Disorders - Stimulant Use
Sinsak-Suvanchot, K., Somrongthong, R., Phukhao, D.
Objective: To evaluate the efficacy of a Group Motivational Interviewing plus Brief Cognitive Behavior Therapy (GMI-BCBT) in reducing
amphetamine dependency in drug abused patients with recurring psychological problems. Material and Method: A quasi-experimental study was used with
200 patients from two psychiatric hospitals forming two groups of participants. The patients reported amphetamine use at least once in the past month
prior to the present study. They were all assessed at baseline with three follow-up sessions. Patients in one psychiatric hospital were assigned to
usual care and were the study group (n = 100) and patients at the other psychiatric hospital, the intervention group, were assigned to four sessions
of GMI-BCBT plus usual care (n = 100). Regarding the follow-up outcomes, comparison of GMI-BCBT plus usual care and usual care only was analyzed by
survival analysis since stopping amphetamine use. Results: Most (59.5%) patients suffered from major depression. The intervention group had
significantly more survival rate within three months (p-value < 0.001). Both groups had a similar pattern of drug use in quantity and frequency.
Their mean score of anxiety and depression were also reducing at baseline, three, and seven months (p-value < 0.001). Conclusion: The present result
suggested that the combined therapy GMI-BCBT is more effectively reduced the rate of amphetamine use for out-patient at psychiatric hospital than
usual care only.
Journal of the Medical Association of Thailand, 95(8) : 1075-
1080
- Year: 2012
- Problem: Stimulant Use
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Motivational interviewing, includes Motivational Enhancing Therapy
Sherman, Susan G., Sutcliffe, Catherine, Srirojn, Bangorn, Latkin, Carl A., Aramratanna, Apinun, Celentano, David D.
Since the 1990s, there has been
a proliferation of methamphetamine use in Thailand, particularly among young people. Simultaneously, risky sexual behaviors among this population
have increased. This study examined the effects of a peer network intervention and a life-skills intervention on methamphetamine and HIV risk
behaviors among 18-25 year olds in Chiang Mai, Thailand. Between April 2005 and June 2007, we conducted a randomized behavioral trial to compare the
efficacy of a peer educator, network-oriented intervention with a best practice, life-skills curriculum on methamphetamine use, sexual behaviors, and
incident sexually transmitted infections (STIs). Follow-up occurred at 3-, 6-, 9-, and 12 months. Both conditions consisted of seven, 2h, small group
sessions. Longitudinal analyses of the three outcomes were conducted by fitting repeated measures logistic regression models using generalized
estimating equations. Participants (N=983) attended a median of six sessions, with no differences between arms. At each follow-up visit, retention
was greater than 85%. Participants were 75% male and were a median of 19 years old. Over time, participants in both conditions showed a significant
and dramatic decline in self-reported methamphetamine use (99% at baseline vs. 53% at 12 months, p<0.0001) and significant increase in consistent
condom use (32% baseline vs. 44% at 12 months, p<0.0001). Incident STIs were common, with no differences between arms. Chlamydia had the highest
incidence rate, 9.85/100 person years and HIV had a low incidence rate of 0.71/100 person years. Among young Thais, we found that a peer educator,
network-oriented intervention was associated with reductions in methamphetamine use, increases in condom use, and reductions in incident STIs over 12
months. We also found parallel reductions with the life-skills condition. To our knowledge, this is the first such trial targeting this population.
Small group interventions are an effective means of reducing methamphetamine use and sexual risk among Thai youth.
Social Science & Medicine, 68(1) : 69-79
- Year: 2009
- Problem: Stimulant Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Skills training
Shoptaw, Steven J., Kao, Uyen, Heinzerling,
Keith, Ling, Walter
Background: Objectives: Search Strategy: Selection Criteria: Data Collection and Analysis: Main Results: Authors' Conclusions:
Few studies examined treatments for amphetamine withdrawal, although it is a common problem among amphetamine users. Its symptoms, in particular
intense craving, may be a critical factor leading to relapse to amphetamine use. In clinical practice, medications for cocaine withdrawal are
commonly used to manage amphetamine withdrawal although the pharmacodynamic and pharmacokinetic properties of these two illicit substances are
different.To assess the effectiveness of pharmacological alone or in combination with psychosocial treatment for amphetamine withdrawals on
discontinuation rates, global state, withdrawal symptoms, craving, and other outcomes.MEDLINE (1966 - 2008), CINAHL (1982 - 2008), PsycINFO (1806 -
2008), CENTRAL (Cochrane Library 2008 issue 2), references of obtained articles.All randomised controlled and clinical trials evaluating
pharmacological and or psychosocial treatments (alone or combined) for people with amphetamine withdrawal symptoms.Two authors evaluated and
extracted data independently. The data were extracted from intention-to-treat analyses. The Relative Risk (RR) with the 95% confidence interval (95%
CI) was used to assess dichotomous outcomes. The Weighted Mean Difference (WMD) with 95% CI was used to assess continuous outcomes.Four randomised
controlled trials (involving 125 participants) met the inclusion criteria for the review. Two studies found that amineptine significantly reduced
discontinuation rates and improved overall clinical presentation, but did not reduce withdrawal symptoms or craving compared to placebo. The benefits
of mirtazapine over placebo for reducing amphetamine withdrawal symptoms were not as clear. One study suggested that mirtazapine may reduce
hyperarousal and anxiety symptoms associated with amphetamine withdrawal. A more recent study failed to find any benefit of mirtazapine over placebo
on retention or on amphetamine withdrawal symptoms.No medication is effective for treatment of amphetamine withdrawal. Amineptine showed reduction in
discontinuation rates and improvement in clinical presentation compared to placebo, but had no effect on reducing withdrawal symptoms or craving. In
spite of these limited benefits, amineptine is not available for use due to concerns over abuse liability when using the drug. The benefits of
mirtazapine as a withdrawal agent are less clear based on findings from two randomised controlled trials: one report showed improvements in
amphetamine withdrawal symptoms over placebo; a second report showed no differences in withdrawal symptoms compared to placebo. Further potential
treatment studies should examine medications that increase central nervous system activity involving dopamine, norepinephrine and/or serotonin
neurotransmitters, including mirtazapine.
