Speed Drug: What Speed Is, How Amphetamine Speed Differs From Meth, the Symptoms, Effects, Side Effects, and the Hidden Risk of Heavy Drinking Alongside It

A clinician’s guide to the speed drug, including what amphetamine speed actually is, how it differs from methamphetamine and from prescription stimulants like Adderall, the symptoms of acute speed use and chronic use, the dangerous side effects, the withdrawal pattern, and the often invisible alcohol problem that develops alongside stimulant use.

Clinically reviewed by Dr. Ponlawat Pitsuwan, Physician and Addiction Medicine Specialist, Phuket Island Rehab.

Speed is a street name for amphetamine sulfate, a central nervous system stimulant that increases the release and blocks the reuptake of dopamine and noradrenaline in the brain. Speed is sold as a white, pink, or brown powder, sometimes pressed into pills or capsules, and is taken by snorting, swallowing, injecting, or smoking. The effects include alertness, euphoria, increased confidence, talkativeness, reduced appetite, reduced need for sleep, and a sense of energy that often lasts 4 to 8 hours per dose. Speed is chemically related to but less potent than methamphetamine, and is roughly similar in strength to prescription amphetamine medications such as Adderall and Dexedrine, although street speed is typically much less pure and contains cutting agents that produce additional harm. Acute effects include rapid heart rate, elevated blood pressure, dilated pupils, sweating, jaw clenching, and reduced inhibition. Side effects with repeated use include anxiety, paranoia, psychosis, severe weight loss, dental decay, cardiovascular strain, and a withdrawal pattern of profound fatigue, depression, and craving when use stops. Speed addiction commonly co-occurs with heavy drinking, and the combined pattern is responsible for substantial physical and psychological harm.

What is the speed drug?

Speed is a street name for amphetamine, a central nervous system stimulant drug. In its illicit market form, speed is most commonly amphetamine sulfate, a white, pink, beige, or brown powder that is snorted, swallowed wrapped in paper, injected, or occasionally smoked. The pharmaceutical-grade equivalent is the active ingredient in prescription medications including Adderall (mixed amphetamine salts), Dexedrine (dextroamphetamine), and Evekeo (amphetamine). Speed is in the same broad pharmacological class as methamphetamine but is generally less potent on a milligram-for-milligram basis. Common street names include speed, whizz, bennies, dexies, uppers, pep, base, and paste.

Speed has been one of the most widely used illicit stimulant drugs in Europe, Australia, and the United Kingdom since the 1960s. In the United States the typical street stimulant is methamphetamine rather than amphetamine, although amphetamine in the form of diverted prescription medications (Adderall, Vyvanse, Dexedrine) is widely used non-medically. The chemical distinction between amphetamine and methamphetamine matters because methamphetamine is more potent, has higher abuse liability, and produces faster and more severe neurological and psychiatric effects than amphetamine. The two are often confused in popular culture and in casual use language, but the substances are not the same.

Pharmacologically, speed acts on the central nervous system by increasing the release of dopamine and noradrenaline from synaptic vesicles and by blocking the reuptake of these neurotransmitters. The result is a substantial increase in monoamine signalling in the reward, attention, and motor control pathways of the brain. The dopamine surge is what produces the euphoria and the reinforcing effects that drive repeated use. The noradrenaline surge is what produces the physiological effects including elevated heart rate, increased blood pressure, dilated pupils, and the sense of physical energy. Speed also has weaker effects on serotonin, which contribute to mood changes and to the higher-dose risk of serotonin syndrome when combined with certain other medications.

Speed vs methamphetamine vs prescription amphetamines

Speed (amphetamine), methamphetamine, and prescription amphetamines are chemically related but clinically distinct. Methamphetamine has a methyl group added to the amphetamine molecule, which substantially increases lipid solubility and central nervous system penetration. Methamphetamine therefore produces faster onset, stronger effects, and longer duration than amphetamine on a milligram-for-milligram basis. Methamphetamine is also more readily smoked, which produces a faster and more intense effect than snorting or swallowing. Methamphetamine is therefore generally considered more dangerous, more addictive, and more neurotoxic than amphetamine.

