Research Division, Institute of Mental Health, 10 Buangkok View, Singapore.
Research Division, Institute of Mental Health, 10 Buangkok View, Singapore.
Drug Alcohol Depend. 2020 Jul 1;212:108060. doi: 10.1016/j.drugalcdep.2020.108060. Epub 2020 May 13.
Methamphetamine (METH) use is on the rise globally, with the number of treatment seekers increasing exponentially across the globe. Evidence-based therapies are needed to meet rising treatment needs. This systematic review intends to appraise the existing evidence to identify effective non-pharmaceutical approaches for the treatment of METH use disorder.
Five electronic bibliographic databases-Ovid (Medline), Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Web of Science and PsycINFO- were searched to identify relevant studies that were published between January 1995 to February 2020. Studies were selected and assessed by two independent reviewers. A systematic review of data from both randomised control trials (RCT) and non-RCTs was conducted to appraise the evidence.
A total of 44 studies were included in the review. Behavioural interventions, i.e. cognitive behavioural therapy (CBT), contingency management (CM), exercise, residential rehabilitation based therapies, repetitive transcranial magnetic stimulation (rTMS), and matrix model demonstrated treatment efficacy in promoting abstinence, reducing methamphetamine use or craving in the participants. While CM interventions showed the strongest evidence favouring the outcomes assessed, tailored CBT alone or with CM was also effective in the target population.
Behavioural interventions should be considered as the first line of treatment for methamphetamine use disorder. Future studies should address the longevity of the effects, and limitations due to smaller sample sizes and high dropout rates to enable better assessment of evidence.
冰毒（METH）的使用在全球范围内呈上升趋势，寻求治疗的人数在全球呈指数级增长。需要循证治疗来满足不断增长的治疗需求。本系统评价旨在评估现有证据，以确定治疗冰毒使用障碍的有效非药物方法。
检索了五个电子文献数据库 - Ovid（医学文献在线）、Embase、护理学及相关健康专业文献累积索引（CINAHL）、Web of Science 和 PsycINFO-，以确定发表于 1995 年 1 月至 2020 年 2 月之间的相关研究。研究由两名独立的评审员进行选择和评估。对随机对照试验（RCT）和非 RCT 的数据进行系统评价，以评估证据。
共纳入 44 项研究。行为干预，即认知行为疗法（CBT）、条件管理（CM）、运动、基于住院康复的治疗、重复经颅磁刺激（rTMS）和矩阵模型，在促进参与者戒除、减少冰毒使用或渴望方面显示出治疗效果。虽然 CM 干预显示出支持评估结果的最强证据，但针对特定人群的量身定制的 CBT 单独或与 CM 联合使用也有效。
行为干预应被视为治疗冰毒使用障碍的一线治疗方法。未来的研究应解决效果的持久性问题，并解决由于样本量较小和高辍学率导致的局限性，以便更好地评估证据。
