Stimulant-Related Disorders

Definition

Stimulants include a wide range of drugs such as amphetamines, methamphetamine, and cocaine. These drugs increase energy, attention, and alertness and have a wide range of effects on the body, such as increased respiration and heart rate. Stimulants may be prescribed to treat obesity, attention-deficit/hyperactivity disorder, narcolepsy, and depression. Stimulant-related disorders include stimulant intoxication, stimulant-use disorder, and stimulant withdrawal.

Symptoms

Stimulant intoxication is diagnosed when recent exposure to a stimulant causes significant problematic behavioral or psychological changes, such as euphoria, hyper-vigilance, anger, interpersonal sensitivity, auditory hallucinations, paranoid thoughts and/or repetitive movement. Physical symptoms may include abnormally fast or slow heartbeat, dilation of the pupils, elevated or lowered blood pressure, sweating or chills, nausea or vomiting, weight loss, and/or muscle weakness.

Effects such as sadness, decreased heart rate, and decreased blood pressure are generally seen only with chronic high-dose use. Other signs of stimulant-use disorder include taking stimulants in larger amounts or over a longer period of time than was originally intended, having a strong craving or urge to use stimulants, having a strong desire to cut down on stimulant use, or making unsuccessful efforts to do so, spending a lot of time obtaining, using, or recovering from the effects of stimulants, continuing to use stimulants despite problems caused by the drug in major areas of life, using the stimulant repeatedly despite its being physically hazardous, needing an increasing amount of the stimulant to become intoxicated or reach the desired effect, experiencing withdrawal symptoms when the stimulant use is discontinued.

Stimulant-use disorder may be diagnosed when the use of an amphetamine-type substance, cocaine, or other stimulant leads to significant impairment or distress within a 12-month period.

Withdrawal symptoms, though generally not as severe as with other substances, include fatigue, vivid, unpleasant dreams, insomnia or hypersomnia and/or abnormally slow heartbeat. These symptoms typically develop within a few hours to several days after stimulant use has stopped. Drug craving and an inability to feel pleasure (anhedonia) may also be present. Stimulant withdrawal is diagnosed only if the previously mentioned symptoms cause a great deal of distress or impairment to the user.

Causes

Stimulant drugs are classified as controlled substances because they have high potential for addiction and abuse. People who are exposed to cocaine or amphetamine-type stimulants can develop stimulant-use disorder in as little as one week, although the onset is not always this fast. Considerable changes in behavior can rapidly develop with stimulant-use disorder. Injecting or smoking stimulants produces an instant feeling of well-being or euphoria, but long-term use may lead to chaotic or aggressive behavior, social isolation, and sexual dysfunction. Symptoms of withdrawal from stimulants can set in following reduction of heavy and prolonged use of the substance. 

Treatments

Stimulant addiction treatment involves non-confrontational behavioral counseling that provides general information about the addiction process and specifics about the individual treatment plan. Counseling may be offered to family and significant others for general treatment information and their own self-help purposes. In addition to initial individual counseling, a treatment plan for stimulant-related disorder usually includes setting up abstinence goals, attending group therapy, encouraging family support, and establishing long-term support and follow-up.

References

Treatment Improvement Protocols (TIP) Series No. 33. Treatment for Stimulant Use Disorder. Center for Substance Abuse Treatment. Rockville MD. December 2001. 

American Psychiatric Association. Understanding Mental Disorders: Your Guide to DSM-5. 2015. American Psychiatric Publishing.

Last reviewed 09/20/2017