Why are stimulants dangerous?

Misusing prescription stimulants over time and using illicit stimulants can lead to serious health problems.

​Mixing Drugs is Especially Dangerous

Stimulants that are not prescribed by your doctor could be mixed with fentanyl. Fentanyl is an extremely strong synthetic (human-made) opioid that cannot be seen, smelled, or tasted when mixed into other drugs. Even a small amount of fentanyl can be deadly.

Fentanyl test strips (FTS) (PDF) can be used to check if fentanyl is present in a drug but they cannot show how much fentanyl is present. It's important to know that testing stimulants for fentanyl usually requires more water than testing opioids. Learn how to use FTS.

Whether done on purpose or by accident, mixing drugs significantly increases the risk of harm. Never mix prescription medications without a doctor's guidance.

When drugs are taken together, they can interact in dangerous ways. For example, mixing drugs or mixing drugs with alcohol can raise the risk of overdose.

Learn more about signs of a stimulant overdose at the Signs of a Drug-Related Overdose web page.

​Stimulants Come in Many Forms

Stimulants can appear as powders, pills, liquids, or crystal-like rocks. Methods of use include smoking, inhaling, swallowing, snorting, or injecting. The drugs may look like colorful pills, white or brown powder, or shiny blue-white rocks.

People can take stimulants by smoking, inhaling, swallowing, snorting, or injecting the drugs. Pills and powder can be white, colorful tablets, brown crystalline powder, or shiny blue-white rocks.

Cocaine is a white, crystal-like powder made from coca leaves. It can be snorted, smoked, swallowed, or dissolved and injected. Its other names include "coke," "snow," and "flake." Learn more about coc​aine (PDF).​
​Crack cocaine is a form of cocaine that looks like white or off-white rocks of different sizes and shapes. It is typically smoked. Other names for crack cocaine include "rocks," "candy," and "nuggets." Learn more about crack cocaine (PDF).
​Crystal methamphetamine is a synthetic stimulant. It looks like glass fragments or shiny blue-white rocks. It is often smoked with a glass pipe, but can also be swallowed, snorted, or injected. Other names for crystal meth include "ice" or "glass." Learn more about crystal methamphetamine (PDF).
​Methamphetamine is a pill or powder that can be smoked, snorted, swallowed, or injected. A prescription version (Desoxyn®) is sometimes used to treat ADHD or obesity. Its other names include "meth," "speed," and "crank." Learn more about methamph​etamine (PDF).
​MDMA (Ecstasy) is a synthetic drug with both stimulant and hallucinogenic effects. It is usually taken as a pill, capsule, or liquid. It is often called a “party drug." Its other names include "lover's speed," "hug drug," "molly" and "x." Learn more about M​DMA (PDF).
Prescription stimulants are medicines used to increase alertness, attention, or energy. They are used to treat medical conditions such as ADHD, narcolepsy, and obesity. Common examples include Dexedrine®, Adderall®, Ritalin®, and diet aids. They come in tablet, capsule, or liquid form and can be swallowed, injected,  snorted, or smoked. Learn more about prescription stimulants.
​Synthetic cathinones ("Bath Salts") are human-made stimulants that often look like a white or brown crystal-like powder. They are marketed as plant food, jewelry cleaner, glass cleaner, research chemicals, bath salts, and labeled "not for human consumption." Synthetic cathinones can be snorted, smoked, ingested, or injected. Other names include "vanilla sky," "cloud nine," and "white lightning." Learn more about synthetic c​athinones (PDF).

Treatment

There are currently no approved medications to treat stimulant use disorder. The most effective treatment is behavioral therapy, such as counseling, contingency management, and support programs. There are also no currently approved medications to reverse a stimulant-related overdose. Naloxone doesn't work to reduce the effects of a stimulant. However, if you're not sure what drug someone took, always give naloxone - they may have unknowingly taken an opioid, like fentanyl. Naloxone has very few negative effects, and has no effect if opioids are not in a person's system.

What is California doing?

CDPH's Substance and Addiction Prevention Branch (SAPB) monitors fatal and non-fatal stimulant-related overdose trends over time in California, by sex, age, race/ethnicity, and substance type. These indicators and trends are also available by geography, county, and zip code on the California Overdose Surveillance Dashboard.

• For stimulant-related overdose deaths, stimulants tracked include psychostimulants with abuse potential (e.g., methamphetamine, MDMA, dextroamphetamine, levoamphetamine, or methylphenidate (Ritalin)) and cocaine.

• For stimulant-related non-fatal overdose emergency department visits or hospitalizations, stimulants tracked include amphetamines and cocaine.

• Connecting partners to improve health care access and health equity

• Supporting harm reduction services & holistic approaches to wellness

• Building community engagement to reduce stigma

• Statewide surveillance to provide data for evidence-based decisions 

​Resources

• Naloxone – A life-saving medication that can reverse an opioid overdose. While it doesn't reverse stimulant overdoses, it may be helpful if opioids, especially fentanyl, are also involved.

• Syringe exchange – Programs that provide clean syringes to reduce the spread of disease and offer safe disposal, along with access to health services and harm reduction tools.

• Fentanyl test strips – Information about how to detect the presence of fentanyl in drugs and get access to FTS. This helps people avoid accidental fentanyl exposure, which can be deadly.

• Mental/behavioral treatment  – A list of County Mental Health Plans that can provide Specialty Mental Health Services to Medi-Cal beneficiaries.

• Harm reduction education – Information and strategies that reduce the risks of drug use, including how to stay safe,  recognize overdose signs, and seek support.

• Drug overdose response recommendations and resources – Resources for partner organizations to respond to drug overdoses.

• Emergency Management of Methamphetamine Crisis and Use Disorder – An evidence-based clinical protocol for emergency departments developed by CA Bridge.

• Poison Control Centers – Call (800) 222-1222 – Free, 24/7, confidential advice for drug reactions or accidental ingestion.

​​Sources​​

• National Ins​titute on Drug Ab​use
  
• Drug Enforcemen​t Administration (DEA)
• Substance Abuse and ​Mental Health Services Administration
• Center for Diseas​e Control and Prevention’s Polysubstance Use Facts​