a moderate or severe amphetamine, cocaine, or other stimulant use disorder, reflecting
the fact that amphetamine, cocaine, or other stimulant withdrawal can only occur in the
presence of a moderate or severe amphetamine, cocaine, or other stimulant use disorder.
It is not permissible to code a comorbid mild amphetamine, cocaine, or other stimulant use
disorder with amphetamine, cocaine, or other stimulant withdrawal.
Diagnostic Features
The essential feature of stimulant withdrawal is the presence of a characteristic with-
drawal syndrome that develops within a few hours to several days after the cessation of
(or marked reduction in) stimulant use (genera lly high dose) that has been prolonged (Cri-
terion A). The withdrawal syndrome is char acterized by the development of dysphoric
mood accompanied by two or more of the fo llowing physiological changes: fatigue, vivid
and unpleasant dreams, insomnia or hypers omnia, increased appetite, and psychomotor
retardation or agitation (Crite rion B). Bradycardia is often present and is a reliable mea-
sure of stimulant withdrawal.
Anhedonia and drug craving can often be pres ent but are not part of the diagnostic cri-
teria. These symptoms cause clinically signif icant distress or impairment in social, occu-
pational, or other important areas of functioning (Criterion C). The symptoms must not be
attributable to another medica l condition and are not better explained by another mental
disorder (Criterion D).