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Stimulants (also often referred to as psychostimulants or colloquially as uppers) is an overarching term that covers many drugs including those that increase activity of the central nervous system and the body,[1] drugs that are pleasurable and invigorating, or drugs that have sympathomimetic effects.[2] Stimulants are widely used throughout the world as prescription medicines as well as without a prescription (either legally or illicitly) as performance-enhancing or recreational drugs. The most frequently prescribed stimulants as of 2013 were lisdexamfetamine, methylphenidate, and amphetamine.[3] It is estimated that the percentage of the population that has abused amphetamine-type stimulants (e.g., amphetamine, methamphetamine, MDMA, etc.) and cocaine combined is between 0.8% and 2.1%.[4]

Contents

1 Effects

1.1 Acute 1.2 Chronic

2 Medical
Medical
uses 3 Chemistry

3.1 Amphetamines (class) 3.2 Cocaine
Cocaine
analogues

4 Mechanisms of action 5 Notable stimulants

5.1 Amphetamine 5.2 Caffeine 5.3 Ephedrine 5.4 MDMA 5.5 MDPV 5.6 Mephedrone 5.7 Methamphetamine 5.8 Methylphenidate 5.9 Cocaine 5.10 Nicotine 5.11 Phenylpropanolamine 5.12 Propylhexedrine 5.13 Pseudoephedrine 5.14 Catha edulis (Khat)

6 Abuse 7 Testing 8 See also 9 Notes 10 References 11 External links

Effects[edit] Acute[edit] Stimulants in therapeutic doses, such as those given to patients with ADHD, increases ability to focus, vigor, sociability, libido and may elevate mood. However, in higher doses stimulants may actually decrease the ability to focus, a principle of the Yerkes-Dodson Law. In higher doses stimulants may also produce euphoria, vigor, and decrease need for sleep. Many, but not all, stimulants have ergogenic effects. Drugs such as ephedrine, pseudoephedrine, amphetamine and methylphenidate have well documented ergogenic effects, while cocaine has the opposite effect.[5] Neurocognitive enhancing effects of stimulants, specifically modafinil, amphetamine and methylphenidate have been documented in healthy adolescents, and is a commonly cited reason among illicit drug users for use, particularly among college students in the context of studying.[6] In some cases psychiatric phenomenon may emerge such as stimulant psychosis, paranoia, and suicidal ideation. Acute toxicity has been reportedly associated with a homicide, paranoia, aggressive behavior, motor dysfunction, and punding. The violent and aggressive behavior associated with acute stimulant toxicity may partially be driven by paranoia.[7] Most drugs classified as stimulants are sympathomimetics, that is they stimulate the sympathetic branch of the autonomic nervous system. This leads to effects such as mydriasis, increased heart rate, blood pressure, respiratory rate and body temperature.[8] When these changes become pathological, they are called arrhythmia, hypertension, and hyperthermia, and may lead to rhabdomyolysis, stroke, cardiac arrest, or seizures. However, given the complexity of the mechanisms that underly these potentially fatal outcomes of acute stimulant toxicity, it is impossible to determine what dose may be lethal.[9] Chronic[edit] Assessment of the effects of stimulants is relevant given the large population currently taking stimulants. A systematic review of cardiovascular effects of prescription stimulants found no association in children, but found a correlation between prescription stimulant use and ischemic heart attacks.[10] A review over a four-year period found that there were few negative effects of stimulant treatment, but stressed the need for longer term studies.[11] A review of a year long period of prescription stimulant use in those with ADHD
ADHD
found that cardiovascular side effects were limited to transient increases in blood pressure only.[12] Initiation of stimulant treatment in those with ADHD
ADHD
in early childhood appears to carry benefits into adulthood with regard to social and cognitive functioning, and appears to be relatively safe.[13] Abuse of prescription stimulants (not following physician instruction) or of illicit stimulants carries many negative health risks. Abuse of cocaine, depending upon route of administration, increases risk of cardiorespiratory disease, stroke, and sepsis.[14] Some effects are dependent upon the route of administration, with intravenous use associated with the transmission of many disease such as Hepatitis C, HIV/AIDS
HIV/AIDS
and potential medical emergencies such as infection, thrombosis or pseudoaneurysm,[15] while inhalation may be associated with increased lower respiratory tract infection, lung cancer, and pathological restricting of lung tissue.[16] Cocaine
Cocaine
may also increase risk for autoimmune disease[17][18][19] and damage nasal cartilage. Abuse of methamphetamine produces similar effects as well as marked degeneration of dopaminergic neurons, resulting in an increased risk for Parkinson's Disease.[20][21][22][23] Medical
Medical
uses[edit] Stimulants have been used in medicine for many conditions including obesity, sleep disorders, mood disorders, impulse control disorders, asthma, nasal congestion and as anesthetics.[24] Drugs used to treat obesity are called anorectics and generally include drugs that follow the general definition of a stimulant, but other drugs such as CB1 receptor antagonists exist in this class too.[25][26] Drugs used to treat sleep disorders such as excessive daytime sleepiness are called eugeroics and include notable stimulants such as modafinil.[27][28] Stimulants are used in impulse control disorders such as ADHD[29] and off-label in mood disorders such as major depressive disorder to increase energy, focus and elevate mood.[30] Stimulants such as epinephrine,[31] theophylline and salbutamol[32] orally have been used to treat asthma, but inhaled adrenergic drugs are now preferred due to less systemic side effects. Pseudoephedrine
Pseudoephedrine
is used to relieve nasal or sinus congestion caused by the common cold, sinusitis, hay fever and other respiratory allergies; it is also used to relieve ear congestion caused by ear inflammation or infection.[33][34] Chemistry[edit] For details on stimulant classes, see Substituted phenethylamine
Substituted phenethylamine
and Substituted amphetamine.

