566 Substance-Related and Addictive Disorders
depending on dosage and metabolism. Hair sampl es can be used to detect presence of am-
phetamine-type stimulants for up to 90 days. Other laboratory findings, as well as physical
findings and other medical conditions (e.g., weight loss, malnutrition; poor hygiene), are
similar for both cocaine and amphet amine-type stimulant use disorder.
Functional Consequences of  Stimulant Use Disorder 
Various medical conditions may occur dependin g on the route of administration. Intrana-
sal users often develop sinusitis, irritation, bl eeding of the nasal mucosa, and a perforated
nasal septum. Individuals who smoke the drugs are at increased risk for respiratory prob-
lems (e.g., coughing, bronchitis, and pneumonitis). Injectors have puncture marks and
“tracks,” most commonly on their forearms. Ri sk of HIV infection increases with frequent
intravenous injections and unsafe sexual acti vity. Other sexually transmitted diseases,
hepatitis, and tuberculosis and other lung infections are also seen . Weight loss and mal-
nutrition are common. 
Chest pain may be a common symptom during stimulant intoxication. Myocardial in-
farction, palpitations and arrhythmias, sudden  death from respiratory or cardiac arrest,
and stroke have been associated with stimulant use among young and otherwise healthy
individuals. Seizures can occur with stimulant use. Pneumothorax can result from per-
forming Valsalva-like maneuvers done to better absorb inhaled smoke. Traumatic injuries
due to violent behavior are common among in dividuals trafficking drugs. Cocaine use is
associated with irregularities in placental bl ood flow, abruptio placentae, premature labor
and delivery, and an increased prevalence of infants with very low birth weights.