Stimulant Addiction Signs and Symptoms

This session is all about how your brain is affected by stimulant abuse. So things that fall under the category of stimulants would be things like cocaine, amphetamines, methamphetamines. It is what it sounds like, anything that sort of speeds you up. You used to hear about a drug called speed way back, but you don't really hear about that anymore. But it just comes in different sorts of forms now. So any of the stimulant drugs used to treat ADHD medication, like Vyvanse, Adderall, Concerta, Bocalin, all of those would be stimulant medications. There are a few others that I'm not naming off the top of my head, but also cocaine and methamphetamines. Like when you think about people that use meth, although some of the ADHD medications are actually classified as methamphetamines. But that doesn't mean it's the kind of meth that you're thinking of that people sort of make in their house and use. So there's that kind and then there's methamphetamine type prescription medicines, and then there are other prescription ADD medicines that fall into the category of amphetamines. So how your brain basically digests that is when you're using a stimulant, it triggers your brain to release more dopamine. And hopefully you've already watched the dopamine video in this series, so you remember that dopamine, is that what I call the desire chemical? It's the chemical in your brain that makes you motivated and go after things. So it gives you that zest, that energy that drive. Most people associate dopamine with a pleasurable feeling because generally it is sort of a good feeling. But the overall purpose of it is to make you go after something. It's kind of a reward chemical that your brain releases in order to motivate you towards certain behaviors. And if you remember from watching the dopamine video, your brain is supposed to release that chemical when you do things that are good for your survival. Drugs and alcohol sometimes can trick your brain into releasing that chemical. And stimulants actually sort of have a direct line to dopamine in your brain. So when you're using a stimulant, you are directly stimulating the dopamine receptors in your brain. There are some different dopamine receptors. There's D1 and D2, and that can get pretty complicated. There's other ones. We won't go into all that, but if you'll recognize that when you're taking a stimulant, it increases your focus, your drive, your motivation, which is why it works well for someone that has adhd, but so does something like cocaine or methamphetamine. It just does it to an extreme level, whereas a prescription med does. It depends on how much you take to a lesser degree. So the main chemical that's being affected is it's increasing your dopamine when you're taking the drug. And the other chemical that tends to get affected is glutamate. And glutamate is that other chemical in your brain that's excitatory. It says go. But glutamate, on the other hand, slightly different than dopamine. I would describe as that sort of thinking real fast. Sometimes when your glutamate gets too high, it can make you feel jittery or shaky. And for some people, that's an uncomfortable type feeling. You know, a lot of people don't like the way they feel if they have too much stimulant or caffeine. Some people like that feeling and some people don't like that feeling. For people that tend to have an addiction to some sort of stimulant drug, they are going to get initially large levels of dopamine and some increase in glutamate while they're using that substance. But on the back end of that, as far as the withdrawal is concerned, when you come off of that drug, you get what we call most people refer to it as the crash effect. So basically, when you come off of those stimulants, you feel the exact opposite of that dopamine and glutamate. You feel depressed, you feel unmotivated. You feel like you can't even get up off your bed or your couch or sofa or whatever it is. You have no energy, no drive. You can feel negative or hopeless when you're in withdrawal from stimulant drugs. And so it's like you're taking the drug, you get one effect, but it's actually causing more depression. Lack of motivation, lack of energy. And this is in someone that's abusing the medications. I'm not talking about if you're taking it as your doctor's prescribing it for a purpose, a medical condition like ADD or narcolepsy or something else. I'm talking about stimulant abuse. On the back end of that, when you come off, you're going to be in that with 20 withdrawal, which is going to be really pretty bad. A lot of people can feel pretty the depression can be as bad as making them feel suicidal, very hopeless. You get sort of an extreme negativity because when that dopamine is gone, you're just crashed out. A good way to know what withdrawal symptoms from any particular drug would be is to ask yourself what does that drug do when you use it? Whatever the opposite of that answer is, that's what the withdrawal syndrome is going to be, which is part of the vicious cyclic nature of addiction. It's like the person is trying to achieve X effect, but the longer they use, they are actually getting more and more and more of the exact opposite of what they're trying to achieve. Some of the origins of addiction have to do with possible deficits in those particular neurochemicals to begin with. So if you're dealing with a person that is depressed, not having motivation and energy, their