A chart comparing the chemical structures of different amphetamine derivatives

Classifying stimulants is difficult, because of the large number of classes the drugs occupy, and the fact that they may belong to multiple classes; for example, ecstasy can be classified as a substituted methylenedioxyphenethylamine, a substituted amphetamine and consequently, a substituted phenethylamine.[citation needed] When referring to stimulants, the parent drug (e.g., amphetamine) will always be expressed in the singular[according to whom?]; with the word "substituted" placed before the parent drug (substituted amphetamines). Major stimulant classes include phenethylamines and their daughter class substituted amphetamines.[according to whom?] Amphetamines (class)[edit] Main article: Substituted amphetamines Substituted amphetamines
Substituted amphetamines
are a class of compounds based upon the amphetamine structure;[35] it includes all derivative compounds which are formed by replacing, or substituting, one or more hydrogen atoms in the amphetamine core structure with substituents.[35][36][37] Examples of substituted amphetamines are amphetamine (itself),[35][36] methamphetamine,[35] ephedrine,[35] cathinone,[35] phentermine,[35] mephentermine,[35] bupropion,[35] methoxyphenamine,[35] selegiline,[35] amfepramone,[35] pyrovalerone,[35] MDMA
MDMA
(ecstasy), and DOM (STP). Many drugs in this class work primarily by activating trace amine-associated receptor 1 (TAAR1);[38] in turn, this causes reuptake inhibition and effluxion, or release, of dopamine, norepinephrine, and serotonin.[38] An additional mechanism of some substituted amphetamines is the release of vesicular stores of monoamine neurotransmitters through VMAT2, thereby increasing the concentration of these neurotransmitters in the cytosol, or intracellular fluid, of the presynaptic neuron.[39] Amphetamines-type stimulants are often used for their therapeutic effects. Physicians sometimes prescribe amphetamine to treat major depression, where subjects do not respond well to traditional SSRI medications,[citation needed] but evidence supporting this use is poor/mixed.[40] Notably, two recent large phase III studies of lisdexamfetamine (a prodrug to amphetamine) as an adjunct to an SSRI or SNRI in the treatment of major depressive disorder showed no further benefit relative to placebo in effectiveness.[41] Numerous studies have demonstrated the effectiveness of drugs such as Adderall (a mixture of salts of amphetamine and dextroamphetamine) in controlling symptoms associated with ADHD. Due to their availability and fast-acting effects, substituted amphetamines are prime candidates for abuse.[42] Cocaine
Cocaine
analogues[edit] Main article: List of cocaine analogues Hundreds of cocaine analogues have been created, all of them usually maintaining a benzyloxy connected to the 3 carbon of a tropane. Various modifications include substitutions on the benzene ring, as well as additions or substitutions in place of the normal carboxylate on the tropane 2 carbon. Various compound with similar structure activity relationships to cocaine that aren't technically analogues have been developed as well. Mechanisms of action[edit] See also: central fatigue Stimulants can have a wide variety of mechanisms. Many stimulants exert their effects through manipulations of monoamine neurotransmission. Monoamines are a class of neurotransmitter relevant in reward, motivation, temperature regulation and pain sensation that include dopamine, norepinephrine, and serotonin. Stimulants usually block the reuptake or stimulate the efflux of dopamine and norepinephrine resulting in increased activity of their circuits. Some stimulants, notably those with empathogenic and hallucinogenic effects alter serotonergic neurotransmission. Interference with vesicular storage, activating TAAR1, and reversing the flow of monoamine transporters may play a mechanism in the activity of these drugs. Adrenergic stimulants, such as ephedrine, may act by directly binding and activating the receptors that norepinephrine and epinephrine normally bind to(adrenergic receptors), producing sympathomimetic effects. Some drugs, such as MDMA
MDMA
and derivatives may decrease regulatory capability by antagonizing regulatory pre-synaptic auto receptors.[43] Caffeine
Caffeine
is a notable exception, as it exerts its effects by antagonizing adenosine receptors instead of acting directly on monoamines.[44] Notable stimulants[edit] Amphetamine[edit] Main article: Amphetamine Amphetamine
Amphetamine
is a potent central nervous system (CNS) stimulant of the phenethylamine class that is approved for the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy.[45] Amphetamine was discovered in 1887 and exists as two enantiomers: levoamphetamine and dextroamphetamine.[note 1][46] Amphetamine
Amphetamine
refers to equal parts of the enantiomers, i.e., 50% levoamphetamine and 50% dextroamphetamine.[47][48] Amphetamine
Amphetamine
is also used as a performance and cognitive enhancer, and recreationally as an aphrodisiac and euphoriant.[49][50][51][52] Although it is a prescription medication in many countries, unauthorized possession and distribution of amphetamine is often tightly controlled due to the significant health risks associated with uncontrolled or heavy use.[53][54] As a consequence, amphetamine is illegally synthesized by clandestine chemists, trafficked, and sold.[55] Based upon drug and drug precursor seizures worldwide, illicit amphetamine production and trafficking is much less prevalent than that of methamphetamine.[55] The first pharmaceutical amphetamine was Benzedrine, a brand of inhalers used to treat a variety of conditions.[46][56] Because the dextro isomer has greater stimulant properties, Benzedrine
Benzedrine
was gradually discontinued in favor of formulations containing all or mostly dextroamphetamine. Presently, it is typically prescribed as Adderall, dextroamphetamine (e.g., Dexedrine), or the inactive prodrug lisdexamfetamine (e.g., Vyvanse).[46][57] Amphetamine, through activation of a trace amine receptor, increases biogenic amine and excitatory neurotransmitter activity in the brain, with its most pronounced effects targeting the catecholamine neurotransmitters norepinephrine and dopamine.[38] At therapeutic doses, this causes emotional and cognitive effects such as euphoria, change in libido, increased arousal, and improved cognitive control.[50][51][58] Likewise, it induces physical effects such as decreased reaction time, fatigue resistance, and increased muscle strength.[49] In contrast, much larger doses of amphetamine are likely to impair cognitive function and induce rapid muscle breakdown.[45][50][59] Substance dependence (i.e., addiction) is a serious risk of amphetamine abuse, but only rarely arises from proper medical use.[45][60] Very high doses can result in a psychosis (e.g., delusions and paranoia), which very rarely occurs at therapeutic doses even during long-term use.[61][62] As recreational doses are generally much larger than prescribed therapeutic doses, recreational use carries a far greater risk of serious side effects.[45][59] Caffeine[edit] Main article: Caffeine

Roasted coffee beans, a common source of caffeine.

