From the Guidelines
Methamphetamine use disorder treatment should prioritize a combination of contingency management and community reinforcement approach, as this has been shown to be the most efficacious and acceptable treatment in both the short and long term. This approach is supported by a systematic review and network meta-analysis of 50 clinical studies, including 6,943 participants, which found that the combination of these two psychosocial interventions was the most effective treatment for cocaine and amphetamine addiction 1.
When considering treatment options, it's essential to address both the physical dependence and the psychological aspects of addiction. Cognitive-behavioral therapy (CBT) is a first-line behavioral approach for treating substance use disorders, including methamphetamine addiction, and has been shown to be effective in reducing substance use and improving outcomes 1.
Key components of an effective treatment plan for methamphetamine use disorder include:
- A combination of contingency management and community reinforcement approach
- Cognitive-behavioral therapy (CBT)
- Addressing co-occurring mental health conditions, such as depression and anxiety
- Regular monitoring and adjustments to the treatment plan as needed
- Consideration of medications, such as bupropion, naltrexone, and mirtazapine, which may help reduce cravings, decrease euphoric effects, and alleviate withdrawal symptoms.
Overall, a comprehensive and individualized treatment approach that incorporates behavioral therapies, medications, and support groups can help individuals with methamphetamine use disorder achieve and maintain recovery.
From the Research
Treatment Options for Methamphetamine Use Disorder
- Contingency management is among the most effective interventions for reducing methamphetamine use, with studies showing broad benefits including greater drug abstinence, higher utilization of other treatments and medical services, and reductions in risky sexual behavior 2, 3, 4
- Cognitive-behavioral therapy (CBT) also appears to be associated with reductions in methamphetamine use and other positive changes, even over short periods of treatment 5
- Behavioral activation is another treatment option that shows modest effectiveness in addressing methamphetamine use disorder 6
Effectiveness of Contingency Management
- Twenty of the twenty-one studies that reported abstinence outcomes showed an effect of contingency management on abstinence, and seven of the nine studies that reported sexual risk behavior outcomes showed an effect of contingency management in reducing risky sexual behavior 2
- Contingency management has been demonstrated to be effective in studies restricted to specific populations, such as men who have sex with men (MSM), and in community programs 2
- The use of contingency management in addition to treatment as usual has been shown to result in significantly more negative urine samples and longer periods of abstinence 3
Need for Further Research
- Despite the effectiveness of contingency management and CBT, there is still a need for further research to improve the longevity of the effect of intervention and to address more complex presentations of methamphetamine use disorder 5, 6
- The development of interventions aimed at novel biological targets, such as those related to the neurobiology of methamphetamine use disorder, may lead to greater success in identifying disease-modifying interventions 6