Substitution treatment not only reduces the compulsive use of these addictive substances, but also diminishes the associated negative medical and social concomitants, such as infections, a disruptive life style, and involvement in criminal activities. Substitution or agonist treatment reduces patients’ need to chase the abused drugs and eases the access to psychosocial intervention and social integration. Treatment of substance use disorder has advanced substantially in the last few decades. Psychosocial interventions such as motivational enhancement treatment, CBT for relapse prevention, and contingency management have been developed and are now widely utilized. A number of effective medications have been approved and implemented for the treatment of alcohol, tobacco, and opioid use disorders. The biggest gap, specifically in the pharmacological treatment of addictive disorders, is the lack of medications to treat stimulant use disorders such as cocaine and methamphetamine use disorders. The key result of the study by Levin appears to be the dose dependent reduction in relapses. Higher doses of slow release amphetamine treatment led to better …show more content…
A major emphasis in the early phases of methadone treatment was the need to treat with adequate doses. The tendency was to treat with lower doses, resulting in less effective treatments. Individuals with a history of cocaine use or use of other stimulants may need higher doses for successful treatment. We need carefully designed studies that further explore this potential medical approach; to test this intuitive and surprisingly little-explored course of treatment. Studies would have to closely monitor patients, weighing the damage done by untreated stimulant dependence and potential side effects of a high dose treatment. It appears worthy – if not crucial – to test the application of higher doses of slow release stimulants to treat individuals with stimulant use disorder, specifically those suffering from severe stimulant disorder such as crack cocaine and crystal-meth use disorder. Levin FR, Mariani JJ, Specker S, Mooney M, Mahony A, et al. (2015) Extended-Release Mixed Amphetamine Salts vs. Placebo for Comorbid Adult Attention-Deficit/Hyperactivity Disorder and Cocaine Use Disorder: A Randomized Clinical Trial. JAMA psychiatry