Lynchburg Journal of Medical Science
Approach to Management of Illicit Psychostimulant Use in Parallel to Opioid Use in Primary Care: Clinical Review
Doctor of Medical Science
Elyse Watkins, DHSc, PA-C, DFAAPA, NCMP
Psychostimulant use disorder (PUD) is the misuse of a prescribed or illicit sympathomimetic drug that activates the central nervous system (CNS) leading to increased CNS dopamine availability and subsequent downstream activation of dopaminergic pathways within the mesolimbic system underpinning the experience of “reward and pleasure” sensations. This review intends to discuss the deficiency in chemotherapeutics for the management of PUD in primary care as well as evaluate areas of research into therapeutic modalities for achieving sustained sobriety in persons treated for PUD in parallel to the opioid crisis favorable outcomes. There is limited research on this topic, thus there is no standardized approach to PUD in the outpatient setting. The current recommendation is individual counseling or group therapy if inpatient rehabilitation is not required. Notably, there exists a significant lack of novel pharmaceutical interventions, particularly agents available in the primary care setting that aim to reduce substance cravings, prevent rebound symptoms from the withdrawal of psychostimulant use, and reduce healthcare utilization of a particular psychostimulant agent similar to buprenorphine/naloxone administration for opioid use disorder (OUD).
Norris K. Approach to Management of Illicit Psychostimulant Use in Parallel to Opioid Use in Primary Care: Clinical Review. Lynchburg Journal of Medical Science. 2023; 5(2).
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