Amphetamine Withdrawal Scale
© 2005 By Robert R. Perkinson, Ph.D.
Patient Name _____________________ BP _____ Pulse ____ Res _____Temp ______
Amphetamine Withdrawal Scale Score _____________________ Date _______
______________________________________
AGITATION-Observation
0 Normal activity
1 Somewhat more than normal activity
2
3
4 Moderately fidgety and restless
5
6
7 Paces back and forth or constantly thrashes about
_______________________________________
SWEATING Observation
0 No sweat visible
1 Palms moist
2
3
4 Beads of sweat on forehead
5
6
7 Drenching sweats
_______________________________________
ANXIETY-Ask “Do you feel nervous or
afraid?” Observation
0 No anxiety, calm and tranquil
1 Mildly anxious
2
3
4 Moderately anxious, defensive or guarded.
5
6
7 Severely anxious, equivalent to panic
_______________________________________
PARANOIA-Ask “Do you feel people are paying special attention to you? Do you feel anyone is out to get you or give you a hard time?
0 No paranoia
1 Mildly suspicious
2
3
4 Moderately paranoid or suspicious.
5
6
7 Severely paranoid with delusions of persecution
____________________________________________
CRAVING-Ask “Are you craving drugs or alcohol?
0 No craving
1 Mild or occasionally thinking about drug use
2
3
4 Moderate craving drug use throughout the day.
5
6
7 Severe can’t stop craving.
____________________________________________
DEPRESSION Ask “Do you feel sad or depressed? ”If yes, “On a scale of one to seven how depressed do you feel?”
0 None
1 Mild depression
2
3
4 Moderate depressed most of the day
5
6
7 Severe depressed all day every day.
____________________________________________
TACTILE DISTURBANCES-Ask “Have you had any itching or burning or do you feel bugs crawling on or under your skin?”
0 Not present
1 Mile itching burning or pins and needles
2
3 Moderate itching burning or pins and needles
4 Moderately severe hallucinations
5
6
7 Continuous hallucinations
____________________________________________
AUDITORY DISTURBANCES Ask “Do sounds seem too loud or harsh? Do they frighten you? Are you hearing things that are not there?”
0 Not present
1 Very mild harshness or ability to frighten
2 Mild harshness or ability to frighten
3 Moderate harshness or ability to frighten
4 Moderate hallucinations
5 Severe hallucinations
6 Extremely severe hallucinations
7 Continuous hallucinations
____________________________________________
VISUAL DISTURBANCES Ask “Does the light appear to be too bright? Does it hurt your eyes? Are you seeing things that are not there?”
0 Not present
1 Very mild sensitivity
2 Mild sensitivity
3 Moderate sensitivity
4 Moderate hallucinations
5 Severe hallucinations
6 Extremely severe hallucinations
7 Continuous hallucinations
____________________________________________
ORIENTATION Ask “What day is this? Where are you? Who am I? What is your name?”
0 Oriented
1 Uncertain about date
2 Disoriented by date by no more than 2 days
3 Disoriented to date by more than 2 days
4 Disoriented to place and/or person
Scores:
0-8 = indicates mild withdrawal
8-20 = indicates moderate withdrawal
20+ = indicates severe withdrawal
Observation of over 1000 amphetamine addicts indicates acute withdrawal usually lasts 7-15 days.
Physicians can use benzodiazepines and antipsychotics to modulate withdrawal symptoms
Copyright © 2005 Robert R. Perkinson, Ph.D.
All rights reserved.
Copyright © 2011 [www.robertperkinson.com]. All rights reserved.
Revised:
For permission to copy contact:
Dr. Robert R. Perkinson
perk@iw.net
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