Amphetamines Detox GuideAnna Ciulla
Amphetamines belong to a class of synthetic psychostimulant medications originally developed by Japanese scientist Nagai Nagoyoshi in the late 19th century. Chemically designed to target the central nervous system (CNS) and accelerate the connection between the brain and body, amphetamine’s excitatory properties are used to treat a wide variety of conditions including attention deficit hyperactivity disorder (ADHD), narcolepsy, depression, and asthma. Amphetamine is available legally in the form of popular prescription medications such as Adderall and Dexedrine and illicitly in the form of methamphetamine and ecstasy— both of which are popular on the black market.
Amphetamine’s highly addictive properties and potential for abuse have resulted in its Schedule 11 classification by the Drug Enforcement Administration (DEA). According to the National Survey on Drug Use and Health (NSDUH), approximately 5 million Americans abused prescription amphetamines in 2015—especially adolescents.
AMPHETAMINES WITHDRAWAL SYMPTOMS
Addiction to amphetamines produces a number of behavioral and psychological changes—the unavoidable result of altered brain chemistry. After a user develops tolerance, the brain experiences shock any time there is a lapse between uses or especially complete cessation. Withdrawal is the natural result of rewired brain chemistry being forced to adapt to life without the drug, a process which is unsettling in the best of cases and debilitating in the worst. Common amphetamine withdrawal symptoms may include:
- Blurred vision
- Excessive slumber
- Mood swings
AMPHETAMINES WITHDRAWAL TIMELINE
The severity of amphetamine withdrawal symptoms and exact length of time involved in the withdrawal process depend upon a variety of factors including age, gender, height, weight, overall mental and physical health, as well as exact dosage of amphetamines and length of time used. Amphetamine withdrawal is typically broken down into the following four stages:
- Stage one – for the majority of clients, the initial three days following cessation of use are the most difficult. This intense period is characterized by restlessness, cravings and exhaustion, with the brain forced into overdrive as it adjusts to the absence of amphetamines in the system. Irritability and depression are extremely common during stage one.
- Stage two – after seven days, the severity of withdrawal symptoms typically begins to diminish, although cravings may persist. Although many clients continue to experience fatigue, the nightmare of stage one is over and a significant milestone has been achieved.
- Stage three – the end of week two is characterized by enhanced psychological symptoms including insomnia and disturbing dreams. During this stage, physical processes continue to stabilize despite lingering moods and cravings.
- Stage four – after approximately one month, the majority of symptoms begin to subside as the drug completely exits the system; however, occasional cravings may still arise. At this point, a longer, protracted withdrawal process known as post-acute withdrawal syndrome (PAWS) takes hold as mental and physical processes further stabilize. Depending upon the severity of amphetamine addiction, PAWS can linger for months or even years beyond cessation of use.
INPATIENT TREATMENT FOR AMPHETAMINES
Due to amphetamines’ potency and associated dangers, inpatient treatment is highly recommended. Intensive inpatient treatment is based upon a proven clinical model that involves 24/7 monitoring and the increased security necessary to help stabilize clients recovering from the addictive and debilitating effects of the drug. Inpatient treatment includes ongoing medical assessment and psychiatric evaluation by a team of licensed medical professionals and qualified clinicians— with many reputable facilities providing additional holistic services and ancillary benefits. This comprehensive, client-focused quality of care is why inpatient treatment is generally considered the industry gold standard and the safest bet for those recovering from amphetamine addiction.
Inpatient treatment combines behavioral and psychotherapy in tandem with Food and Drug Administration (FDA) approved pharmacological interventions to ease the symptoms of amphetamine withdrawal. Dialectical behavioral therapy (DBT), motivational interviewing (MI), trauma-informed therapy, family therapy, and cognitive behavioral therapy (CBT) are among the many evidence-based therapies frequently employed.
Prescription medications administered during withdrawal may include the following:
- Benzodiazepines “benzos” – these anti-anxiety medications may be prescribed during the withdrawal process to help ease nervous tension and prevent anxiety attacks or other debilitating psychological symptoms.
- Antidepressants – SSRIs including Zoloft or Lexapro may be prescribed to help ease symptoms of depression and further stabilize the mood shifts that inevitably accompany the withdrawal process.
- Antipsychotics – may be prescribed to treat the various psychotic symptoms associated with amphetamine withdrawal including hallucinations, delusions or mania.
- Sleep Aids – many clients suffer from withdrawal-induced insomnia, which can be treated using either over-the-counter sleep aids such as melatonin, or prescription strength medications as determined by a physician.
