1. Drug Intoxication and Withdrawal: Signs and Symptoms

2. Alcohol Intoxication Recent ingestion of alcohol Clinically significant maladaptive behavioral or psychological changes (e.g., inappropriate sexual or aggressive behaviors). One or more the the following: –Slurred speech-Impairment in attention or –Incoordination memory –Unsteady gait-Stupor or coma –Nystagmus

3. Alcohol Withdrawal Cessation of (or reduction in) alcohol use that has been heavy and prolonged. Two (or more) of the following: –Autonomic hyperactivity (sweating, high pulse rate). –Increased hand tremor-Anxiety –Insomnia-Grand mal seizures –Nausea/vomiting –Psychomotor agitation –Transient visual, tactile, or auditory hallucinations or illusions

4. Sedative/Hypnotic/Anxioly tic Intoxication Clinically significant maladaptive behavioral or psychological changes (e.g., mood lability, inappropriate sexual or aggressive behavior). One or more of the following signs: –Slurred speech-Incoordination –Unsteady gait-Nystagmus –Impairment in attention or memory –Stupor or coma Symptoms not due to GMC or other mental disorder

5. Sedative/Hypnotic/Anx iolytic Withdrawal Two or more of the following: –Autonomic hyperactivity (e.g. sweating or PR >100) –Increased hand tremor-Anxiety –Insomnia-Nausea or vomiting –Psychomotor agitation-Grand mal seizures –Transient visual, tactile, or auditory hallucinations or illusions

6. Amphetamine Intoxication Recent use of amphetamine Clinically significant maladaptive behavioral or psychological changes (e.g., euphoria, hypervigilance). 2 or more of the following: –Tachycardia or bradycardia- Pupillary dilation –Perspiration or chills- Nausea or vomiting –Evidence of weight loss -Elevated or lowered blood pressure

7. Amphetamine Intoxication (Cont’d) –Psychomotor agitation or retardation –Muscular weakness, respiratory depression, chest pain, or cardiac arrhythmias –Confusion, seizures, dyskinesias, dystonias, or coma –Not due to GMC or another mental disorder

8. Amphetamine Withdrawal Cessation of heavy amphetamine use Dysphoric mood, and two or more of the following: –Fatigue –Vivid, unpleasant dreams –Insomnia or hypersomnia –Increased appetite –Psychomotor retardation or agitation Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning Not due to GMC or other mental disorder

9. Cocaine Intoxication Clinically sig. maladaptive behavioral or psychological changes (e.g., euphoria, tension, etc.). Two or more of the following: –Tachycardia or bradycardia-Nausea or vomiting –Pupillary dilation-Perspiration or chills –Elevated or lowered blood pressure –Evidence of weight loss

10. Cocaine Intoxication (Cont’d) –Psychomotor agitation or retardation –Muscular weakness, respiratory depression, chest pain, or cardiac arrhythmias –Confusion, seizures, dyskinesias, dystonias, or coma –Not due to GMC or other mental disorder

11. Cocaine Withdrawal Dysphoric mood and two or more of the following: –Fatigue –Vivid unpleasant dreams –Insomnia or hypersomnia –Increased appetite –Psychomotor retardation or agitation Symptoms cause clinically significant distress or impairment in social, occupational, or other areas of functioning Symptoms not due to GMC or other mental disorder.

12. Caffeine Intoxication Recent consumption of caffeine Five of the following signs: –Restlessness-Nervousness –Excitement -Insomnia –Flushed face-Diuresis –Gastrointestinal disturbance-Muscle twitching –Rambling flow of thought or speech –Tachycardia or cardiac arrhythmia –Periods of inexhaustibility –Psychomotor agitation

13. Caffeine Intoxication (Cont’d) Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Symptoms are not the result of a GMC or other mental disorder.

14. Nicotine Withdrawal Daily use of nicotine for at least several weeks Abrupt cessation of nicotine use followed within 24 hours by four or more of the following: –Dysphoric or depressed mood-Insomnia –Irritability, frustration, or anger-Anxiety –Difficulty concentrating-Restlessness –Decreased heart rate –Increased appetite or weight gain Symptoms cause significant distress in functioning Symptoms not due to GMC or other mental disorder

15. Opioid Intoxication Clinically significant maladaptive behavioral or psychological changes (e.g., dysphoria, impaired judgment, euphoria followed by apathy). Pupillary constriction (or dilation due to anoxia from severe overdose) and at least one of the following: –Drowsiness or coma-Slurred speech –Impairment in attention or memory Symptoms not due to GMC or other mental disorder

16. Opioid Withdrawal Three (or more) of the following: –Dysphoric mood-Nausea or vomiting –Muscle aches-Lacrimation or rhinorrhea –Diarrhea-Yawning –Fever-Insomnia –Pupillary dilation, piloerection, or sweating Symptoms cause significant distress or impairment in functioning Symptoms not due to GMC or other mental disorder

17. Cannabis Intoxication Recent use Clinically significant maladaptive behavioral or psychomotor changes (e.g., euphoria, anxiety). Two or more of the following signs: –Conjunctival injection –Increased appetite –Dry mouth –Tachycardia Symptoms not due to GMC or other mental disorder

18. Hallucinogen Intoxication Clinically significant maladaptive behavior or psychomotor changes (e.g., paranoid ideation, fear of losing one’s mind). Perceptual changes occurring in a state of full wakefulness and alertness (e.g., depersonalization, illusions, etc.). Two or more of the following: –Pupillary dilation-Blurring of vision –Tachycardia-Tremors –Sweating-Incoordination –palpitations

19. Hallucinogen Flashbacks Re-experiencing one or more perceptual symptoms that were first experienced while intoxicated by a hallucinogen (e.g., flashes of color, positive after- images). Symptoms cause clinically significant distress or impairment Symptoms are not due to a GMC or other mental disorder

20. Inhalant Intoxication Clinically significant maladaptive behavioral or psychological changes (e.g., belligerence, apathy, etc.) Two or more of the following signs: –Dizziness-Nystagmus –Incoordination-Slurred speech –Unsteady gait-Lethargy –Depressed reflexes-Psychomotor retardation –Tremors-Generalized muscle weakness –Euphoria-Blurred vision or diplopia –Stupor or coma

21. Phencyclidine Intoxication - PCP Clinically significant maladaptive behavioral changes (e.g., belligerence, impulsiveness, etc.) Within an hour, two or more of the following: –Hypertension or tachycardia-Hyperacusis –Ataxia-Dysarthria –Muscle rigidity-Seizures or coma –Numbness or diminished responsiveness to pain –Vertical or horizontal nystagmus Symptoms are not due to GMC or other mental disorder