Management of substance abuse

Amphetamine-type stimulants

Background

There has been great concern about the use of amphetamines, MDMA and other psychostimulants as a public health issue. While amphetamine-type stimulants (ATS) have been available and used for many years, in the last decade or so their manufacture, trafficking and use have been increasing in many countries. The use of MDMA and other amphetamine analogues is a relatively new international phenomena and it is timely that WHO review the broader issues. In many countries the use of these drugs is widespread. Health risks and other problems associated with amphetamine-type stimulant use are poorly understood. This lack of understanding presents obstacles to prevention, treatment and policy responses.

Reflecting these concerns, WHO has set about to review: epidemiology and social context of ATS use; pharmacology; health risks and other consequences of use; prevention; treatment of users; and policy responses to ATS use. This was initiated by a meeting held in Geneva, Switzerland between 12-15 November 1996 whereby expert participants from fifteen countries, observers from six international organizations and representatives of the Swiss Federal Office of Foreign Affairs and the Swiss Federal Office of Public Health met to discuss amphetamines, MDMA and other psychostimulants. The first phase of this project would comprise a 'state of the art' review of the nature, extent, context and consequences of ATS use.

Following the Geneva meeting, it was proposed that a second phase of studies would be developed which would contribute further to an understanding of the extent and nature of the health and social consequences of ATS use, and to identify and test promising prevention treatment and policy approaches in different settings.

Documents available

WHO Multi-Site Project on Methamphetamine-induced Psychosis: A descriptive report of findings from participating countries

This report presents findings from a mulit-site study of amphetamine-induced psychosis, sponsored by WHO. The project aimed to address several broad questions concerning the nature of adverse health, psychotic and other psychiatric symptoms and their management in persons presenting with methamphetamine-induced psychotic disorders to treatment services.


Amphetamine-type stimulants: a report from the WHO meeting on amphetamines, MDMA and other psychostimulants, Geneva, 12-15 November 1996

This report summarizes both the findings of the Geneva meeting and background papers prepared for the meeting, and subsequently revised, on the key issues related to: the epidemiology and social context of ATS use in different countries; the pharmacology and toxicology of ATS; the health and social consequences of ATS use; treatment approaches to ATS use and prevention and policy responses to ATS use.

Only available in hardcopy


Ecstasy - MDMA and other ring-substituted amphetamines

Given the sustained high level of interest in ecstasy and recent findings relating to neurotoxicity, it was considered timely to undertake a specific review of the health effects of ecstasy. The primary focus of this review is 3,4-methylenedioxymethamphetamine (MDMA). However, some consideration is given to structurally related ring-substituted amphetamines, particularly those that are used or sold as ecstasy, either intentionally or through manufacturing errors.


Systematic review of treatment for amphetamine-related disorders

The ease of synthesis from inexpensive and readily available chemicals makes possible the wide-spread of amphetamine dependence and abuse. The objective of this review is to search and determine risks, benefits and costs for a variety of treatments for amphetamine dependence or abuse, psychosis and withdrawal. This review was conducted using the Cochrane Collboration standards for preparing systematic reviews.

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