Ketergantungan dan Penyalahgunaan Amfetamin Amphetamine

when impaired by substance use 3. recurrent substance-related legal problems e.g., arrests for substance-related disorderly conduct 4. continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance e.g., arguments with spouse about consequences of intoxication, physical fights B. The symptoms have never met the criteria for Substance Dependence for this class of substance. From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text rev. Washington, DC: American Psychiatric Association; copyright 2000, with permission. Tabel 2.3. Tabel Kriteria Diagnosa Ketergantungan Zat Menurut DSM IV TR DSM-IV-TR Diagnostic Criteria for Substance Dependence A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three or more of the following, occurring at any time in the same 12-month period: 1. tolerance, as defined by either of the following: a. a need for markedly increased amounts of the substance to achieve intoxication or desired effect b. markedly diminished effect with continued use of the same amount of the substance 2. withdrawal, as manifested by either of the following: a. the characteristic withdrawal syndrome for the substance refer to Criteria A and B of the criteria sets for Withdrawal from the specific substances b. the same or a closely related substance is taken to relieve or avoid withdrawal symptoms 3. the substance is often taken in larger amounts or over a longer period than was intended 4. there is a persistent desire or unsuccessful efforts to cut down or control substance use 5. a great deal of time is spent in activities necessary to obtain the substance e.g., visiting multiple doctors or driving long distances, use the substance e.g., chain-smoking, or recover from its effects 6. important social, occupational, or recreational activities are given up or reduced because of substance use 7. the substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance e.g., current cocaine use despite recognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption Specify if: With Physiological Dependence: evidence of tolerance or withdrawal i.e., either Item 1 or 2 is present Without Physiological Dependence: no evidence of tolerance or withdrawal i.e., neither Item 1 nor 2 is present Course specifiers see Table 12.1-5 for definitions: Early Full Remission Early Partial Remission Sustained Full Remission Sustained Partial Remission On Agonist Therapy In a Controlled Environment From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text rev. Washington, DC: American Psychiatric Association; copyright 2000, with permission.

2.5. Efek Putus Obat Amfetamin

Gejala seperti ansietas, tremor, disforik, letargi, kelelahan, mimpi buruk, kepala pusing, keringat berlebihan, tegang otot, tegang otot perut, dan rasa lapar yang tidak puas, muncul setelah penghentian obat Amfetamin. Gejala putus obat Amfetamin pada umumnya mencapai puncak dalam dua sampai empat hari dan sembuh dalam satu minggu. Gejala putus obat yang paling serius adalah depresi, yang dapat menjadi berat setelah penggunaan Amfetamin dengan dosis tinggi yang berkelanjutan dan dapat dihubungkan dengan ide bunuh diri. Kriteria diagnosa putus obat Amfetamin menurut DSM IV TR tabel 2.4. menekankan bahwa keadaan disforik dan perubahan psikologi penting dalam penegakkan diagnose Sadock, 2007. Tabel 2.4. Tabel Kriteria Diagnosa Putus Obat Amfetamin Menurut DSM IV TR DSM-IV-TR Diagnostic Criteria for Amphetamine Withdrawal A. Cessation of or reduction in amphetamine or a related substance use that has been heavy and prolonged. B. Dysphoric mood and two or more of the following physiological changes, developing within a few hours to several days after Criterion A: 1. fatigue 2. vivid, unpleasant dreams 3. insomnia or hypersomnia 4. increased appetite 5. psychomotor retardation or agitation C. The symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text rev. Washington, DC: American Psychiatric Association; copyright 2000, with permission.

2.6. Overdosis Amfetamin

Overdosis akut Amfetamin akan menimbulkan gejala seperti kejang, hipertensi, takikardi, hipertermi, psikosis, halusinasi, stroke dan yang paling fatal adalah kematian Handley, 2012.