Prescription amphetamines including Adderall (mixed amphetamine salts: dextroamphetamine and levoamphetamine), Dexedrine (pure dextroamphetamine), and Vyvanse (lisdexamfetamine, a prodrug that converts to dextroamphetamine in the body) are pharmaceutical-grade amphetamine compounds used for attention deficit hyperactivity disorder (ADHD) and narcolepsy. The active drug is essentially the same as street speed; the differences are in purity, dose accuracy, and route of administration. Prescribed at therapeutic doses for ADHD, these medications produce therapeutic effects with relatively low immediate addiction risk in most patients. Used non-medically, snorted, or taken in much higher doses, they produce the same pattern of harm as street speed.

Street speed differs from prescription amphetamines primarily in purity and cutting agents. Pharmaceutical amphetamines are typically more than 95 percent pure with known dose. Street speed is typically 5 to 30 percent pure amphetamine, with the remainder being cutting agents (caffeine, lactose, creatine, ephedrine, paracetamol, and sometimes other psychoactive substances). The variable purity makes dose-titration difficult and contributes to overdose risk. Some of the cutting agents are themselves pharmacologically active, which complicates the clinical picture; ephedrine in particular adds its own cardiovascular and stimulant effects.

The naming conventions are confused in popular use. Bennies is an old street name for benzedrine, an early form of amphetamine in inhaler form widely used in the 1940s and 1950s, and is now a generic name sometimes applied to any amphetamine including diverted Adderall. Dexies refers specifically to dextroamphetamine. Speed in Australia and the UK is the most common street name for amphetamine sulfate. Pep is sometimes used for low-purity amphetamine in the European market. Base or paste refers to higher-purity forms. The user often does not know what specifically they are taking; the label is the seller’s claim, and the contents are variable.

Effects of speed: short-term, by dose

The short-term effects of speed depend on the dose, the route of administration, the purity of the product, and individual factors including body weight, tolerance, and concurrent substance use. At a typical recreational dose (around 30 to 60 mg of amphetamine, equivalent to roughly 0.3 to 0.6 grams of low-purity street speed), the effects begin within 15 to 30 minutes of oral or snorted use and within seconds of injection or smoking. The peak effect lasts 1 to 3 hours, and the overall experience including come-down lasts 4 to 8 hours total.

Subjective effects at recreational doses include increased alertness, talkativeness, sociability, confidence, euphoria, decreased appetite, decreased need for sleep, increased motivation and focus, and a general sense of physical energy. Many users describe a feeling of clarity, productivity, and emotional warmth. The euphoria is less intense than that of methamphetamine or cocaine but is reliable and reinforcing. The sense of being able to do anything, of having unlimited energy, and of feeling more capable and likeable than usual is part of what drives repeated use.

Physical effects at recreational doses include rapid heart rate (tachycardia), elevated blood pressure, dilated pupils, sweating, dry mouth, jaw clenching and teeth grinding (bruxism), muscle twitching, hyperthermia (raised body temperature), and the general sympathetic nervous system activation pattern. Users may pace, talk rapidly, fidget, or struggle to sit still. Coordination is somewhat impaired but in different ways from alcohol or sedatives; speed users often feel more coordinated than they actually are, which can produce risky behaviour.

At higher doses (above 100 mg of amphetamine, or roughly 1 gram or more of low-purity street speed), the picture shifts. Anxiety replaces the social euphoria, paranoia develops, the heart rate and blood pressure rise to dangerous levels, hyperthermia can become severe, and acute psychosis can emerge with visual or auditory hallucinations, delusions of persecution, and disordered thinking. Severe overdose can produce seizures, cardiac arrhythmia, myocardial infarction (heart attack), stroke, and death. The threshold for severe effects is lower in users with cardiovascular disease, in users combining speed with other stimulants, and in users who have not slept for extended periods.

