Examining Amphetamine Use And Abuse In The U.S.

Examining Amphetamine Use and Abuse in the U.S. from the 1950s to Present

The escalating concern regarding stimulant abuse, particularly amphetamines, reflects significant shifts in societal use patterns and regulatory frameworks from the 1950s to today. This paper explores the historical evolution of amphetamine use and abuse in the United States, the legal classification under the Controlled Substances Act, and the physiological, behavioral, and psychological impacts of regular amphetamine consumption, exemplified by the case of Aaliyah. It also evaluates potential behavioral indicators of misuse and assesses whether Aaliyah's pattern conforms to a substance use disorder (SUD) as delineated by the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Change in Amphetamine Use and Abuse in the U.S. from the 1950s to Present

During the 1950s, amphetamines gained popularity owing to their availability in over-the-counter medications and their perceived benefits for weight loss, alertness, and mood enhancement. They became a common tool among soldiers, students, and workers seeking increased productivity (McCabe et al., 2014). The 1960s and 1970s saw the proliferation of illicit amphetamine manufacturing, with the emergence of 'speed' as a recreational drug. This era was marked by widespread abuse, leading to considerable health and social concerns.

In response, federal agencies initiated regulatory measures such as the Controlled Substances Act of 1970, which classified illicit amphetamines as Schedule II drugs due to their high potential for abuse but recognized medical utility when prescribed appropriately (NIDA, 2020). The decline in prescription amphetamine misuse during the late 20th century was offset by the rise of illicit manufacturing and economic incentives for traffickers.

Recently, the landscape shifted again with the advent of prescription stimulant misuse among college students and young professionals, driven by academic pressures and occupational demands (Arria & DuPont, 2010). Simultaneously, methamphetamine abuse surged in certain regions, reflecting a complex pattern of stimulant use that varies geographically and socioeconomically.

Overall, the trend highlights periodic spikes in misuse correlated with societal stressors, regulation levels, and availability, necessitating ongoing monitoring and targeted interventions.

Classifying Amphetamines: Schedule of Controlled Substances and Rationale

Amphetamines are classified as Schedule II controlled substances under the Controlled Substances Act (CSA), which indicates a high potential for abuse and dependence but recognizes their accepted medical uses (DEA, 2021). Schedule II drugs include substances that carry significant risk for psychological and physical dependence yet are still used medicinally, such as ADHD medications (e.g., Adderall) and certain decongestants.

The scheduling policy aims to restrict non-medical use while allowing therapeutic use under strict regulation. The placement of amphetamines in Schedule II reflects their pharmacological potency, addictive potential, and history of misuse, which often results in adverse health outcomes (Glaser & Volkow, 2020). This regulatory classification underscores the importance of controlled distribution and careful medical oversight to mitigate abuse risks.

Effects of Regular Amphetamine Use on Aaliyah: Physiological, Behavioral, and Psychological Impacts

Acute Effects

Initially, Aaliyah might experience heightened alertness, increased energy, decreased appetite, and euphoria—common effects of acute amphetamine use (Kalant et al., 2017). These effects are mediated by the drug’s stimulation of the central nervous system, especially the release of dopamine and norepinephrine, which enhance arousal and mood.

Chronic Effects

Prolonged use can lead to neuroadaptive changes, including deficits in dopamine regulation, cognitive impairments, and psychological dependence. Physiologically, chronic consumption might cause cardiovascular issues such as hypertension, arrhythmias, and potential neurotoxicity (Volkow et al., 2001). Behaviorally, ongoing misuse can diminish motivation and impair social functioning, while mood disturbances, including anxiety, irritability, and depression, often emerge (McGregor et al., 2019).

Withdrawal Symptoms

When Aaliyah attempts to cease or reduce intake, withdrawal symptoms such as fatigue, increased appetite, anhedonia, depression, and intense cravings are likely. Such symptoms reflect the body's attempt to re-establish neurochemical balance disrupted by long-term amphetamine exposure (Baker et al., 2014).

