12- and 18-month follow-up after residential treatment of methamphetamine dependence: Influence of treatment drop-out and different treatment concepts

Kamp, Felicia; Hager, Laura; Proebstl, Lisa; Schreiber, Anna; Riebschläger, Marlies; Neumann, Stefan; Straif, Maximilian; Schacht-Jablonowsky, Maik; Falkai, Peter; Pogarell, Oliver; Manz, Kirsi; Soyka, Michael; Koller, Gabriele

doi:10.1016/j.jpsychires.2020.05.029

Cited by 5 publications

(5 citation statements)

References 19 publications

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“…46 Injecting METH has been related to a lower probability of abstinence and smoking (vs injecting) predicted better outcome in our study. 12,44 However this result should be interpreted with caution because of the small sample size. Counseling strategies may focus on syringe users to increase treatment rates.…”

Section: Discussionmentioning

confidence: 78%

“…In previous studies, being male has not been reported as a predictor of abstinence and this result may seem interesting. 12 , 15 , 44 But due to sample size limitation, the result must be interpreted with caution.…”

Section: Discussionmentioning

confidence: 99%

“…11 In a recent study from 2 different rehabilitation centers investigating treatment drop-outs and METH-negative urine result rates, it was found that 25% of participants showed METHabstinence at 12 months after residential treatment. 12 There has been a powerful emphasis on the fact that continuing abstinence declines over time with early periods of abstinence 2 Substance Abuse: Research and Treatment (especially first 24 weeks of treatment) predicting later and continuing abstinence. 13,14 Cognitive impairment, on the other hand, is also a core feature of psychiatric disorders and a significant predictor of psychosocial functioning.…”

Section: Introductionmentioning

confidence: 99%

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A 6-Month Follow-Up Study: Cognitive Impairment May Predict More Frequent Use of Methamphetamine

Karabulut¹

2023

Subst�Abuse

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Objectives: Methamphetamine (METH) use has been associated with impairments in a variety of cognitive functions. In this study, it was aimed to assess the relation between cognitive measures and frequency of METH use. Methods: Ninety-eight participants with methamphetamine use disorder were assessed with Wisconsin Card Sorting Test (WCST), Victoria-Stroop Word Color Test (SWCT), Trail Making Test (TMT) A and B. Participants were followed up during 6-month period with multiple urine toxicology tests (at baseline, month 1, month 2, month 3 and month 6). Results: Participants who had their prescriptions regularly were more likely to have higher rates of METH-negative urine results ( P = .003). Participants who had more correct numbers, completed more categories and had more conceptual level responses on WCST were more likely to use lower frequency of METH (OR = 0.006, P < .01; OR = 0.171, P < .001; OR = 0.024, P < .001; respectively). The higher error numbers and perseverative error rates on WCST were associated with more frequent METH use (OR = 0.023, P < .001; OR = 0.076, P < .001). Interference factor on SWCT was related with lower frequency of METH use whereas color naming factor on SWCT was related with higher rates of urine results (OR = 0.012, P < .001; OR = 3.628, P < .001; respectively). Higher TMT B-A score was related with more frequent METH use, although the significance disappeared after adjustment (OR = 0.002, P < .001). Having psychotic symptoms predicted less frequent use, but after adjustment for other significant variables, there was no significance. Conclusion: Lower frequency of METH use in the follow-up could be predicted by neurocognitive assessments. Deficits in executive functions, attention, set-shifting and mental flexibility seems to be the most effected domains and this effect may be independent from the severity of psychotic symptoms.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A 6-Month Follow-Up Study: Cognitive Impairment May Predict More Frequent Use of Methamphetamine

Karabulut¹

2023

Subst�Abuse

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“…Sixty-nine publications [ 22 – 30 , 46 – 104 ] reporting fifty-four studies [ 22 – 30 , 46 – 83 , 98 – 104 ] met our eligibility criteria and were included. One companion article [ 105 ] was a long-term follow-up of a study [ 46 ], while other companion articles primarily presented data on additional outcomes, subgroups or additional analyses of outcomes.…”

Section: Resultsmentioning

confidence: 99%

“…1-, 2-, 3-and 4-session CBT; Self-help booklet [27,87,88] 2. Acceptance and Commitment Therapy vs CBT [81] More CBT sessions over fewer sessions, and CBT over self-help booklet with the exception of self-help booklet outperforming 1-session of CBT [27,87,88] • Variation in outcome results between ACT and CBT with no difference in harms [81] Other behavioural interventions (n = 7 studies; 13 articles) • Matrix model outperformed both treatment as usual [70,94,95] and inpatient residential rehabilitation [69] with the exception of retention/dropout, where inpatient residential rehabilitation was favored [69] • Other interventions (i.e., outpatient counseling, community-based residential rehabilitation and community-based detox [53,91,92], blended imaging desensitisation [102], educational intervention [60]) outperformed treatment as usual/no treatment for most outcomes (e.g., meth use/abstinence, change in meth use, mental health), but less often for retention/dropouts [53,91,92,102] • Other comparisons provided results where the more effective treatment depended on the outcome evaluated (e.g., intensive versus standard motivational interviewing [30,86]) or unclear results due to poor reporting [46,105] Behavioural + Pharmacotherapy interventions (n = 7 studies; 13 articles) • Several outcomes could not be assessed due to limitations in reporting • For many methamphetamine use outcomes, mental health outcomes and risk behaviors, many pharmacological therapies (i.e., Baclofen [61], Riluzole [58],…”

Section: Feasibility Assessment: Network Meta-analysismentioning

confidence: 99%

Psychosocial and pharmacologic interventions for problematic methamphetamine use: Findings from a scoping review of the literature

Hersi,

Corace,

Hamel

et al. 2023

PLoS ONE

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Rationale Methamphetamine use and related harms have risen at alarming rates. While several psychosocial and pharmacologic interventions have been described in the literature, there is uncertainty regarding the best approach for the management of methamphetamine use disorder (MUD) and problematic methamphetamine use (PMU). We conducted a scoping review of recent systematic reviews (SR), clinical practice guidelines (CPG), and primary controlled studies of psychosocial and pharmacologic treatments for MUD/PMU. Methods Guided by an a priori protocol, electronic database search updates (e.g., MEDLINE, Embase) were performed in February 2022. Screening was performed following a two-stage process, leveraging artificial intelligence to increase efficiency of title and abstract screening. Studies involving individuals who use methamphetamine, including key subgroups (e.g. those with mental health comorbidities; adolescents/youths; gay, bisexual, and other men who have sex with men) were sought. We examined evidence related to methamphetamine use, relapse, use of other substances, risk behaviors, mental health, harms, and retention. Figures, tables and descriptive synthesis were used to present findings from the identified literature. Results We identified 2 SRs, one CPG, and 54 primary studies reported in 69 publications that met our eligibility criteria. Amongst SRs, one concluded that psychostimulants had no effect on methamphetamine abstinence or treatment retention while the other reported no effect of topiramate on cravings. The CPG strongly recommended psychosocial interventions as well as self-help and family support groups for post-acute management of methamphetamine-related disorders. Amongst primary studies, many interventions were assessed by only single studies; contingency management was the therapy most commonly associated with evidence of potential effectiveness, while bupropion and modafinil were analogously the most common pharmacologic interventions. Nearly all interventions showed signs of potential benefit on at least one methamphetamine-related outcome measure. Discussion This scoping review provides an overview of available interventions for the treatment of MUD/PMU. As most interventions were reported by a single study, the effectiveness of available interventions remains uncertain. Primary studies with longer durations of treatment and follow-up, larger sample sizes, and of special populations are required for conclusive recommendations of best approaches for the treatment of MUD/PMU.

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Psychiatric Comorbidity and Psychopathology of Methamphetamine Users—Are There Gender Differences?

Franke

Neumann

Proebstl

et al. 2022

Int J Ment Health Addiction

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Methamphetamine use disorder is associated with severe psychiatric symptoms and psychosocial problems. Women seem to be more affected than men. Therefore, this study examined psychiatric comorbidities and psychopathology, drug use patterns, and treatment outcomes in women addicted to methamphetamine compared to men. Data on methamphetamine-dependent inpatients were collected in two centers specialized for addiction treatment at admission (T0) and discharge (T1, after treatment for 24 weeks). Sociodemographic and clinical measures were collected with the semi-structured clinical interview I at baseline; the self-reported standardized questionnaire (SCL-90-R) was administered at admission and discharge and after 24 weeks. During the entire treatment procedure, treatment relevant aspects were monitored. Out of all 108 treatment-seeking participants (86 men, 22 women), 64 completed the study (51 men, 13 women; drop-out rate: 40.7% (n = 44)). Methamphetamine-dependent women used other stimulants more often than men, while men used hallucinogens significantly more frequently than women. Female inpatients differed significantly from men in various sociodemographic variables (e.g., having children, single parenting) and were significantly more often affected by current (p < 0.001) and lifetime mental stress disorders (p < 0.001), as well as specific psychiatric disorders (p < 0.001) (e.g., posttraumatic stress disorder). At discharge, mental symptoms decreased significantly in men but not in women. Both before and after treatment, women seem to be more vulnerable to psychiatric comorbidities and psychopathologic symptoms compared to men. Although this study only provides preliminary data on gender-specific characteristics of methamphetamine-dependent patients and their treatment, it seems appropriate to discuss the development of gender-specific treatment options. Further studies in this field are needed.

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12- and 18-month follow-up after residential treatment of methamphetamine dependence: Influence of treatment drop-out and different treatment concepts

Cited by 5 publications

References 19 publications

A 6-Month Follow-Up Study: Cognitive Impairment May Predict More Frequent Use of Methamphetamine

A 6-Month Follow-Up Study: Cognitive Impairment May Predict More Frequent Use of Methamphetamine

Psychosocial and pharmacologic interventions for problematic methamphetamine use: Findings from a scoping review of the literature

Psychiatric Comorbidity and Psychopathology of Methamphetamine Users—Are There Gender Differences?

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