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Your Clinical Guide to Diagnosing and Managing Other Stimulant Abuse

Stanley Efrem

Oct 20, 2025

Stimulant abuse affects 73 million people worldwide—more than double the number struggling with opioid use [12]. Your Clinical Guide to Diagnosing and Managing Other Stimulant Abuse (F15.10) addresses this critical clinical reality facing mental health professionals today.

F15.10 (Other stimulant abuse, uncomplicated) represents a complex diagnostic category that includes amphetamine type substance use disorder, mild [2]. This code covers clients whose symptoms frequently mirror primary psychiatric disorders. Accurate assessment becomes particularly challenging when symptoms overlap significantly with conditions like bipolar disorder or schizophrenia.

The numbers tell a striking story. Approximately 34.2 million people use amphetamines, 20.6 million use ecstasy, and 18.2 million use cocaine [12]. Yet only one in six people with substance use disorders received treatment in 2016—a proportion that remains troublingly low [12].

Your clinical expertise in identifying, documenting, and initiating appropriate treatment directly impacts client recovery outcomes. This guide equips you with practical frameworks for diagnosing and managing other stimulant abuse cases effectively.

You'll learn to recognize key behavioral indicators that distinguish stimulant abuse from other conditions. The guide covers differentiating F15.10 from primary psychiatric disorders—a skill essential for appropriate treatment planning. Evidence-based interventions specific to this challenging yet treatable condition complete your clinical toolkit.

Understanding F15.10: The Scope of 'Other Stimulant Abuse'

F15.10 encompasses far more substances than most clinicians recognize initially. The diagnostic code excludes cocaine-related disorders (F14) but covers synthetic street drugs through diverted prescription medications [2]. Understanding what constitutes "other stimulants" becomes your first clinical priority for effective client care.

Synthetic cathinones, prescription misuse, and khat explained

Synthetic cathinones—marketed as "bath salts"—present serious concerns within F15.10 cases. These cathinone derivatives come from the primary psychoactive component in khat plants [3]. Since gaining popularity in the mid-2000s, synthetic cathinones create effects similar to amphetamines, methamphetamines, and MDMA [3]. Their toxicity profile features sympathomimetic effects plus psychosis, agitation, and violent behavior [3].

Mephedrone and methylenedioxypyrovalerone (MDPV) dominate synthetic cathinone abuse, though approximately 30 variants exist [3]. Their marketing strategy creates particular danger—sold as "plant food" or "bath salts" with "not for human consumption" labels to avoid FDA regulations [3].

Prescription stimulant misuse forms another major F15.10 category. 25.3% of U.S. adults prescribed stimulants report misuse, with 9% meeting use disorder criteria [4]. Amphetamine-based medications show higher misuse rates (3.1 times) and use disorder rates (2.2 times) compared to methylphenidate-based medications [4]. Primary motivation centers on cognitive enhancement—concentration help (56.3%) and studying (21.9%) [5].

Khat remains frequently overlooked in F15.10 diagnoses. This East African and Arabian Peninsula evergreen contains cathine and cathinone alkaloids [3]. Hospital settings report khat as the second most common psychostimulant in medical records [18]. Users chew it like tobacco, producing mild amphetamine-like effects: increased alertness, blood pressure, heart rate, and decreased appetite [3].

Who presents with F15.10? Client profiles beyond expectations

F15.10 clients challenge typical substance user stereotypes. Prescription stimulant misuse rates vary dramatically by demographics. Women aged 18-25 show 36.8% prevalence versus men aged 35-64 at 22% [4]. Prescription stimulant dispensing among women aged 35-64 jumped from 1.2 million in early 2019 to 1.7 million by late 2022 [4].

Synthetic cathinones attract users seeking "legal" alternatives to traditional stimulants [3]. You may encounter clients across socioeconomic backgrounds who started using these substances believing they were safer alternatives.

Khat users typically maintain cultural connections to regions where use is normalized. 5-10 million people worldwide use khat, mainly in Yemen, Somalia, and Ethiopia [19]. Global khat distribution has expanded usage beyond traditional cultural contexts [19].

Co-occurring conditions appear frequently in F15.10 cases. Among methamphetamine users, 57.7% report mental illness, with 25% reporting serious mental illness [8]. Your assessments should recognize stimulant use as potential self-medication for existing symptoms [19].

Recognizing the Signs: Behavioral and Physical Indicators of Abuse

Identifying F15.10 in your practice requires careful observation of specific behavioral and physical manifestations. Early recognition becomes essential as these indicators often emerge gradually.

