TY - JOUR
KW - Amphetamine-Related Disorders/metabolism/physiopathology/therapy
KW - Central Nervous System Stimulants
KW - Humans
KW - Methamphetamine
AU - M. P. Paulus
AU - J. L. Stewart
A1 - 
AB - IMPORTANCE: The prevalence of and mortality associated with methamphetamine use has doubled during the past 10 years. There is evidence suggesting that methamphetamine use disorder could be the next substance use crisis in the United States and possibly worldwide. OBSERVATION: The neurobiology of methamphetamine use disorder extends beyond the acute effect of the drug as a monoaminergic modulator and includes intracellular pathways focused on oxidative stress, neurotoxic and excitotoxic effects, and neuroinflammation. Similarly, the clinical picture extends beyond the acute psychostimulatory symptoms to include complex cardiovascular and cerebrovascular signs and symptoms that need to be identified by the clinician. Although there are no pharmacologic treatments for methamphetamine use disorder, cognitive behavioral therapy, behavioral activation, and contingency management show modest effectiveness. CONCLUSIONS AND RELEVANCE: There is a need to better understand the complex neurobiology of methamphetamine use disorder and to develop interventions aimed at novel biological targets. Parsing the disorder into different processes (eg, craving or mood-associated alterations) and targeting the neural systems and biological pathways underlying these processes may lead to greater success in identifying disease-modifying interventions. Finally, mental health professionals need to be trained in recognizing early cardiovascular and cerebrovascular warning signs to mitigate the mortality associated with methamphetamine use disorder.
AD - Laureate Institute for Brain Research, Tulsa, Oklahoma.; Department of Community Medicine, The University of Tulsa, Tulsa, Oklahoma.; Laureate Institute for Brain Research, Tulsa, Oklahoma.; Department of Community Medicine, The University of Tulsa, Tulsa, Oklahoma.
BT - JAMA psychiatry
C5 - Education & Workforce; Opioids & Substance Use
CP - 9
CY - United States
DO - 10.1001/jamapsychiatry.2020.0246
IS - 9
JF - JAMA psychiatry
LA - eng
M1 - Journal Article
N2 - IMPORTANCE: The prevalence of and mortality associated with methamphetamine use has doubled during the past 10 years. There is evidence suggesting that methamphetamine use disorder could be the next substance use crisis in the United States and possibly worldwide. OBSERVATION: The neurobiology of methamphetamine use disorder extends beyond the acute effect of the drug as a monoaminergic modulator and includes intracellular pathways focused on oxidative stress, neurotoxic and excitotoxic effects, and neuroinflammation. Similarly, the clinical picture extends beyond the acute psychostimulatory symptoms to include complex cardiovascular and cerebrovascular signs and symptoms that need to be identified by the clinician. Although there are no pharmacologic treatments for methamphetamine use disorder, cognitive behavioral therapy, behavioral activation, and contingency management show modest effectiveness. CONCLUSIONS AND RELEVANCE: There is a need to better understand the complex neurobiology of methamphetamine use disorder and to develop interventions aimed at novel biological targets. Parsing the disorder into different processes (eg, craving or mood-associated alterations) and targeting the neural systems and biological pathways underlying these processes may lead to greater success in identifying disease-modifying interventions. Finally, mental health professionals need to be trained in recognizing early cardiovascular and cerebrovascular warning signs to mitigate the mortality associated with methamphetamine use disorder.
PP - United States
PY - 2020
SN - 2168-6238; 2168-622X
SP - 959
EP - 966
EP - 
T1 - Neurobiology, Clinical Presentation, and Treatment of Methamphetamine Use Disorder: A Review
T2 - JAMA psychiatry
TI - Neurobiology, Clinical Presentation, and Treatment of Methamphetamine Use Disorder: A Review
U1 - Education & Workforce; Opioids & Substance Use
U2 - 32267484
U3 - 10.1001/jamapsychiatry.2020.0246
VL - 77
VO - 2168-6238; 2168-622X
Y1 - 2020
Y2 - Sep 1
ER -