Caffeine
Caffeine
is a stimulant compound belonging to the xanthine class of chemicals naturally found in coffee, tea, and (to a lesser degree) cocoa or chocolate. It is included in many soft drinks, as well as a larger amount in energy drinks. Caffeine
Caffeine
is the world's most widely used psychoactive drug and by far the most common stimulant. In North America, 90% of adults consume caffeine daily.[63] A few jurisdictions restrict its sale and use. Caffeine
Caffeine
is also included in some medications, usually for the purpose of enhancing the effect of the primary ingredient, or reducing one of its side-effects (especially drowsiness). Tablets containing standardized doses of caffeine are also widely available. Caffeine's mechanism of action differs from many stimulants, as it produces stimulant effects by inhibiting adenosine receptors.[64] Adenosine receptors are thought to be a large driver of drowsiness and sleep, and their action increases with extended wakefulness.[65] Caffeine
Caffeine
has been found to increase striatal dopamine in animal models,[66] as well as inhibit the inhibitory effect of adenosine receptors on dopamine receptors,[67] however the implications for humans are unknown. Unlike most stimulants, caffeine has no addictive potential. Caffeine
Caffeine
does not appear to be a reinforcing stimulus, and some degree of aversion may actually occur, which people preferring placebo over caffeine in a study on drug abuse liability published in an NIDA research monograph.[68] In large telephone surveys only 11% reported dependence symptoms. However, when people were tested in labs, only half of those who claim dependence actually experienced it, casting doubt on caffeine's ability to produce dependence and putting societal pressures in the spotlight.[69] Coffee
Coffee
consumption is associated with a lower overall risk of cancer.[70] This is primarily due to a decrease in the risks of hepatocellular and endometrial cancer, but it may also have a modest effect on colorectal cancer.[71] There does not appear to be a significant protective effect against other types of cancers, and heavy coffee consumption may increase the risk of bladder cancer.[71] A protective effect of caffeine against Alzheimer's disease
Alzheimer's disease
is possible, but the evidence is inconclusive.[72][73][74] Moderate coffee consumption may decrease the risk of cardiovascular disease,[75] and it may somewhat reduce the risk of type 2 diabetes.[76] Drinking four or more cups of coffee per day does not affect the risk of hypertension compared to drinking little or no coffee. However those who drink 1–3 cups per day may be at a slightly increased risk.[77] Caffeine
Caffeine
increases intraocular pressure in those with glaucoma but does not appear to affect normal individuals.[78] It may protect people from liver cirrhosis.[79] There is no evidence that coffee stunts a child's growth.[80] Caffeine
Caffeine
may increase the effectiveness of some medications including ones used to treat headaches.[81] Caffeine
Caffeine
may lessen the severity of acute mountain sickness if taken a few hours prior to attaining a high altitude.[82] Ephedrine[edit] Main article: Ephedrine Ephedrine
Ephedrine
is a sympathomimetic amine similar in molecular structure to the well-known drugs phenylpropanolamine and methamphetamine, as well as to the important neurotransmitter epinephrine (adrenaline). Ephedrine
Ephedrine
is commonly used as a stimulant, appetite suppressant, concentration aid, and decongestant, and to treat hypotension associated with anaesthesia. In chemical terms, it is an alkaloid with a phenethylamine skeleton found in various plants in the genus Ephedra
Ephedra
(family Ephedraceae). It works mainly by increasing the activity of norepinephrine (noradrenaline) on adrenergic receptors.[83] It is most usually marketed as the hydrochloride or sulfate salt. The herb má huáng ( Ephedra
Ephedra
sinica), used in traditional Chinese medicine (TCM), contains ephedrine and pseudoephedrine as its principal active constituents. The same may be true of other herbal products containing extracts from other Ephedra
Ephedra
species. MDMA[edit]

Tablets containing MDMA

Main article: MDMA See also: Its parent class and MDA 3,4-Methylenedioxymethamphetamine (MDMA, ecstasy, or molly) is a euphoriant, empathogen, and stimulant of the amphetamine class.[84] Briefly used by some psychotherapists as an adjunct to therapy, the drug became popular recreationally and the DEA listed MDMA
MDMA
as a Schedule I controlled substance, prohibiting most medical studies and applications. MDMA
MDMA
is known for its entactogenic properties. The stimulant effects of MDMA
MDMA
include hypertension, anorexia (appetite loss), euphoria, social disinhibition, insomnia (enhanced wakefulness/inability to sleep), improved energy, increased arousal, and increased perspiration, among others. MDMA
MDMA
differs from most stimulants in that its primary pharmacological effect is on the neurotransmitter serotonin rather than dopamine, or norepinephrine. MDMA
MDMA
does not appear to be significantly addictive or dependence forming.[85] Due to the relative safety of MDMA, some researchers such as David Nutt have criticized the scheduling level, writing a satirical article finding MDMA
MDMA
to be 28 times less dangerous than horseriding, a condition he termed "equasy" or "Equine Addiction
Addiction
Syndrome".[86] MDPV[edit] Main article: MDPV Methylenedioxypyrovalerone
Methylenedioxypyrovalerone
(MDPV) is a psychoactive drug with stimulant properties that acts as a norepinephrine-dopamine reuptake inhibitor (NDRI).[87] It was first developed in the 1960s by a team at Boehringer Ingelheim.[88] MDPV remained an obscure stimulant until around 2004, when it was reported to be sold as a designer drug. Products labeled as bath salts containing MDPV were previously sold as recreational drugs in gas stations and convenience stores in the United States, similar to the marketing for Spice and K2 as incense.[89][90] Incidents of psychological and physical harm have been attributed to MDPV use.[91][92] Mephedrone[edit] Main article: Mephedrone Mephedrone
Mephedrone
is a synthetic stimulant drug of the amphetamine and cathinone classes. Slang names include drone[93] and MCAT.[94] It is reported to be manufactured in China and is chemically similar to the cathinone compounds found in the khat plant of eastern Africa. It comes in the form of tablets or a powder, which users can swallow, snort, or inject, producing similar effects to MDMA, amphetamines, and cocaine. Mephedrone
Mephedrone
was first synthesized in 1929, but did not become widely known until it was rediscovered in 2003. By 2007, mephedrone was reported to be available for sale on the Internet; by 2008 law enforcement agencies had become aware of the compound; and, by 2010, it had been reported in most of Europe, becoming particularly prevalent in the United Kingdom. Mephedrone
Mephedrone
was first made illegal in Israel in 2008, followed by Sweden later that year. In 2010, it was made illegal in many European countries, and, in December 2010, the EU ruled it illegal. In Australia, New Zealand, and the USA, it is considered an analog of other illegal drugs and can be controlled by laws similar to the Federal Analog Act. In September 2011, the USA temporarily classified mephedrone as illegal, in effect from October 2011. Methamphetamine[edit] Main article: Methamphetamine Methamphetamine
Methamphetamine
(contracted from N-methyl-alpha-methylphenethylamine) is a neurotoxin and potent psychostimulant of the phenethylamine and amphetamine classes that is used to treat attention deficit hyperactivity disorder (ADHD) and obesity.[95][96][97] Methamphetamine exists as two enantiomers, dextrorotary and levorotary.[98][99] Dextromethamphetamine is a stronger CNS stimulant than levomethamphetamine;[59][98][99] however, both are addictive and produce the same toxicity symptoms at high doses.[99] Although rarely prescribed due to the potential risks, methamphetamine hydrochloride is approved by the United States Food
Food
and Drug
Drug
Administration (USFDA) under the trade name Desoxyn.[96] Recreationally, methamphetamine is used to increase sexual desire, lift the mood, and increase energy, allowing some users to engage in sexual activity continuously for several days straight.[96][100] Methamphetamine
Methamphetamine
may be sold illicitly, either as pure dextromethamphetamine or in an equal parts mixture of the right- and left-handed molecules (i.e., 50% levomethamphetamine and 50% dextromethamphetamine).[100] Both dextromethamphetamine and racemic methamphetamine are schedule II controlled substances in the United States.[96] Also, the production, distribution, sale, and possession of methamphetamine is restricted or illegal in many other countries due to its placement in schedule II of the United Nations Convention on Psychotropic Substances
Convention on Psychotropic Substances
treaty.[101][102] In contrast, levomethamphetamine is an over-the-counter drug in the United States.[note 2] In low doses, methamphetamine can cause an elevated mood and increase alertness, concentration, and energy in fatigued individuals.[59][96] At higher doses, it can induce psychosis, rhabdomyolysis, and cerebral hemorrhage.[59][96] Methamphetamine
Methamphetamine
is known to have a high potential for abuse and addiction.[59][96] Recreational use of methamphetamine may result in psychosis or lead to post-withdrawal syndrome, a withdrawal syndrome that can persist for months beyond the typical withdrawal period.[105] Unlike amphetamine and cocaine, methamphetamine is neurotoxic to humans, damaging both dopamine and serotonin neurons in the central nervous system (CNS).[95][97] Entirely opposite to the long-term use of amphetamine, there is evidence that methamphetamine causes brain damage from long-term use in humans;[95][97] this damage includes adverse changes in brain structure and function, such as reductions in gray matter volume in several brain regions and adverse changes in markers of metabolic integrity.[106][107][97] Methylphenidate[edit] Main article: Methylphenidate Methylphenidate
Methylphenidate
is a stimulant drug that is often used in the treatment of ADHD
ADHD
and narcolepsy and occasionally to treat obesity in combination with diet restraints and exercise. Its effects at therapeutic doses include increased focus, increased alertness, decreased appetite, decreased need for sleep and decreased impulsivity. Methylphenidate
Methylphenidate
is not usually used recreationally, but when it is used, its effects are very similar to those of amphetamines. Methylphenidate
Methylphenidate
acts a norepinephrine-dopamine reuptake inhibitor, by blocking the norepinephrine transporter (NET) and the dopamine transporter (DAT). Methylphenidate
Methylphenidate
has a higher affinity for the dopamine transporter than for the norepinephrine transporter, and so its effects are mainly due to elevated dopamine levels caused by the inhibited reuptake of dopamine, however increased norepinephrine levels also contribute to various of the effects caused by the drug. Methylphenidate
Methylphenidate
is sold in many forms, its most common trade name is the oral tablet Ritalin. Other versions include the long lasting tablet Concerta and the long lasting transdermal patch Daytrana. Cocaine[edit]

