Avoid Stimulant Drugs
Stimulant drugs increase the risk of stroke and sudden death. They must be
used with caution or avoided. The drugs of concern are epinephrine,
norepinephrine, ephedrine, ephedra, pseudoephedrine, phenylpropanolamine, methyphenidate,
ampthetamine, and methamphetamine. Children and adults are prescribed stimulants
such as Ritalin and amphetamines. Many stimulants are sympathomimetic agents
that act on the fight and flight sympathetic nervous system. Effects include
tachycardia, hypertension, sweating, hyperthermia, agitation, and combativeness.
Multiple doses of caffeine are added to stimulant drugs found in weight loss
products, cold remedies, cough syrups, energy drinks and prescription drugs.
Sympathetic amines increase blood pressure, heart rate and decrease brain
perfusion. Stimulant drugs are often hidden in over the counter remedies -
decongestant syrups and sprays, cough syrups, pills and capsules sold to "treat"
colds and flu ( none of these products work as promised and none should be
used.)
Goodmann reported on the increasing use and abuse of stimulant drugs:”
With the nation still reeling from the opioid crisis, drug forecasting
experts say a new wave of addiction is coming and the United States isn't
ready for it. Abuse of stimulants like methamphetamine, cocaine, and even
prescription drugs like Adderall and Ritalin is surging across the country,
fed by cheap, potent, and plentiful supplies. Data from government surveys
on drug use show that stimulant use is climbing and in some cases outpaces
opioid use. In 2016, for example, an estimated 2.3 million people in the US
started using opioids to get high for the first time, while 2.6 million
people started using stimulant drugs for the same purpose. In 2016, an
estimated 3.8 million people said they used opioids to get high within the
last month, while 4.3 million said the same about stimulants. Early data
from the CDC show that the number of overdose deaths due to psychostimulant
abuse -- a drug category that includes prescription and illegal stimulants
-- jumped nearly 30% last year. In 2017, 7,663 people died from a stimulant
overdose, up from 5,992 in 2016. In addition to illegal drugs, legal
supplies of stimulants have never been greater. Prescriptions for stimulant
medications like Ritalin and Adderall are up for all age groups, according
to data from prescription drug monitoring programs. Both are typically
prescribed to treat attention deficit disorders. In Oregon, for example, the
rate of stimulant prescriptions written for every 1,000 adults ages 30 to 44
increased from 159 in 2012 to 238 in 2016, about a 50% increase. The largest
percent increase, puzzlingly, was in prescriptions written for people ages
65 to 74.(Brenda Goodman. Experts Warn of Emerging 'Stimulant
Epidemic' WebMD Health News. April 04, 2018)
High Caffeine Energy Drinks
Emma Hitt reviewed the dangers posed by high caffeine "Energy Drinks."
She wrote:" A lack of research and regulation associated with
energy drinks, combined with reports of toxicity and high consumption, may
result in dangerous consequences in children, adolescents,
and young adults, according to a review of scientific literature and Internet
sources." Sara M. Seifert et al reported that energy drinks are regularly
consumed by 30% to 50% of children, adolescents, and young adults. They
suggested that the use of energy drinks provide no benefit and can have serious
adverse health effects. Energy drinks are categorized in the US under the
bizarre category "nutritional supplements" which includes many products that
have nothing to do with nutrition. Under this category the drinks can have high
caffeine content of 75 to 400 mg caffeine per container, avoiding
the limit of 71 mg caffeine per 12 fluid ounces that the US FDA set for sodas.
They cited a New Zealand report that found that children, teenagers, and
young men would exceed an adverse effect level of 3 mg/kg per day of caffeine
after consuming a single retail unit of energy drink or energy shot in addition
to dietary exposure. Germany, Australia, and New Zealand have reported numerous
adverse outcomes associated with energy drink consumption. These include liver
damage, kidney failure, respiratory disorders, agitation, confusion, seizures,
psychotic conditions, nausea, vomiting, abdominal pain, rhabdomyolysis,
tachycardia, cardiac :dysrhythmias, hypertension, myocardial infarction, heart
failure, and death. Other ingredient in the drinks are also potentially harmful
such as 5-hydroxy tryptophan, vinpocetine, yohimbine, and ginseng. (Emma Hitt. Energy Drinks Pose Serious Health Risks for Young People. Medscape
Medical News. Feb 2011. Pediatrics. 2011;127:511-528.)
Mephedrone, a synthetic stimulant
Mephedrone, a synthetic stimulant, comes in tablet or powder forms and users
typically swallow, snort, or inject this drug.
Bath salts are designer drugs that often contain mephedrone and are available on the Internet. The street
names for mephedrone bath salts are numerous and include ivory snow, vanilla
sky, arctic blast, white rush, and white knight. During a 4-month period, 35
patients who had inhaled, injected, or ingested bath salts presented to
emergency departments in Michigan. Of these 35 patients, 17 were hospitalized
and one was dead upon arrival. After September 2011, possessing and selling
these chemicals became illegal in the US.