Long-term effects and chronic use

Long-term effects of speed use develop over months to years of regular use and overlap substantially with the effects of methamphetamine and prescription amphetamine misuse. The cardiovascular effects include sustained elevated blood pressure, structural changes in the heart muscle, increased risk of arrhythmias, accelerated atherosclerosis, and elevated risk of myocardial infarction and stroke at relatively young ages. Long-term stimulant users have substantially elevated cardiovascular mortality even when they have not had a single acute event.

Neurological effects include changes in dopamine signalling, reductions in dopamine transporter density (visible on imaging studies), persistent cognitive deficits in attention and memory, and elevated risk of Parkinson disease in later life among heavy long-term stimulant users. The cognitive changes often improve substantially with sustained abstinence but may not return fully to baseline in heavy users. Mood disturbances including depression, anxiety, and irritability are common in chronic users, particularly during the come-down and in the early weeks of abstinence.

Psychiatric effects include the development of stimulant-induced psychosis in vulnerable users, which can resemble schizophrenia and can persist for weeks to months after the last use. Repeated episodes of stimulant psychosis raise the risk of developing a primary psychotic disorder. Anxiety disorders, depression, and post-traumatic stress symptoms are all elevated in chronic stimulant users. The boundary between substance-induced and primary psychiatric disorder is often difficult to draw clinically and may require extended observation off stimulants to clarify.

Physical effects of chronic speed use include severe weight loss from appetite suppression, malnutrition from poor eating, dental decay (sometimes called meth mouth but seen with chronic amphetamine use as well, from a combination of dry mouth, bruxism, and poor dental hygiene), skin sores from picking and scratching (formication), and the broader physical decline that accompanies heavy stimulant use. Users sometimes describe themselves as having aged a decade in a year of heavy use, and the visible decline in physical appearance is one of the more striking features of established stimulant addiction.

Speed and alcohol: the hidden problem

Heavy drinking combined with regular speed use is one of the most common polysubstance patterns in addiction medicine, and the alcohol component is often invisible to the user. Speed counteracts the sedative effects of alcohol, which allows the user to drink substantially more without feeling drunk. The user can consume 10 to 15 drinks in an evening while on speed and feel less drunk than they would on 4 drinks without the speed. The body, however, still receives the full alcohol load, and the cumulative harm to the liver, heart, brain, and other systems proceeds as if the drinking were happening without the stimulant masking.

The cardiovascular risk of combined speed and alcohol is substantial. Speed raises heart rate and blood pressure; alcohol on its own has variable cardiovascular effects but at heavy doses also raises the risk of arrhythmia. The combination produces sustained sympathetic activation with periods of profound dehydration, electrolyte derangement, and elevated risk of acute cardiac events. Many of the sudden deaths in young recreational stimulant users are cardiac events that occurred during or shortly after sessions of combined stimulant and alcohol use.

The alcohol use disorder that develops alongside heavy speed use is often the more serious clinical problem in the long term. Patients who present for treatment of stimulant addiction frequently have alcohol use disorder that they had not recognised because the stimulant was the more obviously problematic substance. Treatment of the speed use without addressing the alcohol use often produces relapse to both, because the underlying drive toward intoxication and the patterns of use have not changed. Integrated treatment for both substances together is the standard of care.

The come-down from speed is also a major driver of heavy drinking. Users in the 12 to 48 hours after a session of stimulant use commonly experience profound fatigue, depression, anxiety, irritability, and intense cravings. Alcohol is widely used to manage these symptoms, particularly to sleep through the come-down. The pattern of speed sessions followed by heavy drinking to recover, repeated week after week, drives the development of both alcohol use disorder and the polysubstance pattern that is more harmful than either substance alone.

