Psychosocial interventions for psychostimulant misuse.

Area of Science:

• Addiction Medicine
• Psychiatry
• Public Health

Background:

• Psychostimulant misuse presents a significant and growing medical and social challenge.
• Pharmacotherapy has not demonstrated proven efficacy for treating psychostimulant misuse.
• Psychosocial interventions offer a potential avenue for aiding individuals in reducing or abstaining from drug use.

Purpose of the Study:

• To systematically evaluate the effectiveness of various psychosocial interventions for adults struggling with psychostimulant misuse.

Main Methods:

• Conducted a comprehensive search of multiple electronic databases (Cochrane, MEDLINE, EMBASE, etc.) and clinical trial registries up to November 2015.
• Included randomized controlled trials (RCTs) comparing psychosocial interventions against no intervention, treatment as usual (TAU), or alternative interventions.
• Utilized standard Cochrane methodological procedures for data collection and analysis, assessing risk of bias across included studies.

Main Results:

• Fifty-two trials involving 6923 participants were included, examining interventions like cognitive behavioral therapy and contingency management.
• Psychosocial treatments, when added to usual care, significantly reduced dropout rates (moderate quality evidence) and increased the longest period of abstinence (high quality evidence).
• Evidence for increased continuous abstinence at the end of treatment was moderate, but not consistently maintained at longest follow-up; comparisons between different psychosocial interventions were limited.

Conclusions:

• Adding psychosocial interventions to treatment as usual likely improves adherence and extends abstinence duration, with contingency management being a particularly promising approach.
• While psychosocial treatments may increase short-term abstinence, long-term maintenance requires further investigation.
• The generalizability of findings may be limited due to the predominance of studies from the United States; direct comparative studies of different psychosocial approaches are recommended.