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ConditionsSTIM

Stimulant Use Disorder

Cocaine, methamphetamine, prescription stimulants used in ways not prescribed.

What to know. No FDA-approved medication for stimulant use disorder — however, off-label medications can be used effectively to reduce use.

First-line care
Cognitive behavioral therapy, with off-label medications when helpful

What major medical bodies recommend first when this condition is the focus of care.

Off-label medications can be used in addition to behavioral therapy.


Symptoms

How clinicians think about it.

The DSM-5 lists eleven signs grouped into four areas. The number that fit in the past year suggests a severity — not a verdict.

LOSS OF CONTROL · 4
  • ·Using more than meant to
  • ·Wanting to cut down
  • ·Time spent using
  • ·Cravings
SOCIAL IMPACT · 3
  • ·Trouble at work / school
  • ·Relationship strain
  • ·Giving up activities
RISKY USE · 2
  • ·Risky situations
  • ·Using despite harm
PHYSICAL · 2
  • ·Tolerance
  • ·Withdrawal

Risks worth knowing

Plainly: what makes this condition dangerous.

High concern

Cardiovascular events — heart attack, stroke

High concern

Psychosis with heavy or prolonged use

Moderate concern

Severe sleep disruption and depression on stopping


Treatment options

What's offered, and what we usually start with.

FIRST-LINE — RECOMMENDED FIRST
01
Cognitive behavioral therapyFirst-line

Helps with triggers and relapse prevention.

02
Off-label medication trials

Bupropion, naltrexone, topiramate — modest evidence in select cases.


Common questions

Asked often, answered briefly.

Stimulants work very differently in the brain. Decades of trials haven't found a clearly effective medication. CBT and off-label medications can still help reduce use.

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This is not a diagnosis. These tools are for reflection and conversation. A clinician's evaluation is the only way to confirm a substance use disorder. If you are in crisis, call or text 988.
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