Symptoms of speed addiction

The symptoms of speed addiction are described by the DSM-5 criteria for stimulant use disorder and include taking more speed than intended, persistent desire or unsuccessful efforts to cut down, spending substantial time obtaining and using, craving, failure to fulfil obligations because of use, continued use despite social or interpersonal problems, giving up activities for use, use in physically hazardous situations, continued use despite knowing harm, tolerance, and withdrawal. Meeting two or three of these criteria indicates mild stimulant use disorder; four or five indicates moderate; six or more indicates severe.

Behavioural symptoms of speed addiction include increased social and financial focus on obtaining and using the drug, decline in work and school performance despite the initial productivity boost that stimulants can provide, withdrawal from previous interests and relationships, secrecy around use, and the pattern of binge-and-crash where the user takes speed for several days, sleeps through a long crash, and then begins again. The binge-and-crash pattern is highly destructive to work, relationships, and physical health, and is one of the more recognisable features of stimulant addiction.

Physical symptoms of established speed addiction include severe weight loss, dental decay, skin sores from formication (the sensation of insects crawling under the skin, which is a stimulant-induced hallucinatory experience), persistent insomnia, and the pattern of physical decline that accompanies heavy stimulant use. Cardiovascular symptoms including chest pain, palpitations, and exercise intolerance can develop. Mental health symptoms including paranoia, anxiety, depression, and stimulant-induced psychosis often co-occur and may persist for weeks or months after the last use.

The progression from recreational use to addiction varies. Some users develop addiction within months of regular use; others use recreationally for years before crossing into compulsive use. The risk is higher in users with personal or family history of substance use disorder, in users with co-occurring mental health conditions, in users who escalate to injection or smoking routes of administration, in users who combine with alcohol or other substances, and in younger users. The progression is often invisible to the user until a specific consequence (a job loss, a health event, a relationship ending) forces recognition.

Withdrawal from speed

Withdrawal from speed begins within 12 to 24 hours of the last use and follows a characteristic pattern. The acute phase, often called the crash, includes profound fatigue, intense sleepiness, low mood, increased appetite, and severe craving. The crash typically lasts 1 to 4 days. Most users sleep for extended periods, eat heavily, and feel emotionally flat. The acute phase is uncomfortable but not generally medically dangerous in healthy adults, although patients with cardiovascular disease can experience destabilisation during the abrupt sympathetic withdrawal.

The subacute phase, lasting 1 to 4 weeks, includes persistent low mood and anhedonia (inability to feel pleasure), insomnia or disrupted sleep, anxiety, irritability, difficulty concentrating, and continued craving. This phase is when most users return to use because the symptoms are mistaken for the original baseline state and are uncomfortable. The brain’s dopamine signalling is recovering during this period but has not yet returned to normal; the experience of life without stimulants feels dim and effortful. Patience and structured support are needed.

The post-acute phase, lasting 1 to 6 months, includes lingering mood effects, occasional cravings often triggered by specific cues, and gradual recovery of cognitive function and emotional regulation. By 3 to 6 months of continuous abstinence, most users report that life feels more normal and that the cravings are infrequent and manageable. Recovery is not linear; setbacks are common and do not erase the progress already made. The longer the abstinence, the more durable the recovery becomes.

There is no specific medication for speed withdrawal in the way that buprenorphine and methadone are available for opioid withdrawal. Treatment is largely supportive and behavioural. Medications used to manage specific symptoms include antidepressants for persistent low mood (often started after several weeks of abstinence to clarify the picture), sleep medications used cautiously for short periods, and medications for co-occurring anxiety or psychotic symptoms when these persist beyond the acute withdrawal. Contingency management, cognitive behavioural therapy, and twelve-step or alternative recovery support form the evidence-based core of stimulant use disorder treatment.

Treatment for speed addiction

Treatment for speed addiction is similar to treatment for other stimulant use disorders and follows the broader principles of addiction medicine. The starting point is typically a detoxification period, which for speed alone is largely supportive (sleep, fluids, nutrition, monitoring for psychiatric complications) but may require medical supervision in users with cardiovascular disease, severe psychiatric symptoms, or combined dependence with alcohol or other substances. Most patients do not require inpatient detox specifically for speed but benefit from a structured residential or intensive outpatient setting for the early weeks of recovery.

