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

Chapter 10: The psychiatric comorbidity of psychostimulant use

Page last updated: April 2004

Sharon Dawea and Rebecca McKetinb

a School of Applied Psychology, Griffith University, Queensland
b National Drug and Alcohol Research Centre Inc., New South Wales

Key points:
  • Comorbid disorders are common among psychostimulant users.

  • The most common comorbid psychiatric disorders among psychostimulant users are depression, anxiety and drug-induced psychosis.

  • Standardised screening, diagnostic tools and symptom checklists are available for psychostimulant use and comorbid psychiatric disorders and their use is highly recommended.

  • Comorbid psychiatric conditions among psychostimulant users should be diagnosed and treated.

  • Pharmacological interventions for the treatment of psychostimulant withdrawal, intoxication and comorbid psychiatric conditions are guided by principles of good clinical practice.

  • In practice, the primacy of psychiatric and substance use disorders is difficult to establish and both disorders should be addressed.

  • Following treatment of the acute presentation, integrated treatment for comorbid psychiatric disorder and psychostimulant use should follow.

  • All clinicians working in the mental health and substance use fields should have sound suicide risk assessment skills and know when to appropriately refer to a specialist service when and if it is required.

  • Many psychostimulant users, particularly those whose use is not heavy, may benefit from short interventions such as brief motivational interventions.

  • Adequate resourcing for mental health and AOD staff will be needed to ensure adequate training, supervision and ongoing referral, consultation, liaison and collaboration in service delivery.

  • Monitoring of service outcomes and the effectiveness of training and supervision on client outcomes should be a priority.