Effects on Physiology, Behavior, Mood, and Toxicity

Physiologically, chronic use damages dopamine pathways, potentially causing lasting cognitive deficits and motor control issues. Behaviorally, Aaliyah might exhibit neglect of personal responsibilities, social withdrawal, and risk-taking behaviors. Mood disturbances, including anxiety and depressive episodes, are common. The toxicity associated with high doses or prolonged use increases the risk of cardiovascular events, hyperthermia, and neurotoxicity, which could result in irreversible brain damage (Volkow & Tanzi, 2020).

Behavioral Indicators of Amphetamine Misuse in Aaliyah

Based on her increasing reliance on amphetamines, Aaliyah may exhibit several problematic behaviors. Firstly, she might demonstrate secretive or evasive behavior concerning her drug use, such as lying about her intake or hiding pills. Secondly, a decline in personal responsibilities—missed deadlines, decreased academic performance, or neglect of health and hygiene—may become apparent. Thirdly, her irritability or anxiety levels could escalate, especially when the effects wear off or if she runs out of pills. Recognizing these behaviors is crucial for early intervention and prevention of escalation to addiction or adverse health outcomes.

Assessment of Aaliyah's Substance Use Disorder: Using DSM Criteria

Applying the DSM-5 criteria for Substance Use Disorder (SUD), Aaliyah exhibits several signs indicative of a diagnosis. She compulsively uses amphetamines despite knowing the adverse effects, increases her dosage, and continues usage to maintain alertness and performance, which suggests tolerance and withdrawal symptoms. Her neglect of health (headaches and fatigue), continued use despite negative effects, and inability to control her consumption point towards a pattern consistent with moderate to severe SUD (American Psychiatric Association, 2013).

Furthermore, her behaviors align with criteria such as craving, persistent use despite harm, and failings to meet responsibilities, fulfilling DSM benchmarks for substance dependence (e.g., persistent desire, unsuccessful efforts to cut down). Therefore, Aaliyah's case likely meets the threshold for a Substance Use Disorder, warranting professional assessment and intervention.

Conclusion

The historical context underscores the evolutionary patterns of amphetamine misuse in the United States, shaped by societal behaviors and regulatory policies. Recognizing the scheduling of amphetamines helps frame the potential for abuse and the importance of regulation. Aaliyah's case exemplifies the complex effects of long-term amphetamine use, encompassing physiological, behavioral, and psychological domains. The behavioral signs and DSM criteria strongly suggest that she may be experiencing an SUD, emphasizing the need for timely intervention and comprehensive treatment to mitigate long-term health consequences. Ongoing education, prevention strategies, and treatment are essential to address the multifaceted challenges posed by stimulant abuse.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• Arria, A. M., & DuPont, R. L. (2010). Nonmedical prescription drug use among college students: A review of findings and future directions. Journal of Addiction Medicine, 4(2), 61–69.
• Baker, D. A., McCormick, C. M., & McGinty, J. F. (2014). Long-lasting behavioral and neurochemical effects of chronic amphetamine exposure. Pharmacology & Therapeutics, 144, 159–176.
• DEA. (2021). Drug scheduling. U.S. Drug Enforcement Administration. https://www.dea.gov/drug-scheduling
• Glaser, P. E., & Volkow, N. D. (2020). Neurobiology of stimulant addiction. The New England Journal of Medicine, 382(4), 368–382.
• Kalant, H., et al. (2017). Pharmacology, toxicology, and abuse of amphetamines: An update. Addiction Biology, 22(6), 1229–1249.
• McCabe, S. E., et al. (2014). Trends in nonmedical use of prescription stimulants among college students. Drug and Alcohol Dependence, 146, 84–89.
• McGregor, C., et al. (2019). Long-term consequences of adolescent amphetamine exposure: Neurobehavioral outcomes. Neuropharmacology, 161, 107795.
• NIDA. (2020). What are the effects of stimulant use? National Institute on Drug Abuse. https://www.drugabuse.gov/publications/drugfacts/stimulants
• Volkow, N. D., & Tanzi, R. E. (2020). Neurotoxicity of stimulants. Nature Reviews Neuroscience, 21, 263–270.
• Volkow, N. D., et al. (2001). Neurobiologic advances from the brain imaging of stimulant use disorders. The Journal of Clinical Psychiatry, 62(Suppl 3), 3–9.