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Dr. Asra Hameed
Pharm.D (JUW)
asra_hameed1@hotmail.com
 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
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.
 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.
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 )
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.
 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.
 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.

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Diagnosis and treatment of amphetamine abuse

  • 1. Dr. Asra Hameed Pharm.D (JUW) asra_hameed1@hotmail.com
  • 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 )
  • 6.
  • 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.