Stimulants - Mental Health

Increase risk of substance use disorder and suicide
1. Stimulants are a class of drugs that speed up the brain and nervous system. These drugs can cause and worsen mental health conditions and increase the risk of substance use disorder and suicide.
Risk of overdose and death
1. Rising overdose deaths involving illicit stimulants like cocaine and methamphetamine (meth) have raised concerns of a stimulant overdose crisis. When used in conjunction with opioids like fentanyl, the risk of overdose and death is even greater.
Depict dangers and reduce stigma
1. Storytelling can help reduce the harmful impact of stimulants by spotlighting the dangers of misusing these drugs or combining these drugs with opioids, portraying their long-term negative physical and mental health effects, and reducing stigma around reaching out for help.

This section was developed using scientific resources available from the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health (NIH).

Storytelling Tips

Diversify Representation

Tell a broader range of stories about stimulant misuse and substance use disorder to show the impact across communities. For example, many storylines around prescription stimulant misuse involve young, white males. While this is the audience that most frequently misuses these drugs, there are other audiences with unique risks like Asian Americans and Latinx who are more likely to smoke stimulants, increasing risk of dependency and negative health outcomes.
Use storytelling to shed light on the concerning increases in stimulant overdose deaths among non-Hispanic Native and Indigenous people during the last decade.
Show how, for some communities, stimulants carry risk beyond substance use disorder and overdose. Methamphetamine misuse is associated with a culture of risky sexual behavior, both among men who have sex with men, and straight couples. In addition to addiction and overdose risk, the increased sex coupled with lowered inhibitions and multiple partners raises the risk of contracting HIV or other sexually transmitted infections.

Show Conversations About Mental Health and Help-Seeking

Depict effective family dialogues around substance use, misuse, and substance use disorder. Young people who have good communication with caretakers, including conversations about prescription drug misuse with family members, are less likely to misuse them. Storytelling can help start these conversations.
Work with expert advisors to craft conversations that will be most effective for prevention. Public health research has shown that scare tactics (threat of permanent harm or death) aren’t always effective for deterring some audiences. Instead, it may be more effective to focus on improving school/work performance or other impacts that may resonate better.

Spotlight Support from Friends and Family

Highlight the warning signs of stimulant misuse and substance use disorder to better equip friends and family to identify and support loved ones who are struggling.
Visit the substance use disorder page for common warning signs.
Demonstrate the dangers of sharing prescribed medication. Most misused prescription stimulants are obtained from someone with a prescription. Storytelling can help viewers better understand the health and legal consequences of sharing prescription stimulants.

Depict Effective, Realistic Help-Seeking and Treatment

Highlight the advantages of seeing trained mental health professionals before substance misuse leads to serious consequences. People in the early stages of addiction to drugs that may carry public stigma — like methamphetamine or cocaine — might delay reaching out for help until the situation is severe. Stories that feature characters and cast members getting help before severe consequences occur can encourage viewers to be proactive and avoid damaging outcomes.
Depict accurate treatment options. Currently, there are no approved medications for the treatment of stimulant use disorders and the best available treatment for stimulant use disorders is inpatient or outpatient behavioral therapy with the support of trained mental health professionals. However, researchers are working to develop safe and effective treatments for stimulant use disorders and recent findings suggest that medication can be a promising addition to current treatment approaches. Work with an expert advisor or refer to the Expert Directory to ensure you are showing the most up-to-date and effective treatment options.

Highlight the Power of Coping Skills and Self-Care

Show self-care and coping strategies that can increase productivity at work or school to provide a more effective alternative to prescription drug misuse. The reason most people give for misusing prescription stimulants involves improving productivity and performance. However, research shows these drugs are more likely to ultimately hinder performance and are not effective study aids. Storytelling can help elevate self-care practices, like healthy sleep patterns and exercising, as more effective approaches.

Represent the Causes of Mental Health Challenges Accurately

Highlight the connection between substance misuse and mental health challenges. People with mental health conditions are more likely to misuse substances and people who misuse substances are more likely to have a mental health condition. Storytelling can help viewers understand the importance of addressing underlying problems to decrease the risk of substance misuse or substance use disorder.

Consider the Impact of Language

Try to avoid terminology that may reinforce the false narrative that substance misuse is a moral failing (like “drug abuse” or “addict”). Instead use language like “he’s misusing prescription drugs” or “she’s experiencing substance use disorder.” Check out the language section for more guidelines on using the right terminology.

Move Past Stereotypes

Represent the impact of substance misuse across different groups and move beyond stereotypes that suggest these problems only happen to “certain people.” While research gives us a snapshot of who is most frequently using and being harmed by prescription drug misuse, the reality is that substance use disorder and mental health challenges can impact anyone.

Be Cautious About Overstating and Reinforcing Stigma

Show people speaking up and getting help without blame or judgment. Research shows that structural, public, and self-stigma can prevent people struggling with substance use disorder from speaking up and getting help out of fear that they will be blamed or judged, or that it will negatively impact work or relationships.

Avoid Sharing Potentially Harmful Details

Don’t misrepresent the “benefits” of stimulants. Storytelling can inadvertently reinforce the notion that prescription stimulants are effective study aids or weight loss supplements, or romanticize cocaine as a party drug for the rich and famous. Work with advisors and people with lived experience to make sure the perceived benefits of these substances don’t outweigh the negative consequences.
Avoid providing any details in your story that might help viewers obtain, misuse, or hide misuse of stimulants. Storylines that give specifics about how drugs are inappropriately obtained can unintentionally provide a blueprint for people struggling with misuse to obtain these drugs through similar channels. Likewise, both prescription and illicit stimulants can be consumed in ways that can increase negative impact (like smoking prescription stimulants or injecting cocaine) so stories should avoid giving detail that could help viewers replicate these behaviors.

