Disorders due to Substance Use: Stimulants

Stimulant use disorders (StUDs) afflict over 50 million people worldwide. These disorders are associated with significant impairment in social and occupational function, elevated risks of serious medical illnesses such as HIV, hepatitis C, and cardiovascular disease, and elevated rates of overdose death. An extensive body of preclinical research has identified potential targets for pharmacological therapies, but thus far there remain no FDA-approved medications, nor any commonly used worldwide, to treat StUDs. In the following, the focus is on the three main stimulants involved in StUDs, methamphetamine, cocaine, and prescribed stimulants, describing their epidemiology, clinical features, adverse consequences of the use disorders, and their treatment. Behavioral therapies reviewed in this chapter remain the mainstay of treatment for these difficult disorders.