Another major category of drugs that are frequently abused is stimulants. They bare some similarities to narcotics in terms of presentation and effect, which often leads to combinations of drugs from both categories. This article will discuss the details of stimulants, including types, signs of usage, the side effects that users can experience, and how treatment and recovery works.

What Are Stimulants?

Stimulants are drugs that affect the different systems in a person's body, usually by speeding them up. They mainly work by altering certain neurons in the brain by increasing the amount of signals they send to each other. Levels of dopamine, a chemical naturally present in the brain, rise steadily when a person uses stimulants. In the brain, dopamine is typically associated with attention, movement, and pleasure, which makes stimulants an effective method of treating conditions like ADHD. Many legal stimulants are used for such cognitive conditions and the positive effect it these drugs have on patients have made it a standard therapeutic treatments. Some non-medical users have taken stimulants in an effort to stay awake or energized, especially if their job or profession requires long hours or activity. Like with prescription narcotics, these legal drugs can be abused if used outside of their intended purpose or in dosages higher than what was initially prescribed.

There are also illegal stimulants that are generated through illegitimate methods. Such drugs include cocaine and methamphetamine. They can have similar, but amplified, effects as legal stimulants. Some legal drugs, stimulants or otherwise, are combined to create illegal versions. This is usually the case with methamphetamine, as its active and primary ingredients often can be found in legal medications. On a chemical level, it is similar to amphetamine--better known by the name brand Adderall.

Stimulants are a rather large category of drugs, with many legitimate and illegitimate users. A 2014 survey found that 1.6 million people were using stimulants for non-medical purposes, with about two-thirds of which were methamphetamine users. In terms of age groupings, 169,000 non-medical stimulant users and 45,000 methamphetamine users were 12-17 years old. For those aged 18-25, about 406,000 were non-medical users and 86,000 used methamphetamine. Around 1 million adults, 26 year or older, were estimated to be non-medical stimulant users, with about 438,000 methamphetamine users in the same age group. Those rates were significantly higher when compared to the results of previous surveys from 2005 to 2012, although methamphetamine usage seemed to be consistent with past results.

Due to their high potential for misuse and almost guarantee for dependence, stimulants are controlled as Schedule I substances. The vast majority of stimulant medications are only available via prescription and cannot be purchased over-the-counter. Some over-the-counter products do contain chemicals that are classified as stimulants, such as cold and allergy medicines. The sale of these products are usually monitored, which is why you may find that you are asked to show identification or proof that you're 18 years or older when buying certain items. They may also be accessible by request--as in, not accessible on the shelf or in a locked cabinet--and have a limit to how many can be purchased by a customer at a time. Such tactics have been implemented by retailers to curb illegal usage of these products and illegal manufacturing of methamphetamines, which requires some of these products in its ingredients. Few over-the-counter stimulants do not have these protections, like caffeine, even though there is a conscious effort made by some to avoid or limit their consumption.

Appearances and Usage

Due to the medical uses of stimulants, the vast majority of legal stimulants come in a pill or tablet format. They can also come in a powdered or liquid form. Some stimulants, like crystal meth and crack cocaine, have a rock-like form. Depending on the drug itself, it is possible for a stimulant to be converted into another format for use. Pills, for example, could be ground up into a powder or powdered stimulants converted into a liquid state by adding them to water. They can also be combined with other drugs of a similar format to amplify the effects and generate a stronger high.

The usage of stimulants involves swallowing, snorting, injecting intravenously, or smoking the drug. Swallowing usually results in a slower onset of the drug's effects, as the body needs to break pills down and absorb them first. Methods such as snorting or injection can have a much faster effect, almost instantaneous at times. Users usually refer to this as a "rush" or "flash". This can also happen with high dosages or binge users, who often take the drug frequently over the course of a few hours. As a result, it is not uncommon for heavy users to use up their entire supply and increase their chances for overdose.

Prescription stimulants often are available under a brand name. Some may include:

• Amphetamines--Adderall, Bexedrine, or Dexedrine

• Dietary Aids--Meridia, Didrex, Preludin, Adipex, and Bontril

• Methylphenidate--Ritalin or Concerta

Signs of Usage

Signs that present themselves when prescription stimulants are taken correctly can include an increase in energy and focus, an increased heart rate, and a euphoric sensation. The person may not be hungry or eating as much, as stimulants can suppress a person's appetite, which may result in some weight loss over time. Wakefulness should also be expected, and may affect users' sleeping habits.

• Amphetamine Abuse--Prescription stimulants are often amphetamines and some signs of their abuse may present as amplified versions of those listed above. Higher and more frequent dosages result in more of the drug being in the person's system than there should be, preventing the body from resuming its normal dopamine production. The person's body temperature may be higher, as well as their blood pressure and heart rate. Users may also have dilated pupils and faster breathing as a result of prescription stimulant abuse. Insomnia, due to wakefulness, and intense physical exhaustion are also potential signs of usage.

