Harms of stimulant use

Some people can use stimulants for long periods without developing adverse consequences, others develop severe harms. The spectrum of substance use is described in this guideline by the terms ‘hazardous use’, ‘harmful use’ and ‘substance dependence’, outlined in Terminology describing the spectrum of substance use.

Potential physical and mental harms from stimulant use are outlined in Potential harms of stimulant use. Other harms associated with dependent use include damage in other areas of life, including relationships, work and education.

Table 1. Potential harms of stimulant useCentre for Alcohol and Other Drugs, 2014 NSW Health, 2022 Tseng, 2014
Cardiovascular harms
hypertension arrhythmias myocardial infarction cardiomyopathy heart failure infective endocarditis related to injecting
Neurological harms
clonic seizures haemorrhagic or ischaemic stroke poor attention, memory, concentration, learning, cognitive impairment
Psychiatric harms [NB1]
misperceptions and delusions depression paranoia anxiety aggression, with risk of trauma to others (including children witnessing violence) delirium psychosis
Respiratory harms
nasal inflammation and mucosal and septal damage related to intranasal use (‘snorting’) chronic bronchitis and restrictive-pattern lung fibrosis from inhaling vapour (‘smoking’)
Oral health harms
dental damage from bruxism, poor self-care, periodontal disease mouth burns from pipe smoking
Sexual health harms
sexual risk-taking related to disinhibition
Reproductive health harms
spontaneous abortion, miscarriage, placental abruption, fetal harms, premature labour
Dermatological harms
infections and abscesses related to injecting or skin picking (eg when experiencing the stimulant-induced sensation of insects crawling under their skin [formication])
Other harms
weight loss caused by reduced appetite and accelerated metabolism hyperthermia caused by toxicity; see Stimulant drug poisoning bloodborne infections (eg from injecting, sharing pipes, unprotected sex)
Note: NB1: Mood, anxiety and psychotic symptoms may be predisposing factors to or consequences of stimulant use; a pre-existing condition increases the likelihood that long-term mental health management will be requiredGrigg, 2018.