Lines of illicit cocaine, used as a recreational stimulant

Main article: Cocaine Cocaine
Cocaine
is an SNDRI. Cocaine
Cocaine
is made from the leaves of the coca shrub, which grows in the mountain regions of South American countries such as Bolivia, Colombia, and Peru. In Europe, North America, and some parts of Asia, the most common form of cocaine is a white crystalline powder. Cocaine
Cocaine
is a stimulant but is not normally prescribed therapeutically for its stimulant properties, although it sees clinical use as a local anesthetic, in particular in ophthalmology. Most cocaine use is recreational and its abuse potential is high (higher than amphetamine), and so its sale and possession are strictly controlled in most jurisdictions. Other tropane derivative drugs related to cocaine are also known such as troparil and lometopane but have not been widely sold or used recreationally.[108] Nicotine[edit] Main article: Nicotine Nicotine
Nicotine
is the active chemical constituent in tobacco, which is available in many forms, including cigarettes, cigars, chewing tobacco, and smoking cessation aids such as nicotine patches, nicotine gum, and electronic cigarettes. Nicotine
Nicotine
is used widely throughout the world for its stimulating and relaxing effects. Nicotine
Nicotine
exerts its effects through the agonism of nicotinic acetylcholine receptor, resulting in multiple downstream effects such as increase in activity of dopaminergic neurons in the midbrain reward system, as well as the decreased expression of monoamine oxidase in the brain.[109] Nicotine is addictive and dependence forming. The most common source of nicotine, tobacco's, overall harm to user and self score as determined by a multi-criteria decision analysis was determined at 3 percent below cocaine, and 13 percent above amphetamines, ranking 6th most harmful of the 20 drugs assessed.[110] Phenylpropanolamine[edit] Main article: Phenylpropanolamine Phenylpropanolamine
Phenylpropanolamine
(PPA; Accutrim; β-hydroxyamphetamine), also known as the stereoisomers norephedrine and norpseudoephedrine, is a psychoactive drug of the phenethylamine and amphetamine chemical classes that is used as a stimulant, decongestant, and anorectic agent.[111] It is commonly used in prescription and over-the-counter cough and cold preparations. In veterinary medicine, it is used to control urinary incontinence in dogs under trade names Propalin and Proin. In the United States, PPA is no longer sold without a prescription due to a proposed increased risk of stroke in younger women. In a few countries in Europe, however, it is still available either by prescription or sometimes over-the-counter. In Canada, it was withdrawn from the market on 31 May 2001.[112] In India, human use of PPA and its formulations were banned on 10 February 2011.[113] Propylhexedrine[edit] Main article: Propylhexedrine Propylhexedrine
Propylhexedrine
(Hexahydromethamphetamine, Obesin) is a stimulant medication, sold over-the-counter in the United States as the cold medication Benzedrex.[114] The drug has also been used as an appetite suppressant in Europe. Propylhexedrine
Propylhexedrine
is not an amphetamine, though it is structurally similar; it is instead a cycloalkylamine, and thus has stimulant effects that are less potent than similarly structured amphetamines, such as methamphetamine. The abuse potential of propylhexedrine is fairly limited, due its limited routes of administration: in the United States, Benzedrex is only available as an inhalant, mixed with lavender oil and menthol. These ingredients cause unpleasant tastes, and abusers of the drug have reported unpleasant "menthol burps." Injection of the drug has been found to cause transient diplopia and brain stem dysfunction.[115][116][117] Pseudoephedrine[edit] Main article: Pseudoephedrine Pseudoephedrine
Pseudoephedrine
is a sympathomimetic drug of the phenethylamine and amphetamine chemical classes. It may be used as a nasal/sinus decongestant, as a stimulant,[118] or as a wakefulness-promoting agent.[119] The salts pseudoephedrine hydrochloride and pseudoephedrine sulfate are found in many over-the-counter preparations, either as a single ingredient or (more commonly) in combination with antihistamines, guaifenesin, dextromethorphan, and/or paracetamol (acetaminophen) or another NSAID (such as aspirin or ibuprofen). It is also used as a precursor chemical in the illegal production of methamphetamine. Catha edulis (Khat)[edit] Main article: Khat