Dual Diagnosis Treatment
Frequently, anxiety and depression-related disorders are the driving force behind amphetamine addiction— in addition to post-traumatic stress disorder (PTSD). Untreated, these disorders create an ongoing psychological and physiological imbalance that users seek to self-medicate— ultimately fueling their addiction. The treatment of “co-occurring” disorders is a key ingredient in successful detox program for many clients, especially those who suffer from polysubstance abuse and unresolved trauma. Supplemental medications such as gabapentin, pregabalin, and buspirone may be included in the treatment protocol depending upon individual client needs, and are prescribed only after careful assessment by a team of licensed medical professionals.
OUTPATIENT TREATMENT FOR AMPHETAMINES
Outpatient treatment offers many of the same services and benefits as inpatient treatment, but without the intensive level of clinical care, 24/7 monitoring and additional security. Typically cheaper than inpatient treatment and less effective, it offers the singular advantage of greater flexibility for certain clients based upon their personal and/or professional schedules. Outpatient treatment also represents a natural progression in continuing care for those clients successfully transitioning from more intensive levels of treatment. Unlike residential treatment, outpatient treatment is offered on a non-residential basis in a wide range of public and private facilities.
CAN AMPHETAMINE DETOX BE DONE AT HOME?
Amphetamine is a powerful stimulant that requires professional addiction treatment. At-home, self-guided detox is extremely dangerous and never recommended regardless of the reason. Although those suffering from amphetamine addiction sometimes resort to self-administered treatment in order to save time and money, they end up saving neither while incurring unnecessary risks. The safest, most evidence-based method of detox always involves medical supervision and quality clinical care, both of which lead to improved long-term recovery outcomes and help minimize the likelihood of relapse.
TAPERED VS COLD TURKEY
Amphetamine addiction, especially long-term amphetamine addiction, creates psychological and physiological dependence. For this reason, a tapered approach to weaning users off of the drug is generally considered preferable to quitting cold turkey. Depending upon individual client needs, a wide range of medications—including diminishing doses of amphetamine—may be used during the taper. Such an approach allows the body and mind sufficient time to adjust to life without the drug, and reduces the risk of precipitated withdrawal— the rapid acceleration and intensification of symptoms that frequently lead to relapse. Despite tapering being considered a controversial approach by some clinicians, the majority of clients respond favorably to this method when compared to the shock of quitting cold turkey.
CONSIDERATIONS/ HOW TO DECIDE WHAT IS RIGHT FOR YOU?
The decision to seek professional treatment for amphetamine addiction deserves serious and careful consideration. For the majority of clients, the decision is based largely upon financial feasibility and program location. Although choosing a location close to home becomes a critical factor for some, many industry renowned treatment centers require out-of-state travel. Fortunately, an abundance of treatment centers exist to serve individual needs, and certain programs feature an impressively diverse range of treatment options and therapeutic modalities.
Reputable facilities will have trained admissions staff available to help answer questions regarding insurance coverage and address cost-related concerns for those seeking treatment. Many programs are also willing to assist those of limited financial means with the possibility of private scholarships, federal grants, or other alternative arrangements. Cost alone should never be the only factor when considering where to seek professional help. The following considerations should also be factored into any informed decision:
- Program reputation, locally and nationally
- Addition of amenities, aftercare services and on-site benefits
- Use of state-of-the-art technology and treatment options
- Proximity to major recreational attractions (ocean, mountains, etc.)
- Accessibility from major airports
RECOVERY SUCCESS AND AFTERCARE FOR AMPHETAMINE
Medically managed detox and inpatient treatment are merely one component of a successful long-term amphetamine recovery plan. Optimal long-term recovery outcomes depend upon implementing a comprehensive aftercare plan that should include:
- 12-step group involvement (AA, NA, etc.)
- An ongoing relationship with a sponsor
- Continuing one-on-one and/or group therapy
- Healthy dietary and lifestyle decisions
- Avoidance of social and environmental triggers
- Commitment to a spiritual discipline or routine
WHO NEEDS AMPHETAMINE DETOX?
Amphetamine addiction does not discriminate based upon socioeconomic factors. Anyone, at any time, can find themselves addicted to amphetamines and in need of professional help. Early intervention and aggressive treatment are critical components of long-term recovery.
If you or someone you love is addicted to amphetamines, call a substance abuse professional today. And remember, in the event of an overdose, call an ambulance immediately or visit your nearest hospital emergency room (ER).
For more about amphetamine addiction and recovery, check out these related articles:
- “What Does a Day in Rehab Look Like?”
- “Addiction Recovery: An Overview of the Entire Process”
- “Are All Detox Programs the Same?”
- “Should You Consider Traveling for Treatment?”
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Molecular Psychiatry. Potential Adverse Effects of Amphetamine Treatment on Brain and Behavior: A Review. Feb, 2009.
The Journal of Emergency Medicine. Amphetamine Abuse in Emergency Department Patients Undergoing Psychiatric Evaluation. Nov, 2012.
The Journal of Neuroscience. Amphetamine Mechanisms and Actions at the Dopamine Terminal Revisited. May, 2013.