Models of intervention and care for psychostimulant users, 2nd edition - monograph series no. 51

Assessment for detoxification

Page last updated: April 2004

The assessment process for psychostimulant detoxification is similar to the process for other drug detoxification. The essential components of an accurate assessment include:

Psychostimulant use:

  • Amount of psychostimulant used3.
  • Type of psychostimulant used (e.g. methamphetamine, amphetamines, cocaine).
  • Route of administration (e.g. intranasal, intravenous, oral or inhalation).
  • Frequency of use (e.g. regular daily use or irregular 'binge' pattern).
  • Duration of current use and age of initiation.
Other drug use:
  • Use of other drug classes (particularly alcohol, benzodiazepines and opiates), including criteria above.
Dependence:
  • Meets criteria for a diagnosis of dependence for psychostimulants and/or other drugs.
  • Severity of dependence on each drug used.
  • Evidence of tolerance (uses more of the drug to achieve the same effect).
History of withdrawal:
  • Experience of previous withdrawal symptoms, severity, course and treatment outcomes.
Other conditions:
  • Presence of concomitant physical illness including blood borne viruses (HCV, HBV and HIV).
  • Presence of concomitant psychiatric illness or psychiatric symptoms (psychosis, paranoia, depression, suicidal ideation etc).
Other factors that may impact on completion of detoxification include:
  • precipitants to treatment-seeking;
  • social/family supports;
  • parenting status and other familial responsibilities;
  • employment status;
  • accommodation (stability, exposure to psychostimulants etc);
  • unresolved legal/social issues;
  • understanding/knowledge of withdrawal process;
  • readiness to change drug use behaviour;
  • client's goal for treatment; and
  • confidence in ability to complete withdrawal and expectation of the process and outcomes.Top of page

Footnotes

3 The amount of amphetamines used can be measured either in dollars spent on the drug or in 'points' or grams or number of 'pills'. The street value of amphetamines (powder, 'base', pills) varies considerably across cities and states and clinicians should determine local costs so an accurate assessment can be made if using amount of money spent as a guide to consumption. IDRS data for each state is a useful indicator of local prices and purity.