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Amphetamine and methamphetamine use disorder

最后审阅: 20 Aug 2025
最后更新: 14 May 2025

小结

定义

病史和体格检查

关键诊断因素

  • 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
完整详情

其他诊断因素

  • 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
完整详情

危险因素

  • 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
完整详情

诊断性检查

首要检查

  • 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
完整详情

需考虑的检查

  • blood toxicology testing
  • abdominal flat plate x-ray
  • abdominal CT scan
  • echocardiogram
完整详情

治疗流程

初步治疗

acute intoxication or withdrawal

急症处理

nonpregnant adults and adolescents

pregnant

持续性治疗

sustained remission

continued use or relapse

treatment resistant

撰稿人

作者

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

利益声明

TEA declares that he has no competing interests.

同行评议者

Alexis Ritvo, MD, MPH

Assistant Professor and Addiction Psychiatry Fellowship Director

University of Colorado School of Medicine

Aurora

CO

利益声明

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

Disclosures

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.

References

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.

Key articles

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].Full text

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

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).Full text  Abstract

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

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.Full text  Abstract

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

Reference articles

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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    • The ASAM/AAAP clinical practice guideline on the management of stimulant use disorder
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