Psychosocial and pharmacologic interventions for problematic methamphetamine use: Findings from a scoping review of the literature

Rationale Methamphetamine use and related harms have risen at alarming rates. While several psychosocial and pharmacologic interventions have been described in the literature, there is uncertainty regarding the best approach for the management of methamphetamine use disorder (MUD) and problematic me...

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Published in:PloS one 2023-10, Vol.18 (10), p.e0292745-e0292745
Main Authors: Hersi, Mona, Corace, Kim, Hamel, Candyce, Esmaeilisaraji, Leila, Rice, Danielle, Dryburgh, Nicole, Skidmore, Becky, Garber, Gary, Porath, Amy, Willows, Melanie, MacPherson, Paul, Sproule, Beth, Flores-Aranda, Jorge, Dickey, Chandlee, Hutton, Brian
Format: Article
Language:English
Subjects:
Artificial intelligence
Behavior modification
Bisexuality
Bupropion
Care and treatment
Clinical trials
Comorbidity
Complications and side effects
Contingency
Database searching
Diagnosis
Dosage and administration
Drug abuse
Drug use
Effectiveness
Emergency medical care
Health risks
HIV
Human immunodeficiency virus
Internet/Web search services
Intervention
Literature reviews
Medical research
Medicine and Health Sciences
Medicine, Experimental
Mental depression
Mental health
Methamphetamine
Modafinil
Mortality
Mud
Online searching
Pharmacology
Practice guidelines (Medicine)
Prevention
Psychological aspects
Research and Analysis Methods
Retention
Risk factors
Risk taking
Sexual behavior
Sexually transmitted diseases
STD
Subgroups
Topiramate
Transgender persons
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Summary:Rationale Methamphetamine use and related harms have risen at alarming rates. While several psychosocial and pharmacologic interventions have been described in the literature, there is uncertainty regarding the best approach for the management of methamphetamine use disorder (MUD) and problematic methamphetamine use (PMU). We conducted a scoping review of recent systematic reviews (SR), clinical practice guidelines (CPG), and primary controlled studies of psychosocial and pharmacologic treatments for MUD/PMU. Methods Guided by an a priori protocol, electronic database search updates (e.g., MEDLINE, Embase) were performed in February 2022. Screening was performed following a two-stage process, leveraging artificial intelligence to increase efficiency of title and abstract screening. Studies involving individuals who use methamphetamine, including key subgroups (e.g. those with mental health comorbidities; adolescents/youths; gay, bisexual, and other men who have sex with men) were sought. We examined evidence related to methamphetamine use, relapse, use of other substances, risk behaviors, mental health, harms, and retention. Figures, tables and descriptive synthesis were used to present findings from the identified literature. Results We identified 2 SRs, one CPG, and 54 primary studies reported in 69 publications that met our eligibility criteria. Amongst SRs, one concluded that psychostimulants had no effect on methamphetamine abstinence or treatment retention while the other reported no effect of topiramate on cravings. The CPG strongly recommended psychosocial interventions as well as self-help and family support groups for post-acute management of methamphetamine-related disorders. Amongst primary studies, many interventions were assessed by only single studies; contingency management was the therapy most commonly associated with evidence of potential effectiveness, while bupropion and modafinil were analogously the most common pharmacologic interventions. Nearly all interventions showed signs of potential benefit on at least one methamphetamine-related outcome measure. Discussion This scoping review provides an overview of available interventions for the treatment of MUD/PMU. As most interventions were reported by a single study, the effectiveness of available interventions remains uncertain. Primary studies with longer durations of treatment and follow-up, larger sample sizes, and of special populations are required for conclusive recommendations of
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0292745