Cochrane Database of Systematic
Reviews, (2) : CD003021
- Year: 2009
- Problem: Stimulant Use
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Tetracyclic antidepressants (TECA/NSSAs), Medications used to treat substance abuse, Other antidepressants
Srisurapanont, Manit, Sombatmai,
Sangworn, Boripuntakul, Theerarat
This study evaluated the short-term (eight-week) benefits of brief intervention (BI) in students aged 14-19 years old who met the
DSM-IV diagnostic criteria for methamphetamine (MA) dependence or abuse. The participants were randomly assigned to receive two 20-minute sessions of
BI or one 15-minute session of psychoeducation (PE). Primary outcomes of interest were the decrease of MA use in days of use (per week) units and MA
tablets used (per day when used). All outcomes were assessed at baseline (week 0), week 4, and week 8 (endpoint). A total of 48 participants were
enrolled in the study (24 on BI and 24 on PE treatment). At week 4, the numbers of dropouts in the BI and PE groups were 7 and 5, respectively. The
frequency and amount of MA use decreased significantly in both groups. At week 8, the days of MA use had decreased in the BI group by a significantly
larger number than in the PE group (t=2, df=34, p=0.04). BI appears to have some minimal short-term benefits for adolescents with MA use disorders.
It may decrease the number of days that MA is used.
American Journal on Addictions, 16(2) : 111-6
- Year: 2007
- Problem: Stimulant Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Personalised feedback, normative feedback
Spoth, Richard L., Clair, Scott, Shin, Chungyeol, Redmond, Cleve
OBJECTIVE: To examine the long-term effects of universal preventive interventions
on methamphetamine use by adolescents in the general population during their late high school years. DESIGN: Two randomized, controlled prevention
trials. SETTING: Public schools in the Midwest from 1993 to 2004. PARTICIPANTS: Study 1 began with 667 sixth grade students from 33 rural public
schools; the follow-up included 457 students. Study 2 began with 679 seventh grade students from 36 rural public schools; the follow-up assessment
included 597 students. INTERVENTIONS: In study 1, schools were assigned to the Iowa Strengthening Families Program (ISFP), Preparing for the Drug
Free Years, or a control condition. In study 2, schools were assigned to a revised ISFP (SFP 10-14) plus Life Skills Training (SPF 10-14 + LST), LST
alone, or a control condition. RESULTS: Self-reports of lifetime and past-year methamphetamine use were collected at 6(1/2) years past baseline
(study 1) and at 4(1/2) and 5(1/2) years past baseline (study 2). In study 1, the ISFP past-year rate was 0.0% compared with 3.2% in the control
condition (P = .04). In study 2, SFP 10-14 + LST showed significant effects on lifetime and past-year use at the 4(1/2) year follow-up (eg, 0.5%
lifetime use in the intervention condition vs 5.2% in the control condition, P = .006); both SFP 10-14 + LST and LST alone had significant lifetime
use effects at the 5(1/2) year follow-up. CONCLUSION: Brief universal interventions have potential for public health impact by reducing
methamphetamine use among adolescents.
