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Review
. 2009 May;22(3):263-8.
doi: 10.1097/YCO.0b013e32832a3b44.

Psychological treatments for stimulant misuse, comparing and contrasting those for amphetamine dependence and those for cocaine dependence

Frank J Vocci  1 , Iván D Montoya
Affiliations
Review

Psychological treatments for stimulant misuse, comparing and contrasting those for amphetamine dependence and those for cocaine dependence

Frank J Vocci et al. Curr Opin Psychiatry. 2009 May.

Abstract

Purpose of review: The aim is to compare and contrast psychological treatments for amphetamine and cocaine dependence.

Recent findings: Stimulant dependence, in the form of cocaine or amphetamine/methamphetamine dependence, is prevalent worldwide, and their ratio may vary across different countries and regions of countries. The treatment of stimulant disorders has greatly advanced in recent years, and scientific evaluation of behavioral therapies, using randomized clinical trials designs and a stage-wise approach, have demonstrated the safety and efficacy of interventions. Psychological interventions such as cognitive behavioral therapy and contingency management for cocaine and methamphetamines use disorders are well tolerated and moderately effective in achieving drug abstinence. There is evidence that contingency management interventions can help to improve retention in treatment and, in turn, other treatment outcomes. Although there are important differences in the neuropsychiatric and medical consequences of cocaine and amphetamine use disorders, there is currently no evidence for a differential treatment effect of any psychosocial treatment in the management of these disorders.

Summary: As there are no Food and Drug Administration-approved medications for the treatment of these disorders, psychological interventions form the basis of their treatment. More research is needed to address the specific psychosocial needs of cocaine and amphetamine-dependent individuals in order to improve their treatment outcomes.

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References

    1. 2008 World Drug Report. United Nations Office on Drug Use and Crime; 2008.

    2. This is the most recent estimate of stimulant users in the world, which shows differences in the prevalence of cocaine and amphetamine use disorders in different countries.

    1. Office of Applied Studies. Results from the 2006 National Survey on Drug Use and Health: National findings. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2008. 2008. NSDUH Series H-32, DHHS Publication No. #SMA 07-4293.
    1. Carroll KM, Onken LS. Behavioral therapies for drug abuse. Am J Psychiatry. 2005;162:1452–1460. - PMC - PubMed
    1. Dutra L, Stathopoulou G, Basden SL, et al. A meta-analytic review of psychosocial interventions for substance use disorders. Am J Psychiatry. 2008;165:179–187. - PubMed

    2. This is a meta-analysis of 34 well controlled clinical trials of psychological interventions for different substance use disorders. The results show differences in the treatment effect depending on the type of intervention and the drug of choice.

    1. Plebani Lussier J, Heil SH, Mongeon JA, et al. A meta-analysis of voucher-based reinforcement therapy for substance abuse disorders. Addiction. 2007;101:192–203. - PubMed

    2. This meta-analysis of 12 studies shows a moderate effect size of voucher-based contingency management for the treatment of cocaine dependence.

MeSH terms

Substances