RESUMO
To raise awareness of attention-deficit/hyperactivity disorder (ADHD) as an underdiagnosed, undertreated disorder in adult patients with comorbid substance use disorder (SUD) who are misdiagnosed with other common psychiatric illnesses and to reduce fear and hesitancy in prescribing stimulants as treatment in such a patient population. ADHD diagnosis is easier in the child and adolescent population than the adults due to comorbidities of other psychiatric illnesses and SUD. However, diagnosing ADHD appropriately in an increasing number of adult patients presents challenges. Even if they get diagnosed appropriately, the stigma of substance use disorder holds the providers prescribing stimulant medications for such patient populations due to the high comorbidity of ADHD with SUD. Accurate diagnosis of ADHD in adults is a worthwhile endeavor as this diagnosis is comorbidly present in many mood and substance use disorders patients. Treating ADHD in this population can improve clinical symptoms and overall quality of life.
RESUMO
In the last decade, methamphetamine (MA) use has substantially increased in rural America. These changes in the epidemiological trends could be attributed to the restricted availability of opioids after measures against the opioid epidemic were enforced. The availability of cheaper alternatives, such as fake prescriptions mixed with fentanyl, is a few among the many recent developments in the ongoing mental health and substance abuse crisis in rural America. A serious clinical effect of MA use is psychosis, which inadvertently has stretched mental health services. In recent times, the atypical clinical presentations of these psychotic episodes with a refractory course have challenged clinicians. Hence, the knowledge of its unique pharmacodynamics, neurotoxicity, similarities with schizophrenia amid the evolving empirical evidence is critical to addressing this unique conundrum.