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Amphetamine and methamphetamine use disorder

Last reviewed: 20 Aug 2025
Last updated: 14 May 2025

Summary

Definition

Анамнез и осмотр

Ключевые диагностические факторы

  • compulsive stimulant use despite negative consequences
  • hypervigilance
  • hyperarousal
  • anxiety
  • hallucinations
  • chest pain
  • paranoia
  • increased BP
  • dilated pupils
  • tachycardia
  • skin picking, skin lesions, excoriations
  • dental decay, gum disease
  • trismus, bruxism
  • dyspnea
  • hyperthermia
Полная информация

Другие диагностические факторы

  • guarded/suspicious behavior
  • euphoria
  • alertness
  • increased concentration
  • headache
  • irritability
  • aggression
  • nausea, vomiting
  • depression
  • anorexia
  • increased motor activity
  • anhedonia
  • hemoptysis
  • pacing
  • cardiac arrhythmias
  • vasculitis
  • cerebral hemorrhage
Полная информация

Факторы риска

  • Adverse childhood events
  • history of previous stimulant use
  • selling/producing drugs, or other criminal justice system involvement
  • polysubstance use
  • history of body packing, body stuffing, or "parachuting"
  • history of illicit manufacturing or distribution
  • history of a mental health disorder
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • comprehensive blood panel
  • cardiac blood markers
  • serum creatine kinase
  • hepatitis serology
  • HIV serology
  • urine toxicology testing
  • gas chromatography/mass spectrometry of urine or blood
  • ECG
  • chest x-ray
Полная информация

Исследования, проведение которых нужно рассмотреть

  • blood toxicology testing
  • abdominal flat plate x-ray
  • abdominal CT scan
  • echocardiogram
Полная информация

Алгоритм лечения

Начальные

acute intoxication or withdrawal

Острый

nonpregnant adults and adolescents

pregnant

ПРОДОЛЖЕНИЕ

sustained remission

continued use or relapse

treatment resistant

Составители

Авторы

Timothy E. Albertson, MD, MPH, PhD, FRCP
Timothy E. Albertson

Distinguished Professor of Medicine

Anesthesiology, Pharmacology and Toxicology, and Emergency Medicine

Division of Pulmonary and Critical Care Medicine

University of California Davis School of Medicine

Sacramento

CA

Раскрытие информации

TEA declares that he has no competing interests.

Рецензенты

Alexis Ritvo, MD, MPH

Assistant Professor and Addiction Psychiatry Fellowship Director

University of Colorado School of Medicine

Aurora

CO

Раскрытие информации

AR declares that he is contracted as medical director for the Alliance for Benzodiazepines Best Practices, a nonprofit organization.

Maria Rahmandar, MD

Medical Director, Substance Use & Prevention Program

The Potocsnak Family Division of Adolescent and Young Adult Medicine

Ann & Robert H. Lurie Children's Hospital of Chicago

Assistant Professor

Northwestern University Feinberg School of Medicine

Chicago

IL

Раскрытие информации

MR declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

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

National Institute on Drug Abuse. Methamphetamine research report: what is methamphetamine? Oct 2019 [internet publication].Полный текст

Paulus MP, Stewart JL. Neurobiology, clinical presentation, and treatment of methamphetamine use disorder: a review. JAMA Psychiatry. 2020 Sep 1;77(9):959-66.Полный текст  Аннотация

Substance Abuse and Mental Health Services Administration (SAMHSA). Treatment for stimulant use disorders: updated 2021. Treatment Improvement Protocol (TIP) series, no. 33. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1999 (updated 2021).Полный текст  Аннотация

World Health Organization. Guidelines for identification and management of substance use and substance use disorders in pregnancy. Nov 2014 [internet publication].Полный текст

Siefried KJ, Acheson LS, Lintzeris N, et al. Pharmacological treatment of methamphetamine/amphetamine dependence: a systematic review. CNS Drugs. 2020 Apr;34(4):337-65.Полный текст  Аннотация

Soares E, Pereira FC. Pharmacotherapeutic strategies for methamphetamine use disorder: mind the subgroups. Expert Opin Pharmacother. 2019 Dec;20(18):2273-93. Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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