Amphetamine dependence
304.40 Amphetamine Dependence
Refer, in addition, to the text and criteria for Substance Dependence (see p. 192). The patterns of use and course of Amphetamine Dependence are similar to those of Cocaine Dependence because both substances are potent central nervous system stimulants with similar psychoactive and sympathomimetic effects. However, amphetamines are longer acting than cocaine and thus are usually self-administered fewer times per day. As with Cocaine Dependence, usage may be chronic or episodic, with binges ("speed runs") punctuated by brief drug-free periods. Aggressive or violent behavior is associated with Amphetamine Dependence, especially when high doses are smoked, ingested, or administered intravenously. As with cocaine, intense but temporary anxiety resembling Panic Disorder or Generalized Anxiety Disorder, as well as paranoid ideation and psychotic episodes that resemble Schizophrenia, Paranoid Type, are often seen, especially in association with high-dose use. Withdrawal states are often associated with temporary, but potentially intense, depressive symptoms that can resemble a Major Depressive Episode. Tolerance to amphetamines develops and often leads to substantial escalation of the dose. Conversely, some individuals with Amphetamine Dependence develop sensitization, which is characterized by enhanced augmentation of an effect following repeated exposure. In these cases, small doses may produce marked stimulant and other adverse mental and neurological effects.
Specifiers
The following specifiers may be applied to a diagnosis of Amphetamine Dependence (see p. 195 for more details):
- With Physiological Dependence
- Without Physiological Dependence
- Without Physiological Dependence
- Early Full Remission
- Early Partial Remission
- Sustained Full Remission
- Sustained Partial Remission
- In a Controlled Environment