Psych CASC / OSCE · Addiction psychiatry — acute stimulant syndromes
Explain stimulant crash and why there is no methadone for ice — CASC communication station
MRCPsych/FRANZCP-style communication station: explain MAP vs primary psychosis, crash/suicide risk, absence of approved anti-craving standard, CM/psychosocial plan, and negotiate family fears without stigma.
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Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry/addiction registrar. Examiner may play patient and/or sister. [1]
Candidate instructions. Explain what happened during ice intoxication and psychosis in plain language. Describe the crash and why suicide risk needs a plan. Explain honestly that there is no approved methadone-like anti-craving medicine as standard care. Outline psychosocial next steps (including contingency management concepts in lay terms) and negotiate against premature lifelong schizophrenia labelling. Check understanding and agree a collaborative safety and follow-up plan. [1][2]
References4ShowHide
- [1]ASAM/AAAP Clinical Guideline Committee The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder J Addict Med, 2024.PMID 38669101
- [2]McGregor C, Srisurapanont M, Jittiwutikarn J, et al. The nature, time course and severity of methamphetamine withdrawal Addiction, 2005.PMID 16128721
- [3]McKetin R, Lubman DI, Baker AL, et al. Dose-related psychotic symptoms in chronic methamphetamine users: evidence from a prospective longitudinal study JAMA Psychiatry, 2013.PMID 23303471
- [4]Pfund RA, Ginley MK, Boness CL, et al. Contingency Management for Drug Use Disorders: Meta-Analysis and Application of Tolin's Criteria Clin Psychol (New York), 2024.PMID 38863566