Anxiety level and correlates in methamphetamine-dependent patients during acute withdrawal

Abstract

Anxiety is often a core element of withdrawal symptoms; however, risk factors associated with anxiety symptoms during the early stage of withdrawal in methamphetamine (METH) users are not well understood. Two hundred ten METH-dependent subjects who had been abstinent for 1 to 7 days were recruited. We used a set of self-administrative questionnaires eliciting information on sociodemographics, detailed drug use history and anxiety. Beck Anxiety Inventory (BAI) was used to measure anxiety symptoms. METH users had a mean BAI score of 6.9; 72 (34.3%) of the study sample had anxiety symptoms during acute METH withdrawal, including 42 (20.0%) with mild anxiety, 25 (11.9%) with moderate anxiety, and 5 (2.4%) with severe anxiety. In addition, gender (female), higher frequency of drug use, and history of polysubstance use were significantly correlated with anxiety symptoms during acute METH withdrawal. Anxiety symptoms appear to be common during the first week of METH abstinence, and several risk factors are identified.

Dark Times: The Role of Negative Reinforcement in Methamphetamine Addiction

“…Alternatively, among a sample of 203 non-treatment seeking methamphetamine users, the opposite pattern was observed, wherein depression and anxiety symptoms positively correlated with methamphetamine craving among men, but not women (31). This difference in findings may be related to use status at the time data were collected, given that two studies reported on abstinent users (34,73) and one examined current users (31). Gender differences have also been observed among self-reported reasons for use.…”

“…Negative emotional symptoms are also a well-documented manifestation of methamphetamine withdrawal; after 1-7 days of abstinence, 34% of 210 MUD individuals report some symptoms of anxiety disorders ranging from mild to moderate (73). But with continued abstinence from methamphetamine (ranging from 6 days to 1 year), self-reported emotional symptoms of depression and anxiety appear to decrease among a crosssectional sample of MUD (76).…”

Mechanisms of Shared Vulnerability to Post-traumatic Stress Disorder and Substance Use Disorders

“…Chronic exposure to alcohol and other drugs of abuse causes long-term changes in reward processing that are thought to promote a continued escalation of substance use. Even though positive hedonic feelings occur shortly after the drug intake, negative hedonic responses follow-especially after repeated exposures-due to alterations in the brain reward system and stress-related structures such as the extended amygdala, resulting in a withdrawal syndrome including dysphoria, irritability, anxiety, and other negative emotional states (Zhang and Schulteis, 2008;Leventhal et al, 2013;Su et al, 2017;Fleming et al, 2019). Some hypothesize that over time the desire to avoid the negative feelings associated with withdrawal becomes the primary motivational factor for compulsive drug-seeking behavior (Solomon and Corbit, 1974;Koob and Volkow, 2010).…”

Diazepam reverses increased anxiety-like behavior, social behavior deficit, and dopamine dysregulation following withdrawal from acute amphetamine

“…Acute withdrawal from drugs of abuse, including psychostimulants, can produce an anxiety-like state [17][18][19]. In humans, anxiety is one of the most prominent symptoms of psychostimulant withdrawal during the first several weeks of abstinence [20].…”