CNS stimulants and the look-alike drugs.

Abuse of amphetamine and especially the stimulant look-alikes represent a serious problem in the United States. The danger of amphetamine lies in its ability to produce tolerance, psychological addiction, psychosis, hypertensive crisis, and major depression following withdrawal after long-term use. The danger of the look-alikes is of a psychosocial nature and has less to do with the physical properties of the drugs. Easy availability and a casual attitude toward these drugs may introduce children and young adults to the concept of recreational use of drugs at an early age. Look-alikes also divert the efforts of law enforcement officials whose time is better spent on efforts to control illegal distribution of controlled substances. However, look-alikes do produce severe to life-threatening effects including seizures, hypertensive crises, and psychoses. Unfortunately, there are no fast and easy solutions to the stimulant drug abuse problem. Abuse of CNS stimulants has a long history. Effective approaches must involve greater education about the dangers of these drugs and improved recognition among medical professionals of trends in CNS stimulant abuse in order to better diagnose and treat resulting problems. It is unlikely that federal controls on amphetamine production can be increased. The OTC drugs, such as PPA, caffeine, and ephedrine could be moved to prescription-only status to emphasize their potential for abuse and for producing adverse reactions, but this approach is counter to society's current trend toward self-medication.