Catha edulis

Khat
Khat
is a flowering plant native to the Horn of Africa
Horn of Africa
and the Arabian Peninsula.[120][121] Khat
Khat
contains a monoamine alkaloid called cathinone, a "keto-amphetamine", that is said to cause excitement, loss of appetite, and euphoria. In 1980, the World Health Organization
World Health Organization
(WHO) classified it as a drug of abuse that can produce mild to moderate psychological dependence (less than tobacco or alcohol),[122] although the WHO does not consider khat to be seriously addictive.[121] It is a controlled substance in some countries, such as the United States, Canada, and Germany, while its production, sale, and consumption are legal in other nations, including Djibouti, Ethiopia, Somalia, and Yemen.[123] Abuse[edit] Main article: Recreational drug use
Recreational drug use
§ Stimulants See also: Substance abuse Abuse of central nervous system (CNS) stimulants is common. Addiction to some CNS stimulants can quickly lead to medical, psychiatric, and psychosocial deterioration. Drug
Drug
tolerance, dependence, and sensitization as well as a withdrawal syndrome can occur.[124] Stimulants enhance the activity of the central and peripheral nervous systems. Common effects may include increased alertness, awareness, wakefulness, endurance, productivity, and motivation, arousal, locomotion, heart rate, and blood pressure, and a diminished desire for food and sleep. Use of stimulants may cause the body to reduce significantly its production of natural body chemicals that fulfill similar functions. Until the body reestablishes its normal state, once the effect of the ingested stimulant has worn off the user may feel depressed, lethargic, confused, and miserable. This is referred to as a "crash", and may provoke reuse of the stimulant. Stimulants may be screened for in animal discrimination and self-administration models which have high sensitivity albeit low specificity.[125] Research on a progressive ratio Self-administration protocol has found amphetamine, methylphenidate, modafinil, cocaine, and nicotine to all have a higher break point than placebo that scales with dose indicating reinforcing effects.[126]

Drug Mean Pleasure Psychological dependence Physical dependence.[127]

Cocaine 2.39 3.0 2.8 1.3

Tobacco 2.21 2.3 2.6 1.8

Amphetamine 1.67 2.0 1.9 1.1

Ecstasy 1.13 1.5 1.2 0.7

Testing[edit] The presence of stimulants in the body may be tested by a variety of procedures. Serum and urine are the common sources of testing material although saliva is sometimes used. Commonly used tests include chromatography, immunologic assay, and mass spectrometry.[128] See also[edit]

Antipsychotics Depressants Hallucinogens Nootropics Psychoanaleptics

Notes[edit]

^ Enantiomers are molecules that are mirror images of one another; they are structurally identical, but of the opposite orientation. Levoamphetamine
Levoamphetamine
and dextroamphetamine are also known as L-amph or levamfetamine (INN) and D-amph or dexamfetamine (INN) respectively. ^ The active ingredient in some OTC inhalers in the United States is listed as levmetamfetamine, the INN and USAN of levomethamphetamine.[103][104]

References[edit]

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Methylphenidate
Abuse and Psychiatric
Psychiatric
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Stimulant
Use Disorders.Chapter 5— Medical
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Stimulant
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and Drug Administration. April 2015. Retrieved 7 March 2016. Topical nasal decongestants --(i) For products containing levmetamfetamine identified in 341.20(b)(1) when used in an inhalant dosage form. The product delivers in each 800 milliliters of air 0.04 to 0.150 milligrams of levmetamfetamine.  ^ "Identification". Levomethamphetamine. Pubchem Compound. National Center for Biotechnology Information. Retrieved 2 January 2014.  ^ Cruickshank CC, Dyer KR (July 2009). "A review of the clinical pharmacology of methamphetamine". Addiction. 104 (7): 1085–1099. doi:10.1111/j.1360-0443.2009.02564.x. PMID 19426289.  ^ Hart H, Radua J, Nakao T, Mataix-Cols D, Rubia K (February 2013). "Meta-analysis of functional magnetic resonance imaging studies of inhibition and attention in attention-deficit/hyperactivity disorder: exploring task-specific, stimulant medication, and age effects". JAMA Psychiatry. 70 (2): 185–198. doi:10.1001/jamapsychiatry.2013.277. PMID 23247506.  ^ Spencer TJ, Brown A, Seidman LJ, Valera EM, Makris N, Lomedico A, Faraone SV, Biederman J (September 2013). "Effect of psychostimulants on brain structure and function in ADHD: a qualitative literature review of magnetic resonance imaging-based neuroimaging studies". J. Clin. Psychiatry. 74 (9): 902–917. doi:10.4088/JCP.12r08287. PMC 3801446 . PMID 24107764.  ^ AJ Giannini; WC Price (1986). "Contemporary drugs of abuse". American Family Physician. 33: 207–213.  ^ Benowitz, Neal L. (1 January 2009). " Pharmacology
Pharmacology
of Nicotine: Addiction, Smoking-Induced Disease, and Therapeutics". Annual Review of Pharmacology
Pharmacology
and Toxicology. 49: 57–71. doi:10.1146/annurev.pharmtox.48.113006.094742. ISSN 0362-1642. PMC 2946180 . PMID 18834313.  ^ Nutt, David J.; King, Leslie A.; Phillips, Lawrence D. (6 November 2010). " Drug
Drug
harms in the UK: a multicriteria decision analysis". Lancet. 376 (9752): 1558–1565. doi:10.1016/S0140-6736(10)61462-6. ISSN 1474-547X. PMID 21036393.  ^ Flavahan NA (April 2005). " Phenylpropanolamine
Phenylpropanolamine
constricts mouse and human blood vessels by preferentially activating alpha2-adrenoceptors". Journal of Pharmacology
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chewing is on the rise in Yemen, raising concerns about the health and social consequences". World Health Organization. Retrieved 8 January 2014.  ^ Nutt D, King LA, Blakemore C (March 2007). "Development of a rational scale to assess the harm of drugs of potential misuse". Lancet. 369 (9566): 1047–53. doi:10.1016/S0140-6736(07)60464-4. PMID 17382831.  ^ Haight-Ashbury Free Medical
Medical
Clinic, Journal of psychoactive drugs, Volume 41, (Haight-Ashbury Publications: 2009), p.3. ^ Dackis CA, Gold MS (1990). "Addictiveness of central stimulants". Advances in Alcohol & Substance Abuse. 9 (1–2): 9–26. doi:10.1300/J251v09n01_02. PMID 1974121.  ^ Huskinson, Sally L.; Naylor, Jennifer E.; Rowlett, James K.; Freeman, Kevin B. (7 January 2017). "PREDICTING ABUSE POTENTIAL OF STIMULANTS AND OTHER DOPAMINERGIC DRUGS: OVERVIEW AND RECOMMENDATIONS". Neuropharmacology. 0: 66–80. doi:10.1016/j.neuropharm.2014.03.009. ISSN 0028-3908. PMC 4171344 . PMID 24662599.  ^ Stoops, William W. (7 January 2017). "Reinforcing Effects of Stimulants in Humans: Sensitivity of Progressive-Ratio Schedules". Experimental and Clinical Psychopharmacology. 16 (6): 503–512. doi:10.1037/a0013657. ISSN 1064-1297. PMC 2753469 . PMID 19086771.  ^ Nutt King, Saulsbury, Blakemore (2007). "Development of a rational scale to assess the harm of drugs of potential misuse". Lancet. 369 (9566): 1047–53. doi:10.1016/S0140-6736(07)60464-4. PMID 17382831. CS1 maint: Multiple names: authors list (link) ^ AJ Giannini. Drug
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External links[edit]