glutamate and their dopamine are too low, then that person may feel like that stimulant drug is medicating that. You hear the term self medicating all the time. So in some ways that is a self medicating. Although I'm not, I'm not endorsing that in any way. I'm just saying that the person can be doing that either consciously or even sometimes subconsciously. They just know it fixes whatever this thing is that doesn't feel right inside of them. One of the things that stand out to me the most about stimulant addiction is that the withdrawal from that, although doesn't necessarily require inpatient detox, physically means you're probably not going to die. Coming off of cocaine or Adderall or methamphetamine, you might be so depressed that you might lay there in the bed and wish you would die, but you're probably not going to physically die. But it can be so uncomfortable that it's very difficult not to just get up and go use because it's just that miserable. So it's a pretty, it's a pretty strong feeling that a lot of people have difficulty getting through without some sort of structure treatment or detox facility. So although you may not physically have to have a detoxing medication to bring you off of the substance, sometimes you need the structure and support just to get through that, even if you're doing that on your own. The other thing to remember is with stimulants, this is sort of personal observation from treating clients for lots of years, is that you can see what a lot of what we call a post acute withdrawal or protracted withdrawal syndrome, which basically means after you get out of that acute phase where you're not sort of in the physical withdrawal, like severely that first week to ten days after you stop using the drug. Post acute withdrawal are those symptoms that happen over the next several weeks and sometimes months, up to about a year or so. I tend to see more of that post acute protracted withdrawal, Particularly in patients that are having trouble with stimulant abuse. Sometimes patients will come off of these medications and they can be depressed and feel not themselves for months afterwards. So I do want to warn you about that. It doesn't happen every time. I don't see that in every case, But I have seen some cases where it seems like that depressed lack of energy, lack of motivation, just cannot sort of get into the groove. A lot of times having difficulty, like just getting everyday things done, like getting your house cleaned up or taking care of your child or getting to your meetings can be very difficult when you have this really heavy depression on you because those brain chemicals are just taking longer to regulate back out. And that can cause some difficulty for your recovery and just for your personal life and your family and friends of the situation or your career. The other thing that you may see in stimulant withdrawal is weight gain. Because when you are using stimulants, usually one of the side effects of that is decreased appetite. And so like I said, the withdrawal is always the opposite of that. So when you come off of those stimulants, usually like really hungry. So you're tired, depressed, no energy, and you're hungry. And so a lot of times people start to gain weight. Four are particularly for females that have had a stimulant addiction and they're in their recovery phase. Gaining weight can be a big trigger to return back to using the stimulant. Because sometimes that was part of, part of the reason why the person. It doesn't have to be a female, but I've seen that in females be a trigger more than males when they start to gain that weight from that withdrawal process. It really can be a trigger for relapse. And so I think understanding what to expect is important because it's hard to get back up into daily life Coming off of this particular drug. It's hard to go to work every day. It's hard to just make up your bed, take a shower and wash your hair sometimes. That should get better every single day that you're clean and sober. But I have to tell you, I've seen that one last a little bit longer. And the times I've seen It have been particularly in women. And it really affects the self esteem that post acute withdrawal that like, why can't I get it together? Other people in my recovery group seem to be moving on with their life, you know, at least they're functioning and they may feel like they're not functioning. Another thing to note that's different about methamphetamine abuse and I'm talking about not the prescription methamphetamine necessarily, but like when you buy it off the street. Is that that what the research is about? That is that it actually is showing to have a higher chance of more permanent changes or damage to the brain. We used to think that when you use drugs and alcohol that you permanently damaged your brain, as in forever. Once you killed a brain cell, it didn't fix or come back or what's the word, regrow or whatever that is. But newer research shows that our brains are pretty placid and flexible. And what that means is that's good news for all us addicts and alcoholics, is that for most of us, if we will stop using our brain, we'll heal for the most part and catch back up. Where you see some pretty significant differences in that is when you look at the scans of brains of people that are methamphetamine users, you'll see some changes in the brain that don't necessarily always come back or maybe they don't come back as quickly as some of