B4: 6

Psychostimulants HO4

Amphetamine Withdrawal Assessment Scale

Drug & Alcohol Services Council, SA, 2002
Note: Only use in isolation from other withdrawal scales where the
person has solely an amphetamine use problem.
Note: Total Score is indicative of increasing or decreasing severity of
withdrawal. Scores are not directly linked to pharmacological
management as occurs with alcohol scores based on the CIWA-Ar.

Surnam Given
e: name:

Date of
birth:
Date
Time
Temperature
Pulse
Respiration rate
Blood pressure
Weight
Score range = 0-7
Irritability
Depression
Racing thoughts
Restlessness/Agit
ation
Feelings of
unreality
Drowsiness
Nausea/Vomiting
TOTAL

Sleep (0800 obs

only)

Resource Kit for GP Trainers on Illicit Drug Issues

Part B4 Drugs: Psychostimulants
Other symptoms

Resource Kit for GP Trainers on Illicit Drug Issues

Part B4 Drugs: Psychostimulants
 Amphetamine Withdrawal Assessment Scale cont.

These questions refer to how the person is feeling right now, at the
present moment.
1 IrritabilityObservation 5 Feelings of unreality
. Ask Do you feel irritable? . Ask Do you feel that things
around you are not real or
change in shape?
0 No irritability 0 No
1 Mild 1 Mild
4 Moderate 4 Moderate
7 Severe 7 Severe feelings of
unreality, everything looks
strange or different
2 DepressionObservation 6 DrowsinessObservation
. Ask Do you feel sad? . Ask Do you feel sleepy or
drowsy?
0 No sadness 0 No drowsiness
1 Slow to respond but 1 Mild
4 reactive 4 Moderate
7 Moderately withdrawn 7 Severe, cannot keep
Withdrawn, unresponsive awake
3 Racing thoughts 7 Nausea/Vomiting
. Ask Are your thoughts racing? . Observation
Ask Do you feel sick in the
stomach, have you vomited?
0 No racing thoughts 0 No nausea or vomiting
1 Mild 1 Mild nausea
4 Moderate 4 Intermittent nausea with
7 Severe dry retching
7 Constant nausea, frequent
dry retching/vomiting
4 Restlessness/Agitation 8 Sleep
. Ask Do you feel more restless . Ask How did you sleep last
or agitated than you are night?
normally?
0 Normal activity 0 Sufficient sleep
1 Some what more than 1 Some sleep
normal activity 4 Moderate/restless sleep
4 Moderately fidgety or 7 No sleep
7 restless
Unable to sit or stand still

Resource Kit for GP Trainers on Illicit Drug Issues

Part B4 Drugs: Psychostimulants
Cited in deCrespigny, C et al 2003, Alcohol Tobacco and Other Drugs Guidelines for Nurses and
Midwives: Clinical Guidelines. Flinders University and Drug and Alcohol Services Council, Adelaide
Also available at wwww.dasc.sa.gov.au

Resource Kit for GP Trainers on Illicit Drug Issues

Part B4 Drugs: Psychostimulants