Misuse of amphetamines and related drugs

This article discusses the misuse of drugs which act as stimulants, an effect mainly produced by enhancement of the central transmission of catecholamines, particularly dopamine. Stimulant misuse is extremely widespread in the UK and elsewhere, but primary users of such drugs present relatively rarely for treatment at drug services. At present such services mainly see heroin users, not only because the greater addictiveness of heroin produces generally higher levels of problems, but because a substitute treatment can be used in that group in the form of methadone. There are several reasons, however, why it is important to have a good working knowledge of stimulant misuse. Drug services consider amphet amine misuse a hidden epidemic, in which the heaviest users experience many of the same problems as heroin users without receiving similar treatment, and various policy initiatives are underway to attract this group into services. Meanwhile in recent years cocaine usage has transferred to the much more potent form known as 'crack', which is causing severe problems in some of the UK's inner cities. Use of methylenedioxymethamphetamine (MDMA, 'ecstasy') by young people, associated with the 'rave' nightclub