Extreme mood shifts and insomnia-linked paranoia

Stimulant users display distinct mood patterns that provide critical diagnostic clues. Initial euphoria, excitement, and heightened alertness resemble manic episodes [9]. These pleasant effects diminish as tolerance develops, leading to psychological complications including paranoia, anxiety, and depression [10].

Insomnia serves as a particularly revealing marker. Moderate to severe sleep disturbance appears in over 50% of individuals with persecutory delusions [11]. This creates a dangerous cycle: stimulant use disrupts sleep, insomnia generates anxiety and perceptual anomalies, which reinforces paranoid ideation [11]. Users often self-medicate this "crash" with depressants like alcohol or benzodiazepines [12].

Dilated pupils, sweating, and stimulant-related weight loss

Physical indicators provide objective evidence that clients struggle to conceal. Pupil dilation occurs commonly with amphetamine use and remains easily detectable during assessment [13]. Excessive sweating without corresponding physical activity strongly suggests stimulant use [14].

Weight changes offer particularly valuable diagnostic information. Stimulant users typically lose 1.4±0.96kg of fat within six months of regular use [15]. Even minor weight reductions correlate with significant body composition changes [15]. College women may misuse stimulants specifically for weight control—they're 15 times more likely to engage in purging behaviors than those using stimulants for other reasons [16].

Additional physical signs include tachycardia, elevated blood pressure, excessive fidgeting, and decreased appetite [17]. Chronic methamphetamine users present with distinctive skin problems and dental health deterioration [10].

Motivational interviewing prompts for uncovering use

Strategic questioning becomes vital since stimulant users often minimize or hide their use. Employ reflective listening techniques rather than direct confrontation. Open-ended questions about sleep patterns, energy fluctuations, or weight changes frequently reveal stimulant use without creating defensiveness.

Stimulant withdrawal produces intense cravings that may lead to recurrent use [12]. Your empathetic, non-judgmental approach increases the likelihood of capturing accurate usage information, especially during acute withdrawal characterized by dysphoria, anxiety, and agitation [12].

Recognizing these behavioral and physical indicators early positions you to differentiate accurately between primary psychiatric disorders and stimulant-induced symptoms—a critical distinction explored next.

Differentiating F15.10 from Primary Psychiatric Disorders

Distinguishing between substance-induced symptoms and primary psychiatric disorders represents one of your most complex clinical challenges. This distinction directly shapes your treatment approach and determines client outcomes.

Substance-induced psychosis vs. schizophrenia

Methamphetamine-induced psychotic disorders present with persecutory delusions in 82% of cases, accompanied by auditory hallucinations (70.3%) and visual hallucinations (44.1%) [2]. Visual and tactile hallucinations strongly indicate stimulant-induced psychosis rather than a primary psychotic disorder [2].

The DSM-5 establishes a one-month timeframe for differentiation. Psychotic symptoms persisting beyond one month after last stimulant exposure suggest primary schizophrenia as the more likely diagnosis [3]. However, this criterion has limitations. Approximately 11% of individuals initially diagnosed with substance-induced psychotic disorder eventually develop schizophrenia [3]. Cannabis and stimulants show higher conversion rates to schizophrenia compared to alcohol-induced psychosis [3].

Family history provides another discriminating factor. Those who progress from substance-induced psychosis to schizophrenia typically demonstrate significantly higher familial risk scores for nonaffective psychosis [3].

Stimulant withdrawal vs. bipolar mania

Stimulant effects and bipolar mania overlap considerably. Both conditions feature heightened energy, reduced sleep needs, and impulsive behaviors [18]. The key differences lie in temporal relationships and progression patterns.

Stimulant withdrawal produces low mood, increased suicidal ideation, fatigue, and irritability. These acute symptoms typically last 1-2 days [19]. Post-Acute Withdrawal Symptoms (PAWS) may persist longer, featuring concentration difficulties, cravings, and insomnia [19].

Speech patterns offer critical diagnostic clues when evaluating possible bipolar disorder. Problems with speech and thought disorder appear more prominent in methamphetamine users [2]. Formal thought disorder and bizarre delusions predict schizophrenia with odds ratios of 3.55:1 and 6.09:1 respectively. Suicidal ideation and intravenous cocaine abuse show inverse relationships with schizophrenia diagnosis [20].

Why substance-induced should be your first hypothesis

Starting with substance-induced symptoms represents sound clinical practice. Substance use disorders and mental illnesses frequently co-occur, with each condition potentially exacerbating the other [21]. Substance-induced symptoms typically resolve with abstinence. Inappropriate treatment for presumed primary disorders may introduce unnecessary medications with potential side effects.

