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Diagnosis
Assessment of Stimulant Use Disorder
Note: Amphetamine-type stimulant (ATS) Use Disorder and Cocaine Use
Disorder are discussed separately because of the different pharmacological
mechanisms of action, which may impact the effectiveness of
pharmacotherapies. ATS include amphetamine and its derivatives,
including methamphetamine.
Initial Assessment
1. When assessing patients for StUD, the first clinical priority should
be to identify any urgent or emergent biomedical or psychiatric signs
or symptoms, including acute intoxication or overdose, and provide
appropriate treatment or referrals (CC-S).
Non-acute issues and complications of stimulant use include but are
not limited to:
• General complications, including weight change (eg, body mass index [BMI]) and
deficits in hygiene
• Cardiovascular complications, such as hypertension, arrhythmia, ischemia,
pulmonary hypertension, and heart failure
• Dental complications, such as poor dentition, dental caries, and abscesses
• Dermatologic complications, such as picking, neurodermatitis, cellulitis, abscesses,
and other skin or soft tissue infections
• Hepatic complications, such as drug-induced hepatitis
• Infectious complications, including sexually transmitted infections (STIs)
(eg, HIV, hepatitis C virus [HCV])
• Neurologic complications, such as involuntary movement disorders, rigidity, tremor,
seizures, stroke, and cognitive impairment (eg, deficits in memory and/or attention)
• Nutritional deficits, such as malnutrition, cachexia, and sequalae involving specific
vitamin deficiencies
• Oropharyngeal complications, such as teeth grinding and jaw clenching, earache,
headache, and facial pain
• Renal complications, such as acute kidney injury and chronic kidney disease
• Rhinologic complications such as rhinitis, mucosal atrophy, rhinorrhea, anosmia,
oronasal fistula, and septum perforation
• Sexual dysfunction (use trauma-sensitive screening practices)
