There is a growing concern in several regions of the world due to the significant levels of substance use (amphetamine-type stimulants, cocaine, ecstasy etc.) for non-medical purposes. In 2021, stimulants were the second most commonly used internationally controlled substance worldwide, with cannabis being the most widely used. The total number of people using drugs worldwide was approximately 296 million that year, marking a 23% increase over the past decade. Of these, an estimated 78 million people used stimulants annually, and notably nearly as many women had used synthetic stimulants as men. Stimulant use has led to a high demand for treatment, with notable variations across subregions: stimulants being a primary drug for 11% seeking treatment in Africa, 14% in Europe, 36% in the Americas, 42% in Oceania and 48% in Asia. 

Despite the rising need for efficacious interventions, no medication has yet been approved for the treatment of stimulant use disorder to date. Additionally, the implementation of evidence-based psychosocial treatment, such as contingency management (CM), cognitive-behavioral therapy (CBT), family therapy and continued social support remains very limited. There is an urgent need to bridge the global treatment gap for stimulant use disorders by developing and implementing scalable interventions. While some countries are advancing research (including on pharmacological treatments), coordination across studies on key outcome measures, that would meet the regulatory requirements and the needs of affected populations, would be crucial.

This publication stemmed from an expert group meeting organized by the UNODC’s Prevention, Treatment and Rehabilitation Section (UNODC PTRS) in 2017, where leading experts in the area of stimulant use disorders from 25 countries discussed integrated models of treatment that may be effective and suitable for implementation in a variety of settings once translated and culturally adapted. Following several presentations and exchanges on the topic, the participating experts concluded that there was evidence to call for more research on psychosocial and pharmacological treatment options and to conduct multicountry effectiveness, feasibility and safety trials.