Behavioural treatments form the core of stimulant use disorder treatment. Cognitive behavioural therapy helps the patient identify and change thought patterns and behaviours that drive use. Contingency management, which provides tangible rewards for negative drug tests, has substantial evidence for stimulant use disorder specifically and is increasingly available in clinical practice. The Matrix Model is a structured 16-week intensive outpatient program developed specifically for stimulant addiction with strong evidence behind it. Twelve-step programs including Crystal Meth Anonymous, Cocaine Anonymous, and Narcotics Anonymous provide community-based recovery support.

Treatment of co-occurring conditions is essential. Alcohol use disorder, depression, anxiety, ADHD (which often pre-dates the speed use and may have driven self-medication), trauma, and stimulant-induced psychiatric conditions all need integrated treatment. ADHD specifically requires careful management because the standard medications are themselves stimulants and the patient with both ADHD and stimulant use disorder needs a treatment plan that addresses both without driving relapse. Non-stimulant ADHD medications (atomoxetine, guanfacine, bupropion) are sometimes used in this setting.

Long-term recovery from speed addiction typically involves continued participation in a recovery community, ongoing therapy or counselling for the first year or two, and structured attention to the lifestyle factors that supported the use (sleep, nutrition, exercise, work patterns, social connections, financial stability). Recovery is gradual and the early months are the most fragile. Phuket Island Rehab provides residential addiction medicine treatment in Thailand for stimulant use disorder, alcohol use disorder, dual diagnosis cases, and the polysubstance patterns that often involve speed.

When speed use has become more than occasional

For readers who recognise themselves in the descriptions above, the practical question is what to do. The first step is honest self-assessment. Are you using speed regularly enough that it has become a routine rather than an occasional event? Are you spending more on it than you can afford? Is the come-down driving heavy drinking or other substance use? Are your relationships, work, sleep, or physical health showing the effects? Have you tried to cut down and failed? Are you using to manage feelings or situations rather than for the original recreational reasons? These questions clarify whether the use has crossed from recreational into a clinical problem.

The combination of speed and heavy drinking is one of the patterns that most often goes unrecognised by the user. The stimulant masks the alcohol effect, the user does not see the drinking as a problem because they feel fine while drinking, and the alcohol consumption escalates substantially over months. The medical harm proceeds despite the user’s perception. Patients in this combined pattern who arrive at addiction medicine treatment often describe being surprised at the alcohol component of their problem because they thought of themselves as having a speed problem only.

Treatment options include outpatient counselling, intensive outpatient programs, the Matrix Model 16-week structured stimulant addiction program, contingency management, residential rehab, and integrated treatment for any co-occurring alcohol use disorder, depression, anxiety, or ADHD. The right starting point depends on the severity of the use, the medical and psychiatric picture, the home environment, and the resources available. Phuket Island Rehab provides residential addiction medicine treatment in Thailand for stimulant use disorder, with particular focus on patients with co-occurring alcohol use disorder and the polysubstance patterns that often accompany speed addiction.

Summary

Speed is a street name for amphetamine, a central nervous system stimulant in the same broad pharmacological class as methamphetamine and prescription amphetamines such as Adderall and Dexedrine. Speed is sold as a powder of variable purity (typically 5 to 30 percent amphetamine) and is taken by snorting, swallowing, injecting, or smoking. The effects last 4 to 8 hours per dose and include alertness, euphoria, increased confidence, reduced appetite, and reduced need for sleep. Acute side effects include rapid heart rate, elevated blood pressure, jaw clenching, sweating, and at high doses anxiety, paranoia, psychosis, hyperthermia, arrhythmia, and stroke. Chronic use produces cardiovascular harm, dental decay, severe weight loss, neuropsychiatric effects, and the binge-and-crash pattern. Withdrawal is characterised by an acute crash phase (1 to 4 days), a subacute phase (1 to 4 weeks) of low mood and craving, and a post-acute phase (1 to 6 months) of gradual recovery. Heavy drinking combined with speed use is one of the most common and most under-recognised polysubstance patterns; the stimulant masks the alcohol effect, drinking escalates substantially, and alcohol use disorder develops alongside the stimulant addiction. As Dr. Ponlawat Pitsuwan summarises, “Speed users almost always have an alcohol problem by the time they reach treatment, and they almost never see it as the problem. The stimulant is what they came in for; the drinking is what we have to address before the recovery has a chance of holding.”

