I am currently being told they’re completely different, even though they’re both amphetamines with a similar side effect profile and potential for abuse. So whats the difference?
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Psychiatrist here – lots of very good information here, couple of other things in addition:
1) dose: most people using methamphetamine use much higher doses (100-1000mg/day) than dexamphetamine (typically 10-60mg/day, rarely up to 100mg/day). I’ve had some patients who’ve used low doses of methamphetamine and report it’s quite similar to being on a prescription psychostimulant.
2) mode of delivery: some modes cause a rush of the substance into the blood causing higher peak levels in the blood which create different and greater effects. Many prescription psychostimulants get absorbed slowly.
I strongly emphasise you must not take more dexamphetamine than prescribed or in any way other than tablet form. It can be very dangerous and if used in a certain way can easily cause serious health problems. If used as prescribed, dexamphetamine is generally very safe.
I’ve had to counsel a lot of patients about the difference between psychostimulants and illicit amphetamines. The reality is that for most illicit drugs (hallucinogens being the exception for now) there is a medication with a similar structure. Part of the reason for this is that many substances started off having medical uses and then people realised the recreational effects. Examples are:
Heroin / fentanyl – both very effective pain medications, quite safe when used appropriately and not dissimilar to opioids available from the pharmacy.
Cocaine – has some use as a topical anesthetic and structurally similar to a lot of local anaesthetics.
Marijuana – started to be used medically, some other medications (eg paracetamol) are suspected to work on the endocannabinoid system
Special K (ketamine) – used regularly as an anaesthetic and anti-depressant
Valium / xannies – if prescribed on rare occasions can be effective anti-anxiety medicines
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