The stimulant class of substances contains several drugs that increase energy, alertness, focus, heart rate, blood pressure, and breathing rate.1 The class itself encompasses both illicit stimulants, such as methamphetamine (meth) and cocaine, and legally prescribed medications (though these too may be abused illicitly). Some examples of prescription stimulants include Dexedrine, Adderall, Ritalin, and Concerta.2 Ecstasy, or MDMA, is a somewhat unique member of the stimulant class due to its entactogenic and mild hallucinogenic properties.
According to the United States Drug Enforcement Administration (DEA), many stimulants, such as pharmaceutical methamphetamine, cocaine, Dexedrine, Adderall, and Ritalin, are Schedule II substances, while MDMA is classified as a Schedule I controlled substance.4 Their controlled status means that, despite legitimate medical uses, they have a high potential for abuse and use may result in dependence.4 Abusing stimulants can place significant stress on the heart, which increases the user’s risk of experiencing adverse consequences and even death.5
There are many different types of stimulants that are commonly used or abused. They may be taken alone or in combination with other psychoactive substances, such as alcohol or marijuana. Popular stimulants of abuse include:1,2,3,6
Each one of the above-mentioned stimulants increases the user’s heart rate, blood pressure, and respiratory rate, thus increasing the risk of adverse cardiovascular effects.
Stimulant use can have some desirable, if ultimately dangerous, effects. For example, stimulant use may lead to feelings of pleasure, sexual arousal, increased confidence, and increased focus.3 It may also promote weight loss by decreasing appetite.5 When used therapeutically by those with ADHD, stimulant can increase motivation, cognition, learning, and memory. The allure of such effects helps explain why so many people abuse them in the absence of medical necessity, despite the risks of detrimental and even fatal consequences.7
Because stimulants increase focus and motivation and decrease the need for sleep, many students use prescription stimulants as study aids. Research has found that college students are more likely to use prescription stimulants than their non-college-attending peers, potentially due to the need to stay awake to study.8 Research has also shown that college students in particular are not only using prescription stimulants as study aids, but also to stay awake longer to drink and party more.8 Mixing stimulants and alcohol is particularly risky since stimulant effects may delay or mask the symptoms of increased alcohol intoxication. Therefore, when a person mixes a stimulant with alcohol, they may end up drinking more than they otherwise would because they were not able to read their body’s warning signs, which can increase the risk of alcohol poisoning.9 Mixing stimulants with other substances may also put extra stress on the cardiovascular system, leading to dangerously high blood pressure or irregular heart rhythms, which is already a major concern with stimulant use, alone.10
There are many negative effects associated with stimulant use, but concerns regarding their impact on cardiopulmonary systems are especially significant. Stimulants have been known to cause the following:5
In excessive doses and long-term use, stimulants have been found to cause the following:5,6,13
Furthermore, intravenous stimulant users have an increased risk of contracting bacterial endocarditis, an infection of the heart lining.13 Bacterial endocarditis, if left untreated, can damage heart valves, leading to an inability to effectively pump blood to the body. This can progress to congestive heart failure. Additionally, pieces of myocardial vegetation (bacterial overgrowth and resulting blood clotting and immune system deposition) located at the site of infection can break off and travel through the blood vessels to the extremities and vital organs, which can lead to embolic damage to the lungs, kidneys, spleen, brain, intestines, and liver.14
Other serious consequences of stimulant abuse can include malnourishment, dental problems, suicidal ideation or behaviors, psychotic features such as paranoia and delusions, cerebral hemorrhaging (bleeding into the brain), brain damage, coma, seizures, and death. MDMA abuse can result in kidney, liver, or heart failure. The abuse of stimulants in general is associated with risky sexual behaviors, which increases the risk of sexually transmitted diseases (STDs) and other communicable diseases, such as HIV and hepatitis.5 MDMA, in particular, elicits feelings of emotional warmth and trust, which could also put the user at risk of engaging in unsafe sexual practices.6 Due to these potentially serious consequences, it is important to get treatment if you or a loved one is struggling with stimulant use or any kind.
The sooner you quit abusing stimulants, the lower your risk of experiencing significant harmful, long-term mental and physical consequences, particularly to the heart. Damage to the heart can negatively impact many other organs as well, thus causing significant impairment and harm. Completing an initial detoxification period and engaging in comprehensive substance abuse treatment can help you achieve and maintain sobriety.
Detoxification is the process by which the body rids itself of a substance.11 While the body eliminates the drug, withdrawal symptoms may occur. Stimulant withdrawal symptoms may include:12
Some people may be more susceptible to cardiovascular complications during stimulant withdrawal than others. Studies have shown that patients who abuse alcohol and cocaine may experience persistent problems associated with the heart, such as irregular heart beat and heart attacks due to the production of a deadly chemical, called cocoethylene.12 Professional detox can help to mitigate possible cardiovascular complications and enhance your safety.
There are several settings where this detoxification process may take place, including in a hospital, an inpatient setting, a physician’s office, or an outpatient setting. More information on them:12
It is important to note that many stimulant detox programs are very short-term, typically lasting several days. While the detoxification process is an important part of the journey to stopping stimulant use, it is important to continue the journey with longer-term substance abuse treatment.
Substance abuse treatment may include education about the risks and consequences associated with drug use, along with strategies regarding how to prevent relapse. It also includes addressing deeper, underlying issues that trigger substance use. Formal substance abuse treatment is offered in a number of settings and each program is likely to utilize a somewhat unique therapeutic approach. These treatment varieties include inpatient, outpatient, luxury, executive, holistic, and population-specific.
Although they are not considered formal substance abuse treatment, many people find 12-step programs, such as Narcotics Anonymous (NA), to be helpful as an adjunct to formal treatment or as ongoing support after the recovery program has been completed.
It is important to remember that even after you have completed substance abuse treatment, aftercare and ongoing support is key to preventing relapse. Having the support of others and knowing which resources you can use when you experience triggers and feel like using can help guide you to stay clean and sober in the long run, and thus prevent damage to the heart and other organs.