Frequently asked questions

What is speed made of?

Street speed is most commonly amphetamine sulfate cut with substances including caffeine, lactose, creatine, ephedrine, paracetamol, and other diluents. Typical purity is 5 to 30 percent amphetamine, with the remainder being cutting agents. Pharmaceutical-grade amphetamine (the active ingredient in Adderall, Dexedrine, and Evekeo) is more than 95 percent pure. The variable purity of street speed makes dose-titration unpredictable and contributes to overdose risk.

Is speed the same as meth?

No. Speed is amphetamine; meth is methamphetamine. The two are chemically related and pharmacologically similar but methamphetamine has a methyl group that substantially increases its central nervous system penetration. Methamphetamine is more potent, faster-acting, longer-lasting, and more neurotoxic than amphetamine. The two are often confused in popular use and both produce overlapping clinical pictures, but the substances are not the same.

How long does speed last?

The effects of a single oral or snorted dose of speed typically last 4 to 8 hours, with peak effect at 1 to 3 hours. Injected or smoked speed produces faster onset and slightly shorter duration. Methamphetamine effects last substantially longer, typically 8 to 16 hours per dose. Repeated dosing extends the effect substantially and the binge pattern often produces sleeplessness for 2 to 4 days at a time.

What are the long-term effects of speed?

Long-term effects include cardiovascular harm (elevated blood pressure, structural heart changes, increased heart attack and stroke risk), neurological changes (cognitive deficits, dopamine system alterations, elevated Parkinson disease risk), psychiatric effects (depression, anxiety, stimulant-induced psychosis), severe weight loss and malnutrition, dental decay, skin sores from formication, and the broader physical decline of chronic stimulant use.

What does speed feel like?

Speed produces feelings of alertness, energy, confidence, sociability, talkativeness, mild euphoria, reduced appetite, and reduced need for sleep. Many users describe a feeling of clarity, productivity, and emotional warmth. Physical sensations include rapid heart rate, dilated pupils, jaw clenching, sweating, and a sense of physical energy that can be uncomfortable in higher doses. The come-down brings fatigue, depression, anxiety, and craving.

How addictive is speed?

Speed has substantial addiction potential, although the addictive liability is lower than for methamphetamine, crack cocaine, or heroin. Stimulant use disorder develops in a substantial fraction of regular users, particularly those who use frequently, escalate doses, switch to injection or smoking routes, or combine with alcohol or other substances. The DSM-5 criteria for stimulant use disorder are met in many users who consider themselves recreational; the diagnosis is more common than the cultural framing suggests.

Sources

• National Institute on Drug Abuse (NIDA). Methamphetamine and prescription stimulants. https://nida.nih.gov/research-topics/methamphetamine
• U.S. Drug Enforcement Administration. Amphetamines fact sheet. https://www.dea.gov/factsheets/amphetamines
• European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Amphetamine drug profile. https://www.emcdda.europa.eu/publications/drug-profiles/amphetamine_en
• Substance Abuse and Mental Health Services Administration (SAMHSA). Stimulant use disorder treatment. https://www.samhsa.gov/substance-use/treatment/stimulants
• Australian Government Department of Health. National Drug Strategy Household Survey. https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey
• National Institute for Health and Care Excellence (NICE). Drug misuse in over 16s: psychosocial interventions. https://www.nice.org.uk/guidance/cg51

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