Archives of Pediatrics & Adolescent Medicine, 160(9) : 876-
82
- Year: 2006
- Problem: Stimulant Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Skills training, Other Psychological Interventions
Marsden, John, Stillwell, Garry, Barlow, Helen, Boys, Annabel, Taylor, Colin, Hunt, Neil, Farrell, Michael
AIMS: To investigate whether a stimulant-
and alcohol-focused brief motivational intervention induces positive behaviour change among young, regular users of MDMA ('ecstasy'), cocaine
powder and crack cocaine. DESIGN AND MEASUREMENTS: A randomized trial of the intervention versus a control group who received written health risk
information materials only. All participants completed a baseline self-assessment questionnaire before randomization. Outcome measures were self-
reported period prevalence abstinence from ecstasy, cocaine powder and crack cocaine and the frequency and amount of stimulant and alcohol use in the
previous 90 days, recorded at 6-month follow-up via self-completion questionnaire and personal interview. PARTICIPANTS AND SETTING: A total of 342
adolescent and young adult stimulant users (aged 16-22 years) were recruited and 87% were followed-up. The intervention was delivered by a team of 12
agency youth drug workers and two researchers at five locations in Greater London and south-east England. FINDINGS: There were no significant
differences in abstinence for ecstasy, cocaine powder or crack cocaine use between the experimental and control groups. Contrasting follow-up with
baseline self-reports, there were no between-group effects for changes in the frequency or amount of stimulant or alcohol use. Participant follow-up
data suggested that the baseline assessment was a contributing factor in within-group behaviour change among experimental and control condition
participants. CONCLUSIONS: Our brief motivational intervention was no more effective at inducing behaviour change than the provision of information
alone. We hypothesize that research recruitment, baseline self-assessment and contact with study personnel are influences that induce positive
reactive effects on stimulant use.
Addiction, 101(7) : 1014-26
- Year: 2006
- Problem: Stimulant Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy
Srisurapanont, M., Jarusuraisin, N., Jittiwutikan, J.
OBJECTIVE: The aim of this study was to examine the benefits of amineptine, a dopamine agonist
antidepressant, in treating amphetamine withdrawal. METHOD: Inpatients with amphetamine withdrawal were recruited to participate in this placebo-
controlled, randomised, double-blind, parallel group, 2-week comparison of amineptine and placebo treatments. The treatment effects were evaluated by
means of the self-administered Amphetamine Withdrawal Questionnaire (AWQ) and the interviewer-administered Clinical Global Impression (CGI) scale. An
intention-to-treat analysis was applied to evaluate the therapeutic effects at the end of week 1 and week 2. RESULTS: Twenty-two patients took part
in each treatment group. The week-1 and week-2 intention-to-treat analyses showed that the mean AWQ reversed vegetative scores (combined scores of
decreased energy, increased appetite and craving for sleep items) of the amineptine group were significantly lower than those of the placebo group.
The general condition of the amineptine group assessed by CGI also significantly improved at the end of week 2. Although the discontinuation rate due
to dissatisfaction with treatment of amineptine group (1/21) was much lower than that of placebo group (6/22), those rates were not significantly
different (p = 0.09). CONCLUSIONS: Amineptine is specifically effective for treating a major component of amphetamine withdrawal: a reversed
vegetative syndrome. Although more than 2 weeks of amineptine treatment may contribute further benefits, both risks and benefits should be taken into
account in doing so.
Australian & New Zealand Journal of Psychiatry, 33(1) : 94
-8
- Year: 1999
- Problem: Stimulant Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Medications used to treat substance abuse, Other antidepressants
Jittiwutikan, J., Srisurapanont, M., Jarusuraisin, N.
Temporary inability to function without amphetamine and the experience of withdrawal syndrome enhance the tendency for repetitive use.
The investigators proposed to examine the therapeutic effects of amineptine, an antidepressant with dopamine reuptake inhibition effect, for the
treatment of amphetamine withdrawal. The 14-day study was carried out on a randomised, double-blind, placebo-controlled design. The authors assessed
the severity of amphetamine withdrawal syndrome by using two measures and performed both end-point and intent-to-treat analyses. The results showed
that amineptine helped relieve a depressed mood within one week and improved the general condition within 2 weeks. In conclusion, amineptine is
effective in rapid relief of depressed mood and improves the general condition of patients with amphetamine withdrawal. Since the amphetamine
withdrawal may last for several weeks, studies with longer duration should be conducted before incorporating amineptine into the clinical practice a
of amphetamine withdrawal treatment.
Journal of the Medical Association of Thailand, 80(9) : 587-
92
- Year: 1997
- Problem: Stimulant Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Medications used to treat substance abuse, Other antidepressants
Giannini, A. J., Loiselle, R. H., Graham, B. H., Folts, D.
J.
The effects of
buspirone in treating cocaine and phencyclidine (PCP) withdrawal were studied. Withdrawal symptoms of these two street-drugs are thought to be due to
norepinephrine, dopamine and possibly serotonin depletion. Buspirone acts by enhancing dopaminergic and noradrenergic firing as well by suppressing
serotonergic activity. Thirty-two cocaine abusers and 24 PCP abusers were withdrawn over a 30-day period. Half of each group received buspirone 10 mg
t.i.d. and the other half 10 mg placebo t.i.d. In the cocaine group, buspirone was significantly more effective from the fifth day onward. In the PCP
group, significant improvement was seen on the thirtieth day. Delayed effectiveness in PCP is thought due to its actions at other neurotransmitter
sites.
Journal of Substance Abuse
Treatment, 10(6) : 523-7
- Year: 1993
- Problem: Stimulant Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Anxiolytics including benzodiazepines, Medications used to treat substance abuse