PSYCHOSTIMULANT ABUSE - THE CASE FOR COMBINED BEHAVIORAL AND PHARMACOLOGICAL TREATMENTS

Behavioral and pharmacological therapies have been used alone and in c ombination for the treatment of substance abuse; however, to date, no single treatment approach for psychostimulant abuse has demonstrated w idespread efficacy. This paper describes the various functions that ar e served by both behavioral therapies and pharmacotherapies and their respective mechanisms of action. II is argued that combined treatments can be expected to produce additive effects because the two approache s operate through different and potentially complementary mechanisms. Illustrations of these underlying principles and experimental support for the use of combined treatments are drawn from smoking cessation re search, which has broadly applied combined behavioral and pharmacologi cal therapies for treating abuse of nicotine, a mild stimulant, In add ition, the results of recent studies that have evaluated the efficacy of behavioral techniques and/or potential pharmacotherapies for treati ng cocaine abuse are reviewed. Finally, methodological strategies are recommended for future evaluations of combined therapy approaches to c onclusively evaluate separate and combined efficacy of treatments for psychostimulant abuse. (C) 1997 Elsevier Science Inc.