What is Amphetamine-Related Psychiatric Disorders (Amphetamine Mental Health)?
Amphetamines, like methamphetamine and MDMA, belong to a group of compounds known as phenethylamines. These compounds have stimulating effects in the brain and blood circulation. First produced in 1893 to help with breathing problems and congestion caused by asthma, amphetamines have since found wider use in the medical field. Nowadays, they’re used in healthcare for treating temporary obesity issues, sleep disorders like narcolepsy, and attention deficit disorder with hyperactivity.
However, outside of proper medical use, these drugs are also consumed recreationally, which has become a major problem in Asia, Australasia, and the United States. In North America, illegal production mostly happens in hidden labs located in rural Mexico and the United States, using simple household materials and over-the-counter medicines.
Amphetamines can be consumed in various ways, such as inhaling, injecting, or orally. The time it takes for the drug to reach its maximum level in the blood ranges from 5 to 10 minutes if injected, up to 2 to 3 hours if consumed orally. The effects can last for several hours or even days depending on the dose and potency, and they end once the body removes the drug. However, the symptoms of amphetamine use can sometimes resemble mental disorders, making it challenging for doctors to identify if a patient is experiencing amphetamine-related psychosis or a mental disorder’s symptoms.
Furthermore, there’s a recognized link between regular high doses and an increased chance of drug-induced psychosis. Amphetamines can disrupt clear thinking which often leads to acute psychosis. This suggests that continued use of amphetamines and the resulting disruption of cognitive function can pave the way towards psychosis.
What Causes Amphetamine-Related Psychiatric Disorders (Amphetamine Mental Health)?
Mental health disorders that are linked to amphetamine use can often occur with both short-term and long-term usage. These disorders have been extensively researched, especially in relation to the use of methamphetamine.
Risk Factors and Frequency for Amphetamine-Related Psychiatric Disorders (Amphetamine Mental Health)
Amphetamines are the second most commonly abused illegal drug around the world, after cannabis. According to a global drug report in 2019, around 29 million people, or 0.6% of the global population between the ages of 15 and 64, used amphetamines in 2017. Of these, about 17 million people are dependent on amphetamines.
- In the United States, about 1.9 million people aged 12 or older used amphetamines in the last year, as per a 2018 survey.
- The use of amphetamines has remained steady since 2015.
- Overdose deaths related to amphetamines increased by 33% from 2015 to 2016, with over 10,000 deaths in 2017.
Risks of amphetamine use disorder are higher among people living in rural areas, those of Caucasian, Hispanic, and Asian ethnicities, people with low socioeconomic status, males, those with preexisting mood disorders, people with adverse childhood experiences, and those with prior substance use disorders.
- Approximately 59% of people entering treatment for amphetamine use disorder were referred by the justice system, compared to 38% of people with other substance use disorders.
- Amphetamine users are twice as likely to require long-term treatment compared to users of other drugs (17% versus 8%).
- About 30% of patients with amphetamine-induced psychosis eventually develop a primary psychosis over time.
Signs and Symptoms of Amphetamine-Related Psychiatric Disorders (Amphetamine Mental Health)
Psychiatric disorders related to the use of amphetamines can occur when a person uses these substances either once or multiple times. These disorders can mimic symptoms related to the overstimulation of the nervous system, known as a ‘sympathomimetic toxidrome’. This overdose state can cause symptoms such as a faster heart rate, high blood pressure, agitation, paranoia and even psychosis. The doctors might struggle to get a detailed health history or check vital signs, as the patient may not cooperate due to severe agitation or psychosis.
It is essential for the doctors to find out how the drug was consumed, how much was taken and for how long, even though this might be difficult due to the patient’s state of mind. Furthermore, it is important to know if the patient has also consumed other substances, as amphetamine users often also use calming substances like alcohol, opioids, benzodiazepines, or cannabis. Safety for the patient and medical staff are a key consideration in such situations.
- Increased heart rate (tachycardia)
- High blood pressure (hypertension)
- Overactive body temperature (hyperthermia)
- Excessive sweating (diaphoresis)
Physically, amphetamine users might look very thin and untidy, and may show unstable mood or behavior changes. They often have scratched and scarred skin due to illusions of pests on their skin leading to compulsive skin picking. This can result in a certain type of skin condition called ‘prurigo nodularis’, also known as ‘speed bumps’. A look inside their mouths may reveal damaged tooth enamel and swollen gums, often referred to as ‘meth mouth’. This happens due to neglect of oral care, less saliva production, and teeth grinding. In addition, these individuals might display random, purposeless bodily movements, constant pacing, or other repetition in actions. Suicidal or homicidal thoughts, severe mood swings, hallucinations, unfounded suspicions and psychosis are associated with both one-time and regular use of amphetamines.
