Amfetamine and methamphetamine use disorder

Diagnostic and statistical manual of mental disorders, fifth edition, text revision (DSM-5-TR)[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edition, text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.​​

Amfetamine and methamphetamine use disorders fall under the heading of stimulant use disorders in DSM-5-TR. Stimulant use disorder is defined as a pattern of amfetamine-type substance, cocaine, or other stimulant use leading to clinically significant impairment or distress, defined by presence of at least 2 of 11 symptoms during a 12-month period:[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edition, text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.

• Using larger amounts of stimulant or over a longer period than was intended

• Persistent desire to cut down or unsuccessful efforts to control use

• Great deal of time spent obtaining, using, or recovering from use

• Craving, or a strong desire or urge to use the stimulant

• Inability to fulfil major role obligations at work, school, or home due to recurrent stimulant use

• Continued use despite recurrent or persistent social or interpersonal problems caused or exacerbated by the effects of stimulant use

• Giving up or reducing social, occupational, or recreational activities due to stimulant use

• Recurrent stimulant use in physically hazardous situations

• Continued stimulant use despite knowledge of having a persistent or recurrent physical or psychological problem caused or exacerbated by its use

• Tolerance (a need for markedly increased amounts; markedly diminished effect with continued use of the same amount)

• Withdrawal as manifested by the characteristic withdrawal syndrome for the stimulant, or use of the stimulant (or a closely related substance) to relieve or avoid withdrawal symptoms.

Severity is categorised as mild (presence of 2-3 symptoms), moderate (4-5 symptoms), or severe (6 or more symptoms). It should be specified if the individual is in an environment where access to the stimulant is restricted.[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edition, text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.

Remission is categorised as:[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edition, text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.

• In early remission: where none of the criteria for stimulant use disorder have been met for at least 3 months but for less than 12 months (with the exception of craving, or a strong desire or urge to use the stimulant), but full criteria for the stimulant use disorder were previously met.

• In sustained remission: where none of the criteria for stimulant use disorder have been met at any time during a period of 12 months or longer (with the exception of craving, or a strong desire or urge to use the stimulant), but full criteria for the stimulant use disorder were previously met.