Diagnosis and treatment of amphetamine abuse
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The document discusses amphetamine-related psychiatric disorders as per the DSM-5 and outlines the diagnostic criteria for amphetamine dependence. It details symptoms used for diagnosis, treatment goals, and various treatment options, including hospitalization, therapy, and medication. The document also highlights the severe risks associated with sustained amphetamine use, including potential overdose and difficulty in treatment adherence.
Diagnosis and treatment of amphetamine abuse
- 1. Dr. Asra Hameed Pharm.D (JUW) [email protected]
- 2. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) describes the following 11 amphetamine-related psychiatric disorders: Amphetamine-induced anxiety disorder Amphetamine-induced bipolar disorder Amphetamine-induced depressive disorder Amphetamine-induced psychotic disorder Amphetamine-induced sexual dysfunction Amphetamine-induced sleep disorder Amphetamine intoxication Amphetamine intoxication delirium Amphetamine withdrawal Amphetamine-induced obsessive-compulsive and related disorder Unspecified stimulant-related disorder
- 3. How Is Amphetamine Dependence Diagnosed? To diagnose amphetamine dependence, your doctor may: ask you questions about how much and how long you’ve been using amphetamines take blood tests to detect amphetamines in your system perform a physical exam and order tests to detect health problems caused by your amphetamine abuse Check for the following symptoms. You may have amphetamine dependence if you’ve experienced three or more within the same 12-month period.
- 4. Build Up of Tolerance You’ve built up a tolerance if you need larger doses of amphetamines to achieve the same high. Mental Health Is Affected Withdrawal is characterized by depression, anxiety, fatigue, paranoia, aggression, and intense cravings. You may need to use a similar drug to relieve or avoid amphetamine withdrawal symptoms. Inability to Cut Down or Stop You have wanted to cut down or stop using amphetamines but have been unsuccessful. You continue to use amphetamines even though you know thye’re causing persistent or recurrent physical or psychological problems. Lifestyle Changes You miss out on or don’t go to as many recreational, social, or work activities because of your amphetamine use.
- 5. Stimulant Use Disorder (Amphetamine-Type) 304.40 This diagnosis is based on the following findings: Abused "crystal meth" (methamphetamine) in the past 5 years ( still present ) Greater use of a stimulant (amphetamine-like) drug than intended ( still present ) There is a persistent desire or unsuccessful efforts to cut down or control use of a stimulant (amphetamine-like) drug ( still present ) A great deal of time is spent in obtaining a stimulant (amphetamine-like) drug, using it, or recovering from its effects ( still present ) Craving, or a strong desire or urge to use a stimulant (amphetamine-like) drug ( still present ) Recurrent use of a stimulant (amphetamine-like) drug resulting in a failure to fulfill major role obligations at work, school or home ( still present ) Continued use of a stimulant (amphetamine-like) drug despite having persistent social problems that it made worse ( still present ) Important social, occupational, or recreational activities are given up or reduced because of use of a stimulant (amphetamine-like) drug ( still present ) Developed tolerance to a stimulant (amphetamine-like) drug ( still present ) Developed withdrawal symptoms to a stimulant (amphetamine-like) drug ( still present )
- 7. Treatment Goals Goal: stop stimulant use because using more than intended. Goal: stop stimulant use because it is getting out of control. Goal: stop stimulant use in order to prevent wasting so much time using a stimulant, or recovering from its use. Goal: stop stimulant use in order to decrease craving for this stimulant. Goal: stop stimulant use so that she can better fulfill major role obligations at work, school or home. Goal: stop stimulant use in order to improve the stimulant-related social problems. Goal: stop stimulant use in order to increase time spent on important social, occupational, or recreational activities. Goal: stop stimulant use in hazardous situations in order to prevent injury. Goal: stop stimulant use in order to prevent further worsening of current stimulant-related physical or emotional problems. Goal: stop stimulant use because tolerance to this stimulant is developing. Goal: stop stimulant use because withdrawal symptoms are developing.
- 8. Treatments for amphetamine dependence may include a combination of the following. Hospitalization If you experience strong drug cravings, you may find it easier to go through amphetamine withdrawal in a hospital setting. This setting may also help if you have negative mood changes, including aggression and suicidal behavior. Therapy Individual counseling, family therapy, and group therapy can help you: identify why you use drugs resolve problems that led you to use drugs repair relationships with your family learn ways to avoid amphetamine use discover activities you enjoy in place of drug use get support from others who have been amphetamine users because they understand what you’re going through (usually in a 12-step drug treatment program) Medication Your doctor may prescribe medication to ease severe symptoms of withdrawal. Your doctor may prescribe methylphenidate if you have severe intravenous amphetamine dependence. Fluoxetine may decrease your cravings. Imipramine may help you stick with your treatment for amphetamine dependence. Your doctor may prescribe other medications to help relieve symptoms of anxiety, depression, and aggression.
- 9. Consistent amphetamine dependence and abuse can lead to: overdose brain damage (you may notice symptoms that resemble Alzheimer’s disease, epilepsy, or stroke) death Amphetamine dependence can be difficult to treat. You may relapse after treatment and start using amphetamines again. Participating in a 12-step drug treatment program and getting individual counseling can reduce your chances of relapse. Drug education programs can reduce the odds for new amphetamine use or a relapse. Counseling for emotional problems and family support can also help. However, none of these have been proven to prevent amphetamine use in everyone.