Cited by 310Substance Abuse Treatment and OutcomesHIV, Drug Use, Sexual RiskYouth, Drugs, and Violence

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Responding to global stimulant use: challenges and opportunities

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Farrell, Michael, Martin, Natasha K, Stockings, Emily, Bórquez, Annick, Cepeda, Javier A, Degenhardt, Louisa, Ali, Robert, Tran, Lucy Thi, Rehm, Jürgen, Torrens, Marta, Shoptaw, Steve, McKetin, Rebecca·2019·The Lancet

DOI 10.1016/s0140-6736(19)32230-5PMC PMC6924572

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Abstract

We did a global review to synthesise data on the prevalence, harms, and interventions for stimulant use, focusing specifically on the use of cocaine and amphetamines. Modelling estimated the effect of cocaine and amphetamine use on mortality, suicidality, and blood borne virus incidence. The estimated global prevalence of cocaine use was 0·4% and amphetamine use was 0·7%, with dependence affecting 16% of people who used cocaine and 11% of those who used amphetamine. Stimulant use was associated with elevated mortality, increased incidence of HIV and hepatitis C infection, poor mental health (suicidality, psychosis, depression, and violence), and increased risk of cardiovascular events. No effective pharmacotherapies are available that reduce stimulant use, and the available psychosocial interventions (except for contingency management) had a weak overall effect. Generic approaches can address mental health and blood borne virus infection risk if better tailored to mitigate the harms associated with stimulant use. Substantial and sustained investment is needed to develop more effective interventions to reduce stimulant use.

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“One therapeutic approach to counteract the toxic and addictive psychoactive effects of cocaine is to accelerate the drug’s metabolism using cocaine-hydrolyzing enzymes (Farrell et al., 2019; Zheng and Zhan, 2011).”
Background
Does correctional supervision of amphetamine users reduce the risk of re‐offending?
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“…that the study will not only add to the literature on treatment barriers faced by people who use ATS in the context of a Southeast Asian country (Cumming, et al., 2016; McKetin et al., 2018; Farrell et al., 2019) but also provide insights on how to increase voluntary participation at such centers.”
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The Correlation between NPS and Polysubstance Use in High-Risk Population: a Five-year Longitudinal Study in Taiwan
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“(Farrell et al., 2019) In 2015, 50% of a sample in Colorado had either co-injected or injected separate substances in the previous 12 months.”
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“…hospitalisation we observed across follow-up may also be reflective of the fact that there is currently no effective pharmacotherapy to manage methamphet-amine withdrawal [64], or to treat methamphetamine use disorder and that modest efficacy has been observed for psychosocial therapy [65].”
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Abdulfattah, S., Ahmad, A. R., Kitaneh, R., Alsharaydeh, T., Almudallal, F., Alzoubi, R., Abbadi, R., Haddad, T. A., Wazaify, M., Alkayed, Z., et al. (2024) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000001308 · Cited by 3
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FBSA-CNN: A convolutional neural network framework for EEG-based detection of non-acute methamphetamine use disorders
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How does a family history of psychosis influence the risk of methamphetamine‐related psychotic symptoms: Evidence from longitudinal panel data
McKetin, R., Clare, P. J., Castle, D. J., Turner, A., Kelly, P. J., Lubman, D. I., Arunogiri, S., Manning, V., & Berk, M. (2023) · Addiction · doi:10.1111/add.16230 · Cited by 3
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Binge Drug Injection in a Cohort of People Who Inject Drugs in Montreal: Characterizing the Substances and Social Contexts Involved
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“Yet specific mentions or assessments of binge are largely lacking from studies reporting on stimulant use and related harms (e.g. Farrell et al., 2019; Marshall et al., 2011; McKetin et al., 2019).”
Prenatal and postnatal methamphetamine exposure alters prefrontal cortical gene expression and behavior in mice
Adeniyi, P., Adeyelu, T. T., Shrestha, A., Liu, C.-C., & Lee, C. C. (2024) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2024.1286872 · Cited by 1
“Methamphetamine, a highly potent and profoundly addictive substance, has garnered a pervasive presence on the global stage, particularly resonating with adolescents and young adults (Chomchai and Chomchai, 2015; Farrell et al., 2019).”
Background
Effect of a Smartphone App (S-Check) on Actual and Intended Help-Seeking and Motivation to Change Methamphetamine Use Among Adult Consumers of Methamphetamine in Australia: Randomized Waitlist-Controlled Trial
Siefried, K. J., Bascombe, F., Clifford, B., Liu, Z., Middleton, P., KAY‐LAMBKIN, F. J., Freestone, J., Herman, D., Millard, M., Steele, M., et al. (2024) · JMIR mhealth and uhealth · doi:10.2196/55663 · Cited by 3
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Yang, Y., Müller, C. P., & Singh, D. (2024) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2024.2424277 · Cited by 2
“Their consumption is associated with adverse health consequences (Farrell et al. 2019), including poor mental health (McKetin et al. 2019).”
Methamphetamine Pharmacotherapy: A Need to Re-focus on the Complex Neurobiological Changes that Occur Both During and After Methamphetamine Use Disorder
McKetin, R., Kim, J. H., Turner, A., & Berk, M. (2025) · CNS Drugs · doi:10.1007/s40263-025-01214-3 · Cited by 4
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InfluentialSelf-citation
Methamphetamine‐Associated Pulmonary Arterial Hypertension: Impact, Mechanisms, and a Framework for Management
Sood, N., Weerasekare, J., Zhyvylo, I., Goncharova, E. A., & Marco, T. D. (2026) · Pulmonary Circulation · doi:10.1002/pul2.70242 · Cited by 2
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Lozano, C. D. S., Wilkins, C., & Rychert, M. (2022) · Drugs Education Prevention and Policy · doi:10.1080/09687637.2022.2072188 · Cited by 2
“…may result in other potential issues such as an increased risk of early mortality, blood-borne illness, sexually transmitted infections, exposure to violence, drug-related risk behavior, and difficulty in accessing treatment for drug or alcohol use (Damon et al., 2019; Farrell et al., 2019).”
Central nervous system stimulants promote nerve cell death under continuous hypoxia
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BackgroundInfluentialSelf-citation

