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Cited by 143Substance Abuse Treatment and OutcomesOpioid Use Disorder TreatmentNeurotransmitter Receptor Influence on Behavior

Non-pharmacological interventions for methamphetamine use disorder: a systematic review

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AshaRani, PV, Hombali, Aditi, Seow, Esmond, Ong, Wei Jie, Tan, Jit Hui, Subramaniam, Mythily·2020·Drug and Alcohol Dependence
DOI 10.1016/j.drugalcdep.2020.108060
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Abstract

BACKGROUND: Methamphetamine (METH) use is on the rise globally, with the number of treatment seekers increasing exponentially across the globe. Evidence-based therapies are needed to meet rising treatment needs. This systematic review intends to appraise the existing evidence to identify effective non-pharmaceutical approaches for the treatment of METH use disorder. METHODS: Five electronic bibliographic databases-Ovid (Medline), Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Web of Science and PsycINFO- were searched to identify relevant studies that were published between January 1995 to February 2020. Studies were selected and assessed by two independent reviewers. A systematic review of data from both randomised control trials (RCT) and non-RCTs was conducted to appraise the evidence. RESULTS: A total of 44 studies were included in the review. Behavioural interventions, i.e. cognitive behavioural therapy (CBT), contingency management (CM), exercise, residential rehabilitation based therapies, repetitive transcranial magnetic stimulation (rTMS), and matrix model demonstrated treatment efficacy in promoting abstinence, reducing methamphetamine use or craving in the participants. While CM interventions showed the strongest evidence favouring the outcomes assessed, tailored CBT alone or with CM was also effective in the target population. CONCLUSIONS: Behavioural interventions should be considered as the first line of treatment for methamphetamine use disorder. Future studies should address the longevity of the effects, and limitations due to smaller sample sizes and high dropout rates to enable better assessment of evidence.

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  • A systematic review of reviews on psychosocial and pharmacological interventions for StUD found contingency management to be the only efficacious intervention.

    “A systematic review that evaluated reviews covering various psychosocial and pharmacological interventions for StUD found that CM was the only efficacious intervention. 43”

    From The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder (2024) · cites this paper as [43]

    The Abstract says this review assessed trials and non-randomised studies of non-pharmaceutical interventions, not reviews of psychosocial and pharmacological treatments. Its Conclusion explicitly identifies CM, CBT and exercise as efficacious for methamphetamine use disorder, contrary to the claim that CM was the only efficacious intervention. (LLM, conf=0.90)

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  • Contingency management has shown the greatest effectiveness among studied interventions for stimulant use disorder and is the current standard of care.

    “Contingency management (CM) has demonstrated the best effectiveness in the treatment of stimulant use disorders (StUDs) compared to any other intervention studied and represents the current standard of care.”

    From The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder (2024) · cites this paper as [43]

    The Discussion reports that contingency management had better outcomes than other methods for methamphetamine use disorder, and the Results describe it as having the strongest evidence among the interventions reviewed. The paper does not establish that it is the most effective intervention for all stimulant use disorders or identify contingency management specifically as the current standard of care; its conclusion recommends behavioural interventions more broadly as first-line treatment for methamphetamine use disorder. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Strong evidence indicates that contingency management effectively increases treatment engagement and reduces stimulant use.

    “There is strong evidence that CM is an effective intervention for increasing treatment engagement and reducing stimulant use.”

    From The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder (2024) · cites this paper as [43]

    The Discussion reports that CM consistently reduced drug use and improved treatment retention during treatment for methamphetamine use disorder. The claim extends that finding to stimulant use generally; this review’s own findings concern methamphetamine, and it says the durability of the benefits after treatment is not well studied. (LLM, conf=0.86)

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Cited by

Sorted by citations

Authors
AshaRani, P., Hombali, A., Seow, E., Ong, W. J., Tan, J. H., & Subramaniam, M.
Affiliations
Institute of Mental Health (SG)
Corresponding author
AshaRani, PV
ORCID
Venue
Drug and Alcohol Dependence
Publisher
Elsevier BV
Published
2020-07
Volume
212
Pages
108060
ISSN
0376-8716 (ISSN-L)
DOI
10.1016/j.drugalcdep.2020.108060
OpenAlex
W3024910468
Cited by
143
References
14
Citations by year
2026: 15 · 2025: 34 · 2024: 24 · 2023: 32 · 2022: 25 · 2021: 10 · 2020: 3
FWCI
2.56
Type
journal article
Language
en
Open access
Licence
Locations
  • Drug and Alcohol Dependence (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
Ministry of Home Affairs - Singapore
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Keywords
methamphetamine dependence, non-pharmacological treatment, behavioral interventions, cognitive behavioral therapy, contingency management, physical activity, residential rehabilitation, repetitive transcranial magnetic stimulation, matrix models, abstinence, craving reduction, treatment efficacy
MeSH terms
Behavior Therapy, Humans, Methamphetamine, Exercise, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome, Amphetamine-Related Disorders

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