Stimulant Use Disorder

To be diagnosed with stimulant use disorder, an individual must demonstrate a pattern of problematic use with a stimulant other than caffeine or nicotine, which leads to at least two of the following criteria within 12 months:

• Frequent urges or cravings for stimulants
• A desire to cut back or stop using stimulants but extreme difficulty doing so
• Disruption of school, work, or home life due to the use of stimulants
• Continued stimulant use despite the disruption of social life and relationships
• Building tolerance to stimulants, requiring more for the same impacts 
• Avoiding regular routines, habits, or obligations due to stimulant use
• Physical and psychological withdrawal symptoms when not using stimulants
• Using stimulants in a harmful, non-medically indicated way
• Engaging in high-risk behaviors due to stimulant use 
• Using stimulants despite recurring physical or psychological problems that may be attributed to, or exacerbated by, the use of stimulants

The disorder may be specified as mild, moderate, or severe by the number of symptoms present. 

• Mild: The presence of two or three symptoms
• Moderate: The presence of four to five symptoms
• Severe: The presence of six or more symptoms

Depending on the type of stimulant used, a person with stimulant use disorder may also experience the following physiological and cognitive symptoms:

• Aggression
• Hyperactivity
• Anxiety or panic attacks
• Poor impulse control
• Sweating
• Pain in the chest
• Paranoia 
• Hallucinations
• Delusions
• Itching 
• Periods of depression
• Sexual dysfunction
• Poor sleep
• Significant weight loss
• Anemia
• Breathing problems

As with other substance use disorders, the cause of stimulant use disorder may include biological and environmental factors that contribute to the susceptibility of an individual to develop this disorder. 

Risk factors

Below are some of the risk factors² that may contribute to the development of stimulant use disorder: 

• Some begin using stimulant drugs for weight loss or to improve work or school performance. Shift workers can be at greater risk of using stimulants to stay awake at late hours. 
• Childhood trauma, including exposure to community violence, abuse in the home, or unstable home environment, can be predictors of stimulant use in teens.
• People with other mental health conditions like bipolar disorder, antisocial personality disorder (ASPD),³ or other substance use disorders⁴ may be at a higher risk of stimulant use disorder. 
• Smoking and intravenous use of stimulants can quickly escalate use and may lead to addiction.

Treatment for stimulant use disorder includes the initial detoxification stage, successfully reducing or eliminating stimulant use, as well as support and follow-up care for long-term treatment. 

Medication 

There are no FDA-approved medications currently approved for the treatment of stimulant use disorder. Medications may be used to treat co-occurring mental health conditions, such as depression or anxiety. 

Consult a healthcare provider before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis. 

Other treatment options

Some more severe cases of stimulant use disorder may require initial detoxification in a medical facility or a short-term stay in a detox clinic. Side effects of withdrawal can be intense for those who have used substances heavily for an extended period, and medical interventions may help them manage unpleasant symptoms, such as nausea, depression, and anxiety. 

Support groups, including 12-step programs, may also be helpful for substance use disorders. Social support can be a tool for creating new healthy habits. Family therapy may also help in this way, as a therapist can offer guidance on the best ways to support the person attempting to avoid stimulants. 

Self-care

A therapist treating clients with substance use disorders may work with them on establishing lifestyle habits that can regulate mood and support a healthy body. These habits may include the following: 

• Establishing a consistent sleep routine
• Avoiding situations and people associated with using stimulants
• Eating nutritious, well-balanced meals
• Getting regular, moderate exercise 
• Becoming involved in interesting or enjoyable hobbies  
• Maintaining a strong, healthy social group

The clinically recommended treatment for substance use disorders over the long term is to participate in psychotherapy, most commonly CBT or contingency management (CM). A licensed therapist can help clients address old negative patterns, establish new healthy habits, and learn stress management strategies to manage challenging emotions. 

Specialized therapy like CBT or CM for substance use may not be available in some geographical areas. In other areas, there may not be a diverse selection of providers. Online therapy can be a solution, as it offers accessibility and a significant variety of therapists to anyone with an internet connection. Online therapy platforms like BetterHelp can match you with a licensed therapist that clients can meet with via phone, video, or live chat sessions. 

Below are several other resources individuals can visit to find out more about stimulant use disorder or find support: 

• US Department of Veteran Affairs: Stimulant Use Disorder Resource Page
• Substance Abuse and Mental Health Services Administration (SAMHSA)
• United Nations Office on Drugs And Crime (UNODC): Treatment Of Stimulant Use Disorders

For those experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7. Please also see our Get Help Now page for more immediate resources.

A systematic review completed in 2020 examined various treatment methods for stimulant use disorder. Researchers found that contingency management continues to be the most evidence-based practice for treatment and that further research into using pharmacological treatments to supplement therapy practices is needed. 

One study, conducted by researchers from Johns Hopkins Bloomberg School of Public Health and the National Institute on Drug Abuse (NIDA), showed that reducing cocaine or methamphetamine use from five or more days to one to four days a month led to lower drug cravings, less depression, and fewer drug-related difficulties. This finding indicates that cutting down on stimulant use, along with quitting entirely, can be an important step in treating addiction.

A 2021 study investigating the use of antipsychotics to manage psychosis during intoxication from methamphetamines found that while this treatment may be warranted in some instances, the research into this method is not robust enough to indicate this as a consistent treatment for stimulant use disorder.

Below are several statistics on stimulant use disorder:

• 3.7% of people (around 10.3 million) in the United States aged 12 and over misused stimulant medications in the past year (reported in 2020). Of those, a third used only cocaine, a third misused prescription stimulants, and one in seven used only methamphetamine.
• The population with the highest reports of substance use disorder was the 18 to 25-year-old category.
• Seven out of 10 (around 20.9 million) adults who have ever had a substance use problem reported themselves as “recovering” or “in recovery".