Amphetamine use disorder
Last reviewed: 26 Apr 2022
Last updated: 10 Sep 2020
Summary
Definition
History and exam
Key diagnostic factors
- hypervigilance
- hyperarousal
- anxiety
- hallucinations
- chest pain
- paranoia
- increased BP
- dilated pupils
- tachycardia
- hyponatremia
- skin picking, skin lesions, excoriations
- dental decay, gum disease, "meth mouth
- trismus, bruxism
- dyspnea
- hyperthermia
More key diagnostic factors
Other diagnostic factors
- guarded/suspicious behavior
- euphoria
- alertness
- increased concentration
- headache
- irritability
- aggression
- nausea, vomiting
- depression
- anorexia
- increased motor activity
- anhedonia
- hemoptysis
- increased empathy
- pacing
- cardiac arrhythmias
- vasculitis
- cerebral hemorrhage
Other diagnostic factors
Risk factors
- history of previous stimulant misuse
- violent or criminal "lifestyle
- polysubstance misuse
- history of body packing, body stuffing, or "parachuting
- history of illicit manufacturing or distribution
- preexisting depression
More risk factors
Diagnostic investigations
1st investigations to order
- urine toxicology testing
- gas chromatography/mass spectrometry of urine or blood
- ECG
- serum sodium
- serum creatine phosphokinase
- abdominal x-ray
More 1st investigations to order
Investigations to consider
- blood toxicology testing
- echocardiogram
More investigations to consider
Treatment algorithm
ACUTE
acute toxic exposure via ingestion
ONGOING
chronic misuse and dependence
Contributors
Authors
Timothy E. Albertson, MD, MPH, PhD, FRCP
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
Disclosures
TEA declares that he has no competing interests.
Peer reviewers
Richard J. Geller, MD, MPH, FACP
Associate Clinical Professor of Medicine
University of California San Francisco School of Medicine
San Francisco
CA
Disclosures
RJG declares that he has no competing interests.
Differentials
- Cocaine misuse
- Malignant hypertension
- Anticholinergic drug exposure
More DifferentialsGuidelines
- Guidelines for identification and management of substance use and substance use disorders in pregnancy
- Substance misuse detainees in police custody: guidelines for clinical management (fourth edition)
More GuidelinesPatient leaflets
Amphetamine-use disorder
More Patient leaflets
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