Abnormal Psychology

Substance Use Disorders 393

schizophrenia; see Chapter 12). Abuse of, or dependence on, amphetamines

can bring irreversible effects—including problems with memory and physical

coordination—that arise from enduring changes in neurons (Volkow et al., 2001a),

as well as reversible effects of irritability and violent behavior (Leccese, 1991;

Wright & Klee, 2001). Withdrawal symptoms may include depression, fatigue,

anxiety, and irritability. Mary Beth, discussed in Case 9.4, began using amphet-

amines not to experience a sense of euphoria, but to help her stay awake so that

she could study more.

CASE 9.4 • FROM THE OUTSIDE: Amphetamine Dependence

Mary Beth was a 20-year-old college student when she began using amphetamines to stay

awake during the fi nal exam period in the spring of her sophomore year. Although her exams

didn’t turn out very well (in part, because the drugs interfered with her ability to concentrate

and remember), she continued to use them on and off over the next few months. Because

tolerance gradually reduced the effects of the drug, she began taking more and more of it. In-

creasingly, the feelings of euphoria that at fi rst had been induced by the drug were replaced

by restlessness, irritability, and anger. People learned to stay away from her when she was

studying late at night, because they knew she could lash out at them for the slightest provo-

cation. Worse, though, were the profound feelings of depression that Mary Beth had begun to

experience when the drug wore off. At those times, the best she could do (if she had no more

drug to take) was to go to bed and try to fall asleep. The depression she experienced when she

“crashed” was worse than anything she’d ever experienced before.

(Wilson et al., 1996, p. 286)

Methamphetamine

Another stimulant that is abused and leads to dependence is methamphetamine

(“meth” or “speed”), which is chemically similar to amphetamines but has a

greater and longer-lasting effect on the central nervous system. It can be inhaled,

swallowed, smoked, or injected. Methamphetamine use can lead to an intense

“rush” of pleasure, and use rapidly becomes abuse and then dependence as

the person’s life becomes focused on obtaining and using the drug. Both use of

methamphetamine and the behaviors that are required to obtain it can impair

functioning (NIDA, 2008a); as with all injected drugs, sharing needles increases

the user’s risk of contracting or spreading disease (such as HIV/AIDS). One man,

BillH., describes his dependence on methamphetamines after his first injection

of the drug:

It was amazing. It also ruined my life. For the next 10 years my life went to hell. It was

torture. I lost my job, family, respect, dignity, even my soul. I began doing things I still

can’t believe I’ve done. Lied, cheated, and screwed friend after friend until I had no

friends at all.... I began to get paranoid, carried a 20-gauge sawed off shotgun around

with me.... I saw people in trees, behind sofas, where there couldn’t possibly be any-

body there. It was a nightmare. That was 25 years ago; today I am a proud member of

AA [Alcoholics Anonymous].

(Adapted from KCI, 2007)

Methamphetamine, like cocaine and amphetamines, can cause irritability,

heart problems, hallucinations and paranoia at high doses (Ksir, 2000; NIDA,

2007e). Methamphetamine abuse can adversely affect the functioning of the

neurotransmitters dopamine and serotonin, which leads to motor problems and

impaired memory and emotional regulation; the increased blood pressure that

results from taking the drug can cause strokes (NIDA, 2007e; Thompson et al.,

2004). Table 9.5 summarizes the effects of long-term methamphetamine abuse.

Some—but not all—of the brain damage infl icted by methamphetamine abuse is

reversible with long-term abstinence (Volkow, Chang, et al., 2001a; Wang

et al., 2004).

• Dependence


• Psychosis, including:
  
  
  • paranoia
  
  
  • hallucinations
  
  
  
  


• Repetitive motor activity


• Changes in brain structure and function


• Memory loss


• Aggressive or violent behavior


• Mood disturbances


• Severe dental problems


• Weight loss
  Source: NIDA, 2008c.

Table 9.5 • Long-Term Effects of

Methamphetamine

Abuse