Psychosocial interventions for stimulant use disorder

Area of Science:

• Addiction Medicine
• Psychiatry
• Public Health

Background:

• Stimulant use disorder presents a growing medical and social challenge with no approved pharmacological treatments.
• Psychosocial interventions are a key strategy for managing stimulant consumption and improving treatment retention.

Approach:

• Systematic review and meta-analysis of 64 randomized controlled trials (RCTs) involving 8241 adult participants with stimulant use disorder.
• Searches included multiple databases and trial registers up to September 2023, encompassing non-English literature.
• Interventions were compared against no intervention, treatment as usual (TAU), or alternative psychosocial approaches.

Key Points:

• Psychosocial treatments significantly reduce dropout rates (high-certainty evidence) and frequency of stimulant use (high-certainty evidence) compared to no intervention.
• Contingency management was the most studied intervention, showing promise in improving outcomes.
• Evidence for improving point or continuous abstinence was mixed, with moderate to low certainty for some outcomes.

Conclusions:

• Psychosocial interventions are effective in reducing dropout rates and drug use frequency in stimulant use disorder, offering vital support for treatment retention.
• While not consistently improving abstinence rates, these interventions are crucial for managing chronic, relapsing stimulant use disorders.
• Further research is needed for less-studied interventions to fully ascertain their efficacy.