• Methamphetamine Abuse--Methamphetamine or Meth is one of the most well-known illegal stimulants. The effect it has is intense, regardless of the form it is in or how it is used. The most common sign of meth usage is known as "meth mouth," where users exhibit oral and dental issues like broken or decaying teeth and dry mouth. The damage from meth mouth often makes it easier for bacteria to thrive, which can result in tooth infections and mouth sores that may bleed or become infected themselves. Usage of meth often results in high spikes of dopamine, which may trigger violent behavior, anxiety, and paranoia. Sudden mood swings and exhibiting strange or inappropriate emotions--think laughing hysterically when they should be crying--may occur. There is also the potential for hallucinations, both auditory and visual, which may trigger additional aggressive behavior in response. Scratching and itching are also common, as users experience the sensation of something crawling on or underneath their skin; many meth users have noticeable scratch marks, scabbing, and other such injuries as a result.

• Cocaine Abuse--Cocaine is often cut with other substances, including other drugs, which may affect what signs the person exhibits. Most cocaine users develop a tolerance quickly and need to take higher dosages the longer they use, which can amplify the effects. Cocaine users may develop similar symptoms as meth users, specifically high levels of energy and alertness, as well as anxiety or paranoia. Users may also exhibit restlessness, irritability, and a fluctuation of emotions all at once. They may become unexplainably hostile towards those around them, and may even overestimate their own abilities. Instances of sensory hypersensitivity are also possible.

There are also signs related to the method of usage, just as with narcotics. The symptoms for meth mouth, mentioned previously, are usually a result of oral usage of meth via swallowing or smoking the drug. Injection users will often have needle marks, bruising, infections, and collapsed veins as a result of their drug use. Users who snort stimulants will often have evidence of damage to their nasal passages, such as redness and frequent nosebleeds. Constant runny noses or sniffling are also potential signs of snorting.

The Side Effects

Many of the short term side effects of stimulant abuse present themselves as signs of use. Changes in cardiac function--heart rate, blood pressure, pulse, etc.--usually resolve themselves once the drug leaves the person's system. The same can be said of insomnia or any instance of decreased appetite. Additional side effects can include:

• Short Term--A loss of appetite often results in weight loss, which can be severe in cases of long-term stimulant use. This can prompt further side effects, such as gastrointestinal problems, amenorrhea, or the absence of the menstrual cycle in females, impotency in males, and disturbances in the person's cardiovascular and respiratory functions. In some cases, nausea or vomiting may occur in response to the drug or to a substance it was cut with. Poor hygiene often occurs, which can prompt other health concerns and side effects like body odor. Depression may persist in some users, even after other symptoms have faded. Infections from injections, meth mouth, and frequent scratching may also persist and cause additional problems if left untreated.

• Long Term--The long-term effects of stimulant abuse are often going to result in a permanent resistance or tolerance to dopamine, both from chemical assistance and natural occurrence. The damage done from the methods of abusing stimulants is serious and may also remain for long lengths of time or may not ever fully heal. Users who snort, smoke, or swallow their drugs may have permanent changes to their sense of taste and smell. Snorting cocaine, for example, has been known to cause erosion in a person's upper nasal cavity.  This may affect the person's ability to swallow and prompt several respiratory problems later on. Damage to a person's gastrointestinal tract, including bowel decay, can occur in users who used stimulants by ingesting them. Instances of heart disease, respiratory disease, and damage to brain tissues are not uncommon in former stimulant abusers. Severe brain damage can often prompt seizures and strokes in former users. The damage caused by meth mouth may require extensive dental repair and may even lead to loss of teeth, jaw, or tissues. Residual signs of stimulant abuse, such as delusions or hallucinations, may resurface later in a person's life.

While under the influence of stimulants, users may do things that they otherwise wouldn't do. These actions can have serious effects for the person as well. Users often lose their inhibitions, and may practice unsafe sex with partners they wouldn't have sex with while sober. They may share needles with other users. Both cases can increase a person's risk of contracting diseases like HIV, hepatitis, and other such conditions. There is also the possibility of injury or death if they operate heavy machinery or drive while under the influence. These conditions have lasting effects of their own that a person and those in their life may be affected by due to stimulant abuse.

Treatment and Recovery

Seeking treatment for stimulant abuse requires looking at the damage the drug has done to a person and working to reduce its effects. Withdrawal is the first step for any substance abuse treatment, and it may be especially harrowing for long-term stimulant abusers. The stress that withdrawal puts on a person's body can generate complications for users who are anorexic or malnourished due to their drug use. Professional assistance for stimulant abuse treatment is highly recommended to ensure the safety of the person as they go through withdrawal.

Any damage to a person's body caused by stimulant abuse will need to be treated in addition to their addiction. This may mean that they will need in-patient care at a hospital, monitored medication, and regular examinations to check on progress. Stimulant abusers seeking treatment should keep in mind that they need to be patient, as their progress towards recovery is going to take some time. The people in the users life--friends, family, peers, etc.--should also keep that in mind as they support them in their efforts to get better.