Testing for Amphetamine-Related Psychiatric Disorders (Amphetamine Mental Health)
If someone comes into the hospital but can’t provide clear information about their substance use, doctors can use urine or blood tests to screen for drugs. They also usually check several other things in your blood, like salt levels, kidney health markers, muscle enzymes, blood clotting factors, thyroid hormones, and liver enzymes.
A quick, simple test called an electrocardiogram can be done to check the heart’s rhythm as it can be helpful for patients with a high heart rate. It also helps identify any heart-related problems.
X-ray images are used to check for injuries, like a collapsed lung, air leaks in the chest, or pneumonia. Sometimes a CT scan, which is a more detailed kind of X-ray, may be done to look for possible strokes, blood vessel tears, and issues in the belly or chest.
Treatment Options for Amphetamine-Related Psychiatric Disorders (Amphetamine Mental Health)
A comprehensive study from 2015 offers evidence-supported guidelines for handling mental health disorders linked to amphetamines, a type of stimulant drug. In cases where patients are intensely agitated and experiencing psychotic symptoms, medications like lorazepam, diazepam, or midazolam are typically administered intravenously as a first step in treatment. If this isn’t sufficient, other medications like risperidone, haloperidol, ziprasidone, and olanzapine, all of which have a history of success in managing psychosis linked to amphetamines, might be used. Specific types of heart medications, known as lipophilic beta-blockers (like metoprolol and labetalol), can also effectively alleviate agitation and symptoms like a fast heart rate.
Healthcare providers should not hesitate in treating suspected mental health disorders linked to amphetamines while waiting for test results of urine or blood samples. With abstinence from the drug, symptoms of psychosis typically go away within a week. This suggests that long-term drug treatment may not be necessary for amphetamines-related mental health disorders; instead, the focus should be on helping the patient abstain from drug use. Cognitive behavioral therapy (a type of therapy that helps people understand and change harmful thought patterns) along with support groups like Alcoholics Anonymous and Narcotics Anonymous can be effective in fostering a strong support network for the patient.
What else can Amphetamine-Related Psychiatric Disorders (Amphetamine Mental Health) be?
When a person comes into the doctor’s office with certain symptoms like a racing heart, high blood pressure, dilated pupils, a high temperature, and feeling very agitated, it’s possible they could be experiencing a reaction to amphetamines, which are a type of stimulant drug. However, these symptoms can also be a sign of other drug overdoses or toxic reactions, so the doctor has to be very careful in making the correct diagnosis. Some key things to remember are:
- People with a toxic reaction to drugs that decrease the activity of the body’s nervous system will not sweat, unlike those experiencing a reaction to amphetamines.
- It’s important to consider how long the drug effects last – for example, the effects of cocaine generally don’t last as long as amphetamines do (one hour versus roughly 10 hours).
There are other conditions that look very similar and can be hard to distinguish from amphetamine reactions. These include drug interactions involving antidepressants, antipsychotic drugs, and other mental health medications.
Another condition to consider is heatstroke which can be determined based on the patient’s recollection of recent events. But confusion can hinder this process. Also, there are certain uncommon medical conditions that mimic these symptoms, but additional testing can help in deciding whether these are the culprits.
It’s also common to have more than one harmful substance in the body at the same time, which can make diagnosis more difficult due to the mixed reactions they can cause.
What to expect with Amphetamine-Related Psychiatric Disorders (Amphetamine Mental Health)
Amphetamine-induced acute psychosis, when compared to schizophrenia, generally shows a quicker recovery. This condition also tends to improve when the person stops using the substance. However, this recovery may not always be complete.>
Interestingly, research from Japan indicates that it might take much longer, potentially several years, to fully recover from amphetamine-induced psychosis.
Possible Complications When Diagnosed with Amphetamine-Related Psychiatric Disorders (Amphetamine Mental Health)
- Depression
- Psychosis
- General anxiety
- Insomnia
- Memory loss
- Neurological problems
- Substance abuse
- Difficulty in social interactions
