SynthesisDrug and alcohol dependence2020
A systematic review and meta-analysis of medications for stimulant use disorders in patients with co-occurring opioid use disorders.
Synthesis in Drug and alcohol dependence, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Psychosocial interventions for stimulant use disorder.The Cochrane database of systematic reviews · 2024Pooled it
- The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder.Journal of addiction medicineGuideline
- A gender-based secondary analysis of the ADAPT-2 combination naltrexone and bupropion treatment for methamphetamine use disorder trial.Addiction (Abingdon, England) · 2023Trial
- Bupropion Slow Release vs Placebo With Adaptive Incentives for Cocaine Use Disorder in Persons Receiving Methadone for Opioid Use Disorder: A Randomized Clinical Trial.JAMA network open · 2023Trial
- Estimating the impact of stimulant use on initiation of buprenorphine and extended-release naltrexone in two clinical trials and real-world populations.Addiction science & clinical practice · 2023Trial
- Polysubstance use before and during treatment with medication for opioid use disorder: Prevalence and association with treatment outcomes.Journal of substance abuse treatment · 2022Trial
- Implementation outcomes and strategies of a peer recovery coach program: findings from a qualitative assessment in the U.S. South, 2024-2025.Addiction science & clinical practice · 2025Article
- Functions of Interdisciplinary Primary Care Teams That Support Pregnant People With Substance Use Disorders.Annals of family medicine · 2025Observational
- Digitally delivered contingency management during methadone treatment for people with co-occurring cocaine and opioid use: a protocol for a randomized controlled trial.Frontiers in psychiatry · 2025Article
- Sociodemographic and patient reported outcomes by racial and ethnicity status among participants in a randomized controlled trial for methamphetamine use disorder.Drug and alcohol dependence reports · 2024Article
- The Association Between Self-Reported Anxiety and Retention in Opioid Agonist Therapy: Findings From a Canadian Pragmatic Trial.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2024Article
- Navigating the Complex Intersection of Substance Use and Psychiatric Disorders: A Comprehensive Review.Journal of clinical medicine · 2024Review
- Linkage facilitation services for opioid use disorder: Taxonomy of facilitation practitioners, goals, and activities.Journal of substance use and addiction treatment · 2024Review
- Associations between stimulant use and return to illicit opioid use following initiation onto medication for opioid use disorder.Addiction (Abingdon, England) · 2024Article
- The health needs of people leaving prison with a history of methamphetamine and/or opioid use.Drug and alcohol review · 2023Article
- Development and multimodal validation of a substance misuse algorithm for referral to treatment using artificial intelligence (SMART-AI): a retrospective deep learning study.The Lancet. Digital health · 2022Article
- A Study of the MTHFR Gene Prevalence in a Rural Tennessee Opioid Use Disorder Treatment Center Population.International journal of environmental research and public health · 2022Article
- U.S. older adults' heroin and psychostimulant use treatment admissions, 2012-2019: Sociodemographic and clinical characteristics.Drug and alcohol dependence · 2022Article
- "It's called overamping": experiences of overdose among people who use methamphetamine.Harm reduction journal · 2022Article
- The role of enkephalinergic systems in substance use disorders.Frontiers in systems neuroscience · 2022Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundStimulant (cocaine and/or methamphetamine) use has increased among people with opioid use disorder. We conducted a systematic review of medications for stimulant use disorders in this population.
methodsWe searched for randomized controlled trials in multiple databases through April 2019, and dual-screened studies using pre-specified inclusion criteria. Primary outcomes were abstinence defined as stimulant-negative urine screens for ≥3 consecutive weeks; overall use as the proportion of stimulant-negative urine specimens; and retention as the proportion of participants who completed treatment. We rated strength of evidence using established criteria and conducted meta-analyses of comparable interventions and outcomes.
resultsThirty-four trials of 22 medications focused on cocaine use disorder in patients with opioid use disorder. Most studies enrolled participants stabilized on opioid maintenence therapy, generally methadone. None of the six studies that assessed abstinence found significant differences between groups. We found moderate-strength evidence that antidepressants (desipramine, bupropion, and fluoxetine) worsened retention. There was moderate-strength evidence that disulfiram worsened treatment retention (N = 605, RR 0.86, 95 % CI 0.77 to 0.95). We found low-strength evidence that psychostimulants (mazindol and dexamphetamine) may reduce cocaine use, though the difference was not statistically significant (standard mean difference 0.35 [95 % CI -0.05 to 0.74]). There was only 1 trial for methamphetamine use disorder, which showed insufficient-strength evidence for naltrexone.
conclusionsCo-occurring stimulant/opioid use disorder is an important problem for targeting future research. Medication trials for methamphetamine use disorder are lacking in this population. Most of the medications studied for cocaine use were ineffective, although psychostimulants warrant further study.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.