Treatment of psychostimulant 1 addiction has been a major, and not fully met, challenge. For opioid addiction, there is strong evidence for the effectiveness of several medications, including methadone, buprenorphine, and naltrexone.
Can agonist maintenance be used to treat psychostimulant addiction?
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.
What are the treatment options for psychostimulant addiction?
The mainstay of treatment has been behavioral interventions such as cognitive-behavioral therapy (CBT). In this paper, we will discuss advances in pharmacological as well as behavioral treatments for psychostimulant addiction.
What is a “psychostimulant?
This work was supported by the Intramural Research Program of the National Institute on Drug Abuse, National Institutes of Health. We define “psychostimulant” to include agents that act primarily by increasing synaptic levels of dopamine and other monoamines.
Which psychostimulants are approved in the US for treatment of ADHD?
Some psychostimulants, including methylphenidate, amphetamine, and methamphetamine are approved in the US for treatment of Attention Deficit Hyperactivity Disorder (ADHD) ( Dopheide and Pliszka, 2009 ), weight control ( Greenway and Caruso, 2005 ), and narcolepsy ( Morgenthaler et al., 2007 ).
What are psychostimulant medications?
Psychostimulants,1 broadly construed, include drugs of abuse, such as cocaine and methamphetamine, as well as therapeutic drugs such as mixed amphetamine salts (Benzedrine, Adderall, Vyvanse), methylphenidate (Ritalin, Concerta, Focalin), and modafinil (Provigil, Sparlon2).
Which medications are most commonly used in the treatment of addictive disorders?
Some of the most well-known medications that are used during addiction treatment are Naltrexone or Buprenorphine....Medications that are commonly used to treat addiction include the following:Naltrexone or Vivitrol.Buprenorphine, Suboxone, and Methadone.Disulfiram or Antabuse.Acamprosate or Campral.
What is the treatment for stimulant use disorder?
Behavioral therapy is the most effective treatment for stimulant use disorder. One such method, contingency management, gives patients tangible rewards for positive behaviors, aiding their efforts to stop using stimulants.
What is the most common form of treatment for addictions?
Counseling and other behavioral therapies are the most commonly used forms of treatment. Medications are often an important part of treatment, especially when combined with behavioral therapies. Treatment plans must be reviewed often and modified to fit the patient's changing needs.
What is pharmacotherapy used for?
Pharmacotherapy is the use of prescribed medication to assist in the treatment of addiction. Pharmacotherapies can be used to reduce the intensity of withdrawal symptoms, to manage cravings and to reduce the likelihood of a lapse or relapse by blocking a drug or addictive behaviour's effect.
Is there a medication for addiction?
Several medications have been found to be effective in treating addiction to opioids, alcohol, or nicotine in adults, although none of these medications have been approved by the FDA to treat adolescents.
Which medication is initially used to treat stimulant intoxication?
Benzodiazepines are often used as first-line therapy for the treatment of severe agitation or aggression during methamphetamine intoxication. Addition of antipsychotics may be considered if benzodiazepines are not sufficient or symptoms of hallucinations and delusions are present.
How many treatment Improvement Protocols are there?
Since 1993,23 TIPS have been developed and issued. SAMHSA estimates the average cost for developing each TIP to be approximately $300,000, not including printing costs.
What are benzodiazepines?
Benzodiazepines are a type of sedative medication. This means they slow down the body and brain's functions. They can be used to help with anxiety and insomnia (difficult getting to sleep or staying asleep)....This means these drugs can:make you feel relaxed and sleepy (sedation)reduce your anxiety.relax your muscles.
What are treatment modalities?
Treatment modalities, or methods of treatment, are the ways that a doctor or administrative health professional treat a patient with mental, emotional, personality disorders or dual diagnosis.
What is a treatment plan for substance abuse?
A substance abuse treatment plan is an individualized, written document that details a client's goals and objectives, the steps need to achieve those, and a timeline for treatment. These plans are mutually agreed upon with the client and the clinician.
What is group therapy and its role in the management of drug abuse?
In drug addiction treatments, the group leaders will see to it that they can work on building the members' coping skills, boost their motivation, limit conflicts, and make them see the connections between their drug use and their feelings and thoughts.
What is the treatment for psychostimulant addiction?
Treatment of psychostimulant 1 addiction has been a major, and not fully met, challenge. For opioid addiction, there is strong evidence for the effectiveness of several medications, including methadone, buprenorphine, and naltrexone. For psychostimulants, there is no corresponding maintenance medication that has met criteria for regulatory approval or generally accepted use. The mainstay of treatment has been behavioral interventions such as cognitive-behavioral therapy (CBT). In this paper, we will discuss advances in pharmacological as well as behavioral treatments for psychostimulant addiction.
What is a stimulant use disorder?
