Pilot randomized controlled study of dexamphetamine substitution for amphetamine dependence

Aims. To test the feasibility of conducting a definitive randomized control led trial of dexamphetamine substitution for amphetamine dependent people a nd provide preliminary data. Design. An open, two-group pre-post randomized controlled trial. Participants. Forty-one long-term, dependent amphetamine users seeking treatment. Intervention. Twenty subjects were offered weekly counselling. Twenty-one subjects were, in addition, prescribed up to 60 mg dexamphetamine daily. Measurements. Immunoassay and mass spectrometric uri nalysis techniques were used to identify the presence of amphetamine and me thylamphetamine in urine. The Opiate Treatment Index and Severity of Depend ence Scale were used to collect pre- and post-self-report data. Subjects we re screened using the Composite International Diagnostic Interview. Finding s. Reduced street amphetamine use and amphetamine dependence was observed b oth in subjects prescribed dexamphetamine and subjects receiving counsellin g only. Treatment subjects appeared more likely to attend counselling. Conc lusions. A definitive randomized controlled trial of dexamphetamine substit ution using the techniques and instruments piloted in this study is feasibl e. Users appeared to be attracted and retained in substitution treatment. T he intervention also appeared to be acceptable to clinicians.