The American Society of Addiction Medicine (ASAM) and the American Academy of Addiction Psychiatry (AAAP) collaborated to develop the Clinical Practice Guideline on the Management of Stimulant Use Disorder (referred to as the Guideline). It was published on November 8, 2023. The Guideline aims to provide evidence-based strategies and clinically informed standards of care for the treatment of stimulant use disorder (StUD), stimulant intoxication, and stimulant withdrawal. Additionally, the Guideline addresses secondary and tertiary prevention of harms associated with stimulant use. By drawing on existing empirical evidence and clinical judgment, the goal is to enhance the quality of care for individuals with StUD.

In this article, we will explore the key takeaways and insights surrounding the guideline’s recommendations for stimulant use disorder. Please note that this list does not encompass all major points. For a complete list of recommendations, refer to the full text guideline located here or the free pocket guide provided here. Now, let’s get to it!

ASAM/AAAP Stimulant Use Disorder Guidelines – Key Takeaways:

  • Universal Screening: The guideline advocates for universal screening of all patients to detect StUD early. Upon identification, immediate discussions about stimulant use and associated medical risks are recommended to facilitate comprehensive risk assessment and management.
  • Medications: Effective pharmacotherapy options such as topiramate, bupropion, bupropion and naltrexone, and mirtazapine are endorsed for managing StUD. Psychostimulant medications like modafinil, extended-release amphetamine salts, and methylphenidate are also suggested, under the supervision of board-certified addiction specialists equipped with appropriate training and monitoring skills.
  • Behavioral Therapies: Contingency management (CM) stands out as a highly effective treatment approach, complemented by psychosocial interventions such as the Community Reinforcement Approach (CRA) and Cognitive Behavioral Therapy (CBT). These therapies are pivotal in addressing the behavioral and psychological aspects of StUD.
  • Monitoring and Assessment: Healthcare providers prescribing controlled substances for StUD are advised to conduct regular assessments. This ongoing evaluation helps to balance the risks and benefits of treatment, ensuring its safety and efficacy for individual patients.
  • Withdrawal Management: Addressing symptoms of stimulant withdrawal, including depression, anxiety, insomnia, and paranoia, which can last for weeks, is crucial for sustained treatment engagement and relapse prevention.
  • Prevention Strategies: The guideline stresses the implementation of secondary and tertiary prevention strategies. These include measures to reduce overdose risk, promote safe injection practices, address oral health issues, and manage nutritional deficiencies that may arise from chronic stimulant use.

Despite StUD being one of the most prevalent addictions, resources and treatment options remain limited. By outlining clear pathways and best practices for diagnosis and treatment, this guideline intends to enhance available resources and improve outcomes for individuals affected by StUD. For a comprehensive overview of recommendations, please refer to the full guideline. 

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