There are many dangerous chemicals on the drug market that are very dangerous to the health and even life of the users. New products, often in blends and reinforced concentrations, encourage people to try them. One such substance is amphetamine and its derivatives. The law clearly states that we are not allowed to carry drugs with us. Even the smallest amount can cause a court to pass judgment. The punishment that will be imposed depends on the amount and type of drugs that you possess, the defendant’s previous criminal record and the defendant’s lifestyle to date. Courts usually pronounce a sentence of up to 1.5 years’ imprisonment with a conditional sentence of up to 5 years, it all depends on the defendant and how he behaves at the trial, the greater the repentance the milder the sentence. In order to approximate the consequences of the abuse of amphetamine in terms of emergency medicine, it is necessary to start by characterising the structure and use of this drug.

Amphetamine (chemical designation: (±)-2-amino-1-phenylpropane; chemical formula: C9H13N; molar mass: 135.21 g/mol) is a prototype of psychostimulating drugs, which are characterized by sympathicomimetic effects and strong effects on the central nervous system (CNS). It was first synthesized in 1887 by Romanian chemist Lazar Edeleanu. The properties of amphetamine were first described in 1927. In the list of psychotropic substances, besides the international name, amphetamine has another name – psychedrin. Amphetamine reaches its maximum concentration in the blood about 2 to 3 hours after consumption, and the half-life is 7 to 14 hours. It increases when the pH is less than 6.7 and then it can reach up to 34 hours. Amphetamine in its pure state is a colourless liquid, which dissolves poorly in water, but well in acids. It is commonly found as a salt. Illegally produced amphetamine sulfate is in the form of white, yellow or brown powder, depending on the type of contamination and production technology. Sometimes it has an unpleasant solvent smell (1-4).

Amphetamine has many hallucinogenic compound derivatives, i.e.:

– methamphetamine – an organic chemical compound called stimulant, which is based on the β-phenylethylamine skeleton. It is a white, odorless powder with a bitter taste, easily dissolved in water. It is most often found in the form of an unpurified, white and yellowish egg-smelling powder or as a high-purity methamphetamine hydrochloride – characteristic transparent crystals,

– 2,4,5-trimethoxy-amphetamine (TMA) – first synthesized in 1933. TMA is equivalent to naturally occurring mescaline in cacti (Peyotl and San Pedro). TMA may be present in 1 of 6 groups of substances (TMA, TMA-2, TMA-3, TMA-4, TMA-5 and TMA-6),

– methyl-2,5-dimethoxyaamphetamine (DOM) – first synthesized in 1963,

– paramoxyamphetamine (PAM) – first synthesized in 1963,

– 3,4-methylenedioxyamphetamine (ecstasy) – an organic chemical compound which resembles the structure of amphetamine. The half-life of MDMA is about 7 to 10 hours and its maximum serum concentration after consumption reaches about 2 to 3 hours (3, 4).

Amphetamine as a therapeutic agent – benzidine – was introduced in 1932 by Smith, Kline and French. It was used to treat inflammation of the nasal mucosa and bronchial asthma, in addition to treating narcolepsy. During World War II its properties were used as a stimulant by American soldiers. In the sixties of the twentieth century amphetamine was used as an aid to weight loss. According to the sources, in 2000, over 30 million tablets were sold on the European market (5).

Amphetamine is a drug that is highly addictive mentally and physically weak. Psychoderine affects the body in such a way that it tolerates everything and everyone. The drug is most often used in an oral form dissolved in liquid because it is well absorbed from the digestive tract. Another method of taking amphetamine is to take it through the nose or by intravenous injection. “The ideal dose”, the drug is 1 g but there are often cases where the dose is increased up to 7 g per day. Amphetamine is a favorite drug of young people, because it helps to concentrate on the activity, gives a relaxing effect and above all it is cheap. This drug has small side effects compared to other drugs available on the illegal market.

