The treatment of stimulant dependence

Rehabilitation efforts offered to individuals with stimulant dependence incorporate a series of maneuvers to accomplish three major goals. Following active detoxification, most clinicians attempt to: (1) increase motivation for abstinence and maintain a high level of commitment to this goal; (2) help individuals to rebuild a stable life–style without substances; and (3) actively work toward ways of decreasing the probability of relapse (relapse prevention). While these activities incorporate education, counseling, outreach to families and exposure to self–help groups (e.g. Cocaine Anonymous), numerous pharmacological approaches have been tested. Each mode of drug therapy is based on a reasonable hypothesis, but appropriately controlled and structured clinical trials have not yet revealed any pharmacological approach for rehabilitation of stimulant–dependent individuals for which the risks have been shown to outweigh the assets.