Amphetamine

Amphetamine is a potent central nervous system stimulant that increases alertness, attention, and energy. Pharmaceutical formulations (Adderall) contain dextroamphetamine and amphetamine salts and are prescribed for ADHD and narcolepsy. Street amphetamine (speed) is an illicit stimulant with variable purity and composition. Effects include elevated mood, increased focus, reduced fatigue, and enhanced physical performance.

How It Works

Amphetamine functions as a non-selective monoamine releaser. It blocks reuptake transporters (DAT, NET, SERT) and inhibits monoamine oxidase (MAO), increasing synaptic dopamine, norepinephrine, and serotonin concentrations. At higher doses, it directly releases these neurotransmitters from presynaptic vesicles via transporter reversal. This mechanism produces stimulation, euphoria, and enhanced cognitive function.

Legal Status

Schedule II controlled substance in the United States (high potential for abuse, accepted medical use). Strictly regulated pharmaceutical formulations available by prescription for ADHD and narcolepsy. Illicit manufacture and possession are felonies. Legal status varies internationally.

Dosage Guide (Oral)

Note: Dosages refer to pharmaceutical amphetamine (Adderall). Street amphetamine purity is highly variable (0-80%), making accurate dosing impossible. Insufflation dosages are typically 10-30mg. IV doses range 5-20mg but vary dramatically. Tolerance develops rapidly with repeated use. Medical dosing for ADHD is 5-40mg daily in divided doses.

Organ System Impacts

cardiovascular — Dangerous

Acute: Increased heart rate, elevated blood pressure, increased myocardial oxygen demand, arrhythmias, coronary vasoconstriction. Chronic: Cardiomyopathy, persistent hypertension, atherosclerosis acceleration, increased cardiovascular disease risk, myocardial infarction, sudden cardiac death.

neurological — High

Acute: Enhanced dopamine signaling, increased alertness, tremors, agitation, seizure risk at high doses. Chronic: Dopaminergic neurotoxicity with repeated high-dose exposure, reduced dopamine receptor sensitivity, cognitive impairment, movement disorders, Parkinson's-like symptoms.

ocular — Low

Acute: Mydriasis (pupil dilation), increased intraocular pressure, blurred vision. Chronic: Retinal changes, visual field defects, keratoconjunctivitis (from reduced blinking and eye lubrication), dry eye syndrome.

dermatological — Moderate

Acute: Flushing, sweating, hyperthermia. Chronic: Acne, abscesses (especially with injection), chronic dermatitis, poor wound healing, skin picking lesions (formication), tissue necrosis at injection sites, premature aging.

respiratory — Moderate

Acute: Increased respiratory rate, hyperventilation, shortness of breath. Chronic: Bronchitis (especially with smoking route), chronic obstructive pulmonary disease, reduced lung function, increased respiratory infection risk.

hepatic — Low

Acute: Hepatotoxicity is rare at therapeutic doses. Chronic: Potential liver damage with very high chronic doses, impaired hepatic metabolism of other drugs.

hematological — Moderate

Acute: Increased clotting tendency (hypercoagulability), hemoconcentration with dehydration. Chronic: Increased thrombotic risk, stroke risk, myocardial infarction risk.

renal — Low

Acute: Dehydration, acute kidney injury (especially in overdose), myoglobinuria (from rhabdomyolysis). Chronic: Chronic kidney disease with repeated high-dose exposure, hypertension-related kidney damage.

gastrointestinal — Low

Acute: Nausea, vomiting, constipation (later phases), reduced appetite, abdominal pain. Chronic: Malnutrition, gastritis, ulcer risk, chronic constipation or diarrhea, poor nutrient absorption.

musculoskeletal — Low

Acute: Increased muscle tension, jaw clenching, teeth grinding (bruxism), tremors, rhabdomyolysis (at very high doses). Chronic: Dental damage from bruxism, muscle weakness, osteoporosis (from poor nutrition and reduced physical activity), joint pain.