the other substances happen or some of that sort of brain balances back out. So that is something to be aware of, particularly with this. If this is the drug of choice or the main substance of abuse for yourself or for your loved one. I don't say that to scare you a thing, just just so we can even the playing field for alcoholics, for long standing alcoholics, brain change that can happen in them is permanent memory damage. So in severe cases of this, someone loses their ability to form short term memories or to sort of learn from experience the same way as other people do. So it's not just that stimulant drugs damage your brain and other drugs, it's just especially with methamphetamine particular abuse that we are seeing, at least the research is showing a higher chance of brain damages that don't come back. That word, I don't really even like to say it, brain damage because it seems like severe. Sometimes that damage is subtle, could mean I just don't focus as well or my memory is not as good as it used to be, or it could be more severe than that. Other Drugs, I guess that would fall under the stimulant category. You may or may not have heard of a drug a couple years ago, they were talking a lot about it called bath salts, which is similar to methamphetamine. It's a different kind of thing, but similar. That would also fall into the category of these substances. Another thing, trying to think of all the things I want you to know that really apply specifically to stimulant abuse would be when the person is using stimulants too, and they have an excessive, like a lot in their system, they can be prone to psychosis, which means seeing, hearing, feeling things that aren't there. And so you can like, see something. Like maybe you see. You feel like you see. Saw a person in the bushes that was watching you. A lot of times paranoia is associated with this psychosis because when dopamine levels get too high, then there's a tendency towards psychosis in the disease of schizophrenia that's associated with dopamine levels being too high. That doesn't mean the person was abusing stimulants. It's just. I just give you that example so you understand that when dopamine gets too high, this can be symptomatic. So one of the scarier things about someone that's using stimulants is, especially methamphetamine users, they have a reputation for being pretty paranoid. And when people get paranoid, it doesn't matter really why, whether it's from drug abuse or some other reason, they can be pretty dangerous, even if they're not normally. Because if you feel like and your brain is telling you you're in danger, that there's a threat, then your natural human survival instincts are going to kick in. And based on whatever the situation is that you're perceiving, is going to determine how you react to that. If you feel like someone is chasing you out of your house, you might do something crazy like jump out of the window. Or if you feel like someone's following you and they're staring at you, you might start an argument or a fight in the grocery store about it. I don't mean that everyone does that. I just want you to know that usually psychosis, if you're seeing psychosis most often, I would see that associated with large amounts of stimulant use. The other time that we see that is in alcohol withdrawal. It's interesting because you don't. People drink excessively, you don't usually see psychosis, although you can see blackout effect. So when you stop drinking alcohol, you can have psychosis. But when you are excessively using stimulants, you can see psychosis. Sometimes that involves seeing things like the examples that I gave. And sometimes people can even have like tactile hallucinations. And basically what that is is it's, it's a sensory input, like a feeling on your skin. Pretty common thing is talk about sort of like cocaine bugs. It feels like there are little bugs on your skin and that's a, it's a tactile psychosis hallucination. So it can be something that you hear that's not there, something that you're seeing that's not there, or something that you're feeling that's not there. Remember that's associated with the increased dopamine levels. I hope this helps give you a general understanding about what's going on in the brain of someone that's using or abusing, excuse me, any kind of stimulants. And I also want you to remember that if you're struggling or your loved one is struggling with pretty serious post acute withdrawal symptoms, you know they've been sober for a while and it just doesn't seem to be really getting better. I would suggest that you see a physician, not necessarily get put back on the stimulant, but to get that Medicaid or to get that depression treated depends on how you work in your recovery program or where you're going to do that. And you may feel like, well, if you take an antidepressant or something that you're not sober, that's not true. Or at least that's not what I believe at all. And I do think that it's important to get that depression treated, whether that's through therapy and, or medication that get your sleep cycle treated. Because if left unchecked, it can leave you much more vulnerable to relapse. So don't suffer needlessly just to sort of be like a cowboy and feel like you have to. Like I said, that's not an excuse to go out and get more of that particular drug. But a lot of times there are ways to help someone get through this and increase their chances of successful long term recovery.