The use of psychostimulants has increased considerably in Australia over the past decade, particularly among certain groups such as youth and IDUs. The use of cocaine is less widespread, however pockets of problematic users may be located in cities such as Sydney (see Chapter 2: Prevalence and patterns of psychostimulant use). Prescription stimulants, such as methylphenidate ('RitalinTM') are also misused, often in a quest to lose weight or with the diagnosis of adult attention deficit hyperactivity disorder used as a pretext. Similarly, prescription anorectics such as 'DuromineTM' can also be misused.

This chapter reviews the national and international literature pertaining to cocaine and amphetamine withdrawal and recommended management. Recommendations for assessment and monitoring are included and a one-page decision tree has been developed for quick reference. Gaps in the literature are identified throughout, in addition to brief recommendations for further research. As the pattern of MDMA use is unlike that of amphetamines and cocaine (see Chapter 2: Prevalence and patterns of psychostimulant use), it is unusual for someone to become dependent and require withdrawal specifically from MDMA, hence withdrawal management of MDMA is not addressed in this chapter.