Amphetamine PDF - Heilpraktiker-Prufungstrainer Psychotherapie

# Heilpraktiker-Prüfungstrainer Psychotherapie ## Amphetamine ### Wichtige Vertreter - Ecstasy (MDMA) - Speed (Amphetamin) - Crystal Meth (Methamphetamin) New substances from this group are constantly being developed to avoid detection ("designer drugs"). Methylphenidate, used in the treatment...

# Heilpraktiker-Prüfungstrainer Psychotherapie ## Amphetamine ### Wichtige Vertreter - Ecstasy (MDMA) - Speed (Amphetamin) - Crystal Meth (Methamphetamin) New substances from this group are constantly being developed to avoid detection ("designer drugs"). Methylphenidate, used in the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) is also abused. ### Problem: Addiction Potential of Psychostimulants The administration of Methylphenidate is subject to the regulations of the Narcotic Drug Act, but in people with ADHD it tends to inhibit the onset of drug abuse. Nevertheless, care must be taken when treating patients at risk of addiction (is the diagnosis confirmed? Is the intended use likely?). In people with ADHD who take Methylphenidate for therapeutic purposes, addiction is not expected. ### Mechanism of Action of Amphetamines Amphetamines and their derivatives act as psychostimulants, i.e. they have a general stimulating effect. Most substances from this group enhance the effects of the sympathetic nervous system by increasing the release of dopamine and noradrenaline from presynaptic neurons (indirect sympathomimetics). Additionally, they inhibit (similar to modern antidepressants) serotonin reuptake, i.e., they prevent its reabsorption from the synaptic cleft. This combination causes a euphoric "high," subjectively enhanced mental and physical performance, increased alertness, suppression of sleep, fatigue and hunger. ### Frequency of Use According to the German Federal Center for Addiction Issues, about 6% of the population have used amphetamines or ecstasy at least once in their lives. About 1% of those surveyed reported using amphetamines or ecstasy at least once in the last 12 months. The consumption rate is highest in the age group of 21 to 24 years. An estimated 0.1% of the population are addicted to amphetamines. ### Forms of Consumption and Symptoms After Consumption Amphetamines and their derivatives are usually taken in tablet form as "party drugs". Methamphetamine is usually snorted, smoked or injected intravenously. Other "applications" of amphetamines include doping in competitive sport and use as an appetite suppressant for weight loss. ### Typical Changes After Taking Ecstasy Typical changes after taking Ecstasy are euphoria, increased activity levels, activation of the sympathetic nervous system with rising blood pressure and heart rate, decreased appetite and mydriasis (pupil dilation). Euphoria can escalate to manic states. The need for sleep is greatly reduced, those affected are socially uninhibited and disinhibited, and they have a strong urge to talk ("chatterbox"). ### High Dosage At high dosages, adverse effects and the risk of complications increase: Those affected are restless, they show a strong urge to move with restlessness. The euphoric mood can shift to aggression, confusion, anxiety to panic reactions, and dysphoria (dissatisfied, sullen, grumpy, irritable or angry mood). Muscle reflexes are increased, the hands become shaky (tremor), the risk of seizures increases. Blood pressure rises sharply, there is a risk of hypertensive crises with cerebral hemorrhage and heart attack. Life-threatening cardiac arrhythmias also occur. Nausea, vomiting and abdominal pain are common. Body temperature can rise sharply (hyperthermia), there is a risk of muscle breakdown (rhabdomyolysis). The most important measures in acute care are monitoring vital functions, balancing fluids and electrolytes, and as needed, administering benzodiazepines. ### Caution Amphetamines impair the perception of physical warning symptoms such as thirst, hunger, fatigue, dizziness and pain. Fluid loss due to physical activity (e.g., dancing) and sweating can lead to severe disturbances in electrolyte and fluid balance and body temperatures > 41°C, making them life-threatening. ### Typical Consequences of Amphetamine Use (from: Raschka, Nitsche, Practical Sports Medicine, Thieme, 2016) #### Typical Consequences of Chronic Use Amphetamines primarily lead to psychological dependence, physical dependence is only slight. Most users only take these substances on occasion (e.g. at parties), actual dependence is only rarely established. After intense consumption for short periods, irritability, anxieties and hallucinations set in, followed by fatigue and exhaustion. Frequent use leads to a significant tolerance development that necessitates increasing dosages. Possible consequences of chronic use are personality changes, depression, concentration disorders, but also psychotic reactions in the form of drug-induced psychosis. Withdrawal phases are characterized by sleeplessness, fatigue, lack of motivation and a strong urge to get high. ### Therapy for Addiction Disorder The general principles of addiction therapy described in the Spicker "Addiction, Dependence and Substance Abuse" are applicable.