Stimulant Use
The risks of cocaine, methamphetamine and misused prescription stimulants, which speed up the body and brain.
Last revised
Key takeaways
- Examples: cocaine, methamphetamine, and prescription stimulants used without a prescription
- Effects on the body: raised heart rate, blood pressure and body temperature
- Most useful single change: Carry naloxone because of fentanyl contamination.
- Commonest mistake: Using stimulants alone.
- See a doctor if any of the signs under "When to get help" below apply to you.
Why it matters
Stimulants can cause heart attacks, strokes and seizures, and many are now contaminated with fentanyl.
The numbers, in one place
| Measure | Figure |
|---|---|
| Examples | cocaine, methamphetamine, and prescription stimulants used without a prescription |
| Effects on the body | raised heart rate, blood pressure and body temperature |
| Fentanyl | is often found in stimulants, so naloxone can still be needed |
| Treatment | behavioral therapies, including contingency management, are the main treatment |
| Medicines | there are no FDA-approved medicines for stimulant use disorder |
What helps
- Carry naloxone because of fentanyl contamination
- Keep prescription stimulants locked up and never share them
- Talk to your doctor or call the SAMHSA National Helpline at 1-800-662-4357 for treatment options
- Use FindTreatment.gov to search for programs near you
What to avoid
- Using stimulants alone
- Mixing stimulants with alcohol or opioids
- Taking a friend's prescription stimulant to study or stay awake
In depth
Stimulants increase the activity of brain chemicals such as dopamine and norepinephrine, which affect alertness, energy, mood and the body's fight-or-flight response. Prescription stimulants, used as directed, can help people with ADHD and some sleep disorders. Cocaine and methamphetamine are illegal stimulants that produce intense highs and carry serious risks.
The short-term effects include feeling energetic, confident and alert, with less need for sleep or food. At the same time, heart rate, blood pressure and body temperature rise, and blood vessels narrow. These effects can trigger heart attacks, abnormal heart rhythms, strokes and seizures, even in young people without known heart problems.
With repeated use, the brain adapts, and people may need more to feel the same effects. When the drug wears off, a crash can follow, with exhaustion, low mood, anxiety and strong cravings. Long-term use can cause paranoia, hallucinations, weight loss, dental problems and damage to the heart and brain. Treatment works, and recovery is possible.
Signs and symptoms
- Very high energy, talking fast and needing little sleep
- Dilated pupils, sweating and a racing heart
- Weight loss and skipped meals
- Paranoia, anxiety, agitation or aggressive behavior
- Exhaustion and low mood after a period of heavy use
- Skin sores from picking, or nosebleeds from snorting
Causes and risk factors
- Using stimulants to stay awake, study, work longer hours or lose weight
- Social settings where cocaine or methamphetamine use is common
- Untreated ADHD, depression or other mental health conditions
- Trauma and chronic stress
- Family history of substance use
- Easy access to prescription stimulants not prescribed to you
How it is checked
Your doctor will ask about stimulant use, other substances and mental health, and check your heart rate and blood pressure. Stimulant use disorder is diagnosed when use causes significant problems and is hard to control. Urine drug tests can detect cocaine and amphetamines, but they cannot say how much or how often someone uses.
If you have chest pain, palpitations, severe headache or other worrying symptoms after using stimulants, clinicians may check your heart with an electrocardiogram and blood tests. Telling them what you used and when helps them treat you safely, since some heart medicines can be risky after cocaine use.
Related topics
- Epilepsy: Sorting the Evidence From the Noise (Brain Health)
- Heat and Medications: What Published Guidance Supports (Heat, Cold and Weather Safety)
- Traveling with Medicines: What Published Guidance Supports (Travel Health)
- The Evidence on Stress, Without the Hype (Mental Health)
Where to go next
- What the Guidance Really Says About Stimulant Use
- Why Stimulant Use Matters, Explained Simply
- Substance Use: The Complete Guide
- Medications for Opioid Use Disorder: What Published Guidance Supports
- Finding Substance Use Treatment: What Published Guidance Supports
When to get help
Call 911 for chest pain, seizures, very high body temperature, severe agitation or confusion, signs of stroke, or slow or stopped breathing. Give naloxone if breathing is slow or stopped.
Where this comes from
- National Institute on Drug Abuse — Methamphetamine DrugFacts
- National Institute on Drug Abuse — Cocaine DrugFacts
- CDC — Stimulant Guide
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.