Disorders due to use of stimulants including amphetamines, methamphetamine or methcathinone

Disorders Due to Use of Stimulants including Amphetamines, Methamphetamine or Methcathinone are characterized by the pattern and consequences of use of these substances. There is a wide array of naturally occurring and synthetically produced psychostimulants other than cocaine. The most numerous of this group are the amphetamine-type substances, including methamphetamine. Prescribed stimulants including dexamphetamine are indicated for a limited number of conditions such as for Attention Deficit Hyperactivity Disorder. Methcathinone, known in many countries as ephedrone, is a synthetic potent stimulant that is a structural analogue of methamphetamine and is related to cathinone. All these drugs have primarily psychostimulant properties and are also vasoconstrictors to a varying degree. They induce euphoria and hyperactivity as may be seen in Stimulant Intoxication. They have potent dependence-producing properties, which may lead to the diagnosis of Stimulant Dependence and Stimulant Withdrawal following the cessation of use. Several Stimulant-Induced Mental Disorders are described. Stimulants are a widespread cause of hospitalization and clinic attendance, and significant causes of morbidity and mortality, often due to violence related to Stimulant-Induced Psychotic Disorder.

Diagnostic Categories that Apply to Stimulants

Following is a list of specific diagnostic categories of that apply to stimulants including amphetamines, methamphetamine or methcathinone:

• 6C46.0 Episode of Harmful Use of Stimulants including Amphetamines, Methamphetamine or Methcathinone
• 6C46.1 Harmful Pattern of Use of Stimulants including Amphetamines, Methamphetamine or Methcathinone
• 6C46.2 Stimulant Dependence including Amphetamines, Methamphetamine or Methcathinone
• 6C46.3 Stimulant Intoxication including Amphetamines, Methamphetamine or Methcathinone
• 6C46.4 Stimulant Withdrawal including Amphetamines, Methamphetamine or Methcathinone
• 6C46.5 Stimulant-Induced Delirium including Amphetamines, Methamphetamine or Methcathinone
• 6C46.6 Stimulant-Induced Psychotic Disorder including Amphetamines, Methamphetamine or Methcathinone
• 6C46.70 Stimulant-Induced Mood Disorder including Amphetamines, Methamphetamine or Methcathinone
• 6C46.71 Stimulant-Induced Anxiety Disorder including Amphetamines, Methamphetamine or Methcathinone
• 6C46.72 Stimulant-Induced Obsessive-Compulsive or Related Disorder including Amphetamines, Methamphetamine or Methcathinone
• 6C46.73 Stimulant-Induced Impulse Control Disorder Including Amphetamines, Methamphetamine or Methcathinone
• 6C46.Y Other Specified Disorder Due to Use of Stimulants including Amphetamines, Methamphetamine or Methcathinone
• 6C46.Z Disorder Due to Use of Stimulants including Amphetamines, Methamphetamine or Methcathinone, Unspecified

The first three diagnoses listed above (Episode of Harmful Use of Stimulants, Harmful Pattern of Use of Stimulants, and Stimulant Dependence) describe the pattern of stimulant use. One of these three diagnoses, or Disorder Due to Use of Stimulants, Unspecified, for cases in which the use pattern in unknown at the time of evaluation, is considered to be the primary diagnosis. That is, one of these four diagnoses should be assigned when making a diagnosis of a Disorder Due to Stimulant Use.

The remaining diagnoses reflect the impact of the pattern of stimulant use and are thus considered to be associated with one of the primary use pattern diagnoses. These diagnoses should therefore be assigned together with the relevant primary diagnosis. For example, 6C46.1/ 6C46.5 is Harmful Pattern of Use of Stimulants associated with Stimulant-Induced Psychotic Disorder, 6C46.2/6C46.70 is Stimulant Dependence associated with Stimulant-Induced Mood Disorder, 6C4Z/6C46.3 is Disorders Due to Substance Use, Unspecified associated with Stimulant Intoxication (i.e., the pattern of use in this last case is unknown).

Stimulant-induced Mental Disorders are characterized by psychological, cognitive, or behavioural symptoms that develop during or soon after stimulant intoxication or withdrawal or use or discontinuation of a psychoactive medication. The duration or severity of the symptoms is substantially in excess of the characteristic syndrome of Stimulant Intoxication or Stimulant Withdrawal.