Stimulant Use Disorder

Stimulant Use Disorder is a substance use disorder characterized by a problematic pattern of stimulant use leading to clinically significant impairment or distress. Like with all substance use disorders, there is a complex interplay between biological, social, psychological, and cultural factors.

  • Route: snorted, smoked, injected
  • Effects: Euphoria, energy, hyperactivity, tachycardia
  • At high doses: paranoia, irritability, formication
  • Mechanism of Action: Cocaine inhibits reuptake of serotonin, norepinephrine, and dopamine, resulting in elevated concentrations of these neurotransmitters in the brain.[1]
  • Street names: Coke, blow, base, crack
  • Cost 1/8 ounce (“eight ball”) of cocaine: $100-200
  • Physiological effects: Short-term physiological effects of cocaine use include constricted blood vessels; dilated pupils; and increased body temperature, heart rate, and blood pressure.

Normal cocaine has a hydrochloride component and a high melting point, which makes it hard to smoke (and is thus snorted). Crack cocaine is created from mixing cocaine with a base (such as ammonia or baking soda). This technique is called freebasing, and allows it to sublimate at lower temperatures so it can be smoked.

  • Crack cocaine is pure cocaine vapour that goes directly from the lungs (which have lots of surface area) and directly to the brain. This method of use is bypasses first-pass metabolism), which makes crack coaine highly addictive
  • If you tried to smoke cocaine powder, it would just melt, it would be like smoking sugar
  • Using crack cocaine with heroin is a practice known as speedballing.
  • Cost: cheap ($20 per “rock”)

3,4-Methylenedioxymethamphetamine (commonly known as MDMA/Ectasy)

  • Effects: openness, empathy, energy, euphoria, and well-being
  • Physical: pupil dilation, enhanced color perception. Restlessness, decreased appetite, altered focus / concentration. Dyspnea, paresthesia, hyperhydrosis, tachycardia.
  • At high doses: facial dystonia (“gurning”)
  • Mechanism of Action: Release and re-uptake inhibition of serotonin, dopamine and norepinepherine, and binds to 5-HT2A and alpha2 receptors
  • Street names: E, XTC, X
  • Cost: $10-20 per pill

Amphetamine was first synthesized in 1887. Amphetamines and its derivatives are now clinically used in the treatment of narcolepsy and attention deficit hyperactivity disorder.

  • Route: oral, intravenous
  • Effects: Euphoria, increased energy, alertness, decreased appetite
  • High doses: paranoia, dystonia, aggression, cardiac arrhythmias
  • Cost: $20 per gram

Also known as Crystal meth, or N-methylamphetamine

  • Route: Smoked, injected, oral
  • Mechanism of Action: Catecholamine release and inhibits reuptake
  • Street names: ice, crystal meth, crystal, crank
  • Cost: 1/8 ounce $50