Snapshot

Stimulants are a class of drugs that speed up the brain and central nervous system. They include prescription stimulants (like Adderall, Dexedrine, Ritalin, and Concerta) and illicit stimulants (like methamphetamine, cocaine, synthethic cathinones (known as bath salts).

Prescription stimulants are medicines generally used to treat attention deficit hyperactivity disorder (ADHD) or narcolepsy. They increase alertness, attention, and energy. The primary reason young adults say they misuse prescription stimulants like Adderall is that they want to improve school or work performance, but a review of the research has shown that the misuse of prescription drugs does not improve academic or occupational performance. In fact, there is an inverse relationship between grade point average (GPA) and misuse of prescription stimulants, and students with lower GPAs are more likely to misuse stimulants.

When misused, prescription stimulants can impact mental health and increase the risk for physical health problems and substance use disorders. While prescription stimulants can be effective when used as prescribed for the treatment of ADHD or narcolepsy, and are not generally associated with increased risk of substance use disorder in those patients, prescription stimulant misuse is associated with higher rates of depression, suicidal ideation, and substance use disorders.

Misuse of prescription stimulants may also lead to symptoms of psychosis, anger, or paranoia, as well as heart, nerve and stomach problems. While overdose deaths by prescription stimulants alone are rare, misuse can contribute to heart attacks or seizures. Research suggests that prescription stimulants can interfere with healthy sleep patterns (even when the drug is taken in the morning), and sleep problems have been associated with a range of mental health challenges. After long-term misuse, people who misuse prescription stimulants can develop a tolerance, which can lead to higher dosages, more dangerous methods of snorting or smoking the drugs, or turning to other drugs, like sleeping pills, to counteract the stimulant effect.

Illicit stimulants use can increase the risk for substance use disorders and suicide.

Cocaine is a powerfully addictive stimulant that is usually snorted or smoked and can cause feelings of euphoria, heightened alertness and senses, and boosted confidence for 15 to 30 minutes. After the high, individuals may experience a crash where they may feel exhausted, depressed, and irritable, with increased urges to use more of the drug.
The mental health impacts of cocaine use may include behavior that can negatively impact relationships, work, or school; confusion, anxiety, and depression; losing touch with reality; and substance use disorder.
Methamphetamine (also called meth, speed, crank) is a stimulant drug with powerful and dangerous effects on the central nervous system. The drug can be smoked, snorted, taken orally, and injected, and it increases sexual arousal and causes feelings of euphoria, increased confidence, and increased alertness for 6 to 12 hours. Coming down off the drug can lead to feelings of depression and exhaustion, so some people will take the drug for days in a row without food or sleep. (This is sometimes called binging or tweaking).
Mental health risks of methamphetamine use can include irritability, confusion, anger, and delusions. It may also increase risk for suicide or mental health conditions, including substance use disorder.

While overdose prevention efforts have been focused heavily on the opioid crisis in recent years, experts and government agencies are also concerned about a stimulant overdose crisis. A 2019 study estimates that over 45% of all of all drug overdose deaths involve illicit stimulants, and from 2012 through 2019, the rate of drug overdose deaths involving methamphetamine increased more than sixfold and overdose deaths involving cocaine more than tripled.

Because illicit stimulants like cocaine and methamphetamine are not regulated, dealers often mix them with other things to increase profit. This could include “fillers,” like cornstarch or talcum powder, or other drugs like amphetamines or synthetic opioids (like fentanyl) that can increase risk of dependency, physical health issues, mental health challenges, substance use disorder, and overdose.

Facts & Stats: Prescription Stimulants

Almost 7% (16 million) of adults in the United States use prescription stimulants annually. 69% of adults (about 11 million) using these stimulants have a prescription.

Young adults ages 18 to 25 are most likely to misuse prescription stimulants, and college students are twice as likely to misuse these drugs as non-students. Adolescents and teenagers are more likely to report using prescription stimulants for recreational purposes. Young adults and college students are more likely to use them for academic or occupational performance.

White people are most likely to misuse prescription stimulants, and Black people have the lowest incidence of prescription stimulant misuse compared to all ethnic groups. Men are more likely to misuse prescription stimulants than women; however, women are more likely than men to use them for weight loss.

Deaths involving methamphetamines more than quadrupled among non-Hispanic Native and Indigenous peoples from 2011 to 2018.

Misused prescription stimulants are most often obtained from a friend with a prescription; the second most common means is purchasing it from someone. 35% of college students with a prescription say they’ve been approached for stimulants, 20% shared stimulants for free, and 9% shared stimulants for money.

Misuse of prescription stimulants like Adderall is most common among young adults looking to improve school or work performance — but data shows the drugs are often ineffective for those purposes, and can increase risk of physical health problems, mental health challenges, and substance use disorder.

Facts & Stats: Illicit Stimulants

A 2019 study estimates that over 45% of all drug overdose deaths involved illicit stimulants.

From 2012 through 2018, the rate of drug overdose deaths involving cocaine more than tripled.

From 2012 through 2018, the rate of drug overdose deaths involving methamphetamine increased more than fivefold. Native and Indigenous people had the highest rates of methamphetamine use, followed by non-Hispanic white people. Non-Hispanic Asian and Hispanic people had relatively low rates of methamphetamine use, while non-Hispanic Black people had the lowest rates.

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