The Diagnostic and Statistical Manual of Psychiatric Disorders, 5th edition (DSM-5) defines a Stimulant-Use Disorder (SUD) as a pattern of use of amphetamine-type substances, cocaine, or other stimulants leading to clinically significant impairment or distress, as manifested by at least two of the following 11 problems within a 12-month period: taking larger amounts or over a longer period of time than intended; persistent desire or unsuccessful efforts to cut down or control; great deal of time spent in activities necessary to obtain, use, or recover; craving; use resulting in failure to fulfill major role obligations; continued use despite recurrent social or interpersonal problems; giving up social, occupational, or recreational activities; recurrent use in physically hazardous situations; continued use despite persistent or recurrent physical or psychological problems; tolerance; withdrawal symptoms, or avoidance of withdrawal symptoms by continued use ( American Psychiatric Association, 2013 ). 2
What is the purpose of agonist-like replacement therapy?
The rationale behind agonist-like replacement therapy in the treatment of SUDs is that a low-dose, slow-release psychostimulant formulation should alleviate craving and block the euphorigenic effects of cocaine or methamphetamine while having little or no abuse potential of its own. Given the nonselective monoaminergic actions of cocaine and methamphetamine, possible targets include the dopamine (DA), serotonin (5-HT), and norepinephrine (NE) systems ( Herin et al., 2010 ).
What are the treatments for SUDs?
Pharmacological interventions for SUDs may include agonist therapy, antagonist therapy (including vaccines, in research settings), and symptomatic relief of withdrawal symptoms or of a comorbid mental or cognitive disorder. The strategy may be to change psychostimulant metabolism, to reduce craving, or to change the balance of reinforcing and aversive effects of psychostimulant self-administration. Numerous pharmacological agents have been tried for SUDs over the years, with limited success. We will discuss some of the more promising pharmacological agents in detail and provide a brief overview of those with equivocal results. It is important to note that the strongest evidence for or against the efficacy of any treatment comes from double-blind, randomized clinical trials with appropriate negative and/or positive controls and with enough participants to make negative results credible. Post hoc findings of benefits in subsets of the original sample, especially in the absence of positive finding on the primary measure, should be viewed with skepticism.
Is NTX a competitive antagonist?
Naltrexone hydrochloride (NTX) is a non-selective competitive antagonist at opioid receptors. It reduces alcohol consumption in laboratory animals and reduces the positive subjective effects of alcohol in humans ( Setiawan et al., 2011 ); in clinical trials for treatment of alcoholism, it reduces relapse and to a lesser degree enhances abstinence, both in adolescents ( De Sousa and De Sousa, 2008, Deas et al., 2005) and adults ( Garbutt, 2010 ). The mechanism of action of NTX in alcoholism is not fully understood, but preclinical data suggest that it may partly involve blockade of the effects of endogenous opioids ( Chiu et al., 2005 ).
Is methamphetamine a psychostimulant?
The pharmacokinetics and pharmacodynamics of psychostimulants are discussed elsewhere in this issue. In brief, methamphetamine is structurally very similar to amphetamine and related agents, such as MDMA (3,4-methylenedioxy-N-methylamphetamine), which is widely known as “ecstasy,” and designer drugs, such as cathinone derivatives (including “bath salts”). The amphetamines, including methamphetamine, are similar to cocaine in causing an increase in synaptic levels of the monoamine neurotransmitters dopamine (DA), norepinephrine (NE), and serotonin, in both the central nervous system (CNS) and peripheral nervous system (PNS) ( Lott et al., 2006, Rothman et al., 2000, White and Kalivas, 1998 ). Cocaine is a reuptake inhibitor; amphetamines are releasers, taken up by the reuptake transporter in exchange for neurotransmitter ( Koob and Bloom, 1988 ).
Is stimulant use a long term or short term problem?
Stimulant-use disorders remain prevalent and can result in both short-term and long-term adverse consequences. The search for an effective medication continues, and until one is found, the mainstay of treatment remains behavioral interventions.
What is psychostimulant addiction?
Addiction on psychostimulants like any other drug addiction is a complex medical and social problem involving biological changes in the brain as well as numerous social, familial, and environmental aspects. Therefore, psychostimulants addiction treatment is also must be complex and address a variety of problems. To be effective psychostimulant treatment strategies must include pharmacological, psychological and social aspects of the patient's drug abuse.
How does CBT help with addiction?
CBT is one of the most effective psychological interventions for psychostimulant addiction, that helps the addicts create and then enforce their motivation to quit the addiction and provides them with techniques to avoid relapse. This approach helps patients to recognize, avoid, and cope with the situations in which they are most likely to use drugs. Through this method our patients learn skills how to cope with craving for drugs, to overcome negative life events, to build up the new relationships and to obtain social support.
