Stimulant Addiction: Cocaine and Methamphetamine
Cocaine and Methamphetamine are powerfully addictive stimulants. Addictions to these drugs are very difficult to treat because they are so addictive. Even using stimulants once is often all it takes to be hooked. Once addicted, people will sell their soul for another hit.. In experiments a mouse given cocaine every time it presses a lever will do nothing else but press that lever. It won’t stop for a minute to take a sip of water or a bite to eat, and eventually it will die from a cocaine overdose.
The Newest Killer: Combining Stimulants and Fentanyl
- The opioid epidemic and overdose deaths have been described as a “triple wave epidemic,” with the first wave involving prescription opioids, followed by heroin-related overdoses, and the current wave involving illicit fentanyl and fentanyl like drugs.
- There is actually a “fourth wave”. This latest wave involves using multiple substances at the same time, primarily combining fentanyl with either methamphetamine or cocaine. This poly-addiction is a combo of an “upper” with a “downer”.
- Cocaine or Meth alone or in combination with an opioid are involved in 60-70% overdose deaths.
The Need for Better Medications for Stimulant Addictions
- While there is evidence that medications such as Wellbutrin in combination with Naltrexone is safe and effective in treating adults with moderate to severe methamphetamine addiction there is currently no FDA approved medication.
- Currently there are no approved FDA medications for the treatment of cocaine addiction, and while some individuals may respond to medications such as Antibuse or Modafinil, no off label used medications have been shown to be uniformly effective in treating cocaine addiction.
Harm Reduction: Saving Lives
- Harm reduction is exactly what it sounds like; reducing the harm associated with using drugs. While there are currently no FDA approved medical treatments for cocaine or methamphetamine addictions, addiction psychiatrists directly address poly-addictions, dual-diagnoses, and prescription medications-abuse problems seen in these addictions. In doing so, they play a critical role in reducing the overall burden of stimulant addictions, most importantly reducing overdose deaths.
- Medically treating opioid addictions is essential. This includes fentanyl, alcohol, and benzodiazepines addictions. Managing co-occurring psychiatric illness is vital.
- Monitoring prescription medications used in psychiatry that have abuse potential is crucial.
Adderall and Concerta
- Attention Deficit Disorders like ADHD are often treated with psychostimulants, such as Adderall or Concerta. These FDA approved medications have relatively low abuse risks if they are taken as prescribed in patients with documented Attention Deficit Disorders.
- Research shows that taking ADHD medication does not make kids with ADHD more likely to abuse substances.