The illicit use of amphetamines, the stimulants commonly known as ‘speed’, is linked to a 5-fold heightened risk of psychosis, finds a 10 year study published online in the journal Evidence-Based Mental Health.
This increased risk was seen across all age groups, but was especially noticeable among women and those who had been arrested several times for possession of the drug, the findings show.
The estimated global prevalence of amphetamine use is less than 1%, but around 1 in 10 users become addicted.
The drug’s impact on neurotransmitter signalling in the brain often causes psychosis, the symptoms of which mimic those of schizophrenia, with paranoia, voices, and hallucinations.
These psychotic episodes usually subside after a few days, but may persist for years in up to 15% of users.
While the link between amphetamine misuse and psychosis has been known for many decades, it’s not clear exactly what the magnitude is of this risk or how effective rehab is at successfully weaning users off the drug.
The TDID contains anonymised data on date of birth, sex, arrest records and deferred prosecution for rehabilitation treatment for illicit drug users, while the NHIRD contains anonymised data on mental and physical health issues for the population of Taiwan.
The researchers identified 74,601 illicit amphetamine users and 298,404 people matched for age and sex as a comparison group from these records. Their average age was 33 and most (84%) were men.
Compared with those who weren’t using, illicit amphetamine users had poorer health: depression (2% vs 0.4%); anxiety (0.9% vs 0.3%); ischaemic heart disease (1.3% vs 0.8%); cardiovascular disease (0.8% vs 0.45%); and stroke (1.3% vs 0.7%).
By the end of the 10 year monitoring period, amphetamine users were more than 5 times as likely to experience psychosis than those who weren’t using after accounting for age, sex, and coexisting health issues.
The number of new cases of psychosis was similar across all age brackets, but was more common in the amphetamine users among those aged 45 and above.
While the likelihood of psychosis increased in tandem with the number of coexisting conditions, overall, it was higher among illicit amphetamine users without coexisting conditions, suggesting a direct impact of amphetamine on inducing psychotic symptoms, say the researchers.
The risk of psychosis rose in tandem with the number of arrests, and fell when patients received psychotherapy for their addiction (rehab).
Those who had been arrested 5 or more times were more than 6 times as likely to experience psychosis, while users who went to rehab during deferred prosecution were 26% less likely to experience psychosis than those who didn’t.
This suggests that rehab may help to stave off the risk of subsequent psychosis, say the researchers.
In line with previous research, illicit amphetamine use in this study was associated with greater levels of anxiety and depressive symptoms as well as cardiovascular complications.
“Because persistent psychotic symptoms could represent a risk for cognitive decline in amphetamine users, identifying [those] with psychosis and providing treatment early might prevent subsequent damage of cognitive functions,” write the researchers.
But rehab is voluntary, and only offered to around 1 in 10 users, they point out.
By way of an explanation for the gender discrepancy observed, the researchers suggest that the detrimental impact of amphetamines on behaviour might be enhanced by the presence of oestrogen.
“Another possibility is that women arrested for illicit amphetamine use were particularly disadvantaged in comparison with men, with higher levels of trauma, lack of psychosocial support and stigma,” they add.
This is an observational study, and as such, can’t establish cause, nor was it possible for the researchers to quantify addiction as there were no validated measures of dose, frequency, amount of use or severity of dependence in the TIDID.
Illicit amphetamine use could also precipitate and aggravate schizophrenic symptoms, so it’s possible that amphetamine induces rather than causes the psychotic symptoms seen in amphetamine users, point out the researchers.
They conclude: “The relation of an induced paranoid psychosis with amphetamine abuse has been known for many decades. None the less, our findings are from a detailed and comparative analysis using a comprehensive and large population dataset.
“Furthermore, it would be worthwhile to investigate the health benefits and cost effectiveness of deferred prosecution for drug crime offenders by providing appropriate therapy for drug addiction.”
Ritalin is a Methylphenidate, which is a Central Nervous System (CNS) Stimulant. Methylphenidates have effects and pharmacological uses similar to Amphetamines and Cocaine.
Ritalin comes in tablets and capsules and is mostly prescribed to children and adults for attention deficit hyperactivity disorder (ADHD) or narcolepsy. It comes in both sustained-release and extended-release compounds. When used according to a prescription by properly diagnosed individuals, Ritalin has a calming effect and helps them focus on tasks. There is widespread agreement that Ritalin, when taken as prescribed and intended, is a comparatively safe drug.