Cocaine
Cocaine made from coca leaves is a common abused drug. Cocaine is the second
most popular illegal drug in the United States, the world's largest
consumer of cocaine. The estimated U.S. cocaine market exceeded US$70 billion in
street value (2005). In Canada cocaine bought on the street costs $80/gm. The drug is marketed by drug cartels in Mexico
and South America. Cocaine is commonly used in middle to upper-class communities
and is known as a "rich man's drug". It is also popular amongst college
students, as a party drug. Cocaine addicts become drug dealers, thieves, and
commit violent crimes. Cocaine is snorted, inhaled as smoke,
injected into a vein as a solution. Effects may include loss of contact with
reality, an intense feeling of happiness, strengthen or confidence, or agitation. Physical symptoms may
include a fast heart rate, sweating, and large pupils. High doses can result in
high blood pressure and/or body temperature. After a short period of use, there
is a risk that dependence will occur. Cocaine use
increases the risk of stroke, myocardial infarction, lung problems,
blood infections, and sudden death. Cocaine sold on the street is
commonly mixed with local anesthetics, cornstarch, quinine, caffeine,
amphetamine, or sugar which can result in additional toxicity.
Ephedra
Haller and Benowitz warned that: “Dietary supplements that contain ephedra
alkaloids (also known as ma huang) and guarana-derived caffeine are widely
consumed in the United States for purposes of weight reduction and energy
enhancement. A number of reports of adverse reactions to dietary supplements
that contain ephedra alkaloids, some of which resulted in permanent injury or
death, have appeared in the medical literature. In response to growing concern
about the safety of ephedra alkaloids in dietary supplements, the Food and Drug
Administration (FDA) requested an independent review of reports of adverse
events related to the use of ephedra alkaloids to assess causation and determine
the level of risk these products pose to consumers.”Ritalin and Amphetamines
In the US, a FDA advisory committee heard testimony indicating that 2.5
million children take stimulants for ADHD, including nearly 10 percent of all
10-year-old boys in the United States. The use of these agents is much less
prevalent in European countries, where the diagnosis of ADHD is relatively
uncommon. The popularity of the diagnosis, Adult ADHD is relatively recent
leading to at least 1.5 million adults who take stimulants on a daily basis,
with 10 percent of users older than 50 years of age. Drug-related events
reviewed by the committee included 25 cases of sudden death in children or
adults that included myocardial infarction, stroke, and serious heart
arrhythmias. The committee concluded: “We rejected the notion that the
administration of potent sympathomimetic agents to millions
of Americans
is appropriate. We sought to emphasize more selective and restricted use, while
increasing awareness of potential hazards. We argued that the FDA should act
soon and decisively. “
Professor Sroufe wrote: “Three million children in the USA
take drugs for problems in focusing. Toward the end of last year, many of their
parents were deeply alarmed because there was a shortage of drugs like Ritalin
and Adderall that they considered absolutely essential to their children’s
functioning. But are these drugs really helping children? Should we really keep
expanding the number of prescriptions filled? In 30 years there has been a
twentyfold increase in the consumption of drugs for attention-deficit disorder.
As a psychologist who has been studying the development of troubled children for
more than 40 years, I believe we should be asking why we rely so heavily on
these drugs. Attention-deficit drugs increase concentration in the short term,
which is why they work so well for college students cramming for exams. But when
given to children over long periods of time, they neither improve school
achievement nor reduce behavior problems. The drugs can also have serious side
effects, including stunting growth. Sadly, few physicians and parents seem to be
aware of what we have been learning about the lack of effectiveness of these
drugs.”
A highly regarded Cochrane Review showed that there is only
very low-quality evidence to support the use of methylphenidate (Ritalin,
Concerta, other brands) in children with attention deficit hyperactivity
disorder (ADHD) leading the reviewers to urge more caution when prescribing
stimulants. Dr Storebø and Dr Zwi stated: "We should view the average reduction
in symptom scores attributable to treatment with a high degree of caution," they
add. "Clinicians need to weigh what we now believe to be an uncertain degree of
benefit against the many adverse events that are known to be associated with
methylphenidate, such as appetite suppression and sleep difficulties. The
general perception of methylphenidate as an effective drug for all children with
ADHD seems out of step with the new evidence. This new information from our
review should challenge the mindset of clinicians because there is more
uncertainty to factor in to balancing the benefits and risks of these
medications."
(Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD) Cochrane
Database of Systematic Reviews. November 25 2015.)
May 26 2006 Canada's health ministry warned individuals with hypertension,
heart disease or abnormalities, arthrosclerosis or hyperthyroidism not to take
drugs used to manage attention deficit hyperactivity disorder (ADHD). All ADHD
drugs stimulate the heart and blood vessels... in some patients this stimulation
may result in cardiac arrests, strokes or death.
The drugs mentioned by Health Canada include:
Adderall XR, made by Britain's Shire Pharmaceuticals Group Plc
* Concerta, made by Johnson & Johnson
* Ritalin and Ritalin SR, made by Novartis AG
* Dexedrine, made by GlaxoSmithKline Plc
* Strattera, made by Eli Lilly and Co.
Walter N. Kernan, et al. Phenylpropanolamine and the Risk of Hemorrhagic
Stroke N Engl J Med 2000;343:1826-32
Nissen S. ADHD Drugs and Cardiovascular Risk. Published at www.nejm.org March
20, 2006
High Blood Pressure According to the Canadian Coalition for High Blood
Pressure Prevention and Control, non-drug strategies should be the priority for
hypertension control.
The Alpha Nutrition Program can be recommended, along with exercise
and rational
learning assistance
without drugs to manage ADHD.
