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Reduced drug use valid treatment for stimulant disorder: Study

  • Abstinence widely seen as standard treatment goal for substance abuse
  • Researchers found using drugs less also had beneficial results
  • Doctor: Findings align with 'evolving understanding' of addiction

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(NewsNation) — People with stimulant use disorder showed significant improvements in their health by reducing their use of substances even if they did not stop using them completely, a new study has found.

Typically, total abstinence has been the standard goal of medical experts when treating substance abuse disorders. With these new findings, though, researchers are urging the scientific community to look at other perspectives on measuring treatment success, according to a news release.

Published in the peer-reviewed journal “Addiction” Wednesday, the study was led by scientists at the Johns Hopkins Bloomberg School of Public Health in Maryland, who collaborated with National Institute on Drug Abuse researchers. 

Data from 13 randomized clinical trials of treatments for stimulant use disorders involving methamphetamine and cocaine were analyzed for the article.

Transitioning from “high use,” defined as five or more days a month, to using one to four days a month was linked with lower levels of drug craving, depression and other drug-related challenges.

Abstaining from drugs was associated with the greatest clinical improvement, the news release said, but reduced use was still very strongly correlated with multiple measures of success in psychosocial functioning at the end of the trials. 

More participants, 18%, chose to stop using their drug of choice as often rather than stopping it altogether. Only 14% of people abstained completely. 

Temporarily returning to using drugs after periods of not doing so is part of many recovery journeys, scientists said in the news release, so relying exclusively on abstinence as an outcome in previous clinical trials might have masked the beneficial effects of other treatments. 

“These findings align with an evolving understanding in the field of addiction, affirming that abstinence should be neither the sole aim nor only valid outcome of treatment,” said NIDA Director Dr. Nora Volkow. “Embracing measures of success in addiction treatment beyond abstinence supports more individualized approaches to recovery, and may lead to the approval of a wider range of medications that can improve the lives of people with substance use disorders.”

As the news release pointed out, while there are Food and Drug Administration-approved pharmacological treatments for opioid use disorder and alcohol use disorder, none currently exist for those who use stimulants. 

“This study provides evidence that reducing the overall use of drugs is important and clinically meaningful,” Dr. Mehdi Farokhnia, a staff scientist in the NIDA Intramural Research Program and study author, said. “This shift may open opportunities for medication development that can help individuals achieve these improved outcomes, even if complete abstinence is not immediately achievable or wanted.”

Study authors said more research is necessary, as the study did not include behavioral treatment trials, only those enrolled in clinical trials, “which could limit generalizability,” they said. 

“Additional research is needed to understand the potential clinical benefits of reduced drug use, along with other harm reduction-based indicators of clinical improvement in real-world populations,” authors wrote.

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