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The most commonly used stimulants are amphetamines and cocaine. Cocaine is derived from the leaf of the coca plant (Erythroxylum Coca) and amphetamines are manufactured both legally and illegally. Most recently, the recreational use of Ecstasy has become common, particularly among young people who follow the club scene.

Drugs include:

Drug name

Street name

Amphetamine sulphate Speed
Cocaine hydrochloride Cocaine
Catha edulis-khat Khat
Dexamphetamine sulphate Dexedrine
Methlamphetamine Meth/ice
Methylenedioxymethamphetamine Ecstasy
Street use Stimulants can be swallowed, sniffed or injected. Amphetamine sulphate can also be smoked and cocaine freebase, heated and inhaled. Ecstasy is usually taken by mouth.
Drug effect Stimulants increase cerebral activity, causing excitement and euphoria. They also dilate the pupils of the eye, increase heart rate and blood pressure, cause sleeplessness and anorexia (loss of appetite). Cocaine is a powerful local anaesthetic but amphetamines are not. Low to moderate doses of stimulants do not disrupt thinking but users may experience mood swings. High doses, on the other hand, can cause thought disorder and a drug-induced psychosis resembling paranoid schizophrenia is not uncommon. Their use may also cause hallucinations and paranoid thinking.
Dependency Tolerance develops quickly with amphetamines, provoking massive increases in doses. Tolerance to cocaine tends to be much less marked, although tolerance to the euphoric effects of “freebase” has been noted, causing increasing frequency of use.
Dependence on stimulants is said to be more psychological than physical although recent evidence suggests possible long-term changes to the nervous system. Withdrawal is characterised by hunger, fatigue, periods of fitful sleep, increase in dreaming and depression. In some individuals, depression can be prolonged and severe.
Long-term use Prolonged use of stimulants can lead to weight loss, insomnia, exhaustion and mental confusion, severe depression and drug-induced psychosis (usually resolved after drug taking is stopped).
Overdose risk Death from drug overdoses is more common with cocaine than with amphetamines and often results from respiratory failure. Individuals with high blood pressure or a heart condition are at risk when using stimulants because extra stress is placed on the cardio-vascular system.
Risks in pregnancy Stimulants can cause congenital abnormalities, miscarriage, premature labour and smaller than average babies. Drug use should be stopped immediately, without any drug substitution, because of risk to the baby. Babies born to mothers who continue to take stimulants during pregnancy show a withdrawal syndrome. Withdrawal among newborn babies is characterised by shrill crying, irritability and repeated sneezing.
Legal status Cocaine and amphetamines are prescription-only medicines and controlled drugs. It is illegal to possess either without a prescription or to supply the drugs to others.
Maximum penalty
For possession:For dealing:
Class A
Seven years and/or unlimited fine
Life and/or unlimited fine
Class B
Five years and/or unlimited fine14 years and/or unlimited fine

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Amphetamine sulphate

 

Street name Sulphate, sulph, whizz, speed, billy
Drug effect Strong stimulant (“upper”)
Street form White/yellow crystalline powder, usually sold in “wraps”
Method of use Eaten, sniffed or injected
Dependency Yes (mainly psychological)
Withdrawal Tolerance to amphetamine sulphate develops rapidly and users can increase dose up to 50-fold. Effects of amphetamine sulphate last for three to four hours. Withdrawal from this drug is divided into two phases. The immediate “crash” or rebound lasts two to three weeks and is characterised by hunger, extreme fatigue and long periods of disturbed sleep. In the second phase, heavy users become irritable and depressed (sometimes severely). The second phase can last weeks and sometimes months.
Long-term use Excessive restlessness and insomnia; weight loss; amphetamine psychosis (hallucinations and paranoid thinking).
If injected:
  • infection risk
  • circulatory problems.
Overdose risk Death from overdose is possible with large doses, but rare. Overdose risk increases if amphetamine is mixed with drugs such as heroin or depressants like barbiturates or alcohol.
Legal status Amphetamine sulphate is a class B controlled drug (Schedule 2). It is illegal to possess amphetamine sulphate or to supply it to others.
Maximum penalty
For possession:                    Five years and/or unlimited fine
For dealing:                         14 years and/or unlimited fine
If prepared for injection the increased maximum penalties apply
For possession:                    Seven years and/or unlimited fine
For dealing:                         Life and/or unlimited fine

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Cocaine hydrochloride (cocaine/cocaine freebase)

 

Street name Coke, snow, crack, freebase, rock
Drug effect Strong stimulant (“upper”), local anaesthetic
Description Cocaine – white powder
Cocaine freebase – small white chips
Therapeutic use As local anaesthetic for eyes, ears and nose (rarely used)
Method of use Cocaine hydrochloride – sniffed/injected
Cocaine freebase – heated and inhaled
Dependency Yes (mainly psychological)
Withdrawal Effects of cocaine last for 15 to 30 minutes. Effects of freebase/crack last for only five to 10 minutes. No physical withdrawal symptoms but after the “high”, users experience a “crash” or rebound dysphoria when they feel extremely tired and depressed.
Long-term use Excessive restlessness and insomnia; weight loss; increase in blood pressure; paranoid psychosis.
If sniffed:
  • damage to nasal membrane
  • damage to septum between nostrils

If injected:

  • circulatory problems
  • infection risk

If inhaled:

  • respiratory problems and lung damage
Overdose risk High doses can result in an increase in body temperature, extreme agitation, convulsions and respiratory arrest. Overdose risk increases if cocaine is mixed with other drugs such as heroin or depressants like barbiturates and alcohol.
Legal status Cocaine is a prescription-only medicine and a class A controlled drug (Schedule 2). It is illegal to possess cocaine or to supply it to others.
Maximum penalty
For possession:                    Seven years and/or unlimited fine
For dealing:                         Life and/or unlimited fine

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Dexamphetamine sulphate (Dexedrine)

 

Street name Dexies
Brand name Dexedrine (Evans)
Drug effect Strong stimulant (“upper”)
Description White scored tablet (5mg) marked DB5
Therapeutic use Narcolepsy (uncontrolled sleeping) and hyperactivity in children
Method of use By mouth or injected
Dependency Yes (mainly psychological)
Withdrawal Tolerance to Dexedrine develops rapidly and users can use up to 50 times the therapeutic dose. Effects last for three to four hours. Withdrawal is divided into two phases. The immediate “crash” or rebound lasts for two to three weeks and is characterised by hunger, extreme fatigue and long periods of fitful sleep. In the second phase, heavy users become irritable and depressed (sometimes severely). The second phase can last weeks and sometimes months.
Long-term use Excessive restlessness and insomnia; weight loss; psychosis (hallucinations and paranoid thinking).
If injected:
  • circulatory problems
  • infection risk
Overdose risk Death from overdose is possible with large doses, but rare. Overdose risk increases if Dexedrine is mixed with other depressant drugs such as opiates, barbiturates or alcohol.
Legal status Dexamphetamine sulphate is a prescription-only medicine and a class B controlled drug (Schedule 2). It is illegal to possess it without a prescription or to supply it to others.
Maximum penalty
For possession:                    Five years and/or unlimited fine
For dealing:                         14 years and/or unlimited fine
If prepared for injection the increased maximum penalties apply
For possession:                    Seven years and/or unlimited fine
For dealing:                         Life and/or unlimited fine

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Catha edulis-khat (contains cathinone and cathine)

 

Street name Khat, chat, qat, quaadka
Drug effect
Khat is a mild stimulant. Users often report a calming effect.
Description Green leafy plant cultivated throughout Africa.
Therapeutic use Khat is used socially in many African countries in much the same way as coffee is used in Western culture.
Method of use Chewing leaves or drinking infusion of leaves (like tea). Use has been linked in Scotland to the dance/rave scene.
Dependency There is no record of dependency, though it would be reasonable to expect similar psychological dependency exhibited by other stimulant users.
Withdrawal There is no recorded withdrawal syndrome. It would be reasonable to expect listlessness and tiredness experienced by other stimulant users.
Long-term use Khat is normally chewed and this can cause medical problems associated with the oral cavity and digestive tract, leading to inflammation and secondary infections. There is evidence that excessive khat use can cause psychological problems such as depression and anxiety leading to drug-induced psychosis. There have been some reports of poisonings of khat chewers as a result of the inappropriate use of fertilisers used in farming. There is also some evidence of increased risk of oral cancer.
Overdose risk There is no known record of khat resulting in overdose, although it would be likely to act with other stimulants causing palpitations and agitation.
Legal status The khat plant is not controlled under the Misuse of Drugs Act. However, the active ingredients, cathinone and cathine, are class C (Schedules 1 and 3 respectively). This does not mean that khat leaves are illegal. They may be considered illegal by a court if it is felt that the active ingredients have been prepared. There have been no test cases.

