Amphetamines

How are amphetamines used?

Amphetamines can affect everyone differently, based on:

• size, weight and health
• whether the person is used to taking it
• whether other drugs are taken around the same time
• the amount taken
• the strength of the drug (varies from batch to batch)
• the environment (where the drug is taken).

Onset and duration of effects

How fast a drug takes effect and how long it lasts can vary depending on how it's taken - for example, whether it's snorted, swallowed, or injected.9

• If snorted or injected: effects can be felt immediately and can last 3 – 6 hours.
• If swallowed: effects can be felt in 30 – 45 minutes and can last 6 – 8 hours.¹⁰

Effects

Effects can include:

• feeling happy and confident
• talking more and feeling energetic
• large pupils and dry mouth
• fast heartbeat and breathing
• increased blood pressure
• high body temperature
• dehydration
• teeth grinding
• reduced appetite
• nausea and vomiting
• increased sex drive.^{2, 6, 10, 11}

Snorting amphetamines can damage the nasal passage and cause nose bleeds.

If injecting drugs, there is an increased risk of:

• tetanus
• infection
• vein damage and blood clots.^{12, 13}

If sharing needles, there is an increased risk of:

• hepatitis B.
• hepatitis C.
• HIV and AIDS.¹⁴

Impact of mood and environment

Drugs that affect a person’s mental state (psychoactive drugs) can also have varied effects depending on a person’s mood (often called the ‘set’) or the environment they are in (the ‘setting’):

• Set: a person’s state of mind, previous encounters with the drug, and expectations of what’s going to happen. For example, feelings of stress or anxiety before using amphetamines may result in an unpleasant experience and make those feelings worse.
• Setting: the physical and social environment where you take amphetamines – whether it’s known and familiar, who you're with, if you're indoors or outdoors, the type of music or sounds, and lighting. The ideal setting to take amphetamines will vary based on the individual and drug they’re using.¹⁵

Being in a good state of mind, with trusted friends and a safe environment before taking amphetamines reduces the risk of having a bad experience.¹⁵

Overdose

If you take a large amount of amphetamines or use a strong batch, you could overdose.

Your risk of overdose can also increase if you mix amphetamines with alcohol or other drugs, including medications.

Amphetamine overdose can cause death.¹⁰

Call triple zero (000) and request an ambulance if you or someone else has any of the following symptoms (emergency services are there to help and can provide more instructions).

Signs of amphetamine overdose can include:

• unconscious or non-responsive
• spasms or seizures
• feeling tired or fatigued
• heart attack symptoms such as:
• difficulty breathing
• sharp pain/discomfort in chest, arm, shoulder, back, neck, or jaw
• severe agitation, confusion, or panic
• racing heartbeat
• hot, flushed (red), or sweaty skin
• very large pupils.^{16, 17}

Mixing with other drugs

Mixing amphetamines with other drugs can have unpredictable effects and increase the risk of harm.

Mixing includes using more than one drug (including alcohol or medications) at the same time, or one after another. You should also consider what drugs you’ve taken in the last 24 hours.

• Amphetamines and alcohol: may feel less intoxicated due to stimulant effects of amphetamine. Increases risk of alcohol poisoning.
• Amphetamines and benzodiazepines: can decrease/mask the effects of both drugs. Risk of overdose if one wears off before the other – depending on amount taken.
• Amphetamines and cocaine: can cause anxiety and heart strain which can lead to stroke.
• Amphetamines and MDMA: can cause anxiety, heart strain, and increase toxic effects on the brain.
• Amphetamines and opioids: can increase the risk of heart strain and respiratory arrest.^{10, 18, 19}

Using more than one drug or type of drug at the same time is called polydrug use.¹⁶

Reducing harm

There are ways you can reduce the risk of harm when using amphetamines:

• Prescription amphetamines like dexamphetamine come with their own dosage instructions which should be followed.
• Use around people you trust in a safe environment.
• Eat about 30 minutes before use, then every 2-3 hours after use. Smoothies or sports drinks can help replace electrolytes.
• Take regular breaks from physical activity to cool down.
• Stay hydrated. Drink around 250ml (1 cup) of water per hour when resting, or 500ml per hour when active.
• Try to sleep or rest within a 24-hour period to prevent sleep deprivation.¹⁸

If snorting 

• Use your own straws/spoons, not money, to avoid infections or blood-borne viruses.
• Switch nostrils and take breaks to minimise nasal damage.¹⁸

If injecting

• Always use new, sterile injecting equipment (including sterile water)
• Wash hands thoroughly before and after injecting
• Learn and follow safer injecting practices.
• Safely dispose of used injecting equipment
• Consider using a supervised injecting facility.¹⁸

Coming down

In the two to four days after amphetamine use, you may be experience:

• restless sleep and exhaustion
• headaches
• paranoia, hallucinations and confusion
• twitching and muscle aches
• fluctuating temperatures
• irritability, mood swings, anxiety and depression.^{10, 20}

Learn more about drug comedowns here.

