Stimulant Intoxication 567
somnia, nervousness, and other unpleasant side effects. Cocaine users often use alcohol,
while amphetamine-type stimulant users ofte n use cannabis. Stimulant use disorder may
be associated with posttraumatic stress diso rder, antisocial personality disorder, atten-
tion-deficit/hyperacti vity disorder, and gambling di sorder. Cardiopulmonary problems
are often present in individuals seeking treatm ent for cocaine-related problems, with chest
pain being the most common. Medical problems occur in response to adulterants used as
“cutting” agents. Cocaine users who ingest co caine cut with levamisole, an antimicrobial
and veterinary medication, may experience agranulocytosis and febrile neutropenia. 
Stimulant Intoxication
Diagnostic Criteria
A. Recent use of an amphetamine-type substance, cocaine, or other stimulant.
B. Clinically significant problematic behavioral or psychological changes (e.g., euphoria
or affective blunting; changes in sociability; hypervigilance; interpersonal sensitivity;
anxiety, tension, or anger; stereotyped behaviors; impaired judgment) that developed
during, or shortly after, use of a stimulant. 
C. Two (or more) of the following signs or symptoms, developing during, or shortly after,
stimulant use: 
1. Tachycardia or bradycardia.
2. Pupillary dilation.
3. Elevated or lowered blood pressure.
4. Perspiration or chills.
5. Nausea or vomiting.
6. Evidence of weight loss.
7. Psychomotor agitation or retardation.
8. Muscular weakness, respiratory depression , chest pain, or cardiac arrhythmias.