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Methylamphetamine (methedrine)

 

Street name Meth, ice
Drug effect Has a very strong and long-lived stimulant effect
Description White/yellow/pink crystalline powder, clear liquid, ampoules (meth).
Small whitish chips (ice). Most methylamphetamine is illicitly manufactured and, as such, is of questionable quality.
Therapeutic use Methedrine is no longer available on prescription.
Method of use Smoked or injected
Dependency Yes, though mainly psychological
Withdrawal Tolerance to methylamphetamine develops quickly. The effects last from three to four hours. Like amphetamine sulphate, withdrawal is in two phases. Firstly, the “crash” or “come down”, which produces tiredness and depression. In the second phase, users can become irritable and severely depressed. This will last for three to four weeks and in some cases, can last for months.
Long-term use Prolonged use of methylamphetamine can lead to severe weight loss, insomnia, exhaustion, paranoid psychosis (this is generally drug-induced and as such will be resolved within a few weeks after drug taking has stopped) and severe depression. Smoking “ice” over long periods causes severe psychotic episodes with both visual and auditory hallucinations, presenting not unlike schizophrenia.
Overdose risk Overdose is not so common with methylamphetamine, but when it does occur, it can result in heart and/or respiratory failure. Users who exhibit a predisposition for a heart condition are at risk due to excess stress placed on the cardiovascular system.
Legal status All amphetamine-based drugs are controlled under the Misuse of Drugs Act, within Schedule 2 class B. However, once an amphetamine has been prepared for injection, it comes under class A, resulting in higher sentences.
Maximum penalty
For possession:                    Five years and/or unlimited fine
For dealing:                         14 years and/or unlimited fine
If prepared for injection the increased maximum penalties apply:
For possession:                    Seven years and/or unlimited fine
For dealing:                         Life and/or unlimited fine
Special note Most amphetamine-based drugs are manufactured illicitly and are of questionable purity. In most cases, it is these impurities that cause damage to amphetamine users.
In relation to “ice”, this is similar to “crack” and will produce similar problems.

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3,4 Methylenedioxymethamphetamine (Ecstasy/MDMA)

 

Street name Ecstasy, E, Eccy, adam XTC, Dennis the Menace. Sometimes known by “brand names” such as “doves”, “speckled doves”, “new yorkers” or “mercedes”, though these names frequently change as the logos change.
Drug effect Stimulant with mild psychedelic effect. Possible hallucinogenic effect, particularly in high doses.
Description Off-white or occasionally coloured tablets
Clear or coloured capsules
White powder (rare)
Method of use Particularly associated with the dance music scene. Usually taken by mouth.
Dependency Psychological
Withdrawal Tolerance to Ecstasy develops with time, but not as rapidly as cocaine or amphetamine. Drug effects begin within 20-60 minutes after use. There is no evidence of physical withdrawal, although after-effects of the drug can include fatigue, depression and anxiety. “Flashbacks” following repeated use over several days have been reported.
Long-term use Ecstasy use can be associated with anxiety, panic attacks and insomnia, especially in cases of long-term use, or use of large doses. Increased susceptibility to minor infections such as colds, flu and sore throats has also been reported. Some female users have reported an increase in genito-urinary infections. Pre-existing conditions such as high blood pressure, glaucoma and epilepsy can be exacerbated. In addition, there is some evidence to suggest that Ecstasy may have the potential to cause brain damage associated with mood disorders. Ecstasy increases body temperature and has a dehydrating effect. Users should take care to replenish lost body fluids and take regular breaks from physical exertion to help avoid dehydration and overheating. In acute cases of Ecstasy-related overheating and dehydration, the body temperature regulation system can be impaired, or break down altogether.
Overdose risk Overdose risk still needs to be properly assessed. However, there have been a number of deaths in the UK linked to the use of Ecstasy. Most of these are thought to have been associated with a rare but fatal drug reaction which can cause blood clots to develop in the lungs. Furthermore, heat stroke or dehydration are also thought to be possible contributing factors. There is also evidence that Ecstasy can damage the liver. The risk of overdose from MDA (a close relative of MDMA which is stronger and often sold as Ecstasy) is significantly greater. (A dose of 500mg of MDA has proved fatal in tests. Such a dose is the equivalent of 3 MDA tablets.)
Some deaths associated with the taking of Ecstasy have been attributed to dilutional hyponatremia. That is, people have drunk too much water in attempting to counteract the dehydrating effect of the drug. One effect of MDMA is to cause the release of a hormone called anti-diuretic hormone (ADH) which prevents the production of dilute urine. Excessive drinking in turn causes fluid build-up inside the body cells, particularly in the brain, which soaks up the fluid and is eventually “crushed” as it swells against the inside of the skull. All its functions are irreparably damaged, which leads to death (additional information courtesy of the Institute for the Study of Drug Dependence [ISDD]).
Legal status MDMA (Ecstasy) is a class A (Schedule 1) controlled drug. This means it is an offence both to possess the drug and to supply it to others.
Maximum penalty
For possession:                    Seven years and/or unlimited fine
For dealing:                         Life and/or unlimited fine
Special note A range of drugs including amphetamine sulphate, LSD, ketamine, paracetamol and Beechams Powders have been sold in capsule form as Ecstasy

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