Section 2
What is A stimulant?
Stimulants increase heart rate, sensitivity, and also a euphoric-like feeling of being “on top of the world.” Stimulants are a category of drugs that are defined by their effects on the person using them. Stimulants produce a variety of results including feelings of heightened alertness, euphoria, energy, and confidence.
Examples include:
Crystal methamphetamine, powder cocaine and crack cocaine, amphetamines, dextroamphetamines, caffeine.
Stimulants in Depth
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Stimulants may be used socially, to self-medicate for mental health or physical pain, or because of ongoing cravings and dependency. The ways that stimulants affect people vary based on the chemical, the individual person, and the circumstances surrounding their drugs use – all of these factors also impact the reasons why someone may use stimulants.
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Much like opioids, stimulants are used in a variety of ways that depend on the type and form. Stimulants are commonly used through smoking (via pipe), injection, insufflation, or ingestion. Injection with stimulants is a bit different than injection for opioids; because stimulants tend to have a shorter half-life than most opioids, people who inject stimulants are at greater risk of vein and soft tissue damage because of the increase in frequency.
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While each stimulant is chemically different, in the brain they tend to impact the brain’s dopamine receptors by allowing them to rapidly build up dopamine. With the introduction of dopamine, the body receives rapid signals from the brain, meaning heart rate rapidly increases, sweating, body temperature heats up, restlessness, alert, insomnia, and low appetite. The brain becomes flooded with dopamine, leading to feelings of euphoria, alertness, and potentially agitation, irritability, and paranoia.
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The drug trade of stimulants impacts many of our Native communities, especially with the trade of cocaine.
Traditionally, coca leaf is used ceremonially and spiritually by Indigenous communities in the Andes region. The 1900s drug trade exploited this medicine and removed the spiritual aspect of its traditional use to create a condensed cocaine. While the coca leaf is a traditional plant, synthetic cocaine products are much different spiritually and physically.
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Regular stimulant use can lead to cravings which can be so severe they feel difficult or impossible to manage. Though there isn’t a chemical reaction causing physical dependency in the same way as opioids, stimulant dependency can be a similarly overwhelming, painful, and challenging process with many of the same obstacles. Stimulant withdrawal can lead to severe emotional pain, resurfacing of physical pain, and suicidal thoughts.
Overamping:
Stimulant Overdose
Note about naloxone: naloxone is the overdose reversal medication used for all drugs within the opioid category (not stimulants). However, trace amounts of opioids in the stimulant a person is using may be enough to cause an opioid overdose. If someone used stimulants but is showing signs of an opioid overdose, follow naloxone protocols!
A typical stimulant high may look like a burst of energy, restlessness, sex drive, euphoria, dilated (big) pupils, and social outgoingness. “Overamping” is a term used to describe when a person has used too many stimulants and is overdosing. Meanwhile, a stimulant overdose can look like delirium; break from reality; incoherent; ongoing insomnia; & cardiac emergencies.
Unlike opioids, stimulant use doesn’t have as clear of a boundary between a regular high and an emergency. There is a wide range of stimulant overdose symptoms, but if someone is very unlike themselves or is showing signs of a physical health emergency, it can be a sign of overamping!
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If the person is intoxicated but there’s no immediate cause for concern, you can support them and monitor in case it advances. This might include if someone has had trouble sleeping for a few days, seems worn down, or is having difficulty calming down. Examples of ways you can support a manageable but uncomfortable stimulant high:
Calm and quiet environment with low lighting
Gently introduce water and food
Calmly explain what’s happening
Monitor for signs of cardiac issues or seizure
If the person has a prescription for benzodiazepines (Xanax, Ativan, Alprazolam) or aspirin, you may administer now
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A stimulant-related medical emergency can look like any of the following:
Extreme agitation
Threat of harm to self
In & out of consciousness
Chest pain, high blood pressure, rapid heartrate
Any signs of stroke
Heart rate/blood pressure dangerously increases
When calling an ambulance, briefly describe their health condition and your location: “I think my friend is having a heart attack/stroke/mental health emergency”. Because there may be another mental or physical health condition unrelated to drug use, and with the stigma they may experience, it may be helpful to avoid mentioning substance use on the call with 911.