Everything you need to know about Amphetamine

The use of amphetamine among the general population in the UK is fairly low; the highest prevalence of users is among those aged under 24 years and decreases through the age groups. The prevalence of amphetamine use in the United Kingdom was 0.5% in 2019, in comparison to other EU nations’ use.

This ranks around mid-table. In 2021, there were 107 amphetamine-related deaths in England and Wales. Although this was a slight increase from the preceding year, the number of deaths as a result of amphetamine use has sharply increased in recent years.

The World Health Organization (WHO) estimates that amphetamines are the second most widely abused drugs worldwide amongst individuals aged 15 to 64.

According to a United Nations (UN) report, some 55 million people around the world used amphetamines in 2016.

Amphetamines are used both medically and recreationally. Unfortunately for many people, use becomes abuse and, eventually, addiction, with potentially devastating consequences for the addict and those around them.

What is amphetamine?

Amphetamine is a synthetic stimulant. Stimulants are drugs that speed up the body’s processes including the heart and breathing rate. Amphetamine is a central nervous system stimulant that has a direct effect on brain chemicals to such a degree that it contributes to hyperactivity, high energy levels, and definitive emotional and psychological disturbances.

Amphetamine was first synthesised in 1887 by Lazăr Edeleanu, a Romanian chemist working in Germany. However, it was not until the 1930s that it was used medically.

Under the trade name Benzedrine, amphetamines were used to treat a whole range of disorders including:

• Fatigue.
• Epilepsy.
• Migraine.
• Depression.
• Alcoholism.
• Schizophrenia.

What are the different forms of amphetamine?

There are several different kinds of amphetamine, some of which are used for legitimate medical purposes when treating conditions such as narcolepsy and ADHD.

Amphetamine is also known under the street names of:

• Amphetamine Sulphate.
• Base.
• Billy.
• Paste.
• Speed.
• Sulph.
• Uppers.
• Whizz.

Speed is the most common street name for amphetamine sulphate, although the term speed is sometimes used to refer to other amphetamine and is man-made in illegal laboratories. Amphetamines come in the form of tablets or an off-white/grey powder and are commonly sold as a wrap. A wrap is usually a square of glossy paper or a self-sealed plastic bag.

By the time the drug is purchased illegally, it is probably only around 5% pure; the other 95% could contain anything from talcum powder to rat poison. Amphetamine tastes bitter and unpleasant.

Another strong form of amphetamine is known as methamphetamine. It comes as powder, crystals or tablets and has a similar euphoric effect to cocaine but a much longer duration of action.

In the crystal form the salt base has been removed, meaning the drug can be ignited on foil and smoked, in a similar way to crack cocaine. This form of the drug is often referred to as crystal meth or ice.

Can amphetamine be addictive?

Amphetamine has a very high potential for psychological dependence. Physical dependence is also a very strong possibility in some people. Dependence can indicate that an amphetamine user has gone beyond abuse and has become addicted.

If you take a lot of amphetamine on a regular basis you can build up a tolerance to the drug so that you need higher doses just to get the same buzz or to feel normal. Regular users can increasingly take more amphetamine to avoid unpleasant withdrawals.

In withdrawal, an amphetamine addict is likely to experience severe cravings that can persist for days. Other withdrawal symptoms include hallucinations, delusions, aggressive tendencies, and a host of physical symptoms that range from headaches to nausea.

The withdrawal symptoms are serious enough that amphetamine addicts should not try to stop using on their own. This is one drug in which medical supervision is absolutely necessary for safe and effective withdrawal. Following withdrawal, recovering addicts enter a psychotherapeutic treatment programme that usually takes up to 12 weeks to complete.

What is amphetamine used for?

Stimulants such as amphetamine work in different ways, but all involve chemical changes that affect the central or peripheral nervous system. Drugs like amphetamine work by increasing the level of a neurotransmitter called dopamine in the brain.

Prescribed amphetamines are used to treat a number of conditions, including but not limited to:

• Depression – In rare cases, amphetamines are used alongside standard antidepressants to treat some types of depression that do not respond to other treatments, especially in people who also experience fatigue and apathy.
• Attention deficit hyperactivity disorder (ADHD) – This is characterised by hyperactivity, irritability, mood instability, attention difficulties, lack of organisation, and impulsive behaviours. Amphetamines reverse some of these symptoms and have been shown to improve brain development and nerve growth in children with ADHD. Long-term treatment with amphetamine-based medication in children appears to prevent unwanted changes in brain function and structure. Scientists carrying out a review of 20 studies concluded that stimulants are probably helpful for people with ADHD.
• Narcolepsy – A person with narcolepsy will experience excessive daytime sleepiness and irresistible sleep episodes, called “sleep attacks”. In a person with this condition, strong emotions can trigger a sudden loss of muscle tone, or cataplexy, which causes a person to collapse and possibly fall down. It also involves frequent and unexpected bouts of sleep. Amphetamines and amphetamine derivatives have been used in the past to treat narcolepsy. Due to concerns over the side effects, however, amphetamines are increasingly being replaced.
• Chronic lethargy – Although Amphetamines are sometimes prescribed, the National Institute for Health and Care Excellence (NICE) state methylphenidate should not be used for the treatment of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).
• Morbid obesity – Under the name Benzedrine, amphetamines were first used to treat obesity in the 1930s, due to their appetite-suppressing capabilities. Currently, medical professionals do not recommend using amphetamines and their derivatives to help reduce obesity. However, in 2015, after carrying out a small study, researchers suggested that dexamphetamine might be a safe and effective way of boosting people’s motivation for lifestyle changes that can lead to weight loss.

