ScaleUp: Options for scalable psychosocial and pharmacological treatment of stimulant use disorder

In 2021, stimulants were the second most commonly used internationally controlled substance worldwide, with cannabis being the first. The number of people using drugs was approximately 296 million, marking a 23% increase over the past decade. Of these, an estimated 78 million people used stimulants annually. Stimulant use has led to a high demand for treatment, with notable variations across sub-regions: stimulants being a primary drug for 11% in Africa, 14% in Europe, and 48% in Asia. Despite the rising need for efficacious interventions, no medication has been approved for the treatment of stimulant use disorder to date. Additionally, the implementation of evidence-based psychosocial treatment such as contingency management remains very limited for a variety of reasons.

This panel discussion aims to discuss key issues around: 1) future options for a combined pharmacotherapy and psychosocial interventions for stimulant use disorder, including in the context of polydrug use, and 2) a multi-country effectiveness and implementation study with the goal to identify scalable interventions for different socioeconomic and prevalence settings. The discussion will focus on the needs of diverse populations across various environments, phases of life, socioeconomic status and health comorbidities. Challenges related to outcome measures will also be presented, while highlighting the need for tailored responses for people with stimulant use disorders within the framework set by regulatory agencies. During the workshop, perspectives from the recent reviews and clinical trials conducted locally will be shared by experts from different regions.

Aiming to gather insights and feedback on the feasibility of conducting a multi-country study, the discussion will consider latest research and distinct socioeconomic contexts regarding the management of stimulant use disorders.

The overall goal of the research and perspectives presented is to increase the availability and access to treatment, and support for those with stimulant use disorders and related conditions. This will be achieved through scalable interventions. The discussion will also focus on the range of psychosocial and pharmacological treatment options available at different regions and treatment settings.

There is an urgent need to bridge the global treatment gap for stimulant use disorders by rapidly disseminating and implementing scalable interventions. While some countries are advancing research on pharmacological treatments, a consensus on uniform treatment intervention and key outcome measures that align with regulatory requirements and the needs of affected populations is essential. Undertaking a multi-country study on combined psychosocial and pharmacological treatment of stimulant use disorder will be instrumental in strengthening the evidence for scalable interventions benefitting different population groups and regions.