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Stimulant Use Disorders: Evidence-Based Treatment Tools

By Rebecca A. Clay

To mark the end of its Methamphetamine Treatment Project, SAMHSA's Center for Substance Abuse Treatment (CSAT) recently released training manuals that provide a structured, evidence-based approach to treat stimulant disorders.

Matrix Intensive Outpatient Treatment for People with Stimulant Use Disorders is a package of publications that gives counselors proven tools to treat clients who have problems with methamphetamine, cocaine, or other stimulants. The manuals and other materials offer step-by-step instructions for providing treatment plus continuing care for clients and their families.

"Stimulants, especially methamphetamine, can have a devastating impact on individuals, families, and communities," said CSAT Director H. Westley Clark, M.D., J.D., M.P.H. "This new publications package expands access to needed treatment."

A Proven Approach

Community-based treatment providers are the main audience for this package, said Project Officer Cheryl J. Gallagher, M.A., a public health advisor at CSAT. The treatment approach has its roots in an outpatient treatment model developed in the mid-1980s by the Matrix Institute on Addictions of Los Angeles, CA.

Aimed at individuals with cocaine and methamphetamine use disorders, the model provides a framework for engaging stimulant abusers in treatment and helping them achieve abstinence. Clients receive direction and support from trained therapists, learn about addiction and relapse, and familiarize themselves with self-help programs. In addition, the program also includes education for family members. Urine testing also helps ensure that clients stay drug-free.

CSAT launched the Methamphetamine Treatment Project in 1999, to test the effectiveness of the Matrix model. The largest randomized clinical trial of treatment for methamphetamine dependence to date, the study compared a "manualized" version of the Matrix model to standard treatment in eight community-based outpatient settings.

The study found that participants undergoing Matrix treatment stayed with the program longer than those who received traditional treatment. They were also more likely to have drug-free urine samples during treatment and more likely to complete treatment.

Components of the new package are:

Counselor's Treatment Manual contains everything counselors need to conduct individual and group sessions using the Matrix approach. After an introductory section about the Matrix model, the manual provides specific instructions for conducting each session. The manual also includes a bibliography for counselors interested in further reading. (NCADI No. BKD546)

cover of Counselor's Family Education Manual - click to view

Counselor's Family Education Manual guides counselors through the process of conducting the family sessions that are a key part of the Matrix approach. Intended to be psychoeducational opportunities rather than family therapy, these sessions teach families about drug use, recovery, and their role in supporting their family members. An accompanying CD-ROM contains slides that can be used in presentations or as handouts. (NCADI No. BKD547)
Client's Handbook contains all of the handouts used in treatment sessions. While some handouts summarize information, others require participants to come up with their own answers to such questions as what triggers their drug use or what kind of leisure activities could offer a sense of rejuvenation. Clients can also review the handbook once treatment is over as a way of strengthening their commitment to recovery. (NCADI No. BKD548)
Client's Treatment Companion gives clients a handy place to record their own ideas and reasons for staying in recovery. The booklet begins by asking users to insert a photo that's important to them and then asks them to explain the subject's role in their recovery. The booklet also offers space for users to list the phone numbers of people to call for help, their reasons for staying abstinent, their favorite ways to reduce stress, ideas for rewarding success, and so on. "It's a pocket-sized book," explains Ms. Gallagher. "Because it's small enough to carry with them, clients can use it to reinforce their relapse prevention." (NCADI No. BKD549)

Ms. Gallagher added, "SAMHSA grantees can arrange for training on the use of these materials through their project officers at the Agency."

To order copies, contact SAMHSA's National Clearinghouse for Alcohol and Drug Information at 1 (800) 729-6686 (English and Spanish) or 1 (800) 487-4889 (TDD). Online, the publications are available at http://kap.samhsa.gov/products/manuals/matrix/index.htm.

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