Authors: Farrell, M., Martin, N. K., Stockings, E., Bórquez, A., Cepeda, J. A., Degenhardt, L., Ali, R., Tran, L. T., Rehm, J., Torrens, M., Shoptaw, S., & McKetin, R.
Affiliations: UNSW Sydney (AU)
University of Bristol (GB)
University of California San Diego (US)
The University of Adelaide (AU)
Centre for Addiction and Mental Health (CA)
Universitat Autònoma de Barcelona (ES)
Corresponding author: Farrell, Michael
ORCID: Farrell, Michael
Martin, Natasha K
Stockings, Emily
Bórquez, Annick
Cepeda, Javier A
Degenhardt, Louisa
Ali, Robert
Tran, Lucy Thi
Rehm, Jürgen
Torrens, Marta
McKetin, Rebecca
Venue: The Lancet
Publisher: Elsevier BV
Published: 2019-11
Volume: 394
Issue: 10209
Pages: 1652-1667
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(19)32230-5
PMC: PMC6924572
OpenAlex: W2981405421
Cited by: 310
References: 135
Citations by year: 2026: 34 · 2025: 48 · 2024: 63 · 2023: 51 · 2022: 41 · 2021: 44 · 2020: 24 · 2019: 4
FWCI: 4.12
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: The Lancet (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: National Institute of Allergy and Infectious Diseases (R01AI147490)
National Institute for Drug Abuse (R01 DA03773)
NIH (P30 AI036214)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Youth, Drugs, and Violence
Keywords: stimulant use, cocaine, amphetamine, prevalence, substance dependence, mortality, suicidality, HIV, hepatitis C, blood-borne viruses, cardiovascular risk, psychosis, depression, violence, pharmacotherapy, psychosocial interventions, contingency management, harm reduction
MeSH terms: Adolescent, Adult, Amphetamines, Central Nervous System Stimulants, Mental Disorders, Cardiovascular Diseases, Cocaine, Female, Hepatitis C, Humans, Male, Middle Aged, Virus Diseases, HIV Infections, Incidence, Prevalence, Dopamine Uptake Inhibitors, Cocaine-Related Disorders, Young Adult

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Responding to global stimulant use: challenges and opportunities

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