After explaining why much of this manual focuses on methamphetamine (meth) disorders, it addresses concurrent opioid and cocaine or meth use among Residential Substance Abuse Treatment (RSAT) clients with opioid-use disorder, the consequences of stimulant use, and evidence-based approaches for treating meth and other stimulant-use disorders.
This manual focuses on meth for several reasons. First, meth has a longstanding relationship to crime, including violent crime. Second, the age demographic of meth users tends to be younger than opioid or cocaine users. Third, meth use is linked to hospitalizations for drug-induced psychosis, increased recidivism and medical costs, and higher crime and criminal justice costs. One section of this manual addresses concurrent opioid and cocaine or meth use among RSAT clients with opioid-use disorder (OUD) and among those receiving medication-assisted treatment (MAT). It includes tools for addressing polysubstance use and the increased risks of relapse, as well as overdose risk posed by adulteration of cocaine and meth supplies with fentanyl. It is rare to treat any substance-use disorder (SUD) without identifying the multiple substances involved. Another section of this manual addresses the consequences of stimulant use, focusing on meth, since understanding the physiological, cognitive, and neuropsychological consequences of chronic meth use is essential for effective treatment. The manual’s concluding section emphasizes that the only evidence-based approaches to treating meth and other stimulant-use disorders are behavioral treatments, since no approved medications are currently available for treating meth users. 7 figures, 1 table, and a categorized resource list