Symptoms of Stimulant Use Disorder

Methamphetamine pipe on a table

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


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, with either a mild, moderate or severe diagnosis of stimulant use disorder being given, 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.

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.


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 to 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 lead 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

When to Be Concerned About Prescribed Stimulant Drugs

Although medication addiction can happen, if you are on prescribed stimulant drugs, such as Ritalin or other medications for treating ADHD, or medications for narcolepsy, then developing tolerance (needing more to achieve the same desired effect) and withdrawal (the physical and mental effects a person experiences after stopping or reducing a medication) are not considered part of stimulant use disorder as long as you are taking 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.

Using Stimulants to Cope With Shift Work

While many people who develop stimulant use disorder take the drugs for recreational reasons, or as an unhealthy method for weight loss which can make eating disorders worse, some people use stimulants to cope with working long or unsocial hours. Although drugs are not being used for pleasure in this context, it is still possible to develop stimulant use disorder and to become addicted.

Staying awake at night, or for longer than usual, conflicts with your body's natural rhythms, and some people are more able to adapt to this than others.

Lifestyle changes, such as always setting your alarm for the same time each day, including days off, getting up rather than sleeping in, and always going to bed at the same time can help. Exposing your eyes to sunlight as early as possible in the daytime and exercising during the day can also help.

If you make these changes and are still struggling to stay awake without drugs, it might be advisable to think about a change of job or even career. Stimulant use disorder is not only unpleasant, but can lead to serious work problems in the future, so it is better to make a change before the problem develops than to lose your job later.

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  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth edition. DSM-5. American Psychiatric Association, 2013.

By Elizabeth Hartney, BSc, MSc, MA, PhD
Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada.