Substitution Treatment for Psychostimulant Use

"Recent trials with extended-release formulations and higher dosages of PPs [Prescription Psychosimulants], particularly prescription amphetamines, have shown promising results promoting abstinence from cocaine and reducing drug use. PPs’ potential as an “agonist-type” treatment seems to be better explored with higher dosage regimens and at clinical settings that have direct observed dosing available. The results from patients with comorbid opioid use disorders are particularly encouraging, and this may be due to the fact that high dosages of potent PPs were used, and this population is already enrolled to a healthcare facility that offers daily attendance, supervised medication intake, evidencebased psychosocial interventions, and a wide-range of ancillary services. A widely used and successful model of treating opioid use disorder or incorporating mobile technology solutions to monitor and enhance medication adherence may now be assessed for treatment of individuals with psychostimulant use disorder and incorporate prescription amphetamines as an agonist intervention. Considering the major public health impact of untreated PSUD, and the absence of the widely accepted pharmacological intervention, there is an urgent need to conduct implementation studies of this treatment approach."