Chapter 11.Treatment of Stimulant-Related Disorders

The category of “stimulant” drugs encompasses the amphetamine-type stimulants as well as the various forms of cocaine-derived products (e.g., powder cocaine, crack). Amphetamine-type stimulants include methamphetamine as well as prescription medications primarily used for the treatment of attention-deficit/hyperactivity disorder (ADHD), such as amphetamine, methylphenidate, and dextroamphetamine. In the Middle East, fenethylline, a stimulant sold in tablet form (Captagon), is widely used and is the leading reason for treatment admissions in Saudi Arabia and other countries in the region. Khat, a naturally occurring herb with stimulant properties, also poses a significant public health problem in Yemen and East Africa. In the United States, the most commonly used amphetamine-type stimulant is methamphetamine (“crystal,” “crank,” “speed”) or “ice,” its smokable form. Methamphetamine is mass-produced and trafficked by Mexican cartels and can also be domestically produced in smaller quantities; such production typically occurs in home-based “mom and pop” labs most often located throughout the western and midwestern United States. Cocaine (and “crack,” its smokable freebase form) is a derivative of the coca plant and is imported into the United States from Central and South America.