Stimulants

There is the lure of the positive effects of stimulants: elevation of mood, increased alertness, reduced fatigue, increased energy, and relief from boredom. But the feeling of reward that comes from increased dopaminergic neurotransmission that activates the reward system of the nucleus accumbens can quickly lead to obsessive use and dependency. With increased dosages, what were once pleasant effects turn into anxiety, insomnia, irritability, and the need for higher and higher dosages to achieve the desired effect. Successful treatment of stimulant-use disorders must include pharmacology, nonpharmacological treatment, training and reinforcement of behavior change, and supportive social systems.

For this Discussion, consider why treatments for stimulant-use disorders have been ineffective and how treatment might be improved in the future. As you prepare for the Discussion, also take into account the role of the placebo effect as it relates to the treatment of stimulant-use disorders (refer to the Looby and Earleywine article in the Learning Resources).

Post by Day 4 an explanation for why researchers have not found any efficacious treatments for stimulant-use disorders. Include in your explanation an analysis of why previously tested treatments have failed. Be sure to include sociocultural and economic issues and references to the placebo effect in your Discussion. Finally, generate strategies for improving treatment of stimulant-use disorders.

Readings for this homework (which can and should be used for this) are:

Readings

Brown, E. S., Tirado, C., Minhajuddin, A., Hillhouse, M., Adinoff, B., Ling, W., . . . Thomas, C. (2010). Association of race and ethnicity with withdrawal symptoms, attrition, opioid use, and side-effects during buprenorphine therapy. Journal of Ethnicity in Substance Abuse, 9(2), 106–114.

Retrieved from the Walden Library databases.

Döpfner, M., Ose, C., Fischer, R., Ammer, R., & Scherag, A. (2011). Comparison of the efficacy of two different modified release methylphenidate preparations for children and adolescents with attention-deficit/hyperactivity disorder in a natural setting: Comparison of the efficacy of Medikinet® retard and Concerta®—a randomized, controlled, double-blind multicenter clinical crossover trial. Journal of Child and Adolescent Psychopharmacology, 21(5), 445–454.

Retrieved from the Walden Library databases.

Filip, M., Alenina, N., Bader, M., & Przegalinski, E. (2010). Behavioral evidence for the significance of serotoninergic (5-HT) receptors in cocaine addiction. Addiction Biology, 15(3), 227–249.

Retrieved from the Walden Library databases.

Julien, R. M., Advokat, C. D., & Comaty, J. E. (2014). Julien’s primer of drug action: A comprehensive guide to the actions, uses, and side effects of psychoactive drugs (13th ed.). New York, NY: Worth.

Chapter 6, “Caffeine and Nicotine” (pp. 167–200)

Chapter 7, “Cocaine, the Amphetamines, and Other Psychostimulants” (pp. 201–236)

Looby, A., & Earleywine, M. (2011). Expectation to receive methylphenidate enhances subjective arousal but not cognitive performance. Experimental and Clinical Psychopharmacology, 19(6), 433–444.

Retrieved from the Walden Library databases.

Nuijten, M., Blanken, P., van den Brink, W., & Hendriks, V. (2011). Cocaine addiction treatments to improve control and reduce harm (CATCH): New pharmacological treatment options for crack-cocaine dependence in the Netherlands. BMC Psychiatry, 11, 135–144.

Retrieved from the Walden Library databases.

Preston, J. D., O’Neal, J. H., & Talaga, M. C. (2013). Handbook of clinical psychopharmacology for therapists (7th ed.). Oakland, CA: New Harbinger.

Chapter 14, “Substance-Related Disorders” (“Stimulants,” pp. 155–156)

Chapter 23, “Child and Adolescent Psychopharmacology” (“Stimulants,” pp. 256–258)

Appendix I: “Patient Information Sheets on Psychiatric Medications” (“Patient Information on Psychostimulants,” pp. 334–335)

Sofuoglu, M., & Kosten, T. R. (2005). Novel approaches to the treatment of cocaine addiction. CNS Drugs, 19(1), 13–25.

Retrieved from the Walden Library databases.

Williams, M. J., & Adinoff, B. (2008). The role of acetylcholine in cocaine addiction. Neuropsychopharmacology, 33(8), 1779–1797.

Retrieved from the Walden Library databases.