Unfortunately, Poland is among the leading countries importing and exporting amphetamine and its derivatives.

Methamphetamine has a much stronger effect on the CNS, causing euphoric effects similar to those of cocaine but with a longer duration. There is a variety of methamphetamine, which you take by burning it in a special pipe. Pure methamphetamine is taken by injecting it intravenously and sometimes it is taken through the nose or orally. After injection or burning, the effect of euphoria occurs within 5 to 15 seconds, after oral or nasal use, the happiness effect has to wait from 15 to 20 minutes and is usually weaker. The consequences of taking methamphetamine are much more serious than those of amphetamine alone. Dependence on this drug is rapid and very serious. A person who takes methamphetamine over time will take more and more doses because he or she is not satisfied, starts neglecting daily activities and only thinks about taking another dose of the drug, and often falls asleep for up to 48 hours after taking it! When he wakes up, he feels depressed and wonders what to do to take another dose of “booster”. Such behaviour often leads to mental and physical problems, such as chest pain, hypertension, subcutaneous micro-inflows and arrhythmia. A human being rolls down to the social bottom. Rapid withdrawal can cause as severe effects as its frequent use, such as headaches, drowsiness, intestinal spasms and depression. Quitting is very difficult and requires the help of doctors and psychologists. Methamphetamine is much more dangerous because it is often used as a cocaine substitute and is much cheaper.

The most popular drug of recent times was the Ecstasy pill. Taking it causes short-term euphoria, increased perception, excitement, talkativeness, a sense of strength and a high dose of energy. When someone takes too much, you may notice short lasting side effects such as: visual and sensory hallucinations, increased pulse and pressure, pupil dilatation. You can also see increased sweating, rapid temperature changes and chest pains. After MDMA you can also see long-term effects such as insomnia, anxiety loss, self-aggression and aggression against others, delusions, psychosis and sometimes even death. When someone overdoses ecstasy, insomnia, irritability, hyperactivity, hallucination, sudden pressure surges, convulsions and sometimes death are observed (6).

Easy accessibility, stressful situations and widespread use are leading to increased levels of drug and drug poisoning. These situations are most common among young people, especially students and young learners.

Methamphetamine has a stimulating effect on the sympathetic part of the autonomic sympathetic system. It causes dilatation of the pupils, narrowing of blood vessels, increase in blood pressure, increase in the frequency of myocardial contractions, increase in body temperature, disruption of bronchial smooth muscles and acceleration of breathing.

A person who has taken methamphetamine has a strong euphoria, is polite and sexually aroused. After taking the drug, nausea, vomiting, jaws, limb muscle tremors or dry skin may occur, and unusual behaviours such as excessive irritability or aggressiveness and panic attacks may also occur.

Acute methamphetamine intoxification leads to strong psychomotor excitation, a significant increase in body temperature, i.e. hyperthermia, and tachycardia. In addition, hallucinations, delusions, panic attacks, fortifications, photophobia and tension headaches can be observed. Hyperthermia in such a state may threaten dehydration or even death. During such poisoning, kidney failure and rhabdomyolysis may occur in the body. Cerebral haemorrhage, ischaemic stroke, myocardial infarction and pulmonary hypertension in such a situation usually lead to death.

A person who has abused the drug may develop a range of conditions such as sight or hearing impairment, arrhythmia or, in more serious cases, myocardial infarction and amphetamine psychosis during amphetamine poisoning. When taken intravenously, the drug can cause cyanosis, clots, blockages and subarachnoid hemorrhages. After taking too much amphetamine, cardiovascular problems such as tachycardia, i.e. accelerated heart rate, chest pain, cardiovascular collapse, vasospasm or even stroke occur. On the part of the nervous system in such people we can encounter symptoms such as agitation, convulsions, anxiety, hyperthermia. Additional symptoms from the autonomic system are dilated pupils, excessive sweating, nausea, or an accelerated rate of tachypnoe breathing.