A novel brief treatment for methamphetamine use disorders in South Africa: a randomised feasibility trial
Open accessAbstract
Background: Effective brief treatments for methamphetamine use disorders (MAUD) are urgently needed to complement longer more intensive treatments in low and middle income countries, including South Africa. To address this gap, the purpose of this randomised feasibility trial was to determine the feasibility of delivering a six-session blended imaginal desensitisation, plus motivational interviewing (IDMI) intervention for adults with a MAUD. Methods: We enrolled 60 adults with a MAUD and randomly assigned them 1:1 to the IDMI intervention delivered by clinical psychologists and a control group who we referred to usual care. Feasibility measures, such as rates of recruitment, consent to participate in the trial and retention, were calculated. Follow-up interviews were conducted at 6 weeks and 3 months post-enrollment. Results: Over 9 months, 278 potential particiants initiated contact. Following initial screening 78 (28%) met inclusion criteria, and 60 (77%) were randomised. Thirteen of the 30 participants assigned to the treatment group completed the intervention. Both psychologists were highly adherent to the intervention, obtaining a fidelity rating of 91%. In total, 39 (65%) participants completed the 6-week follow-up and 40 (67%) completed the 3-month follow-up. The intervention shows potential effectiveness in the intention-to-treat analysis where frequency of methamphetamine use was significantly lower in the treatment than in the control group at both the 6 week and 3-month endpoints. No adverse outcomes were reported. Conclusions: This feasibility trial suggests that the locally adapted IDMI intervention is an acceptable and safe intervention as a brief treatment for MAUD in South Africa. Modifications to the study design should be considered in a fully powered, definitive controlled trial to assess this potentially effective intervention. Trial registration The trial is registered with the Pan African Clinical Trials Registry (Trial ID: PACTR201310000589295)
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One study reported on a seven-session intervention that incorporated multiple psychotherapy techniques including motivational enhancement therapy, cognitive therapy, behavior therapy, family therapy, relapse prevention, and exposure therapy.
“One study reported on a seven-session intervention that incorporated multiple psychotherapy techniques including motivational enhancement therapy, cognitive therapy, behavior therapy, family therapy, relapse prevention, and exposure therapy [92].”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [92]
Methods > Interventions (page unavailable) lists motivational enhancement, behavioural intervention, exposure therapy, cognitive therapy, relapse prevention, and a seventh session involving family. But it marks that family session as optional and calls it “family involvement,” not family therapy. The Discussion describes completion of all six sessions, so calling this an unqualified seven-session intervention overstates the source. (LLM, conf=0.87)
Experimental — accuracy not yet measuredIn adults in South Africa, there were no significant differences between groups for the other secondary outcome measures.
“There were no significant differences between groups for the other secondary out-come measures.”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [92]
In adults in South Africa, the intervention group reported significantly lower anxiety scores than the control group (p = 0.049) at both 6 weeks and at 3 months post-intervention.
“The intervention group reported significantly lower anxiety scores than the control group (p = 0.049) at both 6 weeks and at 3 months post-intervention.”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [92]
In adults in South Africa, the intervention group displayed greater reductions in frequency of methamphetamine use than the control group at week 6 and month 3 in the intention-to-treat analysis.
“In the intention-to-treat analysis, the intervention group displayed greater reductions in frequency of methamphetamine use than the control group at week 6 and month 3.”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [92]
In adults in South Africa, of the 30 participants randomized to the intervention group, 13 (43%) completed all six sessions.
“Of the 30 participants who were randomized to the intervention group, 26 completed session one, 24 completed two sessions, 21 completed three sessions, 18 completed four sessions, 15 completed five sessions and 13 (43%) completed all six sessions.”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [92]
The multi-session BIs resulted in reduced methamphetamine use at 6 weeks and 3 months.
“The multi-session BIs also resulted in reduced methamphetamine use at 6 weeks and 3 months [92].”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [92]
Only three studies reported interventions longer than four sessions i.e., six (n = 2) and seven sessions (n = 1).
“Only three studies reported interventions longer than four sessions i.e., six (n = 2) [86,87] and seven sessions (n = 1) [92]).”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [92]
Among studies reporting race (n = 34), the majority of patients were Caucasian in all but four studies.
“Among studies reporting race (n = 34), the majority of patients were Caucasian in all but four studies [23, 69, 73, 102].”
From Psychosocial and pharmacologic interventions for problematic methamphetamine use: Findings from a scoping review of the literature (2023) · cites this paper as [102]
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- Authors
- Sorsdahl, K., Stein, D. J., Pasche, S., Jacobs, Y., Kader, R., Odlaug, B., Richter, S., Myers, B., & Grant, J. E.
- Affiliations
- University of Cape Town (ZA)
- South African Medical Research Council (ZA)
- Stellenbosch University (ZA)
- University of Minnesota (US)
- University of Chicago (US)
- Corresponding author
- Sorsdahl, K.
- Venue
- Addiction Science & Clinical Practice
- Published
- 2021-01-07
- Volume
- 16
- Issue
- 1
- Pages
- 3-3
- ISSN
- 1940-0632 (ISSN-L)
- 1940-0640
- PMC
- PMC7791768
- OpenAlex
- W3118404258
- Cited by
- 11
- References
- 50
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 2
- FWCI
- 1.26
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Addiction Science & Clinical Practice (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- eSpace (Curtin University) (submittedVersion, cc-by)
- Open University of Cape Town (University of Cape Town) (submittedVersion, cc-by)
- SUNScholar (Stellenbosch University) (submittedVersion)
- Funders
- University of Capetown
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- methamphetamine dependence, short-term treatment, motivational interviewing, feasibility, treatment retention, medication adherence, addiction treatment, South Africa
- MeSH terms
- Adult, Crisis Intervention, Feasibility Studies, Female, Humans, Implosive Therapy, Male, Methamphetamine, South Africa, Amphetamine-Related Disorders, Intention to Treat Analysis, Motivational Interviewing
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