Substance misuse (including intoxication and withdrawal) is the most common cause of ABD. Commonly associated drugs include:

  1. Cocaine (responsible for the majority of cases in the literature)3,4
  2. Methamphetamine
  3. Phencyclidine (PCP)
  4. Lysergic acid diethylamide (LSD)
  5. Various ‘legal highs’, e.g. bath salts
  6. Other drugs may be implicated

Psychiatric illness is another cause, especially in the context of abrupt cessation of antipsychotic drugs.

Learning Bite

The commonest cause of ABD is stimulant drug use, with cocaine accounting for the majority of cases. It often occurs in the context of a long history of cocaine use with recent binges.3