What to Know About Stimulant Use Disorder

Medically reviewed by David Susman, PhD

Stimulant use disorder is a new diagnosis included in the fifth edition of the "Diagnostic and Statistical Manual of Mental Disorders," or DSM-5.

Definition

Stimulant use disorder captures a range of problems associated with the use of a wide variety of stimulant drugs, including meth, cocaine, and amphetamines, but not including caffeine or nicotine.

In the previous edition of the manual, known as DSM-IV-TR, problems with these drugs were reflected in the diagnoses of stimulant abuse and stimulant dependence.

Now the diagnoses have been combined. The condition can be diagnosed as mild, moderate, or severe depending on how many symptoms the person has. There is now no difference in diagnosis or severity simply because the person has the physical aspects of dependence, even though previously the physical symptoms of tolerance and withdrawal were considered to be central to substance-related problems.

Symptoms of Stimulant Use Disorder

The diagnosis of stimulant use disorder can be given to someone who has a pattern of problematic use of amphetamine, cocaine, or other stimulants except caffeine or nicotine, leading to at least two of the following problems within a 12 month period:

• Taking more stimulants than intended

• Unsuccessful in trying to cut down or control use of stimulants, despite wanting to do so

• Spending excessive amounts of time on activities surrounding stimulant use

• Urges and cravings for stimulants

• Failing in the obligations of home, school, or work

• Continuing to use stimulants, even though it has led to relationship or social problems.

• Giving up or reducing important recreational, social, or work-related activities because of using stimulants

• Using stimulants in a way that harms your body

• Continuing to use stimulants even while knowing that it is causing or worsening a physical or psychological problem

• Tolerance to stimulants

• Withdrawal from stimulants if you don't take them

Related: What Is Withdrawal?

Dependence vs. Addiction

If you are on prescribed stimulant drugs, such as Ritalin or other medications for treating ADHD, or medicines for narcolepsy, it is possible to develop a tolerance to the medication. You may also experience withdrawal effects when discontinuing such medications.

Tolerance involves needing more to achieve the same desired effect, and withdrawal refers to the physical and mental effects a person experiences after stopping or reducing medication.

While it is possible to develop an addiction to prescribed stimulants, tolerance and withdrawal are not considered part of stimulant use disorder as long as you take medication as prescribed.

On the other hand, if you are taking more of the medication than prescribed or feeling you want to, you may be at risk for developing a stimulant use disorder.

If you start experiencing cravings for stimulants beyond the prescribed amount, discuss the situation honestly with your doctor.

If it appears you are vulnerable to developing medication addiction, it may make more sense to seek out other non-medication treatments, such as neurofeedback therapy, which is an effective non-medication approach to treating ADHD.

Related: Learn About Prescription Drug Abuse

Causes of Stimulant Use Disorder

Like other substance use disorders, stimulant use disorder does not have a single cause. Instead, various risk factors can increase a person's risk of developing the condition.

Genetic and environmental factors can increase the likelihood of a person developing a stimulant use disorder. Genetics can make some people more susceptible to addiction, and environmental and social influences can also contribute to substance misuse.

Shift Work and Stimulant Misuse

People who work nontraditional hours may develop a sleep disorder known as shift work sleep disorder. Staying awake at night, or for longer than usual, conflicts with the body's natural rhythms, and some people are more able to adapt to this than others.

Certain stimulant medications may be prescribed to treat this condition. While such medicines have a low potential for dependence and abuse, people may develop a stimulant use disorder if such medications are misused or combined with other stimulants.

There are alternatives to stimulants that can help people cope with shift work challenges. Lifestyle changes that can help include:

• Setting your alarm for the same time each day, including days off

• Getting up rather than sleeping in

• Always going to bed at the same time can help

• Exposing your eyes to sunlight as early as possible in the daytime

• Exercising during the day

Related: An Overview of Stimulants and How They're Used

Treatment for Stimulant Use Disorder

If you think you might have a stimulant use disorder, talk to your doctor. Effective treatments are available that can help you discontinue your stimulant use and remain drug-free.

Stopping stimulants can lead to withdrawal symptoms, so talk to your doctor about how to manage these symptoms before you quit.

There are no medications approved by the U.S. Food and Drug Administration to treat stimulant use disorder. Instead, the condition is typically treated with psychotherapy.

Interventions that can be effective include:

• Cognitive behavior therapy (CBT) to help people change the thinking and behavior patterns that contribute to substance use

• Motivational enhancement therapy (MET) to help increase people's motivation and commitment to change their behavior

• Contingency managment (CM) to encourage positive behaviors by offering rewards for drug abstinence

Support groups and 12-step programs can also be helpful. Lifestyle changes such as getting plenty of sleep, eating a balanced diet, and getting regular exercise can also help you on the journey to recovery.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Related: How to Find the Right Addiction Recovery Program for You