TY - JOUR
T1 - Responding to global stimulant use
T2 - challenges and opportunities
AU - Farrell, Michael
AU - Martin, Natasha K.
AU - Stockings, Emily
AU - Bórquez, Annick
AU - Cepeda, Javier A.
AU - Degenhardt, Louisa
AU - Ali, Robert
AU - Tran, Lucy Thi
AU - Rehm, Jürgen
AU - Torrens, Marta
AU - Shoptaw, Steve
AU - McKetin, Rebecca
N1 - Funding Information:
MF and LD have received investigator-initiated untied educational grants for studies of opioid medications in Australia from Indivior, Mundipharma, and Seqirus. RA has received untied educational grants from Reckitt Benckiser/Indivior and Mundipharma for studies of opioid substitution and agonist medication treatments in Australia. NKM has received unrestricted research grants to her university from Gilead and Merck unrelated to this work. MT has received educational grants in Spain from Gilead, Merck Sharp & Dohme, Servier, and Lundbeck unrelated to this work. JR has received educational grants from Lundbeck GmbH. SS has received clinical supplies from Alkermes and Medicinova for randomised trials outside of the submitted work. ES, AB, JAC, LTT, and RM report no competing interests.
Funding Information:
We thank Jude Byrne, Judy Chang, Patricia González, Maryam Alavi, and Jason Grebely, who all assisted with obtaining perspectives from people who use drugs; Tom Santo Jr, Amy Peacock, and Sarah Larney, who assisted with the stimulant mortality reviews; and Julie Bruneau, Geng Zang, Rick Altice, and Katherine Rich for help with analyses and modelling. The Australian National Drug and Alcohol Research Centre, University of New South Wales Sydney (Sydney, NSW, Australia), provided funding towards the costs of this Series paper. The Australian National Drug and Alcohol Research Centre is supported by funding from the Australian Government Department of Health under the Drug and Alcohol Program. The views expressed in this publication do not necessarily represent the position of the Australian Government. The work informing this Series paper received support from the European Monitoring Centre on Drugs and Drug Addiction. LD and ES are supported by National Health and Medical Research Council Fellowships. LD is supported by National Institute of Health (NIH) grants National Institute on Drug Abuse (NIDA; R01DA1104470). RM is supported by a Curtin Senior Research Fellowship. NKM acknowledges funding from the National Institute of Allergy and Infectious Diseases (R01AI147490) and National Institute for Drug Abuse (R01 DA03773). AB is supported by NIDA DP2-DA049295. JAC is supported by NIH grants and NIDA for research and training (K01-DA043421). NKM and JAC also acknowledge funding from the Center for AIDS Research, University of San Diego, San Diego, CA, USA, a NIH funded programme (P30 AI036214). MT acknowledges funding from Instituto de Salud Carlos III-ISCIII, Red de Trastornos Adictivos-RTA RD16/0017/0010, integrated in the National R+D+I and funded by the ISCIII and the European Regional Development Fund. SS is supported by the National Institute of Mental Health under award number P30 MH058107 and the National Institute of Health under award number P30MH058107. JR acknowledges funding from the Canadian Institutes of Health Research, Institute of Neurosciences, and Mental Health and Addiction (CRISM Ontario Node grant no. SMN-13950).
Funding Information:
We thank Jude Byrne, Judy Chang, Patricia González, Maryam Alavi, and Jason Grebely, who all assisted with obtaining perspectives from people who use drugs; Tom Santo Jr, Amy Peacock, and Sarah Larney, who assisted with the stimulant mortality reviews; and Julie Bruneau, Geng Zang, Rick Altice, and Katherine Rich for help with analyses and modelling. The Australian National Drug and Alcohol Research Centre, University of New South Wales Sydney (Sydney, NSW, Australia), provided funding towards the costs of this Series paper. The Australian National Drug and Alcohol Research Centre is supported by funding from the Australian Government Department of Health under the Drug and Alcohol Program. The views expressed in this publication do not necessarily represent the position of the Australian Government. The work informing this Series paper received support from the European Monitoring Centre on Drugs and Drug Addiction. LD and ES are supported by National Health and Medical Research Council Fellowships. LD is supported by National Institute of Health (NIH) grants National Institute on Drug Abuse (NIDA; R01DA1104470). RM is supported by a Curtin Senior Research Fellowship. NKM acknowledges funding from the National Institute of Allergy and Infectious Diseases ( R01AI147490 ) and National Institute for Drug Abuse ( R01 DA03773 ). AB is supported by NIDA DP2-DA049295. JAC is supported by NIH grants and NIDA for research and training (K01-DA043421). NKM and JAC also acknowledge funding from the Center for AIDS Research, University of San Diego, San Diego, CA, USA, a NIH funded programme ( P30 AI036214 ). MT acknowledges funding from Instituto de Salud Carlos III-ISCIII, Red de Trastornos Adictivos-RTA RD16/0017/0010, integrated in the National R+D+I and funded by the ISCIII and the European Regional Development Fund. SS is supported by the National Institute of Mental Health under award number P30 MH058107 and the National Institute of Health under award number P30MH058107. JR acknowledges funding from the Canadian Institutes of Health Research, Institute of Neurosciences, and Mental Health and Addiction (CRISM Ontario Node grant no. SMN-13950).
Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2019/11/2
Y1 - 2019/11/2
N2 - We did a global review to synthesise data on the prevalence, harms, and interventions for stimulant use, focusing specifically on the use of cocaine and amphetamines. Modelling estimated the effect of cocaine and amphetamine use on mortality, suicidality, and blood borne virus incidence. The estimated global prevalence of cocaine use was 0·4% and amphetamine use was 0·7%, with dependence affecting 16% of people who used cocaine and 11% of those who used amphetamine. Stimulant use was associated with elevated mortality, increased incidence of HIV and hepatitis C infection, poor mental health (suicidality, psychosis, depression, and violence), and increased risk of cardiovascular events. No effective pharmacotherapies are available that reduce stimulant use, and the available psychosocial interventions (except for contingency management) had a weak overall effect. Generic approaches can address mental health and blood borne virus infection risk if better tailored to mitigate the harms associated with stimulant use. Substantial and sustained investment is needed to develop more effective interventions to reduce stimulant use.
AB - We did a global review to synthesise data on the prevalence, harms, and interventions for stimulant use, focusing specifically on the use of cocaine and amphetamines. Modelling estimated the effect of cocaine and amphetamine use on mortality, suicidality, and blood borne virus incidence. The estimated global prevalence of cocaine use was 0·4% and amphetamine use was 0·7%, with dependence affecting 16% of people who used cocaine and 11% of those who used amphetamine. Stimulant use was associated with elevated mortality, increased incidence of HIV and hepatitis C infection, poor mental health (suicidality, psychosis, depression, and violence), and increased risk of cardiovascular events. No effective pharmacotherapies are available that reduce stimulant use, and the available psychosocial interventions (except for contingency management) had a weak overall effect. Generic approaches can address mental health and blood borne virus infection risk if better tailored to mitigate the harms associated with stimulant use. Substantial and sustained investment is needed to develop more effective interventions to reduce stimulant use.
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U2 - 10.1016/S0140-6736(19)32230-5
DO - 10.1016/S0140-6736(19)32230-5
M3 - Review article
C2 - 31668409
AN - SCOPUS:85073678616
SN - 0140-6736
VL - 394
SP - 1652
EP - 1667
JO - The Lancet
JF - The Lancet
IS - 10209
ER -