An occasional patient will present with a stimulant induced psychosis which may need admission and management with neuroleptics. In severe cases involuntary detention in a psychiatric hospital is required.

Withdrawal from stimulants is usually not associated with severe physical symptoms and can usually be managed as an outpatient. Some patients may suffer a severe “crash” with drowsiness, lethargy and depression and may need admission because of the severity of their symptoms.

These include rhabdomyolysis, cardiac failure (acute or chronic cardiomyopathy), renal failure, hepatitis and the usual group of conditions associated with IV drug use. Take appropriate action depending on the clinical situation.