Methamphetamine users show higher scores in most delusions compared to non-users [2]. This pattern underscores why ruling out substance effects should precede diagnosing primary disorders. Among psychiatric emergency presentations, methamphetamine users report higher rates of suicide plans (47% vs. 32%) and restlessness (48% vs. 30%) compared to other psychiatric disorders [2].

Researchers note that "Schizophrenia following substance-induced psychotic disorder is better explained as a drug-precipitated disorder in highly vulnerable individuals rather than as a syndrome predominantly caused by drug exposure" [3].

When to Refer: Medical and Psychiatric Red Flags

Your ability to recognize when stimulant abuse becomes a medical emergency can save lives. Certain symptoms signal life-threatening conditions requiring immediate intervention beyond outpatient therapy.

Cardiac symptoms and hyperthermia risks

Cardiovascular complications from stimulant toxicity demand urgent medical evaluation. Watch for cardiac distress signs including palpitations, syncope, or shortness of breath—all dangerous stimulant effects [22]. Cocaine users face a 24-fold increased risk of myocardial infarction during the first hour after use [23]. Prescription stimulants can also trigger serious cardiac events, including documented cases of ventricular tachycardia and out-of-hospital cardiac arrest [24].

Hyperthermia presents equally serious risks requiring immediate referral. Amphetamines induce dangerous temperature elevations, either alone or combined with environmental heat [25]. Workers exposed to both amphetamines and heat stress showed 26.5% prevalence of severe hyperthermia, with temperatures from 103°F to 110.6°F [25]. These extreme temperatures often cause respiratory and circulatory collapse [26].

Severe agitation or hallucinations requiring urgent care

Stimulant-induced agitation constitutes a genuine medical and psychiatric emergency. Severe agitation can harm clients, injure others, and strain healthcare resources when left untreated [27]. Immediate hospitalization becomes necessary when you observe:

Extreme combativeness or "super-human" strength
Diaphoresis with rapid breathing and hyperthermia
Incoherence with inability to maintain attention
Severe metabolic acidosis [28]

Agitation of unknown cause should be considered medical until proven otherwise [27]. This principle proves particularly important with nonverbal clients whose discomfort manifests primarily through agitated behavior.

Your role as therapist when safety is compromised

Your ethical responsibility includes recognizing when client conditions exceed outpatient management. Document all concerning symptoms clearly, including direct quotes indicating danger to self or others [6]. Implement a safety plan immediately—especially when clients access firearms or other harmful means [6].

Connect clients directly with emergency services rather than simply suggesting emergency department visits. Experts criticize clinicians who fail to see high-risk clients frequently enough or obtain consent for physician collaboration [6]. Your documentation must show consistency between identified risks and your treatment plan to meet clinical and legal standards.

Your primary role shifts to safety coordinator when stimulant toxicity presents. This obligation takes precedence over therapeutic alliance concerns until medical stabilization occurs.

Documenting and Collaborating for Effective Treatment

Accurate documentation and coordinated care create the foundation for successful F15.10 treatment outcomes. Your clinical records and collaborative relationships with other providers directly determine treatment effectiveness.

Sample documentation for F15.10 with provisional diagnosis

Clinical documentation for stimulant abuse requires specific elements to ensure proper billing and treatment continuity. F15.10 is a specific ICD-10-CM code indicating "Other stimulant abuse, uncomplicated" [29]. This classification covers mild amphetamine-type substance use disorders or other unspecified stimulant use disorders [30].

Your documentation must clearly show which DSM-5 criteria support the diagnosis—typically 2-3 symptoms occurring within a 12-month period [31].

Essential documentation elements include:

Substance specificity: "Patient reports misusing prescribed Adderall 30mg, taking double prescribed dose (60mg) daily for past 3 months"
Supporting criteria: "Reports continued use despite relationship conflicts with spouse (criterion #6) and unsuccessful attempts to reduce use (criterion #2)"

Working with prescribers on withdrawal and stabilization

Coordinating with prescribing clinicians becomes essential during the withdrawal phase. Stimulant withdrawal produces dysphoria, fatigue, hypersomnia, increased appetite, and strong cravings [32]. Amphetamines have a longer half-life (9-12 hours) than methamphetamine (90 minutes), though methamphetamine metabolizes to amphetamine [33].

Share key physiological information with prescribers. Abstinence triggers an inflammatory response as the brain clears damaged nerve processes, predominantly affecting dopamine and serotonergic neurons [33]. Most intense withdrawal symptoms peak around one week [33].

Coordinating stabilization during this critical period ensures optimal client outcomes.

Psychotherapy focus: relapse prevention and motivation

Your therapeutic approach should center on two evidence-based interventions that show consistent results with stimulant abuse clients.

