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19 - Treatment of stimulant dependence

from Part III - Specific treatments

Published online by Cambridge University Press:  12 May 2010

By
Mehmet Sofuoglu ,
Kostas Agath  and
Thomas R. Kosten
Edited by
Peter Tyrer  and
Kenneth R. Silk
Mehmet Sofuoglu
Affiliation:
Department of Psychiatry Yale University Medical School VA Connecticut Healthcare System Department of Psychiatry West Haven, CT USA
Kostas Agath
Affiliation:
Westminster Substance Misuse Services London UK
Thomas R. Kosten
Affiliation:
Department of Psychiatry Baylor College of Medicine Houston, TX USA
Peter Tyrer
Affiliation:
Imperial College of Science, Technology and Medicine, London
Kenneth R. Silk
Affiliation:
University of Michigan, Ann Arbor
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Summary

Editor's note

Cocaine, amphetamine and methamphetamine are the stimulants considered in this chapter. Yet most of the treatments discussed primarily deal with issues related to cocaine. Despite a growing knowledge base as to the underlying action of stimulants, we have not found psychopharmacologic treatments that consistently can be counted upon to be effective in the treatment of the misuse of substances within this class. There are single randomized control trials that show effectiveness for fluoxetine, imipramine, disulfiram, some dopamine agents and adrenergic blocking agents, but there are few RCT replications of the effectiveness of these agents. The treatment of stimulant abuse remains primarily psychosocial, especially treatments that use a cognitive-behavioral approach, an approach whose effectiveness can be further enhanced with contingency management and the use of vouchers. There is some growing interest and studies of combined cognitive behavioral approaches with pharmacotherapy, but even here no single pharmacotherapeutic agent or class of agents stands out. The measures of effectiveness are usually (a) the presence of drug-free urines and (b) the continued involvement in the treatment program which is referred to as treatment retention.

Introduction

Cocaine and amphetamine addictions have become major public health concerns for over 20 years worldwide. The estimated annual prevalence of cocaine abusers in the population over 15 years of age is 0.3% globally, 0.4% in Europe and 1.7% in the Americas, while the relevant figures for amphetamine abusers are 0.6% globally, 0.7% in Europe and 0.7% in the Americas (United Nations Office for Drug Control and Crime Prevention, 2000).

Type
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Information
Cambridge Textbook of Effective Treatments in Psychiatry , pp. 369 - 380
Publisher: Cambridge University Press
Print publication year: 2008

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  • Treatment of stimulant dependence
    • By Mehmet Sofuoglu, Department of Psychiatry Yale University Medical School VA Connecticut Healthcare System Department of Psychiatry West Haven, CT USA, Kostas Agath, Westminster Substance Misuse Services London UK, Thomas R. Kosten, Department of Psychiatry Baylor College of Medicine Houston, TX USA
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.021
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  • Treatment of stimulant dependence
    • By Mehmet Sofuoglu, Department of Psychiatry Yale University Medical School VA Connecticut Healthcare System Department of Psychiatry West Haven, CT USA, Kostas Agath, Westminster Substance Misuse Services London UK, Thomas R. Kosten, Department of Psychiatry Baylor College of Medicine Houston, TX USA
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.021
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Treatment of stimulant dependence
    • By Mehmet Sofuoglu, Department of Psychiatry Yale University Medical School VA Connecticut Healthcare System Department of Psychiatry West Haven, CT USA, Kostas Agath, Westminster Substance Misuse Services London UK, Thomas R. Kosten, Department of Psychiatry Baylor College of Medicine Houston, TX USA
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.021
Available formats
×