Look up stimulant or upper in Wiktionary, the free dictionary.

Media related to Stimulants at Wikimedia Commons "Long Island Council on Alcohol & Drug
Drug
Dependence – About Drugs – Stimulants". Archived from the original on 5 June 2008. Retrieved 4 August 2007. CS1 maint: Unfit url (link) "Online – Publications – Drugs of Abuse – Stimulants". Archived from the original on 22 September 2006. Retrieved 11 January 2008. CS1 maint: Unfit url (link) Asia & Pacific Amphetamine-Type Stimulants Information Centre (APAIC)

v t e

Stimulants

Adamantanes

Adapromine Amantadine Bromantane Memantine Rimantadine

Adenosine antagonists

8-Chlorotheophylline 8-Cyclopentyltheophylline 8-Phenyltheophylline Aminophylline Caffeine CGS-15943 Dimethazan Paraxanthine SCH-58261 Theobromine Theophylline

Alkylamines

Cyclopentamine Cypenamine Cyprodenate Heptaminol Isometheptene Levopropylhexedrine Methylhexaneamine Octodrine Propylhexedrine Tuaminoheptane

Ampakines

CX-516 CX-546 CX-614 CX-691 CX-717 IDRA-21 LY-404,187 LY-503,430 Nooglutyl Org 26576 PEPA S-18986 Sunifiram Unifiram

Arylcyclohexylamines

Benocyclidine Dieticyclidine Esketamine Eticyclidine Gacyclidine Ketamine Phencyclamine Phencyclidine Rolicyclidine Tenocyclidine Tiletamine

Benzazepines

6-Br-APB SKF-77434 SKF-81297 SKF-82958

Cholinergics

A-84,543 A-366,833 ABT-202 ABT-418 AR-R17779 Altinicline Anabasine Arecoline Bradanicline Cotinine Cytisine Dianicline Epibatidine Epiboxidine GTS-21 Ispronicline Nicotine PHA-543,613 PNU-120,596 PNU-282,987 Pozanicline Rivanicline Sazetidine A SIB-1553A SSR-180,711 TC-1698 TC-1827 TC-2216 Tebanicline UB-165 Varenicline WAY-317,538

Convulsants

Anatoxin-a Bicuculline DMCM Flurothyl Gabazine Pentetrazol Picrotoxin Strychnine Thujone

Eugeroics

Adrafinil Armodafinil CRL-40,940 CRL-40,941 Fluorenol JZ-IV-10 Modafinil

Oxazolines

4-Methylaminorex Aminorex Clominorex Cyclazodone Fenozolone Fluminorex Pemoline Thozalinone

Phenethylamines

1-(4-Methylphenyl)-2-aminobutane 1-Methylamino-1-(3,4-methylenedioxyphenyl)propane 2-Fuoroamphetamine 2-Fuoromethamphetamine 2-OH-PEA 2-Phenyl-3-aminobutane 2,3-MDA 3-Fuoroamphetamine 3-Fluoroethamphetamine 3-Fluoromethcathinone 3-Methoxyamphetamine 3-Methylamphetamine 3,4-DMMC 4-BMC 4-CMC 4-Ethylamphetamine 4-Fluoroamphetamine 4-Fluoromethamphetamine 4-MA 4-Methylbuphedrone 4-Methylcathinone 4-MMA 4-Methylpentedrone 4-MTA 6-FNE AL-1095 Alfetamine a-Ethylphenethylamine Amfecloral Amfepentorex Amfepramone Amidephrine 2-Amino-1,2-dihydronaphthalene 2-Aminoindane 5-(2-Aminopropyl)indole 2-Aminotetralin Acridorex Amphetamine
Amphetamine
(Dextroamphetamine, Levoamphetamine) Amphetaminil Arbutamine β-Methylphenethylamine β-Phenylmethamphetamine Benfluorex Benzedrone Benzphetamine BDB BOH 3-Benzhydrylmorpholine BPAP Buphedrone Bupropion Butylone Camfetamine Cathine Cathinone Chlorphentermine Cilobamine Cinnamedrine Clenbuterol Clobenzorex Cloforex Clortermine Cypenamine D-Deprenyl Denopamine Dimethoxyamphetamine Dimethylamphetamine Dimethylcathinone Dobutamine DOPA (Dextrodopa, Levodopa) Dopamine Dopexamine Droxidopa EBDB Ephedrine Epinephrine Epinine Etafedrine Ethcathinone Ethylnorepinephrine Ethylone Etilamfetamine Etilefrine Famprofazone Fencamfamin Fencamine Fenethylline Fenfluramine
Fenfluramine
(Dexfenfluramine, Levofenfluramine) Fenproporex Feprosidnine Flephedrone Fludorex Formetorex Furfenorex Gepefrine Hexapradol Hexedrone HMMA Hordenine 4-Hydroxyamphetamine 5-Iodo-2-aminoindane Ibopamine IMP Indanylamphetamine Iofetamine Isoetarine Isoethcathinone Isoprenaline L-Deprenyl (Selegiline) Lefetamine Lisdexamfetamine Lophophine MBDB MDA (tenamfetamine) MDBU MDEA MDMA
MDMA
(midomafetamine) MDMPEA MDOH MDPR MDPEA Mefenorex Mephedrone Mephentermine Metanephrine Metaraminol Mesocarb Methamphetamine
Methamphetamine
(Dextromethamphetamine, Levomethamphetamine) Methoxamine Methoxyphenamine MMA Methcathinone Methedrone Methoxyphenamine Methylenedioxycathinone Methylone Mexedrone MMDA MMDMA MMMA Morforex N,alpha-Diethylphenylethylamine N-Ethylbuphedrone N-Ethylhexedrone N,N-Dimethylphenethylamine Naphthylamphetamine Nisoxetine Norepinephrine Norfenefrine Norfenfluramine Normetanephrine L-Norpseudoephedrine Octopamine (drug) Orciprenaline Ortetamine Oxifentorex Oxilofrine PBA PCA PCMA PHA Pentorex Pentedrone Pentylone Phenatine Phenpromethamine Phentermine Phenylalanine Phenylephrine Phenylpropanolamine Pholedrine PIA PMA PMEA PMMA PPAP Phthalimidopropiophenone Prenylamine Propylamphetamine Pseudoephedrine Ropinirole Salbutamol
Salbutamol
(Levosalbutamol) Sibutramine Solriamfetol Synephrine Theodrenaline Tiflorex Tranylcypromine Tyramine Tyrosine Xylopropamine Zylofuramine

