Psychological treatment for methamphetamine use and associated psychiatric symptom outcomes: A systematic review

Abstract

Background: Regular methamphetamine use is associated with increased rates of psychiatric symptoms. Although there has been a substantial body of research reporting on the effectiveness of psychological treatments for reducing methamphetamine use, there is a paucity of research examining the effects of these treatments on co-occurring psychiatric symptoms. We addressed this gap by undertaking a systematic review of the evidence of the effectiveness of psychological treatments for methamphetamine use on psychiatric symptom outcomes in randomized controlled trials. Methods: A narrative synthesis of studies was conducted following the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement to inform methodology. Eight electronic peer-reviewed databases were searched. Ten eligible studies were assessed. Results: Most studies found an overall reduction in levels of methamphetamine use and psychiatric symptoms among samples as a whole. Although brief interventions were effective, there is evidence that more intensive interventions have greater impact on methamphetamine use and/or psychiatric symptomatology. Intervention attendance was variable. Conclusions: The evidence suggests that a variety of psychological treatments are effective in reducing levels of methamphetamine use and improving psychiatric symptoms. Future research should consider how psychological treatments could maximize outcomes in the co-occurring domains of methamphetamine use and psychiatric symptoms, with increasing treatment attendance as a focus. PROSPERO registration number: CRD42016043657. associated rise in levels of dependence (Degenhardt et al., 2016). Hospitalizations, ambulance attendances, overdose and deaths related to methamphetamine use have all increased as a consequence (AIHW, 2017; NSW Ministry of Health, 2015; Sindicich, Stafford, & Breen, 2016). Methamphetamine associated deaths have doubled in Australia between 2009 and 2015 due to an increase in heart disease and stroke, with 1649 deaths in that period, 43% due to drug toxicity (Darke, Kaye, & Duflou, 2017). Regular methamphetamine use can be associated with a range of psychiatric symptoms, particularly psychosis, anxiety, and depression

Psychosocial Interventions for Amphetamine Type Stimulant Use Disorder: An Overview of Systematic Reviews

“…The included systematic reviews also indicated that the effectiveness subsequently declined. Stuart et al (48) concluded that higher numbers of intervention sessions were associated with greater improvement. The intervention effect was often evaluated at the end of treatment or 3, 6, or 12 months after treatment.…”

“…Four of the 11 systematic reviews evaluated the effect of psychosocial interventions on psychiatric symptoms. Psychiatric symptom outcomes included craving, the severity of dependence, depression (15,37) and psychiatric distress (48,50). While reviews with a narrative analysis identified positive impact on reducing craving, depression and anxiety, the review with a meta-analysis identified a non-significant difference between the intervention and control group (37).…”

A novel brief treatment for methamphetamine use disorders in South Africa: a randomised feasibility trial

“…Given the psychological and public health implications associated with MA use, researchers from high-income countries have investigated the efficacy of a variety of psychological treatments for MA use [11]. Contingency management, interpersonal therapy, cognitive behavioural therapy (CBT) (including the Matrix Model), and motivational approaches, such as motivational interviewing, have shown to reduce MA use [11][12][13][14]. Despite the availability of effective treatments, many people globally with a methamphetamine use disorder (MAUD), do not receive adequate treatment [15].…”

Mandatory treatment for methamphetamine use in Australia

“…Non-pharmacological approaches remain first line treatment options for relapse prevention in methamphetamine use disorder [35,37]. Psychosocial interventions include the Matrix Model (MM) [38], Cognitive Behavioural Therapy (CBT) [39] and Contingency Management (CM) [40].…”