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Chemsex Harm
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Substances | Amphetamines

Asset 5

Synonyms

T, Tina, Crystal, 💎, 💨, White Clouds, Adderall, Addies, Ritalin

Class

Stimulant

Mechanism of action

Blocks reuptake and promotes the release of norepinephrine and dopamine [1]

Medical use

Oral amphetamines are approved for ADD/ADHD and for narcolepsy. Some oral amphetamines are also approved in low dose form for weight loss.

Administration routes

Oral
Inhaled (smoke or vapor)
Intranasally “Snorting”
Intravenous (IV) “Slamming”
Rectal Administration “Booty Bump”

Effect

"Upper"

Increases energy and libido, reduces need for sleep, reduces physical fatigue, anxiolytic, increases focus → hyperfocus and thought blocking, strong vasoconstrictor, increases touch and pleasure perception.

Safety Strategies

PO > Smoking > IV or Rectal Administration

Oral administration or consuming amphetamines by mouth is the safest way to use them. This route is often less preferred due to a slower “high” peak, and an increase in amphetamine-associated diarrhea (amphetamines stimulate bowel motility).

All amphetamine use, including recreational inhaled amphetamine use, has been correlated with pulmonary arterial hypertension (PAH), and to a lesser extent, pulmonary fibrosis [2-4]. Screening for PAH in regular amphetamine users has been suggested, and future studies may evaluate the utility and feasibility of screening [5]. The vasoconstricting effects of inhaled amphetamines can be particularly harmful to people with underlying lung pathologies, and can cause permanent damage. However, intravenous (IV) use likely has the greatest potential for harm given the risk of blood borne virus transmission (HIV and Hepatitis C), serious infection (bacteremia, endocarditis, sepsis), as well as the directly damaging effects amphetamines have on the cardiac and pulmonary vasculature [4]. Direct rectal administration, or “Booty Bumps,” are damaging to the rectal mucosa, increasing the risk of sexually transmitted infections (STIs), HIV/Hepatitis C transmission, and more serious complications.

We encourage all people who use amphetamines to try oral administration. If they find oral administration does not suit them, sticking with smoking amphetamines is our next recommendation to avoid the more serious consequences associated with IV and rectal administration. Additionally, we recommend the use of water pipes or bongs over a regular pipe so as to avoid the added heat injury to the pharynx and lungs caused by direct inhalation of heated amphetamines.

Oral Care

Research has demonstrated that use of amphetamines, administration route of amphetamines, and frequency of amphetamine use do not correlate to poor dental outcomes [6]. The causes of what is colloquially known as “Meth Mouth” are the same causes of dental decay in people who do not use amphetamines: poor dental hygiene, lack of routine dental care, xerostomia (dry-mouth), and consumption of sugary beverages/foods [6]. To prevent dental consequences of recreational or chemsex use of amphetamines, we recommend reinforcing basic dental health recommendations: brushing your teeth at least two times a day, flossing daily, and regular appointments with a dental provider. Additionally, as amphetamines can cause relatively severe xerostomia (dry-mouth), we recommend that people using amphetamines during chemsex have common dry mouth products on hand: dry-mouth dental rinses (Biotene, ACT, generics...), dry-mouth lozenges (active ingredient: Xylitol), and dry-mouth gels. Used frequently and gratuitously, these products can prevent any negative dental consequences to amphetamine use. “Orajel Antiseptic Rinse For All Mouth Sores” and other antiseptic/anesthetic mouth rinses can also be helpful for substance-use-associated aphthous ulcers.

Sleep

Coming soon..

Drug Holidays and Tolerance

Coming soon..

Medications to Aid in Recovery

Coming soon..

Injecting "Slamming" Safety

Coming soon..

Citations & Reading

[1] Epocrates. Epocrates, Inc. https://online.epocrates.com/drugs. Published 2020. Accessed.
[2] Drug-induced pulmonary arterial hypertension. Prescrire International. 2020;29(217):180-183.
[3] Vasti E, Papolos A, Kolaitis NA, Mayfield J, Tison GH, De Marco T. Patients with Methamphetamine-Associated Pulmonary Arterial Hypertension Have Less Favorable Hemodynamics Than Other Patients with Group 1 PAH. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation. 2020;39(4):S18-S19.
[4] Kevil CG, Goeders NE, Woolard MD, et al. Methamphetamine Use and Cardiovascular Disease. Arteriosclerosis, thrombosis, and vascular biology. 2019;39(9):1739-1746.
[5] Cheng Y, Tung CK, Chung AKK, et al. Screening Of Pulmonary Hypertension in Methamphetamine Abusers (SOPHMA): Rationale and design of a multicentre, cross-sectional study. BMJ open. 2019;9(8).
[6] Clague J, Belin TR, Shetty V. Mechanisms underlying methamphetamine-related dental disease. Journal of the American Dental Association. 2017;148(6):377-386.

All information posted is for educational and informational purposes. It is not intended as a substitute for professional or medical advice. Should you decide to act upon any information on this website, you do so at your own risk.