Although it has demonstrated significant efficacy in treating ADHD, Ritalin also comes with high abuse potential. During the surge of Ritalin prescriptions throughout the 1990s, there was a consequent rise in abuse. Ritalin is especially dangerous as a recreational drug both because recreational users typically take much larger doses than what would be prescribed and because recreational users typically crush the pills and either snort or inject them, delivering the medication to the body much more quickly. If you or a family member is struggling with addiction, reach out to a treatment provider today.
Ritalin Abuse And Effects
Like Amphetamines, which are also known as “Speed” or “Uppers,” Ritalin increases alertness and concentration. It is often abused by professionals, students, and athletes to increase productivity. It is listed as a Schedule II federally controlled substance because of its high potential for abuse.
Consumption of Methylphenidates like Ritalin is markedly higher in the United States than in other countries. This is likely due to how accessible they are. Many students who are prescribed Ritalin have given or sold their medication to other students to help them study. Students may also take the drug simply to feel high.
The effects of Ritalin usually last between 3 and 4 hours. The half-life of the drug (how long it takes for half of the drug to work its way through the body) is highly variable and dependent on numerous factors. For children, it is approximately 2.5 hours. For adults, it is approximately 3.5 hours. Depending on how long the user has taken Ritalin, among other factors, the half-life can reach 7.7 hours.
Those who abuse Ritalin typically do so because they are trying to exacerbate the side effects of the drug, including a euphoria that is not generally found at therapeutic doses. Individuals with an ADHD diagnosis do not typically experience significantly increased energy levels when taking Ritalin, but non-ADHD individuals often do because the drug affects them differently. People abusing the drug through inappropriate doses, use without a prescription, or snorting or injecting it, run the risk of negative side effects. These may include:
- Suppressed appetite
- Chest pain
- Changes in blood pressure
- Altered heart rate
- Respiratory depression
- Panic attacks
Side effects can vary depending on whether the individual has a diagnosis of ADHD or not. When someone takes a medication that they are not prescribed, the negative side effects can be different and/or more intense.
Those with mood disorders, like bipolar disorder, who abuse Ritalin may exhibit even worse symptoms and behavior. This is because Ritalin is a CNS Stimulant that can trigger manic episodes in some individuals. Therefore, it is important to talk with a physician before beginning to take any Stimulant medications.
Signs Of A Ritalin Addiction
Just like other Stimulants, Ritalin increases the levels of dopamine reaching neuron receptors in the brain. Dopamine is a naturally occurring chemical in the brain essential for activation of the brain’s reward system. The brain’s reward system reinforces behavior that activates dopamine production. Some people with ADHD have too many dopamine transporters, which results in low levels of dopamine in the brain. Ritalin blocks these transporters, keeping dopamine levels at a healthy level and increasing attention, focus, and impulse control. However, Ritalin influences a much higher amount of dopamine to reach receptors in the brain in those who don’t have ADHD. Taking Ritalin can become a learned behavior after repeated abuse, spurring on the compulsion to take the drug regardless of consequences.
A telltale sign of a problem is continuing to use Ritalin despite wanting to quit. If someone recognizes that there are severe negative consequences associated with using Ritalin — such as strained relationships and/or an unmanageably high price tag associated with use of the drug — but still can’t quit on their own, an addiction is likely present. The Diagnostic and Statistical Manual of Mental Disorders outlines criteria of addiction.
Other signs of an addiction include:
- Taking Ritalin in larger amounts or for longer than prescribed
- Spending a lot of time getting, using, or recovering from use of Ritalin
- Experiencing cravings and urges to use Ritalin
- Neglecting responsibilities at home, work, or school
- Continuing to use Ritalin, even when it causes problems in relationships
- Giving up important social, occupational, or recreational activities because of Ritalin use
- Using Ritalin again and again, even when it puts the user in danger
- Continuing to use Ritalin, even when the user knows they have a physical or psychological problem
- Needing more Ritalin to get the effect the user wants (tolerance)
- Experiencing withdrawal symptoms due to sudden cessation or rapid reduction of dose
- Experiencing sudden changes in mood, such as mood swings
- Isolating oneself from family or friends
reference link : https://www.addictioncenter.com/stimulants/ritalin/
More information: Risk of psychosis in illicit amphetamine users: a 10 year retrospective cohort study, Evidence-Based Mental Health, DOI: 10.1136/ebmental-2021-300300