Phenylmorpholines

3-Fluorophenmetrazine Fenbutrazate Fenmetramide G-130 Manifaxine Morazone Morforex Oxaflozane PD-128,907 Phendimetrazine Phenmetrazine 2-Phenyl-3,6-dimethylmorpholine Pseudophenmetrazine Radafaxine

Piperazines

2C-B-BZP 3C-PEP BZP CM156 DBL-583 GBR-12783 GBR-12935 GBR-13069 GBR-13098 GBR-13119 MeOPP MBZP oMPP Vanoxerine

Piperidines

1-Benzyl-4-(2-(diphenylmethoxy)ethyl)piperidine 2-Benzylpiperidine 2-Methyl-3-phenylpiperidine 3,4-Dichloromethylphenidate 4-Benzylpiperidine 4-Fluoromethylphenidate 4-Methylmethylphenidate Desoxypipradrol Difemetorex Diphenylpyraline Ethylnaphthidate Ethylphenidate Methylnaphthidate Isopropylphenidate Methylphenidate
Methylphenidate
(Dexmethylphenidate) Nocaine Phacetoperane Pipradrol Propylphenidate SCH-5472

Pyrrolidines

2-Diphenylmethylpyrrolidine 5-DBFPV α-PPP α-PBP α-PHP α-PVP α-PVT Diphenylprolinol DMPVP FPOP FPVP MDPPP MDPBP MPBP MPHP MPPP MOPVP MOPPP Indapyrophenidone MDPV Naphyrone PEP Picilorex Prolintane Pyrovalerone

Racetams

Oxiracetam Phenylpiracetam Phenylpiracetam
Phenylpiracetam
hydrazide

Tropanes

4-fluorotropacocaine 4'-Fluorococaine Altropane
Altropane
(IACFT) Brasofensine CFT (WIN 35,428) β-CIT (RTI-55) Cocaethylene Cocaine Dichloropane
Dichloropane
(RTI-111) Difluoropine FE-β-CPPIT FP-β-CPPIT Ioflupane (123I) Norcocaine PIT PTT RTI-31 RTI-32 RTI-51 RTI-112 RTI-113 RTI-120 RTI-121
RTI-121
(IPCIT) RTI-126 RTI-150 RTI-177 RTI-229 RTI-336 RTI-354 RTI-371 RTI-386 Salicylmethylecgonine Tesofensine Troparil
Troparil
(β-CPT, WIN 35,065-2) Tropoxane WF-23 WF-33

Tryptamines

4-HO-αMT 4-Methyl-αET 4-Methyl-αMT 5-Chloro-αMT 5-Fluoro-αMT 5-MeO-αET 5-MeO-αMT 5-MeO-DIPT 6-Fluoro-αMT 7-Methyl-αET αET αMT

Others

2-MDP 3,3-Diphenylcyclobutanamine Amfonelic acid Amineptine Amiphenazole Atipamezole Atomoxetine Bemegride Benzydamine BTQ BTS 74,398 Centanafadine Ciclazindol Clofenciclan Cropropamide Crotetamide D-161 Desipramine Diclofensine Dimethocaine Efaroxan Etamivan Fenisorex Fenpentadiol Gamfexine Gilutensin GSK1360707F GYKI-52895 Hexacyclonate Idazoxan Indanorex Indatraline JNJ-7925476 Lazabemide Leptacline Lomevactone LR-5182 Mazindol Meclofenoxate Medifoxamine Mefexamide Methamnetamine Methastyridone Methiopropamine Naphthylaminopropane Nefopam Nikethamide Nomifensine O-2172 Oxaprotiline PNU-99,194 PRC200-SS Rasagiline Rauwolscine Rubidium chloride Setazindol Tametraline Tandamine Thiopropamine Thiothinone Trazium UH-232 Yohimbine

ATC code: N06B

v t e

Pharmacology: major drug groups

Gastrointestinal tract/ metabolism (A)

stomach acid

Antacids H2 antagonists Proton pump inhibitors

Antiemetics Laxatives Antidiarrhoeals/Antipropulsives Anti-obesity drugs Anti-diabetics Vitamins Dietary minerals

Blood
Blood
and blood forming organs (B)

Antithrombotics

Antiplatelets Anticoagulants Thrombolytics/fibrinolytics

Antihemorrhagics

Platelets Coagulants Antifibrinolytics

Cardiovascular system (C)

cardiac therapy/antianginals

Cardiac glycosides Antiarrhythmics Cardiac stimulants

Antihypertensives Diuretics Vasodilators Beta blockers Calcium channel blockers renin–angiotensin system

ACE inhibitors Angiotensin II receptor antagonists Renin inhibitors

Antihyperlipidemics

Statins Fibrates Bile acid sequestrants

Skin (D)

Emollients Cicatrizants Antipruritics Antipsoriatics Medicated dressings

Genitourinary system (G)

Hormonal contraception Fertility agents SERMs Sex hormones

Endocrine system (H)

Hypothalamic–pituitary hormones Corticosteroids

Glucocorticoids Mineralocorticoids

Sex hormones Thyroid hormones/Antithyroid agents

Infections and infestations (J, P, QI)

Antimicrobials: Antibacterials (Antimycobacterials) Antifungals Antivirals Antiparasitics

Antiprotozoals Anthelmintics Ectoparasiticides

IVIG Vaccines

Malignant disease (L01–L02)

Anticancer agents

Antimetabolites Alkylating Spindle poisons Antineoplastic Topoisomerase inhibitors

Immune disease (L03–L04)

Immunomodulators

Immunostimulants Immunosuppressants

Muscles, bones, and joints (M)

