Diagnosis Code for Methamphetamine Use
For methamphetamine use disorder, use ICD-10 code F15.10 for mild use disorder, F15.20 for moderate to severe use disorder, or F15.90 for unspecified amphetamine-type substance use.
DSM-5 Diagnostic Framework
The diagnosis of methamphetamine use disorder follows the DSM-5 substance use disorder criteria, which requires meeting at least 2 out of 11 criteria within a 12-month period 1.
Severity Classification
- Mild disorder (2-3 criteria met): Indicates early problematic use with limited functional impairment 1
- Moderate disorder (4-5 criteria met): Represents escalating problems with methamphetamine use 1
- Severe disorder (6 or more criteria met): Reflects significant impairment and loss of control over use 1
Key Diagnostic Criteria to Assess
When evaluating for methamphetamine use disorder, assess for the following 11 criteria 1:
- Impaired control: Taking larger amounts or for longer than intended; persistent desire or unsuccessful efforts to cut down; significant time spent obtaining, using, or recovering from methamphetamine
- Social impairment: Failure to fulfill major role obligations; continued use despite social or interpersonal problems; giving up important activities
- Risky use: Use in physically hazardous situations; continued use despite knowledge of physical or psychological problems
- Pharmacological criteria: Tolerance (need for increased amounts); withdrawal symptoms; craving (added in DSM-5) 1
Course Specifiers
After establishing the diagnosis, document the clinical course 1:
- Early remission: ≥3 months but <12 months without meeting criteria (except craving may persist) 1
- Sustained remission: ≥12 months without meeting criteria (except craving) 1
- In a controlled environment: When access to methamphetamine is restricted 1
- On maintenance therapy: If receiving pharmacological treatment (though no FDA-approved medications currently exist for methamphetamine use disorder) 1
Clinical Pitfalls
Denial is common: Patients with methamphetamine dependence frequently minimize or deny the severity of their use, particularly regarding continued use despite persistent problems 2. Supplement self-report with collateral information and objective measures when possible 2.
High-risk patterns are increasing: From 2015-2019, the prevalence of methamphetamine use disorder or injection use exceeded non-problematic use in 60-67% of users 3. Frequent use (≥200 days/year) occurred in 27.3% of past-year users, and 52.9% met criteria for use disorder 4.
Polysubstance use is prevalent: Methamphetamine and cocaine co-use increased 60% from 2015-2019 3. Always assess for other substance use disorders, as polysubstance dependence was eliminated as a separate diagnosis in DSM-5 1.
Comorbidities affect diagnosis: Methamphetamine use is associated with psychosis, depression, suicidal ideation, and infectious diseases 4, 3. Substance-induced psychotic symptoms should resolve within 4 weeks of abstinence; persistence beyond this suggests an independent psychotic disorder 5.