Organised by Greece with the support of the UNODC Prevention, Treatment and Rehabilitation Section, the European Monitoring Centre for Drugs and Drug Addiction and the International Society of Addiction Medicine.

Moderator: Crhistos Kouimtsidis – Greek national coordination for drugs.

1. What is the currents state of research on stimulants?

Anja Busse UNODC:  Need for effective and scalable treatment for stimulants. At global level stimulants are contributing to the number of people who use drugs. 75million using stimulants. Stimulants use disorders and interventions, recognize that there are differed patterns in different regions. And subgroups using stimulants. Treatment gap: 1:8. Stimulant use disorders. We need sackable based interventions. Cochrane revises for las 10 years. Psychosocial and medication. In 1971 WHO already requested research for amphetamine use disorders. No gold standard has emerged yet. Guidance form UNODC on stimulant use disorder and care. Treatment standards and guidelines.

• Contingency management
• Cognitive behavioral therapy (CBT)
• Intoxication and overdose, symptomatic treatment and stabilizations. Currently no medications that can reverse life threating stimulant overdose.
• Stimulant withdrawal management.
  • psychosocial treatment
  • Benzos
  • Antipsychotic, antidepressant
• Pharmacological treatment of stimulant related disorders. Acute withdrawal protracted withdrawal. No effective pharmacotherapy. More than 100 medications investigated. No consistent efficacy. Hope on clinical studies on long-acting prescription amphetamines given in robust doses, mainly for cocaine use disorders. Also on methylphenidate for methamphetamine use

Outcome measure coordination

• Abstinence
• Reduction in use /Change in use days
• Addiction severity
• Retention in treatment
• Differences between different stimulants and setting
• Reducción in risky sexual behaviour
• Craving
• Aceptablility and safety
• Co-morbidities included or excluded
• Pharmacological treatment alone is not effective

Research collaboration platforms. Multi country psychosocial assisted pharmacological treatment study.

Dr. Aras ISAM International Society on addiction medicine. Current ISAM Global expert network (ISAM-GEN). 2022. Global survey. 77 experts for 77 countries. Pandemic impact on substance use treatment. Drug demand and supply. Proactive and comprehensive strategy.  Procedures to get experts to join ISAM. Process flowchart on how expert join and get in touch together in ISAM platform. Expert can bring ideas to the platform.

Marica Ferri EMCDDA: Current state of research and evidence for practice on stimulants. The data on seizures on cocaine an amphetamines shoe is a concern What we know from the evidence now is psychosocial and behavioral intervention. Contingency management. people are given some benefits if they behave in a certain way. What is really needed is the side of pharmacological interventions. Also, some revies some good interventions in the abstinence aim. Better use is for the use of amphetamines. Effects are small with pharmacological treatment. Lidesamphetamine added to the standard interventions (Psychosocial approaches) in patenting with dependence to amphetamines undergoing opioid agonist treatment. Wgbinar on march 22 on practices in Chec Republic and other countries.

2. Relation between research and innovation in a fast changing social and political environment?

Marica Ferri EMCDDA. EU Drug strategy gives direction to countries. There are some principles. 1. Grounded in human rights 2. Based on evidence 3. Innovation and foresight . There are some strategic priorities that invite member state to provide comprehensive research and evidence. call to collaborate together in this approach. Alex stevens show the complex networks of cascade effect to policies: need to be based on evidence and foster dialogue.  Research and innovation is important for the multiplying effect and be prepare to change paradigm is evidence shows. Best practice portal BPP Comprehensive package to promote best practices in Europe: briefings, implementation, evidence and standards.  Facilitating the application of evidence. It’s easier to use what has been validated than new and unproven interventions. Need more dialogue and include more people with lived and living experience and a positive approach.

Anja Busse UNODC.  No future medication fort stimulant treatment. Difference between population, etc. Treatment is a health issue, avoid human rights abuses, need evidence to exceptional responses to this question. Trails in Canada, Australia, and inactivates to prove stimulant result, evaluation a data together.  Hope we don’t want to wait too much. Listening the expertise of people with lived experience on this trail is very useful.   Scalable and affordable interventions should be the standard in which government should invest policy money and avoid repressive and coercive interventions that show no effectiveness. Partner with researchers and experts to show evidence.

Closing remarks

Christos:

• No major conclusions
• Need for more collaborations
• Affordable and scalable Interventions
• Constant Training
• Quality standards
• Invents on what we need to develop in the future.