The Singular Destructiveness of Stimulants

Paramedic closeup

For the last decade or more, America has been almost obsessively focused on its opioid problem. And with very good reason. More people die from overdoses of opioids than from any other type of drug, and year after year the number of those overdoses has been increasing.

But during the latter part of the last decade, the threat from stimulants has become ever more serious. Some drug users switched from opioids to stimulants in an effort to escape the threat of fentanyl, the powerful synthetic opioid that was found in heroin and counterfeit pills from one coast to the other.

Another factor in this increase was the development of a cheaper method of making methamphetamine in large quantities. Large shipments of precursor chemicals began making their way from China to Mexico where they were turned into methamphetamine in labs so large and sophisticated they were called Superlabs.

Many people know that fentanyl has been coming across the U.S.-Mexico border in quantity. Once meth’s precursor chemicals began being received from China, methamphetamine began coming right along with fentanyl.

For example, in August 2021, law enforcement personnel seized 5,528 pounds of methamphetamine and 127 pounds of fentanyl at a California Port of Entry. In November 2021, the Department of Justice announced the seizure of 17,584 pounds of methamphetamine and 389 pounds of fentanyl at the same port of entry.

With massive amounts of this and other stimulants pouring into America, it is more important than ever that Americans are informed as to the harm they can do to the body and mind. Stimulants such as cocaine, MDMA (ecstasy) and methamphetamine have very specific ways they do their damage.

Nightclub ecstasy users dancing


The full name of this drug is 3,4-methylenedioxymethamphetamine. It’s also known as MDMA. You can see in the long chemical name that this drug is related to methamphetamine.

It is a favorite of people who like to go to nightclubs for long hours of partying. It ramps up a person’s senses. Music, lights and touch are all more strongly perceived. But it is, in essence, a stimulant which means it also ramps up the body’s basic functions. For some people, this stimulation can lead to such a high fever that they can suffer muscle breakdown that triggers organ shutdown and death. This muscle breakdown is called rhabdomyolysis.

These dangers are more likely if the person fails to keep themselves cool and hydrated during a long night of dancing, or if they are at a hot outdoor venue.

Ecstasy is well known for causing profound changes in the brains of users. One study found that ecstasy use causes long-lasting loss of serotonin in humans. Serotonin is a neurotransmitter that plays an important role in regulating mood, appetite, sleep, learning and memory. In fact, the more ecstasy is used, the more changes there are in the users’ brains.

Some studies show ecstasy use is associated with sleep, mood, and anxiety disturbances, elevated impulsiveness, memory deficits, and attention problems, which may last as long as two years after a person stops using the drug. Also, cardiovascular collapse and epileptic seizures have occurred.

One study found that adolescents who had used ecstasy attempted suicide almost twice as often as adolescents who had used other drugs only, and nine times as often as adolescents that had used no illicit drugs.

Ecstasy has even been associated with sudden liver failure, a problem that can only be survived with a liver transplant.

A note about MDMA purity: There are some people who feel that pure MDMA is a “safe” drug to use. They will test the MDMA they purchase in an attempt to avoid counterfeit or adulterated ecstasy pills. The problems discussed above relate to the use of real MDMA and reveal that the use of MDMA itself can create life-threatening problems.

Cocaine addict


At this time, it is hard to believe that for many years, cocaine had a reputation as a benign, non-addictive drug. In 1974, a medical doctor who later became a Special Assistant to President Carter even wrote, “Cocaine ... is probably the most benign of illicit drugs currently in widespread use .... Short-acting -- about 15 minutes -- not physically addicting.”

The death of basketball star Len Bias abruptly and profoundly refuted that falsehood. In 1986, this young college star who had just been recruited by the Boston Celtics consumed a heavy dose of high-purity cocaine and then collapsed and died from cardiac arrest. In the years that followed, the widespread destruction caused by cocaine and its addictiveness became better understood. Soon, no one was claiming that cocaine was either benign or non-addictive.

Cocaine, like other stimulants, increases the heart rate while it also causes the arteries to constrict. Cocaine in particular is known for its adverse effects on the human heart. A 2010 study in Spain found that most cocaine-related deaths were caused by problems with the heart and related systems. A doctor who worked on this study said, “cocaine use causes adverse changes to the heart and arteries that then lead to sudden death.”