As long as the drug is used as prescribed, it can be very effective at treating these conditions. However, Amphetamine makes the user feel excited, confident and energetic. Some people use amphetamine to suppress their appetite, so they can go for a long time without eating.

Once people begin to notice these appealing effects then it can be tempting for them to begin taking this prescription drug for the wrong reasons. The individual can quickly become addicted and may then turn to illegal sources in order to get their hands on more of the drug.

How is amphetamine abused?

A person abusing amphetamine may be taking the drug because a doctor prescribed it. Taking higher doses than recommended, or more frequently than the prescription calls for, would definitely be considered abuse. Unfortunately, the line between amphetamine addiction and abuse is often sometimes difficult to distinguish because of the psychological effects of this drug.

Illicit amphetamine can be snorted, smoked, swallowed, injected or mixed into a drink. Snorting amphetamine can damage your nose and injecting it is extremely dangerous. Many serious diseases such as H.I.V. are spread by people sharing needles. Remember, if you must inject, always use a clean needle and never share.

Individuals who become addicted to amphetamine frequently take other substances of abuse, either alongside or alternating with their amphetamine consumption, and may become addicted to these other substances as well as to amphetamine.

Behavioural addictions are often found in amphetamine addicts, in particular sex addiction, as amphetamine is frequently used as a sex aid. Amphetamine use lowers inhibitions and decreases the quality of decision-making, making engagement in addictive behaviours significantly more likely. Some individuals addicted to amphetamine are also addicted to gambling, shopping, and other behaviours offering a comparatively intense psychological “rush”.

How does amphetamine affect the body?

Amphetamine is a very dangerous drug when abused.

The physical and psychological side effects ranging from mild to severe can include:

• Loss of appetite, nausea, rapid weight loss.
• Poor diet, which can lead to serious nutritional deficiencies.
• Abdominal pain.
• Difficulty urinating.
• Impotence and loss of libido.
• Erectile dysfunction, and especially frequent or persistent erections.
• Acne, rash, hives.
• Blurred vision.
• Dry mouth.
• Teeth grinding.
• Tics.
• Profuse sweating.
• Increased likelihood of seizures for susceptible individuals.
• Low or high blood pressure.
• Damage to many different organs in the body including the heart – it can trigger rapid heart rate and/or heart failure.
• Damage to the respiratory system including faster, deeper breaths, especially in those with other lung conditions, nasal congestion.
• Nosebleed.
• Raynaud’s phenomenon, where there is reduced blood flow to the extremities.
• Mental health problems including depression and psychosis.
• Increased alertness and focus.
• Apprehension, anxiety, irritability and restlessness.
• Intense mood swings.
• Grandiose behaviour or an exaggerated sense of self-importance.
• Chronic insomnia.
• Obsessive behaviours.
• Aggressive behaviour.
• Suicidal tendencies.
• In rare cases, psychosis may occur.

The comedown from speed can last several days, and users often say they feel lethargic and sad after taking it. Regular use of speed can also lead to problems with learning and concentration.

Psychological cravings for amphetamine can be stronger than the physical cravings. Nevertheless, taking amphetamine long enough can create physical dependence in which the body simply cannot function normally without at least some of the drug in the system. Physical dependence is the direct result of the body having to adjust to increased energy levels while under the influence of amphetamine.

How long the effects last and the drug stays in your system depends on how much you have taken, your size and what other drugs you may have also taken. The high can last between 3 and 6 hours. Amphetamine can be detected in a urine test for 1 to 5 days after using.

People who follow the prescribed, therapeutic dose are unlikely to experience severe adverse effects. If you are taking the drug under prescription and experience any side effects, you should contact your GP immediately.

What are the risks of amphetamine?

Amphetamine puts a strain on your heart, so it is definitely not advisable for people with high blood pressure or a heart condition to take the drug, and some users have died from taking too much. Children and teenagers who have a heart problem may be at risk of sudden death if they use amphetamine.

Other pre-existing conditions that can make amphetamine unsafe to use include:

• Sensitivity to amphetamine or its derivatives.
• Moderate to severe hypertension.
• A tendency to become agitated.
• A history of depression, bipolar disorder, motor or verbal tics, or Tourette’s syndrome.
• Thinking about or attempting suicide.
• Glaucoma.
• Overactive thyroid, known as hyperthyroidism.

People with a history of drug abuse or addiction should not use amphetamine. Anyone who is taking supplements should make sure their doctor knows about this, if they may be prescribed amphetamine. The herbal supplement St. John’s wort, and the nutritional supplement glutamic acid (L-glutamine) can interact with amphetamine.

