Pilot randomized controlled study of dexamphetamine substitution for amphetamine dependence

Area of Science:

• Addiction Medicine
• Psychopharmacology
• Clinical Trials

Background:

• Amphetamine dependence is a significant public health issue.
• Substitution therapy is a potential treatment modality for substance use disorders.

Purpose of the Study:

• To assess the feasibility of a definitive randomized controlled trial (RCT) for dexamphetamine substitution in amphetamine-dependent individuals.
• To gather preliminary data on the efficacy and acceptability of this treatment approach.

Main Methods:

• An open-label, two-group, pre-post randomized controlled trial was conducted.
• Forty-one long-term amphetamine users were randomized to receive either weekly counseling alone or counseling plus daily dexamphetamine (up to 60 mg).
• Urine drug screens and validated self-report measures (Opiate Treatment Index, Severity of Dependence Scale) were used for assessment.

Main Results:

• Both intervention groups showed reductions in street amphetamine use and dependence.
• Participants receiving dexamphetamine substitution appeared more likely to attend counseling sessions.
• The intervention was found to be acceptable to both participants and clinicians.

Conclusions:

• A definitive RCT for dexamphetamine substitution therapy in amphetamine dependence is feasible.
• Dexamphetamine substitution shows potential for attracting and retaining individuals in treatment.
• The piloted techniques and instruments are suitable for future large-scale trials.