“… Cocaine use causes adverse changes to the heart and arteries that then lead to sudden death.”

Deaths from heart-related causes among cocaine users generally occur in younger men than heart-related deaths without cocaine involvement. The cocaine deaths in the group of men included in this study occurred in men aged 21 to 45.

Another study noted the incidence of ischemic stroke and brain atrophy among cocaine users. Cocaine’s ability to constrict the blood vessels can also lead to the death of some sections of the intestines among those who inject, ingest or smoke the drug.

Lengthy binges of high doses of cocaine can have particularly damaging mental effects. The National Institute of Drug Abuse (NIDA) notes these changes in heavy cocaine users:

  • Irritability
  • Panic attacks
  • Paranoia
  • Psychosis
  • Auditory hallucinations.

NIDA also notes these physical effects with long-term use:

  • Chest pain
  • Inflammation of heart muscle
  • Stroke
  • Bleeding in the brain

One of the stimulant-related injuries that strikes me as the most horrific is the aortic dissection. The aorta is a major artery leading away from the heart. It passes through the chest to the lower part of the body. Because of the cardiovascular stress placed on the body by cocaine, the layers of the aorta begin to tear and separate. Blood that should flow to the lower body pools in the ripped layers of the aorta. This can be fatal if it is not detected and treated promptly. Cocaine causes aortic dissections, as does methamphetamine.


Meth effects

Like cocaine, methamphetamine is a very strong stimulant. Those who use this drug like the energetic, euphoric way they feel after it is consumed. But it creates many of the same adverse effects on a person’s mind and body that cocaine does.

Methamphetamine has been found to cause the brain to shrink. One study found that 11% of brain tissue was lost in one region of the brain associated with mood and emotion. The part of the brain associated with memory lost 8%.

As a result of these losses, researchers found that those addicted to methamphetamine were depressed, anxious, unable to concentrate and scored poorly on memory tests. Some of these changes might be able to heal if a person stops using methamphetamine.

NIDA describes the long-term effects of methamphetamine this way:

  • Anxiety
  • Confusion
  • Insomnia
  • Violent behavior
  • Paranoia
  • Delusions
  • Damage to heart and brain

Should We Decriminalize These Drugs?

There are some people who think that individuals should have the right to use drugs if they wish to. These people often advocate for the decriminalization of personal quantities of drugs in the same way that Oregon voters approved in 2020. That law, Measure 110, makes possession of small amounts of cocaine, heroin, LSD, methamphetamine and other drugs more or less equivalent to getting a parking ticket.

When you study the harm that is done by these drugs, it is hard to think of any of them as safe. It’s hard to accept someone you care about putting their bodies and minds at risk by using opioids, stimulants, synthetics or even the potent forms of cannabis on the market.

Family addiction help

I wouldn’t stand by while someone strapped rocks to their waist and then walked into a raging river. I don’t choose to stand by while some individuals make drug use seem innocent and harmless. If I know about the damage done by stimulants, for example, I’m documenting it in the hopes that some people, somewhere, will read this report and decide that sobriety is a safer choice.

I will also encourage any family members of a person using these drugs not to accept that person’s claims that they are only hurting themselves, or that they have the right to do whatever they want with their own bodies. Drugs like MDMA, cocaine and methamphetamine are damaging to every user’s mind and body. Once you read the research on the harm done by these drugs, it is impossible to sit quietly by and smile while someone damages themselves with these potent stimulants.

Some media and entertainment choices may make the use of these drugs seem like acceptable parts of normal lives. Because of the intense damage done by stimulants, this will never be true, no matter who claims they are harmless. There is too much scientific evidence to the contrary. It is important for parents and other family members to make this fact clear to young people to help them preserve their health and mental abilities.


Reviewed and edited by Claire Pinelli; ICAADC, CCS, RAS, LADC, MCAP, LCDC


Karen Hadley

For more than a decade, Karen has been researching and writing about drug trafficking, drug abuse, addiction and recovery. She has also studied and written about policy issues related to drug treatment.