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Stimulant use disorder

Last edited: 4/15/2026

Overview

Stimulant use disorder (StUD) involves problematic use of stimulant substances leading to clinically significant impairment or distress. Treatment focuses on reducing use, managing withdrawal, and preventing secondary harms 1.

Diagnosis

  • Key Diagnostic Criteria: Presence of a pattern of stimulant use leading to clinically significant impairment or distress, failure to cut down despite persistent desire to do so, and tolerance or withdrawal symptoms 1.
  • Recommended Tests: No specific laboratory tests; diagnosis primarily clinical, possibly supported by toxicology screens 1.

    • Management

  • First-Line Treatments:
    • - Contingency Management: Standard of care for treating StUDs, emphasizing positive reinforcement for abstinence 1.
  • Adjunctive Treatments:
    • - Pharmacotherapies: Off-label use of medications such as modafinil, bupropion, or naltrexone may be considered 1.

    Special Populations

  • Pregnancy: Specific management strategies not detailed in provided abstracts 1.
  • Pediatrics: Tailored approaches needed, focusing on developmental considerations; pharmacotherapy use should be cautious and evidence-guided 1.
  • Elderly: Considerations for polypharmacy and comorbid conditions; individualized treatment plans recommended 1.
  • Comorbidities: Integrated treatment approaches addressing both stimulant use disorder and coexisting conditions are advised 1.

    • Key Recommendations

  • Implement Contingency Management for treating stimulant use disorder to enhance abstinence rates (Evidence: Strong 1).
  • Consider Off-Label Pharmacotherapies such as modafinil, bupropion, or naltrexone as adjuncts in treatment plans (Evidence: Moderate 1).
  • Address Acute Stimulant Intoxication in a medically supervised setting to prevent life-threatening complications (Evidence: Expert opinion 1).

    • References

    1 . The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder. Journal of addiction medicine 2024. link

    Original source

    1. [1]
      The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder. Journal of addiction medicine (2024)
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