Motivational interviewing enhances internal readiness through partnership, acceptance, compassion, and evocation [34]. Use DARN questions to elicit change talk: Desire ("How would you like your substance use to change?"), Ability, Reason, and Need [7].

Cognitive-behavioral relapse prevention strategies help clients identify high-risk situations and develop alternative coping mechanisms for negative emotions [1]. Clients need detailed action plans for craving management that they can implement independently.

Contingency management provides tangible incentives for stimulant-negative urine specimens, effectively reducing use frequency [35]. This approach works particularly well with stimulant users who respond to structured reward systems.

Conclusion

Your clinical expertise in managing F15.10 cases directly impacts client recovery outcomes. This guide has equipped you with essential diagnostic and treatment tools for Other Stimulant Abuse cases.

Key diagnostic skills now include recognizing the full spectrum of substances under F15.10—synthetic cathinones, prescription stimulants, and khat. You can identify critical behavioral indicators like extreme mood shifts and insomnia-linked paranoia. Physical markers such as dilated pupils, excessive sweating, and weight loss provide objective evidence during assessment.

Differentiating substance-induced symptoms from primary psychiatric disorders remains crucial. Stimulant-induced psychosis typically resolves within one month of abstinence, while visual and tactile hallucinations suggest substance-induced rather than primary psychotic disorders. Your initial hypothesis should favor substance-induced symptoms—a practice that prevents inappropriate medication interventions.

Safety recognition skills protect your clients from life-threatening complications. Cardiac symptoms, hyperthermia risks, and severe agitation require immediate medical referral. Your role shifts to safety coordinator when toxicity presents, prioritizing medical stabilization over therapeutic alliance concerns.

Documentation and collaborative care create the foundation for effective treatment. Precise recording of substance type, severity level, and DSM-5 criteria supports appropriate diagnosis and billing. Coordination with prescribing clinicians during withdrawal management improves stabilization outcomes.

Evidence-based psychotherapeutic approaches offer the strongest treatment outcomes. Motivational interviewing enhances client readiness for change through partnership and compassion. Cognitive-behavioral relapse prevention strategies help clients identify high-risk situations and develop coping mechanisms. Contingency management provides tangible incentives for sustained abstinence.

Your enhanced ability to identify, assess, and coordinate care for stimulant abuse clients positions you to address a significant public health challenge affecting millions worldwide. These clinical tools enable you to make meaningful differences in individual recovery journeys while contributing to broader treatment outcomes in your community.

Ready to enhance your clinical documentation and focus more on your clients?

Managing F15.10 cases requires detailed progress notes, comprehensive client reports, and careful tracking of treatment outcomes. Yung Sidekick streamlines your documentation process, automatically generating progress notes and insightful therapy reports from your sessions. This allows you to dedicate more time to applying the diagnostic and treatment strategies covered in this guide.

Yung Sidekick ensures you never miss critical details while maintaining your full attention on clients presenting with stimulant abuse. Our AI captures your sessions and quickly generates the documentation needed for effective F15.10 case management, helping you implement evidence-based interventions more efficiently.

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FAQs

What is the diagnostic code F15.10 and what does it represent?

F15.10 is the ICD-10-CM code for "Other stimulant abuse, uncomplicated." It specifically refers to mild amphetamine-type substance use disorders or other unspecified stimulant use disorders, typically involving 2-3 symptoms occurring within a 12-month period.

How can clinicians differentiate between stimulant-induced psychosis and schizophrenia?

While both conditions can present similarly, stimulant-induced psychosis typically resolves within one month of abstinence. Visual and tactile hallucinations are more common in stimulant-induced psychosis. Family history and the persistence of symptoms beyond one month can help distinguish between the two conditions.

What are some key physical indicators of stimulant abuse?

Key physical indicators include dilated pupils, excessive sweating, significant weight loss, tachycardia, elevated blood pressure, and fidgeting. Chronic users may also experience skin problems and dental health deterioration.

When should a therapist refer a client with stimulant abuse for urgent medical care?

Urgent medical referral is necessary when observing signs of cardiac distress (like palpitations or shortness of breath), hyperthermia, severe agitation, extreme combativeness, or hallucinations that compromise safety. These symptoms can indicate life-threatening conditions requiring immediate intervention.

What are effective psychotherapy approaches for treating stimulant abuse?

Evidence-based interventions for stimulant abuse include motivational interviewing to enhance internal readiness for change, cognitive-behavioral relapse prevention strategies, and contingency management. These approaches help clients identify high-risk situations, develop coping mechanisms, and receive tangible incentives for maintaining abstinence.