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Alcohol
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Stimulants
Prescribed Drugs
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Inexperienced Driver
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Amphetamine and methyl-amphetamine
Amphetamine is one of a group of synthetic stimulants derived from ephedrine. It was first synthesised in 1919. Amphetamines were used extensively in the second World War to overcome physical exhaustion and fatigue and were supplied to army personnel (10 milligram in 12 hours or 30 mg in a week) for use when they were physically or mentally fatigued.
Methyl Amphetamine has essentially the same actions as amphetamine and has also been used as an appetite suppressant. For this use it has been prescribed in doses of 2.5 to 5 mg 3 times daily. Its side effects include dry mouth, nausea, constipation, insomnia, agitation and restlessness. Mental depression may follow withdrawal of the drug. Tolerance develops.
Drug dependence with stimulants is well described. It is generally thought to be psychological rather than physical, because there is no characteristic withdrawal syndrome. However, the distinction between psychological and physiological dependence is not clear. When large doses have been used for long periods, withdrawal of the drug can lead to rebound phenomena - ravenous appetite, acute depression, tiredness and lethargy.
Amphetamines are used to produce feelings of well being, elation, euphoria, indestructibility, confidence, and endurance, to reduce the need for sleep and to heighten perception of achievement and sexual power. The drug is frequently used intravenously with doses of 20 to 160 milligram being taken as frequently as 10 times daily. Intra-nasal use has also been reported. Each dose produces a so called "flash" which is likened to an orgasmic experience, but not of a sexual nature.
After a period of intensive use that may last for days, or even weeks, the bout is terminated by a "crash" in which there is prolonged sleep, depression and apathy. The cycle is then started again. The use of other drugs, particularly hypnotic/sedative drugs is also common.
A psychotic reaction to amphetamines may occur with as little as 100 milligram taken in the course of a single day to 500 milligram or more taken for several days. In some individuals a single, moderate dose of amphetamine may produce psychotic reactions. This effect may be due to the unveiling of a pre-existing disorder.
There are few medical indications for the use of amphetamines: the treatment of narcolepsy, the hypokinetic child syndrome, and Parkinsonism. The drugs have also been used for combating fatigue.
Amphetamines are used for their stimulant effects; they may be self-administered either orally or intravenously. If the amphetamine is a quality controlled preparation taken orally in therapeutic doses, the potential for harm is low. If taken in high doses or by the intravenous route, the potential for serious toxicity is great. Illicit synthesis runs the risk of potential contaminants being introduced.
Amphetamines have also been used by athletes, and on horses and dogs, to increase performance. There are also reports of the abuse of these drugs by medical and paramedical personnel (ready availability), actors, musicians and others who have to make public performances (to boost self confidence and sharpen alertness), students (to extend their hours of study when cramming for examination), shift workers and long distance transport drivers. There are innumerable anecdotal accounts of the hazards of using amphetamines whilst driving. Further there have been reports of the use of amphetamines to overcome feelings of boredom, inadequacy, inferiority and shyness and about its use to increase sexual performance and pleasure.
Death may occur after oral or intravenous use. It usually occurs several hours after use with agitation, hyperthermia, convulsions, unconsciousness and cardio-respiratory failure preceding death.
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