Clinical evidence indicates that pharmacotherapy can be effective in the treatment of stimulant abuse, putatively by reversing or compensating for the long-term residual neuroadaptations produced by chronic abuse. Pharmacologic treatments for stimulant abuse generally rest on one of the following approaches:
• blockade of the reinforcing actions of amphetamines;
• the provision of low-grade enhancement of energy-activating or affective tone with direct dopamine agonists, or with classical antidepressants.
The latter approach is thought to reduce the fantasy urges that trigger use.
Many treatment facilities use a combination of approaches to help drug abusers, as do individual therapists. The most common types of therapy used in treatment centers include substance abuse counseling, anger management, group therapy, 12-step facilitation, brief intervention therapy, contingency management/motivational incentives, cognitive-behavioral therapy, relapse prevention therapy, motivational interviewing, the Matrix Model, or community reinforcement that includes vouchers.
Nearly all treatment facilities for individuals with drug problems encourage the patient to talk about his or her individual experiences with the drug and also help the individual attain greater self-understanding of why drug use started and how it can best be ended.