Effects

Desired Effects

• Increased alertness and wakefulness
• Enhanced concentration and focus
• Improved mood and confidence
• Increased energy and motivation
• Euphoria (at higher doses or via rapid-onset routes)
• Suppressed appetite
• Enhanced physical performance
• Improved sexual function (at therapeutic doses)

Negative Effects

• Anxiety
• Irritability and mood lability
• Paranoia (especially at higher doses)
• Tremors
• Sweating
• Headaches
• Nausea
• Dizziness
• Insomnia
• Appetite suppression
• Weight loss
• Skin picking/formication
• Sexual dysfunction (with chronic use)
• Dehydration

Rare but Serious

• Myocardial infarction (heart attack)
• Stroke
• Arrhythmias
• Cardiomyopathy (with chronic use)
• Sudden cardiac death
• Hypertensive crisis
• Seizures
• Intracranial hemorrhage
• Psychosis
• Severe hyperthermia
• Rhabdomyolysis
• Acute kidney injury

Drug Interactions

Detection Times

Amphetamines are detected on all standard drug panels.

Urine

Standard immunoassay for amphetamines. Detection window: up to 4 days.

Blood

Blood detection for recent use. Detection window: up to 2 days.

Hair

Hair follicle test detects amphetamine use. Detection window: up to 90 days.

Saliva

Oral fluid testing. Detection window: up to 3 days.

Harm Reduction Tips

Testing and Purity

• Use reagent test kits (Marquis, Mandelin, Simon's reagent) to confirm amphetamine presence and check for common adulterants
• Understand that test results don't confirm purity percentage—only substance presence
• Consider sending samples for laboratory analysis (services like Energy Control in Spain offer confidential testing)
• Street amphetamine frequently contains methamphetamine, cathinone derivatives, levamisole, phenibut, and dangerous synthetics
• Pharmaceutical amphetamines (Adderall) have verified composition; prescription is safer than illicit sources

Dose Management

• Start with the lowest possible dose to assess individual sensitivity and purity
• Use a milligram scale to measure oral doses; never estimate street drug quantity
• Divide doses and space them apart rather than taking one large dose to reduce peak toxicity
• With oral pharmaceutical amphetamine, follow prescription dosing guidelines exactly
• Avoid frequent re-dosing (redosing) which extends stimulation and increases cardiovascular strain
• Do not exceed 40-60mg single oral doses (far lower for other routes)
• Track cumulative dose over a session to prevent accidental overdose

Temperature and Hydration

• Drink water regularly (250-500mL per hour) but avoid overhydration which can cause hyponatremia
• Monitor core body temperature; stop activity if feeling dangerously hot
• Avoid overheating from physical activity; take breaks to cool down
• If dancing or exercising, drink water and take cooling breaks
• Severe hyperthermia is a medical emergency—cold water immersion and immediate medical care are needed

Route-Specific Safety

• Oral: Preferred route. Slower onset reduces abuse potential and cardiovascular stress. Take with water on empty stomach for consistent absorption.
• Insufflation: If unavoidable, use clean equipment, avoid sharing, alternate nostrils, rinse sinuses with saline afterward, monitor for nasal damage
• Smoking: Extremely high addiction risk and acute cardiovascular danger. Do not recommend. If used: use clean equipment, avoid deep inhalation, limit frequency
• Injection: Highest overdose and infection risk. Only if already injecting other substances—use sterile equipment, rotate injection sites, practice aseptic technique, access clean needle services

Cardiovascular Protection

• Measure baseline blood pressure and heart rate before use; monitor periodically during use
• Avoid use if you have hypertension, arrhythmias, heart disease, or family history of early cardiovascular disease
• Stay adequately hydrated throughout use (drink water, not only alcohol)
• Avoid combining with other stimulants, caffeine, or sympathomimetics
• Avoid tobacco and cannabis which further elevate heart rate and blood pressure
• Stop use immediately if you experience chest pain, shortness of breath, severe headache, or palpitations—seek medical care
• Use lower doses if you are older, have cardiovascular risk factors, or are overweight

Sleep and Recovery

• Plan for 12-24+ hours of impaired sleep after amphetamine use
• Avoid redosing to extend use and sleep deprivation
• Use a sleep aid (melatonin 3-5mg, magnesium glycinate, or prescribed sedatives) 6-8 hours after last dose if needed
• Allow minimum 48-72 hours between uses to recover and reset dopamine systems
• Chronic use with poor sleep increases psychosis, anxiety, and physical health risks exponentially

