Methamphetamine use disorder: Epidemiology, clinical manifestations, course, assessment, and diagnosis
- Martin Paulus, MD
Martin Paulus, MD
- Adjunct Professor of Psychiatry
- University of California San Diego
Methamphetamine is a psychostimulant that causes the release and blocks the reuptake of monoamine neurotransmitters, including dopamine, norepinephrine, and serotonin. Methamphetamine is most often smoked or snorted and is less commonly injected or ingested orally.
Clinical manifestations of methamphetamine use include increased energy and alertness, euphoria, sympathetic nervous system activation, decreased need for sleep, weight loss, dry mouth leading to tooth decay, and chronic adverse mood and cognitive changes, including irritability, anxiety, aggression, panic, suspiciousness, and/or paranoia, hallucinations, executive dysfunction, and memory impairment.
The psychiatric diagnoses, methamphetamine abuse and methamphetamine dependence, in DSM-IV-TR were replaced by one diagnosis, amphetamine-type substance use disorder, in DSM-5 listed under the broader category of stimulant use disorders . Although the crosswalk between DSM-IV and DSM-5 disorders is imprecise, methamphetamine dependence is approximately comparable to amphetamine-type substance use disorder, moderate to severe subtype, while methamphetamine abuse is similar to the mild subtype.
This topic describes the epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis of methamphetamine use disorder. The epidemiology, pathogenesis, clinical manifestations, course, assessment, diagnosis, and treatment of other stimulant use disorders are discussed separately. (See "Cocaine use disorder in adults: Epidemiology, pharmacology, clinical manifestations, medical consequences, and diagnosis".)
Methamphetamine use varies geographically, but overall, amphetamine-type stimulants, which include methamphetamine, are the fastest rising drug of abuse worldwide [2,3]. Amphetamine-type stimulants have become the second most widely used class of illicit drugs worldwide, with use increasing in Asia and Oceania .
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- Health consequences
- - Mortality
- - Cardiovascular disease
- - Risky sexual behaviors
- CLINICAL MANIFESTATIONS
- Cognitive effects
- Abstinence syndrome
- DSM-5 criteria
- Comorbid conditions
- Differential diagnosis
- - Psychosis
- - Anxiety