An Overview of Stimulants and How They’re Used

Stimulants are a class of psychoactive drugs that increase activity in the brain, impacting alertness and mood. In psychology, stimulants are generally defined as substances that excite functional activity in the central nervous system.

Some stimulant drugs are legal and consumed widely, while others are illegal to possess and use. Drugs classified as stimulants include:

• Caffeine
• Nicotine
• Cocaine
• Methamphetamine
• Prescription stimulants

Each of these stimulants has unique properties and mechanisms of action. But they also share many commonalities, one of which is that all of them can be highly addictive, causing negative effects on health and wellness.

Caffeine

Caffeine is the most widely used psychoactive drug in the world. It’s found in various foods and drinks, including coffee, tea, cocoa, chocolate candy, energy drinks, and soft drinks. Many people use caffeine for increased energy and mental alertness. However, consuming too much of this stimulant can cause increased feelings of anxiety, dizziness, fast heart rate, and insomnia. The negative effects of caffeine can be especially problematic for certain individuals. This includes children, teens, and young adults; pregnant and lactating women; and people with underlying heart conditions or mental health issues. Some people continue to consume caffeine despite it leading to behavioral, cognitive, or psychological problems. Health experts believe this should be diagnosable as caffeine use disorder and included in the Diagnostic and Statistical Manual of Mental Disorders as a mental health condition similar to substance use disorder.

Caffeine addiction is associated with:

• Elevated depression risk
• Feelings of burnout
• Greater likelihood of smoking and aggressive behaviors
• Increased impulsiveness
• Symptoms similar to those experienced with attention-deficit hyperactivity disorder (ADHD) and conduct disorder

Quitting or significantly reducing caffeine can result in withdrawal. Caffeine withdrawal symptoms include headaches, fatigue, muscle pain, and irritability. Reducing your intake slowly over time can help you overcome caffeine addiction with fewer withdrawal symptoms.

Nicotine

Nicotine is another widely used psychoactive drug that is often consumed in combination with drugs that are often abused (alcohol, opioids, and other stimulants), leading to an increased intake of each or both substances. This can make quitting nicotine even harder because other drugs are involved.

People can experience a wide variety of adverse effects after using nicotine:

• In the short term, nicotine use can lead to dizziness, headaches, nausea, and abdominal cramps.
• Long-term nicotine effects include stroke, blindness, diabetes, fertility issues, disability, and premature death.
• Consuming too much nicotine at one time can lead to nicotine poisoning, which can cause feelings of confusion, seizures, fast breathing or stopping breathing altogether, and potentially even death.

Nicotine is a primary ingredient in not just cigarettes but also e-cigarettes, and vaping is highly addictive. Vaping nicotine has become an increasing problem among teens and young adults, with more than 2.5 million U.S. youth reporting that they used e-cigarettes in 2022.

Stopping nicotine use can lead to withdrawal, and withdrawal symptoms can hit quickly—within two to three hours from the last use. Symptoms of nicotine withdrawal include irritability, anxiety, depression, headaches, trouble sleeping, and gastrointestinal issues.

If you’re trying to quit smoking, vaping, or using other forms of tobacco, nicotine replacement therapy may help you overcome your addiction to this drug. This therapy often involves tapering nicotine use over time, then eventually quitting this drug.

Cocaine

Cocaine is an illegal psychoactive drug made from the leaves of the coca tree. Psychoanalyst Sigmund Freud initially advocated for its use but withdrew his endorsement of the drug after realizing that it wasn’t harmless and had negative side effects.

Cocaine increases dopamine levels in the brain, a neurotransmitter that plays a role in reward and movement control. Over time, its continued use can make you less sensitive to the drug’s effects, leading to using it more often and in higher amounts.

Cocaine use can result in both short- and long-term side effects. Short-term effects include nausea, increased blood pressure, tremors, and irregular heartbeat. Long-term effects depend on how the cocaine is ingested and range from nosebleeds when it is snorted to hepatitis C and collapsed veins if it is injected.

There are currently no prescription medications approved by the U.S. Food and Drug Administration (FDA) for treating cocaine addiction; although, behavioral therapy has proven effective for this purpose.

Methamphetamine

Methamphetamine, also known as meth, is an often-abused psychostimulant that damages the brain’s structure and function. Specifically, it has negative effects on the blood-brain barrier, also damaging portions of the neurotransmitter systems.

Even small doses of methamphetamines can lead to negative cardiovascular effects such as fast heart rate, irregular heartbeat, and elevated blood pressure. Take in too much of this stimulant and it can lead to high body temps (hyperthermia), convulsions, and, if not treated immediately, death.

There are also many negative consequences associated with long-term use of methamphetamines, including:

• Anxiety and confusion
• Extreme weight loss
• Intense itching
• Memory loss
• Paranoia and hallucinations
• Severe dental issues
• Violent behavior

Like the other stimulants, methamphetamine is highly addictive. Since its “high” quickly fades, users often take repeated doses (referred to as binges) which are followed by crashes, resulting in a “binge and crash” pattern of use. Stopping methamphetamines can lead to withdrawal symptoms

Behavioral therapies can effectively treat methamphetamine addiction. There are also other actions one can take on their own to feel better. For instance, research has found that engaging in physical exercise can help individuals addicted to methamphetamines feel better emotionally, improving abstinence and drug relapse rates.

Prescription Stimulants

Prescription stimulants are a group of psychoactive drugs that affect the central nervous system and the autonomic nervous system. They are used to treat certain physical and psychological disorders, including attention-deficit hyperactivity disorder (ADHD) and narcolepsy.

Common names of prescription stimulants include:

• Ritalin (methylphenidate)
• Adderall (dextroamphetamine-amphetamine)
• Dexedrine (dextroamphetamine)

Prescription stimulants work by enhancing the effects of dopamine and norepinephrine. While this helps improve alertness and energy, it can also lead to increased blood pressure, elevated heart rate, and fast breathing patterns.

Certain effects can also be experienced if prescription stimulants are not taken as prescribed. In addition to a risk of overdose, prescription stimulant misuse can lead to paranoia, psychosis, anger, or problems with the heart, nerves, or stomach—potentially leading to a heart attack or seizure.