238 Amphetamine Intoxication (282.89)

DSM-IV-TR criteria

A. Recent use of amohetamine or a related substance (e.g. methylphenidate).

B. Clinically significant maladaptive behavior or psychological changes (e.g. euporia or affective blunting; changes is sociability; hypervigilance;interpersonal sensitivity; anxiety; tension, or anger; stereotyped behaviors; impaired social or occupational functioning) that developed during, or shortly after, use of amphetamine or a related substance.

C. Two or more of the following, developing during, or shortly after, use of amphetamine or a related substance:

• tachycardia or bradycardia
• pupillary dilation
• elevated or lowered blood pressure
• perspiration or chills
• nausea or vomiting
• evidence of weight loss
• psychomotor agitation or retardation
• muscle weakness, respiratory depression, chest pain, or cardiac arrhythmias
• confusion, seizures, dykinesias, dystonias, or coma

D. The symptoms are not due to a general medical condition and are not better accounted for by another disorder

Specify if:

• With Perceptual Disturbances
• This specifier may be noted when hallucinations with intact reality testing or auditory, visual, or tactile illusions occur in the absence of a delirium. Intact reality testing means that the person knows that the hallucinations are induced by the substance and do not represent external reality. When hallucinations occur in the absence of intact reality testing, a diagnosis of Substance-Induced Psychotic Disorder, With Hallucinations, should be considered

Associated Features

After being intoxicated by recent use, there will be psychological and behavioral changes that will be significantly noticeable. Psychologically there may be some impairments of sociability and judgement There may be hostile or aggressive behavior depending on how much amphetamines were ingested. Hallucinations that are auditory or visual may occur and paranoia is also a possibility. It is actually fairly similar to schizophrenia . Hyperactivity and hypersexuality is also a common feature. The patient may have delusions such as feeling like there are insects crawling under their skin. The person may have issues with the law naturally due to the illegal nature of amphetamines. Their family and work life may suffer as well. There may be a presentation of very dull feelings along with sadness and social withdrawal. Fatigue, cardiac arrythmia, elevated or lowered blood pressure, dialation of the pupils, nausea or vomiting, or sweating and chills are some of the other issues that will probably show in the individuals during, or shortly after, they are intoxicated. Since amphetamines are highly addicting, it is very common for individuals to become addicted in a fairly short amount of time. This, of course, will ultimately lead to amphetamine dependence.

Child vs. adult presentation

Typically, it is rare for children to abuse amphetamines. It is much more common for children to accidentally ingest it than abuse it. For those rare cases of child amphetamine abuse, they will show similar symptoms. Adolescents and young adults, however, are among the highest users today.

Gender and cultural differences in presentation

Men are much more likely to abuse amphetamines than women. There is information that supports men enjoy amphetamines more than women due to the male body releasing 3 times as much dopamine. Different cultures that abuse amphetamines will show the same symptoms as Americans.

Epidemiology

Amphetamine intoxication can happen in any level of society and usually are used by individuals between the ages of 18 to 30 years old. It’s reported that about 8.8 million Americans alone will be intoxicated by some form of amphetamine in some point during their lifetimes. One of the most common, heavily abused amphetamine is methamphetamine. Reports have shown that a 30% increase in emergency room cases involving the use of methamphetamine from 1999 to 2000 alone, and the rates continue to climb.

Etiology

There is more supported evidence that this is environmentally influenced as opposed to biologically. Reseach has found that most use and abuse of amphetamines was started with the intent to aid them with weight loss. Others have been introduced through illegal drug experimentation. Low SES shows a high correlation with more intravenous use, which causes a quicker dependence on the amphetamine.

Empirically supported treatment

• There is currently not a widely supported treatment for amphetamine abuse. One thing that is agreed upon is that it is not a good idea to treat amphetamine abuse with different medications. Since a prescribed medication may have caused the problem in the first place, it is easy to see prescribing more is not a smart idea. There is a little evidence that supports the drugs fluoxentine and imipramine as helpful alternatives, but more research is needed.

• — Amphetamines cause a lack of saliva that causes teeth to decay as a consiquence. See video http://www.youtube.com/watch?v=j5SXjgrJITY