Contents

• Foreword
• Executive Summary
• TIP Development Participants
• Chapter 1—Introduction
  • Purpose of the TIP
  • Organization of the TIP
  • Scope of the TIP
  • Current Stimulant Use in the United States
  • Importance of Science in Building Future Treatments
  • Summary
• Chapter 2—How Stimulants Affect the Brain and Behavior
  • Substance Use Disorders
  • Neurobiology
  • The Reward System or Positive Reinforcement
  • The Stress System or Negative Reinforcement
  • Drug Craving and Memory
  • Role of Technologies
  • Stimulant Use and the Brain
  • Stimulants' Mechanisms of Action
  • General Effects of Stimulants
  • Effects of Route of Administration
  • Psychological and Neurocognitive Effects
  • Cocaine
  • Methamphetamine
  • Prescription Stimulant Medications
  • Assessment and Diagnosis
  • Summary
• Chapter 3—Medical Aspects of Stimulant Use Disorders
  • Toxicity, Addiction, and Other Adverse Reactions
  • Intoxication
  • Clinical Manifestations and Medical Management
  • Identification and Management of Medical Complications
  • Identification and Management of Mental Complications
  • Co-Occurring Disorders and Conditions
  • Linking Treatment Programs and Medical Facilities
  • Summary
• Chapter 4—Approaches to Treatment
  • How To Measure Effectiveness
  • Documented Psychosocial Treatment Approaches
  • Treatment Approaches With Supportive Research
  • Case Management and Coordinated Care
  • Other Interventions With Supportive Research
  • Other Models of Psychosocial Treatment
  • Clinical Issues To Consider
  • Summary
• Chapter 5—Practical Application of Treatment Strategies
  • People With Stimulant Use Disorders Seeking Treatment
  • Treatment Needs of People With Cocaine Use Versus Methamphetamine Use Versus Prescription Stimulant Misuse
  • Maximizing Treatment Engagement
  • Assessment Procedures To Enhance Treatment Engagement
  • Staff Skills To Enhance Treatment Engagement
  • Treatment
  • Strategies for Engagement
  • Strategies for Treatment Initiation
  • Strategies for Stabilization
  • Strategies for Maintenance
  • Other Strategies Useful in Maintaining Abstinence
  • Next Steps
  • Summary
• Chapter 6—Treatment Considerations for Special Populations
  • Racial/Ethnic Minority Populations
  • Women (Including Those Who Are Pregnant)
  • Men Who Have Sex With Men
  • Transgender and Gender Nonbinary Community
  • Adolescents
  • People Experiencing Homelessness/Unstable Housing
  • Rural Populations
  • People Involved in the Criminal Justice System
  • People Taking Medication for Opioid Use Disorder
  • People Who Inject Drugs
  • People Living With HIV/AIDS
  • People With or At Risk for Hepatitis
  • Individuals With Co-Occurring Mental Disorders
  • Summary
• Chapter 7—Resources
  • Resources for Counselors, Providers, and Programs
  • Publications
  • Treatment Locators
  • Client and Family Resources
  • Laws and Regulations
  • Additional Resources
• Bibliography

This publication was prepared under contract numbers 270-95-0013 and 283-17-4901 by the Knowledge Application Program (KAP) for the Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). Sandra Clunies, M.S., ICADC, served as the Contracting Officer's Representative (COR) for initial TIP development. Suzanne Wise served as the COR, and Robert Baillieu, M.D., M.P.H., as the Project Champion, for the TIP update.

Suggested citation:

Substance Abuse and Mental Health Services Administration. Treatment for Stimulant Use Disorders. Treatment Improvement Protocol (TIP) Series 33. SAMHSA Publication No. PEP21-02-01-004. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2021.

The views, opinions, and content expressed herein are the views of the consensus panel members and do not necessarily reflect the official position of SAMHSA or HHS. No official support of or endorsement by SAMHSA or HHS for these opinions or for the instruments or resources described is intended or should be inferred. The guidelines presented should not be considered substitutes for individualized client care and treatment decisions.