Long-term effects

Long-term effects can vary depending on how much, how often and how amphetamines are consumed. Regular use may eventually contribute to:

• reduced appetite and weight loss
• restless sleep
• dry mouth
• dental problems
• regular colds and flu
• anxiety and paranoia
• depression
• increased risk of heart attack or other heart problems
• increased risk of stroke
• tolerance and dependence on amphetamines.^{1, 2, 6, 21}

Amphetamines and mental health

People who use illegal amphetamines are at increased risk of experiencing mental health issues.²²

High doses and frequent heavy use can also create a drug-induced psychosis. This can include experiencing delusions, hallucinations and out of character behaviour.^{22, 23}

These symptoms usually go away after the person stops using amphetamines.^{1, 4}

Tolerance

Regularly taking amphetamines can lead to developing a tolerance, which means you need to take larger amounts to get the same effects.²⁰

Dependence

People who regularly use amphetamines may become dependent. They may feel they need to use amphetamines to go about usual activities like working, studying and socialising, or just to get through the day.²⁰

Withdrawal

Withdrawal refers to the symptoms that can occur when someone who is dependent on a drug, or who has been using it regularly over time, stops or reduces their use.²⁴

Withdrawal can include physical symptoms (such as headaches, or nausea) and psychological symptoms (such as anxiety, or depressed mood).²⁴

Symptoms - including how strong they are and how long they last - will vary depending on the type of drug and a person’s history of use.²⁴

Withdrawal symptoms

Reducing, or stopping using amphetamines after a period of regular use can lead to withdrawal symptoms, including:

• cravings for amphetamines
• increased appetite
• increased sleep
• vivid dreams and nightmares
• exhaustion
• aches and pains
• depression
• confusion and irritability
• anxiety
• paranoia.^{4, 6, 25}

Withdrawal symptoms should settle down after a week and will mostly disappear after a month.

Reduced tolerance and overdose risk

After withdrawing from illegal amphetamines, your body is no longer used to it and your tolerance drops. This means if you use the same amount as before, it can be too much for your body and cause an overdose. Always start with a lower dose after a break from illegal amphetamines.²⁶

Pregnancy and breastfeeding

Illegal amphetamines

Before pregnancy

There isn’t a lot of information about the impact of illegal amphetamines on fertility. However, it may be best to avoid amphetamine use in the lead up to trying to conceive, or while actually trying.²⁷

During pregnancy

Some illegal amphetamines have been shown to negatively impact the health of both the baby and pregnant person.²⁷

The pregnant person may experience:

• miscarriage
• premature (early) labour
• bleeding from the site of the placenta after labour
• increased blood pressure
• increased chances of heart attack or stroke.²⁷

Babies that are exposed to illegal amphetamines during pregnancy may experience:

• lower birth weight
• smaller head size
• behavioural problems
• changes to brain development.²⁷

As there is limited evidence on what a dangerous dose is, the safest option for you and your baby is to not take illegal amphetamines.²⁷

After pregnancy

Amphetamine use during pregnancy can sometimes cause temporary withdrawal symptoms in babies after birth. This is known as neonatal abstinence syndrome (NAS). NAS is easily diagnosed and treated, and not all babies will experience symptoms.²⁸

Illegal amphetamines should be avoided if you’re keen to breastfeed as it’s been shown to reduce milk supply and have negative impacts on the baby’s health.²⁷

Prescribed amphetamines

ADHD is a life-long condition which means that it can affect someone before, during, and after pregnancy.²⁹

Currently there is mixed evidence on the impact of ADHD medications, including prescription amphetamines, on pregnancy and breastfeeding.²⁹

Recent evidence suggests that using prescribed ADHD medication during pregnancy is not linked to significant harm for the pregnant person or baby. This research also found that continuing ADHD medication during pregnancy may have some benefits for the pregnant person, including improved mood and family functioning.^29-32

There’s also evidence to suggest that suddenly stopping your prescription ADHD medication may increase your risk of miscarriage.³¹

If you are taking prescription amphetamines, talk to your doctor before making any changes while trying to become pregnant, during pregnancy, or while breastfeeding.

Getting help

If your use of amphetamines is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about someone, there is help and support.

• Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling about alcohol and other drugs.
• Use the confidential Path2Help portal to get matched with information and services specific to your needs.
• Stimulant Treatment Line offers free counselling and support for people who use stimulants, such as methamphetamine (ice), cocaine and ecstasy: 1800 101 188