The use of stimulants has been rising for the past several years in the United States. These drugs can make people more alert, increase their attention, and raise their blood pressure, heart rate and breathing¹. Stimulants are popular because they “stimulate” the body’s central nervous system and increase catecholamines in the brain. Catecholamines are in the dopamine family and are used by the brain to process reward and motivation². Currently there are two main types of stimulants, ones prescribed and used legally and ones that are used illicitly.

Prescription stimulants are among the most commonly abused medications after opioid pain medications². These medications are often used to treat disorders such as ADD and ADHD and can include medications such as Adderall, Concerta, and Ritalin³. Nationally, around 6 million people misused prescription stimulants in 2016⁴. Approximately 7,500 Americans died from prescription stimulant overdoses and the rate of deaths from these stimulants increased by 33.3% from 2015⁴. Reported past month use in 2016 showed that non-medical or illicit STIMULANT use (4.3 million) exceeded non-medical or illicit OPIOID use (3.8million)⁵.

Illicit stimulants include drugs such as methamphetamine, cocaine, and MDMA. These drugs come in many forms and can be smoked, snorted, injected or orally ingested. When taken these substances distribute to the nervous system and creates a sense of euphoria that is described as very pleasurable⁶. They also increase wakefulness, energy, a sense of well-being⁷. Users have to constantly use the product to remain in this state and it comes with an immense amount of health problems. The most significant mortality from illicit stimulants is from cardiovascular effects and hypertensive crisis, but they are also associated with adverse effects to every organ system in the body⁷.

The past few years our country has focused their attention on the opioid epidemic in the United States due to large overdose rates. The result is that while the United States has been focused on the current opioid crisis, the use of stimulants has been steadily climbing. Overdoses from stimulants have skyrocketed in the past decade with data showing that meth-associated overdose deaths rose more than 450 percent between 2008 and 2016⁸.

Nevada is one of the states most affected by the increase in stimulant use. The state’s death rate from all stimulants currently lead the nation with rates hitting 7.5 per 1000⁹. These numbers are predicted to rise in the coming years due to the potency, amount, and low cost of the products being brought into the state¹⁰. Nevada coroner statistics show that from 2012-2017 meth was the most prevalent drug encountered in overdose deaths¹⁰.

Substance abuse facilities in Nevada are being overwhelmed by the uptick in people suffering from addiction¹¹. Addictions to stimulants are harder to treat than opioid addictions and there are limited resources for users to get treatment. Some of the reasons behind this are:

• There are limited resources for treatment due to lack of treatment facilities and funding
• There are no drugs to help with withdrawal
• Overdose can’t be stopped with products such as naloxone with opioids
• Withdrawal involves loss of dopamine receptors and the ability to feel pleasure response for up to two years in recovery¹². This can cause people in recovery to feel less pleasure in their everyday lives and can cause an increase in suicidal behaviors13.
• Recovery from stimulant misuse needs to be tailored to the specific person. The most effective treatments for methamphetamine addictions are behavioral therapies, such as cognitive-behavioral and contingency-management interventions¹⁴. Depending on the user these treatments can take place in an inpatient facility or in an outpatient setting.
• Generally, this treatment needs to be long-term because of the difficulty in the recovery process.

The number of stimulant treatment admissions has been steadily rising for the past 4 years. According to the Treatment Episode Data Set (TEDS), primary methamphetamine/amphetamine admissions rose 30% in Nevada between 2014 and 2017¹⁰.

Stimulants are one of the deadliest drugs abused in Nevada according to HIDTA data. This is influenced by high availability, low price, and a higher purity of product. Additionally, the percentage of deaths attributed to stimulant overdoses, particularly methamphetamines and cocaine, has significantly increased over the last five years. With Nevada’s stimulant death rate being the highest in the nation this problem will soon eclipse our state’s prescription opioid death rate if the current trends continue¹⁰.

The following link will take you to more resources:

The Emerging Threat of Stimulants

Stimulants and Opioids: An Emerging Drug Threat in the Midst of the Opioid Epidemic

Nevada 2018 HIDTA Threat Assessment

References

1. Substance Abuse and Mental Health Administration. (2016, March 2). Stimulants. Retrieved from https://www.samhsa.gov/atod/stimulants
2. Enos, G. A. (2017). Stimulants the Next Drug Crisis Looms. Addiction Professional.
3. National Institute on Drug Abuse. (2018, July 02). Commonly Abused Drugs Charts. Retrieved from https://www.drugabuse.gov/drugs-abuse/commonly-abused-drugs-charts#prescription-stimulants
4.  Centers for Disease Control and Prevention. Opioid Overdose. (2018, August 02). Retrieved from https://www.cdc.gov/drugoverdose/data/otherdrugs.html
5. National Survey on Drug Use and Health (NSDUH 2010 -2016.)
6. Vearrier, D., Greenberg, M. I., Miller, S. N., Okaneku, J. T., & Haggerty, D. A. (2012). Methamphetamine: History, Pathophysiology, Adverse Health Effects, Current Trends, and Hazards Associated with the Clandestine Manufacture of Methamphetamine. Disease-a-Month, 58(2), 38-89. doi:10.1016/j.disamonth.2011.09.004
7. Stoneberg, D. M., Shukla, R. K., & Magness, M. B. (2017). Global Methamphetamine Trends: An Evolving Problem. International Criminal Justice Review. doi:https://doi.org/10.1177/1057567717730104
8. Lehman, C. F. (2018, June 4). Analysis: There Is a Meth Crisis in America and most of it is coming from across the border. The Washington Free Beacon. Retrieved from https://freebeacon.com/issues/analysis-meth-crisis-america/
9. Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report (MMWR). (2018, March 29). Retrieved from https://www.cdc.gov/mmwr/volumes/67/wr/mm6712a1.htm
10. Lombardo, J., & Carter, K. (2018). Nevada HIDTA 2018 Threat Assessment. National Drug Control Policy.
11. Matheney, M. (2018, April 9). Amphetamine deaths in N. Nevada spike more than 150 percent in 2017, meth to blame. KRNV News 4. Retrieved from https://mynews4.com/news/local/amphetamine-deaths-in-n-nevada-spike-more-than-150-percent-in-2017-meth-to-blame
12. The Focus on Opioids Overshadows Another Worsening Drug Plague. (2017, June 15). The Economist. Retrieved from https://www.economist.com/united-states/2017/06/15/the-focus-on-opioids-overshadows-another-worsening-drug-plague
13. Webb, M., Deitzer, J., & Copes, H. (2016). Methamphetamine, Symbolic Boundaries, and Using Status. Deviant Behavior, 38(12), 1393-1405. doi:10.1080/01639625.2016.1254988
14. NIH. (2013). What treatments are effective for people who abuse methamphetamine? Retrieved from https://www.drugabuse.gov/publications/research-reports/methamphetamine/what-treatments-are-effective-methamphetamine-abusers
15. Eadie, J. (2018). Stimulants and Opioids: An Emerging Drug Threat in the Midst of the Opioid Epidemic. National Rx Drug Abuse & Heroin Summit.