Amphetamines are stimulants, which raise mood, increase the sense of well-being, energy, and alertness, and decrease appetite. Some few users, paradoxically, become the opposite—drowsy, anxious, and irritable.

Normal-dose usage was typically prescribed; an obese, middle-aged, mildly depressed housewife might have taken two or three doses every day as a pick-me-up, a mild stimulant and appetite suppressant. (Some weak physical dependence ensued from such use, mainly seen as sleep changes on withdrawal.) With the discouragement of such indications, usage by physicians and patients has fallen off. Another obsolete use was as a vigilance-enhancer in those who felt the need to keep awake for excessively long periods, such as medical interns or long-distance truck drivers. Few people progressed from iatrogenic oral misuse to intravenous abuse.

Intravenous amphetamine produces euphoria, similar to but more sustained than that following the use of cocaine. Alter a few hours, the effects wear off, leaving the abuser feeling exhausted, drowsy, and depressed. Clandestine laboratories manufacturing amphetamine are still at work. Their preferred substance is METHAMPHETAMINE, which can be synthesized easily. Since intravenous use of methamphetamine is usual, and tolerance quickly occurs, larger and more frequent doses become required to achieve the desired effect. Toxic effects supervene, with repetitive face and hand movements and stereotyped behavior—for example, the user assembling and dismantling mechanical objects. A full-blown paranoid type of psychosis may develop, with loss of reality and delusions of persecution. Individual susceptibility to these toxic effects varies greatly. Polydrug abuse of amphetamines is common; co-administration of amphetamine with heroin ("speedball") or a barbiturate is believed to optimize the pleasurable effects while minimizing the toxic ones.

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