title: Psychosocial interventions for cocaine and psychostimulant amphetamines related disorders.
abstract: BACKGROUND
  The consumption of psychostimulants for non-medical reasons probably occurs because of their euphoriant and psychomotor-stimulating properties. Chronic consumption of these agents results in development of stereotyped behaviour, paranoia, and possibly aggressive behaviour. Psychosocial treatments for psychostimulant use disorder are supposed to improve compliance, and to promote abstinence. Evidence from randomised controlled trials in this subject needs to be summarised.
  
  
  OBJECTIVE
  To conduct a systematic review of all RCTs on psychosocial interventions for treating psychostimulant use disorder.
  
  
  METHODS
  Electronic searches of Cochrane Library, EMBASE, MEDLINE, and LILACS (to may 2006); reference searching; personal communication; conference abstracts; unpublished trials from pharmaceutical industry; book chapters on treatment of psychostimulants abuse/ dependence.
  
  
  METHODS
  All randomised-controlled trials focusing on psychosocial interventions for treating psychostimulants abuse/ dependence.
  
  
  METHODS
  Three authors extracted the data independently and Relative Risks, weighted mean difference and number needed to treat were estimated, when possible. The reviewers assumed that people who died or dropped out had no improvement (intention to treat analysis) and tested the sensitivity of the final results to this assumption.
  
  
  RESULTS
  Twenty-seven randomised controlled studies (3663 participants) fulfilled inclusion criteria and had data that could be used for at least one of the main comparisons. There was a wide heterogeneity in the interventions evaluated: this did not allow to provide a summary estimate of effect and results cannot be summarised in a clear cut way. The comparisons between different type of Behavioural Interventions showed results in favour of treatments with some form of Contingency management in respect to both reducing drop outs and lowering cocaine use..
  
  
  CONCLUSIONS
  Overall this review reports little significant behavioural changes with reductions in rates of drug consumption following an intervention. Moreover, with the evidence currently available, there are no data supporting a single treatment approach that is able to comprise the multidimensional facets of addiction patterns and to significantly yield better outcomes to resolve the chronic, relapsing nature of addiction, with all its correlates and consequences.
authors.affiliation: Universidade Federal do Rio Grande do Sul, Psychiatry, Avenue Paulo Gama 110, Porto Alegre, Brazil. pknapp@terra.com.br
authors.forename: W P
authors.initials: WP
authors.lastname: Knapp
authors.forename: B G O
authors.initials: BG
authors.lastname: Soares
authors.forename: M
authors.initials: M
authors.lastname: Farrel
authors.forename: M S
authors.initials: MS
authors.lastname: Lima
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D019969:Amphetamine-Related Disorders / Q000523:psychology / Q000628:therapy*; D019970:Cocaine-Related Disorders / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003376:Counseling / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods*; D012054:Reinforcement, Psychology; D055502:Secondary Prevention; D016896:Treatment Outcome