Psychostimulant addiction treatment

Abstract

Treatment of psychostimulant addiction has been a major, and not fully met, challenge. For opioid addiction, there is strong evidence for the effectiveness of several medications. For psychostimulants, there is no corresponding form of agonist maintenance that has met criteria for regulatory approval or generally accepted use. Stimulant-use disorders remain prevalent and can result in both short-term and long-term adverse consequences. The mainstay of treatment remains behavioral interventions. In this paper, we discuss those interventions and some promising candidates in the search for pharmacological interventions.

“Chasing the High” – Experiences of Ethylphenidate as Described on International Internet Forums

“…The increased heart rate, blood pressure, and body temperature were occasionally accompanied with breathing difficulties, profuse sweating, and muscle tension. These effects, along with classic psychostimulant symptoms such as sleep deprivation and suppressed appetite, 14 give further support to the notion of ethylphenidate as a highly potent NPS. Another ordeal type of experience appeared to be the administration of the drug.…”

“…The stimulating energy boost, euphoria, and increased self-confidence reported by the users were concordant with the characteristics of other potent psychostimulants such as amphetamine or cocaine. 14 Furthermore, the users stated that they were motivated by an increase in sociableness. Ethylphenidate acted as a social lubricant, enhancing intimacy, empathy, and communication.…”

“Chasing the High” – Experiences of Ethylphenidate as Described on International Internet Forums

“…The increased heart rate, blood pressure, and body temperature were occasionally accompanied with breathing difficulties, profuse sweating, and muscle tension. These effects, along with classic psychostimulant symptoms such as sleep deprivation and suppressed appetite, 14 give further support to the notion of ethylphenidate as a highly potent NPS. Another ordeal type of experience appeared to be the administration of the drug.…”

“…The stimulating energy boost, euphoria, and increased self-confidence reported by the users were concordant with the characteristics of other potent psychostimulants such as amphetamine or cocaine. 14 Furthermore, the users stated that they were motivated by an increase in sociableness. Ethylphenidate acted as a social lubricant, enhancing intimacy, empathy, and communication.…”

Pharmacotherapy for Cocaine Use Disorder—a Systematic Review and Meta-analysis

“…Given the largely disappointing pharmacotherapy results, these interventions (e.g., CM, CBT), alone or in combination, continue to be mainstays of treatment and management of stimulant use disorders. 77,78 A systematic review by Minozzi et al found that any psychosocial treatment likely reduces dropout rates and may increase the period of abstinence (most of the studies reviewed included CM in addition to treatment as usual). 78 The combination of pharmacotherapy with CM is an important area for future research as we do not know how medication may enhance the effectiveness of these interventions.…”

Substance use patterns and health profiles among US adults who use opioids, methamphetamine, or both, 2015-2018

“…Unlike medication for OUD, there is no effective pharmacologic treatment for methamphetamine use disorder. Although there are behavioral treatments available for methamphetamine use disorder, they are less efficacious than medication available for OUD ( Phillips et al, 2014 ). This highlights the importance of prevention and harm reduction strategies in preventing the downstream health effects associated with methamphetamine use.…”

“Chasing the High” – Experiences of Ethylphenidate as Described on International Internet Forums

“…The increased heart rate, blood pressure, and body temperature were occasionally accompanied with breathing difficulties, profuse sweating, and muscle tension. These effects, along with classic psychostimulant symptoms such as sleep deprivation and suppressed appetite, 14 give further support to the notion of ethylphenidate as a highly potent NPS. Another ordeal type of experience appeared to be the administration of the drug.…”

“…The stimulating energy boost, euphoria, and increased self-confidence reported by the users were concordant with the characteristics of other potent psychostimulants such as amphetamine or cocaine. 14 Furthermore, the users stated that they were motivated by an increase in sociableness. Ethylphenidate acted as a social lubricant, enhancing intimacy, empathy, and communication.…”

Pharmacotherapy for Cocaine Use Disorder—a Systematic Review and Meta-analysis

“…Given the largely disappointing pharmacotherapy results, these interventions (e.g., CM, CBT), alone or in combination, continue to be mainstays of treatment and management of stimulant use disorders. 77,78 A systematic review by Minozzi et al found that any psychosocial treatment likely reduces dropout rates and may increase the period of abstinence (most of the studies reviewed included CM in addition to treatment as usual). 78 The combination of pharmacotherapy with CM is an important area for future research as we do not know how medication may enhance the effectiveness of these interventions.…”

Substance use patterns and health profiles among US adults who use opioids, methamphetamine, or both, 2015-2018

“…Unlike medication for OUD, there is no effective pharmacologic treatment for methamphetamine use disorder. Although there are behavioral treatments available for methamphetamine use disorder, they are less efficacious than medication available for OUD ( Phillips et al, 2014 ). This highlights the importance of prevention and harm reduction strategies in preventing the downstream health effects associated with methamphetamine use.…”

“Chasing the High” – Experiences of Ethylphenidate as Described on International Internet Forums

“…The increased heart rate, blood pressure, and body temperature were occasionally accompanied with breathing difficulties, profuse sweating, and muscle tension. These effects, along with classic psychostimulant symptoms such as sleep deprivation and suppressed appetite, 14 give further support to the notion of ethylphenidate as a highly potent NPS. Another ordeal type of experience appeared to be the administration of the drug.…”

“…The stimulating energy boost, euphoria, and increased self-confidence reported by the users were concordant with the characteristics of other potent psychostimulants such as amphetamine or cocaine. 14 Furthermore, the users stated that they were motivated by an increase in sociableness. Ethylphenidate acted as a social lubricant, enhancing intimacy, empathy, and communication.…”

Pharmacotherapy for Cocaine Use Disorder—a Systematic Review and Meta-analysis

“…Given the largely disappointing pharmacotherapy results, these interventions (e.g., CM, CBT), alone or in combination, continue to be mainstays of treatment and management of stimulant use disorders. 77,78 A systematic review by Minozzi et al found that any psychosocial treatment likely reduces dropout rates and may increase the period of abstinence (most of the studies reviewed included CM in addition to treatment as usual). 78 The combination of pharmacotherapy with CM is an important area for future research as we do not know how medication may enhance the effectiveness of these interventions.…”

Substance use patterns and health profiles among US adults who use opioids, methamphetamine, or both, 2015-2018

“…Unlike medication for OUD, there is no effective pharmacologic treatment for methamphetamine use disorder. Although there are behavioral treatments available for methamphetamine use disorder, they are less efficacious than medication available for OUD ( Phillips et al, 2014 ). This highlights the importance of prevention and harm reduction strategies in preventing the downstream health effects associated with methamphetamine use.…”