Methamphetamine use disorder
Intoxication has rapid onset of high energy, alertness, elation (euphoria), and activation of the sympathetic nervous system, which may include increased libido. Decreased appetite, weight loss, sleep disturbance, and dry mouth may occur. Cognitive and personality changes may occur as well as psychiatric symptoms such as hallucinations, paranoia, heightened emotions, aggressiveness, anxious worry, panic, irritability, and impairment of executive function and memory, which can increase risky behaviors. Clinical findings may also include fast talking, impulsive behavior, itching, teeth grinding, dilated pupils, and gastrointestinal symptoms of nausea, vomiting and diarrhea. Chronic users may present with severe dental caries and periodontal disease due to the sympathomimetic effects of the drug causing xerostomia and bruxism, leading to tooth breakage and loss (termed "meth mouth").
Methamphetamine is identified as a Schedule II medicine according to the Controlled Substances Act. Methamphetamine use disorder, or amphetamine-type substance use disorder, falls under the category of stimulant use disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and combines the former concepts of methamphetamine abuse and methamphetamine dependence into a single diagnostic concept ranging from mild to severe.
Criteria for diagnosis of methamphetamine use disorder include increasing use, urges or craving, and time spent on methamphetamine activities; failure to stop use; interference with work, home, school, or previously enjoyed activities; awareness of risky behaviors; and impaired personal relationships related to methamphetamine use. The individual may experience a growing tolerance and onset of withdrawal symptoms.
Methamphetamine use disorder has been associated with primary mood disorder, primary anxiety disorder, depressive disorders, ADHD, and primary psychotic disorder. Use of methamphetamine increases risk of tachycardia and heart disorder. Heightened sexuality in meth users has been associated with risky sexual practices, multiple intimate partners, increased incidence of sexually transmitted diseases, and pregnancy.
Methamphetamine use can result in acute and chronic neuropsychiatric complications. It can cause a dangerous toxic state (sympathomimetic toxicity) when used in unsafe doses, and overdose can be life-threatening. Combined with ethanol, methamphetamine manifests more intense adverse effects. In combination with opioids (speedballing), it can cause severe reactions. Methamphetamine toxicity can lead to heart arrhythmias, intracranial hemorrhage, rhabdomyolysis, septic shock with multiple organ failure, and death.
T43.625A – Adverse effect of amphetamines, initial encounter
F15.20 – Other stimulant dependence, uncomplicated
699449003 – Methamphetamine abuse