Anabolic steroids Anti-inflammatories

NSAIDs

Antirheumatics Corticosteroids Muscle
Muscle
relaxants Bisphosphonates

Brain and nervous system (N)

Analgesics Anesthetics

General Local

Anorectics Anti- ADHD
ADHD
agents Antiaddictives Anticonvulsants Antidementia agents Antidepressants Antimigraine
Antimigraine
agents Antiparkinson
Antiparkinson
agents Antipsychotics Anxiolytics Depressants Entactogens Entheogens Euphoriants Hallucinogens

Psychedelics Dissociatives Deliriants

Hypnotics/Sedatives Mood Stabilizers Neuroprotectives Nootropics Neurotoxins Orexigenics Serenics Stimulants Wakefulness-promoting agents

Respiratory system (R)

Decongestants Bronchodilators Cough medicines H1 antagonists

Sensory organs (S)

Ophthalmologicals Otologicals

Other ATC (V)

Antidotes Contrast media Radiopharmaceuticals Dressings Senotherapeutics

v t e

Recreational drug
Recreational drug
use

Major recreational drugs

Depressants

Barbiturates Benzodiazepines Carbamates Ethanol (alcohol)

Alcoholic drinks Beer Wine

Gabapentinoids GHB Inhalants

Medical

Nitrous oxide

Hazardous solvents

contact adhesives Gasoline nail polish remover Paint thinner

Other

Freon

Kava Nonbenzodiazepines Quinazolinones

Opioids

Buprenorphine

Suboxone Subutex

Codeine Desomorphine

Krokodil

Dextropropoxyphene

Darvocet Darvon

Fentanyl Diamorphine

Heroin

Hydrocodone Hydromorphone

Dilaudid

Methadone Mitragyna speciosa

Kratom

Morphine

Opium

Oxycodone

/paracetamol

Tramadol

Stimulants

Amphetamine Arecoline

Areca

Betel Caffeine

Coffee Energy drinks Tea

Cathinone

Khat

Cocaine

Coca Crack

Ephedrine

Ephedra

MDPV Mephedrone Methamphetamine Methylone Methylphenidate Modafinil Nicotine

Tobacco

Theobromine

Cocoa Chocolate

Entactogens

2C series 6-APB

Benzofury

AMT MDA MDMA

Ecstasy

Hallucinogens

Psychedelics

Bufotenin

Psychoactive toads Vilca Yopo

DMT

Ayahuasca

LSA LSD-25 Mescaline

Peruvian torch Peyote San Pedro

Psilocybin
Psilocybin
/ Psilocin

Psilocybin
Psilocybin
mushrooms

Dissociatives

DXM Glaucine Inhalants

Nitrous oxide alkyl nitrites poppers amyl nitrite

Ketamine MXE Muscimol

Amanita muscaria

PCP Salvinorin A

Salvia divinorum

Deliriants

Atropine
Atropine
and Scopolamine

Atropa belladonna Datura Hyoscyamus niger Mandragora officinarum

Dimenhydrinate Diphenhydramine

Cannabinoids

JWH-018 THC

Cannabis Hashish Hash oil Marijuana

Oneirogens

Calea zacatechichi Silene capensis

Club drugs

Cocaine Quaaludes MDMA
MDMA
(Ecstasy) Nitrous oxide Poppers

Drug
Drug
culture

Cannabis culture

420 Cannabis cultivation Cannabis smoking Head shop Legal history of cannabis in the United States Legality of cannabis Marijuana
Marijuana
Policy Project Medical
Medical
cannabis NORML Cannabis and religion Stoner film

Coffee
Coffee
culture

Coffee
Coffee
break Coffeehouse Latte art Tea
Tea
house

Drinking culture

Bartending Beer
Beer
culture Beer
Beer
festival Binge drinking Diethyl ether Drinking games Drinking song Happy hour Hip flask Nightclub Pub Pub
Pub
crawl Sommelier Sports bar Tailgate party Wine
Wine
bar Wine
Wine
tasting

Psychedelia

Psychonautics Art Drug Era Experience Literature Music Microdosing Therapy

Smoking culture

Cigarette
Cigarette
card Fashion cigarettes Cloud-chasing Loosie Smokeasy Smoking fetishism Tobacco
Tobacco
smoking

Other

Club drug Counterculture of the 1960s Dance party Drug
Drug
paraphernalia Drug
Drug
tourism Entheogen Hippie Nootropic Party and play Poly drug use Rave Religion and drugs Self-medication Sex and drugs Whoonga

Drug production and trade

Drug production

Coca
Coca
production in Colombia Drug
Drug
precursors Opium
Opium
production in Afghanistan Rolling meth lab

Drug
Drug
trade

Illegal drug trade

Colombia

Darknet market Drug
Drug
distribution

Beer
Beer
shop Cannabis shop Liquor store Liquor license

Issues with drug use

Abuse Date rape drug Impaired driving Drug
Drug
harmfulness

Effects of cannabis

Addiction Dependence

Prevention Opioid
Opioid
replacement therapy Rehabilitation Responsible use

Drug-related crime Fetal alcohol spectrum disorder Long-term effects of cannabis Neurotoxicity Overdose Passive smoking

of tobacco or other substances

Legality of drug use

International

1961 Narcotic Drugs 1971 Psychotropic Substances 1988 Drug
Drug
Trafficking Council of the European Union decisions on designer drugs

State level

Drug
Drug
policy

Decriminalization Prohibition Supply reduction

Policy reform

Demand reduction Drug
Drug
Policy Alliance Harm reduction Law Enforcement Action Partnership Liberalization

Latin America

Students for Sensible Drug
Drug
Policy Transform Drug
Drug
Policy Foundation

Drug
Drug
policy by country

Australia Canada Germany India Netherlands Portugal Slovakia Soviet Union Sweden Switzerland United States

Just Say No Office of National Drug
Drug
Control Policy School district drug policies California Colorado Maryland Virginia

Other

Arguments for and against drug prohibition Capital punishment for drug trafficking Cognitive liberty Designer drug Drug
Drug
court Drug
Drug
possession Drug
Drug
test Narc Politics of drug abuse War on Drugs

Mexican Drug
Drug
War Plan Colombia Philippine Drug
Drug
War

Zero tolerance

Lists of countries by...

Alcohol legality

Alcohol consumption

Anabolic steroid
Anabolic steroid
legality Cannabis legality

Annual use Lifetime use

Cigarette
Cigarette
consumption Cocaine
Cocaine
legality

Cocaine
Cocaine
use

Methamphetamine
Methamphetamine
legality Opiates use Psilocybin
Psilocybin
mushrooms legality Salvia legality

Authority control

.