Psychological Safety

• Be aware of mood changes, paranoia, and anxiety during and after use
• Avoid isolated use; have a sober, trusted person nearby who knows about the substance
• Do not use if experiencing depression, anxiety, psychosis, or bipolar disorder (high risk of exacerbation)
• Recognize signs of stimulant psychosis: paranoid ideation, hallucinations, disorganized thinking
• If psychotic symptoms emerge, stop use immediately and seek medical attention
• Use in familiar, safe environments; avoid driving or operating machinery
• Talk to someone if you're experiencing increased anxiety or mood swings

Injection-Specific Safety

• Access sterile equipment from needle exchange programs (syringes, filters, alcohol swabs, tourniquets)
• Never share injecting equipment—hepatitis C, HIV, and bacterial endocarditis transmission risk is very high
• Rotate injection sites to avoid abscess formation, thrombosis, and tissue damage
• Clean injection site with alcohol swab for 30 seconds before injection
• Use proper sterile technique: wash hands, disinfect equipment, use aseptic injection procedure
• Monitor for signs of infection: increasing redness, warmth, swelling, pus, fever
• Access prompt medical care for any injection-related infection or complications
• Consider transitioning to oral or intranasal routes to reduce injection-related harms

Intranasal Safety

• Use clean, sterile equipment (no sharing of snorting devices)
• Crush powder finely and create separate lines for each nostril
• Alternate nostrils with each use to allow tissue healing
• Rinse nasal passages with sterile saline solution after use to remove residual powder
• Monitor for nasal bleeding, chronic congestion, or drainage—these are signs of tissue damage
• Avoid nasal sprays and decongestants which can mask damage and increase problems
• Seek ENT evaluation if experiencing chronic symptoms (septum perforation is irreversible)

Harm Reduction for High-Risk Populations

• Pregnant individuals: Amphetamine is Category C; associated with congenital heart defects, preterm delivery, low birthweight. Strongly avoid or consult OB/GYN.
• Adolescents: Brain development continues to age 25; early stimulant use increases addiction risk, reduces dopamine receptor density, and impairs cognitive development. Use is especially harmful.
• Individuals with psychiatric history: Risk of triggering psychosis, mania, or severe depression is high. Medical consultation strongly recommended.
• Individuals with cardiac disease: Absolute contraindication. High sudden death risk.
• Older adults: Cardiovascular and cerebrovascular risks increase exponentially with age. Therapeutic doses should be minimal.

Withdrawal Symptoms

Severity: Moderate

Crash: 1-3 days (exhaustion, sleep). Acute: 1-2 weeks (depression, cravings). Protracted: weeks to months (mood instability, intermittent cravings).

Physical

• Fatigue and excessive sleep
• Increased appetite
• Psychomotor slowing
• Body aches

Psychological

• Depression
• Anhedonia
• Cravings
• Anxiety
• Irritability
• Difficulty concentrating
• Vivid dreams

Emergency Information

Call 911 If:

• Severe chest pain or pressure
• Difficulty breathing
• Loss of consciousness or unresponsiveness
• Seizures
• Signs of stroke (facial droop, arm weakness, speech difficulty)
• Severe hyperthermia (temperature >104°F / 40°C) not responding to cooling
• Severe confusion or hallucinations
• Severe hypertension (BP >180/120)
• Severe head pain
• Suspected overdose

Warning Signs

• Severe headache or chest pain
• Rapid or irregular heartbeat (palpitations)
• Dangerously high blood pressure
• Difficulty breathing or shortness of breath
• Severe hyperthermia (core temperature >104°F / 40°C)
• Seizures or convulsions
• Confusion, disorientation, or hallucinations
• Severe agitation or violent behavior
• Loss of consciousness
• Tremors or muscle rigidity
• Blue lips or tongue (cyanosis)
• Acute severe anxiety or panic
• Signs of stroke (facial drooping, speech difficulty, arm weakness)

What To Do

1. Stop amphetamine use immediately
2. Move to cool environment to reduce hyperthermia
3. Drink water in small sips (avoid overhydration)
4. Lie down with legs elevated to support circulation
5. Monitor vital signs if possible (heart rate, breathing, temperature)
6. Do not leave person alone
7. Reassure and speak calmly to reduce panic
8. If seizing, protect from injury but do not restrain
9. Remove restrictive clothing
10. Have naloxone (Narcan) available in case of overdose, though amphetamine is not an opioid