6
Treatment
Behavioral Treatment
5. Contingency management (CM) has demonstrated the best
effectiveness in the treatment of stimulant use disorders (StUDs)
compared to any other intervention studied and represents the
current standard of care. (H-S).
6. The following three interventions have the most supportive evidence
and are preferred alongside contingency management:
a. community reinforcement approach (L-C),
b. cognitive behavioral therapy (M-S), and
c. the Matrix Model (M-C).
Technology-Based Interventions
7. Clinicians can consider offering evidence-based behavioral
interventions delivered via digital therapeutics or web-based
platforms as adjunctive StUD treatment components, but they
should not be used as standalone treatment (L-S).
8. Clinicians should consider using telemedicine to deliver treatment
for StUD to patients who may face challenges accessing in-person
care (M-S).
Pharmacotherapy
Non-Psychostimulant Medication
Cocaine Use Disorder: Bupropion
9. For patients with cocaine use disorder, clinicians can consider
prescribing bupropion to promote cocaine abstinence (L-C).
a. Clinicians can give bupropion additional consideration for patients with co-
occurring tobacco use disorder, as this medication can also reduce nicotine/
tobacco use (L-C).
b. Clinicians can give bupropion additional consideration for patients with co-
occurring depressive disorders, as this medication can also treat depression (L-C).
Cocaine Use Disorder: Topiramate
10. For patients with cocaine use disorder, clinicians can consider
prescribing topiramate to reduce cocaine use (L-C).
a. Clinicians can give topiramate additional consideration for patients with
co-occurring alcohol use disorder, as this medication can also reduce alcohol
consumption (L-C).
Amphetamine-Type Stimulant Use Disorder: Bupropion
11. For patients with amphetamine-type stimulant (ATS) use disorder
with low- to moderate-frequency (ie, less than 18 days per month)
stimulant use, clinicians can consider prescribing bupropion to
promote reduced use of ATS (L-C).
a. Clinicians can give bupropion additional consideration for patients with co-
occurring tobacco use disorder, as this medication can also reduce nicotine/
tobacco use (L-C).
b. Clinicians can give bupropion additional consideration for patients with co-
occurring depressive disorders, as this medication can also treat depression (L-C).
