the one most affected by stimulants and many other drugs. Dopamine is what makes people feel good when they do something they enjoy, like eating a piece of chocolate cake or riding a roller coaster. Stimulants cause dopamine to build up in the brain and make users feel intense pleasure and a heightened state of increased energy. But with repeated use, stimulants can decrease some of the brain's dopamine receptors, dampening users' ability to feel pleasure at all. Then users need to take more and more of the drug to experience the same pleasure. [1] [12]

Long-Term Effects

As with many other drugs of abuse, long-term stimulant abuse can result in addiction, a chronic, relapsing disease characterized by compulsive drug-seeking and drug use and accompanied by functional and molecular changes in the brain. [2] [4]

Some cocaine users report panic attacks and feelings of restlessness, irritability, and anxiety. Users may also experience a full-blown paranoid psychosis in which they lose touch with reality and hear voices that are not there (auditory hallucinations). [2]

Use of methamphetamine over time may cause violent behavior, anxiety, confusion, and insomnia. Heavy users may also display a number of psychotic features, including paranoia, auditory hallucinations, mood disturbances, and delusions (for example, the sensation of insects creeping on the skin, called "formication"). The paranoia can result in homicidal as well as suicidal thoughts. [4]

Some users believe that methamphetamine can increase their sex drive. However, research indicates that long-term methamphetamine use may be associated with decreased sexual functioning, at least in men. [4]

Lethal Effects

Using cocaine or crack-whether snorted, injected, or smoked-can lead to overdose, which can cause acute emergencies with the heart or brain, sometimes resulting in sudden death. [2] In rare instances, sudden death can occur with the first use of cocaine. Cocaine-related deaths are often a result of cardiac arrest or seizures followed by respiratory arrest. [2]

People who abuse both cocaine and alcohol compound the danger each drug poses. NIDA-funded researchers have found that when the human liver is exposed to both cocaine and alcohol, it manufactures a third substance, cocaethylene, that intensifies cocaine's euphoric effects, possibly increasing the risk of sudden death. [13]

Hyperthermia (elevated body temperature) and convulsions occur with methamphetamine and cocaine overdoses, and if not treated immediately, can result in death. [4]

References

1.	National Institute on Drug Abuse. Mind Over Matter: Stimulants (http://teens.drugabuse.gov/mom/mom_stim6.asp): Bethesda, MD: NIDA, NIH, DHHS, NIH Publication No. 03-3857. Printed 1997, reprinted 1998, 2000, 2003. Retrieved May 2005.
2.	National Institute on Drug Abuse. NIDA Research Report-Cocaine Abuse and Addiction (http://www.drugabuse.gov/ResearchReports/Cocaine/Cocaine.html): Bethesda, MD: NIDA, NIH, DHHS. NIH Publication No. 99-4342. Printed May 1999. Revised November 2004. Retrieved May 2005.
3.	National Institute on Drug Abuse. Mind Over Matter: Teaching Guide: Methamphetamines (http://www.teens.drugabuse.gov/mom/tg_meth1.asp): Bethesda, MD: NIDA, NIH, DHHS. Printed 1997, Reprinted 1998 and 2000. Retrieved October 2003.
4.	National Institute on Drug Abuse. NIDA Research Report-Methamphetamine Abuse and Addiction (http://www.drugabuse.gov/ResearchReports/methamph/methamph.html): Bethesda, MD: NIDA, NIH, DHHS. NIH Publication No. 02-4210. Printed April 1998. Reprinted January 2002. Retrieved October 2003.
5.	National Institute on Drug Abuse. NIDA InfoFacts: Methylphenidate (Ritalin) (http://www.drugabuse.gov/Infofax/ritalin.html): Bethesda, MD: NIDA, NIH, DHHS. Revised March 2005. Retrieved May 2005.
6.	National Institute on Drug Abuse. Commonly Abused Drugs (http://www.drugabuse.gov/DrugsofAbuse.html): Bethesda, MD: NIDA, NIH, DHHS. Revised December 2004. Retrieved May 2005.
7.	Office of National Drug Control Policy. Street Terms: Drugs and the Drug Trade (http://www.whitehousedrugpolicy.gov/streetterms/default.asp): April 2, 2005. Retrieved August 2005.
8.	National Institute on Drug Abuse. NIDA InfoFacts: High School and YouthTrends (http://www.drugabuse.gov/infofacts/HSYouthtrends.html): Bethesda, MD: NIDA, NIH, DHHS. Revised December 2004. Retrieved May 2005.
9.	Bachman, J.G., Johnston, L. D., & O'Malley, P. M. (2005). Monitoring the Future: Questionnaire Responses from the Nation's High School Seniors, 2004 (http://monitoringthefuture.org): Ann Arbor, MI: University of Michigan Institute for Social Research. Retrieved August 2005.
10.	National Institute on Drug Abuse. Mind Over Matter: Teaching Guide: Stimulants (http://teens.drugabuse.gov/mom/tg_stim1.asp): Bethesda, MD: NIDA, NIH, DHHS. Printed 1997, Reprinted 1998, 2000. Retrieved October 2003.
11.	National Institute on Drug Abuse. NIDA Research Report-Prescription Drugs: Abuse and Addiction (http://www.drugabuse.gov/ResearchReports/Prescription/prescription4.html): Bethesda, MD: NIDA, NIH, DHHS. NIH Publication No. 01-4881. Printed 2001. Retrieved October 2003.
12.	National Institute on Drug Abuse. Mind Over Matter: Methamphetamines. (http://teens.drugabuse.gov/mom/mom_meth1.asp): Bethesda, MD: NIDA, NIH, DHHS. NIH Publication No.03-4394. Printed 1997. Reprinted 1998, 2000, 2003. Retrieved May 2005.
13.	National Institute on Drug Abuse (1998). NIDA InfoFacts: Crack and Cocaine (http://www.nida.nih.gov/Infofax/cocaine.html): Bethesda, MD: NIDA, NIH, DHHS. Revised March 2005. Retrieved May 2005.

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