Amphetamine psychosis3/16/2023 Finally, at the age of 26, after he had lost his driver’s license because of multiple charges of driving while intoxicated, he consented to enter a 1-month inpatient substance abuse treatment program at the state psychiatric hospital. His work history was sporadic he had worked part-time as a truck driver (which was alarming considering the subject’s substance abuse history). However, he had avoided problems with the law except for a few arrests for fighting, public intoxication, and driving while intoxicated. The manner by which he had supported himself, a live-in girlfriend, and his drug habit during these years remains questionable, and it is suspected that he had been involved in some small-time drug dealing. He had never used heroin or other narcotics and had never intravenously administered drugs. By his early twenties he had also begun to use cocaine, although he still preferred amphetamines. This type of behavior persisted throughout his teenage years. Finally, he drank beer, sometimes up to a six-pack per day. He also with some regularity had used hallucinogens, both mescaline and LSD, and he estimated that he had “tripped” once or twice a month for at least a few years. He averaged one to three joints of marijuana per day throughout this time. He estimated that he had taken up to 100 “white crosses” (amphetamines) per week, often for several months running, for almost 10 years. His drugs of choice were amphetamines and marijuana, which were often used to counterbalance one another. Although the patient had denied it at the time, he later admitted that beginning early in high school and for many years after he had used a variety of drugs, some in large amounts. His parents were convinced that the patient had “fallen in with a bad crowd,” and they suspected that he had become involved with drugs. His grades fell progressively, and he finally dropped out in his junior year of high school after he had failed several courses (much to the dismay of his parents, since all of the other siblings had graduated from high school, and two had gone on to college). He became uncharacteristically irritable and unreliable. No problems were noted in either his social adjustment or school performance until his sophomore year in high school.Īt that point, he began to exhibit conduct problems: school truancy, excessive fighting with peers, and disobedience with house rules such as curfews. Early academic performance was in the average range, which was consistent with the performance of his siblings. The patient appeared to achieve all motor and verbal developmental milestones at the same pace as his siblings and peers. His parents stated and medical records confirmed that there was nothing unusual about either the pregnancy or delivery, and there were no perinatal complications. One would be hard-pressed to predict from childhood family photographs ( 1) that the patient would be the one who would become ill as an adult: he had a bright smile, was often pictured in the center of friends, and was often engaged in athletic activities (in which he was said to have excelled). He was the youngest of six children, all of whom had passed the expected age of risk for schizophrenia onset and appeared to be leading healthy and productive lives. He lived with his parents in a small rural town in the same house in which he was raised. The patient was a 36-year-old single white man.
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