Those abusing amphetamine could become caught in a vicious cycle. If they are not taking the drug, they feel dreadful, so they continue with the abuse in order to keep going. The more they abuse the substance, the higher their tolerance for it becomes, which means having to keep on taking more in order to get the same effects.

There is also a temptation for users to use benzodiazepines and anxiolytics to come down from the high (the effects of the drug wearing off). Use of these has additional legal, dependency and medical issues – the come down will pass without using more drugs.

Dose levels between prescribed pharmacy supplied amphetamine and “street” formulations can be difficult to work out so there are dangers of overdosing.

All stimulants, including amphetamine, cause the body to overheat and sweat, so dehydration is a very real danger. Regular amphetamine use can lead to problems eating and sleeping, as well as feelings of anxiety and paranoia and a lowered resistance to infection.

People who crush and inject amphetamine tablets may have blockages in their small blood vessels, as some of the components do not break down.

An amphetamine overdose can be fatal, with death typically resulting from:

• Cardiogenic shock.
• Circulatory collapse.
• Bleeding in the brain.
• Hyperpyrexia.
• Kidney failure.
• Pulmonary hypertension.
• Respiratory collapse.

Other serious physical symptoms of amphetamine overdose include pulmonary oedema, rhabdomyolysis, fluctuating blood potassium levels and metabolic acidosis.

Short-term and long-term effects of amphetamine

There is evidence that amphetamine use to treat ADHD could slow growth in children. Minor effects on the cardiovascular system, including a rise in heart rate and blood pressure, may have long-term effects.

People take amphetamine to boost libido, increase wakefulness, improve cognitive control, enhance sociability, and induce euphoria. It can also speed up reaction times, increase muscle strength, and reduce fatigue. However, when amphetamines are used at higher doses and through routes that are not prescribed by a doctor, they can have severe adverse effects. Dopamine levels in the brain can rise quickly, and to a great extent.

Overuse and repeated abuse can lead to:

• Psychosis and delusions.
• Feelings of paranoia and hostility.
• Cardiovascular problems, including stroke.
• Reduction in cognitive ability.
• Breakdown of muscle and malnutrition.

Many heavy amphetamine users grind or “gurn” their teeth and jaws; this will damage tooth enamel. Amphetamine also causes pupil dilation which is sometimes a very obvious indication of use.

Some other signs which may indicate that an individual is currently experiencing the effects of amphetamine consumption may include:

• Increased body temperature.
• Euphoria.
• Accelerated breathing.
• Increased levels of energy and alertness.
• Decreased fatigue.
• Decreased appetite.
• Increased blood pressure.
• Dry mouth.

The long-term effects of amphetamine use are what make the drug so dangerous. Some of the harm caused by amphetamines can be permanent if the abuser waits too long to be treated. But perhaps worst of all is the tendency amphetamine abusers have toward irrational behaviour.

Thousands of abusers are injured every year as a result of doing things they would not have done had they not been under the influence.

The effect of sustained amphetamine abuse on families of abusers is quite profound. Children and partners can become fearful of the amphetamine user to the point of generally being scared for their lives. Parents can find themselves at their wits’ end with an amphetamine-using teenager who threatens to harm them whenever they are on the drug.

Amphetamine and the law

A drug or other substance is tightly controlled by the UK government because it may be abused or cause addiction. Controlled substances with known medical use, such as amphetamine, are available only on prescription from a medical professional.

The Misuse of Drugs Act (MDA) 1971 established the system by which illicit drugs or controlled substances are classified. Its fundamental purpose is to provide a regulatory framework which controls the availability of, and access to, certain substances.

Within this Act, criminal penalties are set with reference to the risk or to the harm caused by a drug and the type of illegal activity undertaken, for example, possession or supply / trafficking.

There are three categories of drugs which are Class A, Class B and Class C. Most amphetamines are controlled as Class B drugs under the Misuse of Drugs Act, which means it is illegal to have for yourself unless under prescription, give away or sell. Possession can lead to 5 years in prison, an unlimited fine or both. Supplying someone else, even your friends, can lead to 14 years in prison, an unlimited fine or both.

If you are caught driving under the influence of amphetamine, you may receive a heavy fine, driving ban, or prison sentence. Amphetamine that has been prepared for injection becomes a Class A drug under the Misuse of Drugs Act, and can get you tougher sentencing if you are caught with it or selling it.

Methamphetamine, however, is classified as a Class A drug. Possessing methamphetamine leads to a maximum sentence of 7 years and/or a fine. Possession with intent to supply, supplying and production all have a maximum sentence of life imprisonment and/or a fine.

Final thoughts

Anyone who is concerned about drugs, whether this is your own use of substances, or you feel under pressure to take drugs, or if you are worried about a friend or family member taking drugs, there is confidential help and advice available from FRANK 24 hours a day, 7 days a week, call 0300 123 6600.

Other sources of information, help and advice include:

• Drug Wise.
• Recovery 0203 553 0324.
• Release 020 7324 2989 – provides a free confidential and non-judgemental national information and advice service in relation to drugs and drug laws.
• UK Rehab 02038 115 619.