Academic Journal
Comparison of the Treatments in Crack Use Disorder: A Systematic Review.
| Τίτλος: | Comparison of the Treatments in Crack Use Disorder: A Systematic Review. |
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| Συγγραφείς: | Flory Samartino JM; Department of Mental Health and Psychiatry, Service of Addiction Medicine, University Hospitals of Geneva, Geneva, Switzerland, jonathan21fs@gmail.com., Aboulafia-Brakha T; Department of Mental Health and Psychiatry, Service of Addiction Medicine, University Hospitals of Geneva, Geneva, Switzerland., Penzenstadler L; Department of Mental Health and Psychiatry, Service of Addiction Medicine, University Hospitals of Geneva, Geneva, Switzerland., Thorens G; Department of Mental Health and Psychiatry, Service of Addiction Medicine, University Hospitals of Geneva, Geneva, Switzerland., Zullino D; Department of Mental Health and Psychiatry, Service of Addiction Medicine, University Hospitals of Geneva, Geneva, Switzerland. |
| Πηγή: | European addiction research [Eur Addict Res] 2026; Vol. 32 (2), pp. 120-132. Date of Electronic Publication: 2026 Mar 23. |
| Τύπος έκδοσης: | Journal Article; Systematic Review; Comparative Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Karger Country of Publication: Switzerland NLM ID: 9502920 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1421-9891 (Electronic) Linking ISSN: 10226877 NLM ISO Abbreviation: Eur Addict Res Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Basel ; New York : Karger, c1995- |
| Ιατρικοί όροι (MeSH): | Crack Cocaine*/adverse effects , Cocaine-Related Disorders*/therapy , Psychotherapy*/methods, Humans ; Randomized Controlled Trials as Topic |
| Περίληψη: | <p>Background: Many studies address the different treatments for crack cocaine use disorder without distinguishing between crack use and cocaine use disorder. Furthermore, they highlight various approaches, such as psychotherapeutic methods, medications, and social interventions, whose effectiveness remains contentious for crack use disorder. Our aim was to evaluate the relative effectiveness of these various treatments, specifically for crack use disorder. Methods: This systematic review followed PRISMA guidelines; we searched PubMed, Embase, and Web of Science for studies between 2014 and July 2024. Eligibility Criteria: Due to the limited number of available studies, we included all studies worldwide with full text available in English or French, published between 2014 and 2024, reflecting the recent increase in interest in crack use. Studies included adults aged 18 years or older with a clinical diagnosis of crack cocaine addiction based on a validated clinical scale. We excluded studies that did not distinguish between crack and cocaine use in their assessment of crack cocaine (or crack/cocaine) use disorder. We reported the randomized controlled trials (RCTs) results based on the type of interventions, including various outcomes: reduction of health (within the biopsychosocial model), increased accessibility and retention in healthcare, and reduction in drug use. The reliability of the evidence was assessed using Cochrane's tool for evaluating the risk of bias. Results: We identified 3,313 records, of which 46 were eligible, and 33 were finally included. Among the 33 studies, 15 were RCTs. Among the RCTs, the majority had a moderate risk of bias (8/15), followed by high risk (6/15), and only one had a low risk of overall bias. Contingency management was associated with higher abstinence, better treatment retention, and improvements in mental health, although the interpretability of these findings is limited by their generalizability. Pharmacological trials with dexamfetamine showed a reduction in drug use and an increase in abstinence, but only in a specific population receiving heroin-assisted treatment. Adjunct trials such as transcranial direct current stimulation yielded mixed findings, with some studies suggesting improvements in abstinence and quality of life, while others reported no significant effects. The findings highlight that tailored interventions supported by a contingency management approach may enhance engagement and treatment effectiveness. </p>. (© 2026 The Author(s). Published by S. Karger AG, Basel.) |
| References: | Subst Use Misuse. 2017 Aug 24;52(10):1292-1306. (PMID: 28350194) Arch Psychiatr Nurs. 2021 Oct;35(5):526-533. (PMID: 34561069) Addict Behav Rep. 2024 May 01;19:100549. (PMID: 38725607) Psychiatry Res Neuroimaging. 2021 Apr 30;310:111232. (PMID: 33621927) Drug Alcohol Depend. 2014 May 1;138:177-84. (PMID: 24629631) Pharmacol Biochem Behav. 2024 Apr;237:173725. (PMID: 38340989) Int J Drug Policy. 2015 Apr;26(4):352-63. (PMID: 25662894) J Clin Med. 2023 Oct 13;12(20):. (PMID: 37892650) Psychol Addict Behav. 2016 Aug;30(5):536-543. (PMID: 27442691) Drug Alcohol Depend. 2020 Dec 1;217:108429. (PMID: 33250383) AIDS Behav. 2016 Jun;20(6):1236-43. (PMID: 26687093) Eur Neuropsychopharmacol. 2021 Oct;51:106-131. (PMID: 34273801) Psicol Reflex Crit. 2019 Jul 15;32(1):14. (PMID: 32026092) J Psychoactive Drugs. 2018 Jul-Aug;50(3):247-255. (PMID: 29608428) BMC Public Health. 2015 Jul 25;15:706. (PMID: 26209238) J Altern Complement Med. 2015 Mar;21(3):152-8. (PMID: 25695849) Int J Neuropsychopharmacol. 2014 Sep;17(9):1465-75. (PMID: 24776374) Braz J Psychiatry. 2021 Sep-Oct;43(5):467-476. (PMID: 33146345) BMC Public Health. 2017 Feb 3;17(1):163. (PMID: 28158995) Lancet. 2016 May 28;387(10034):2226-34. (PMID: 27015909) Harm Reduct J. 2016 Jun 08;13(1):19. (PMID: 27278459) Harm Reduct J. 2014 Nov 13;11(1):30. (PMID: 25395278) Exp Clin Psychopharmacol. 2022 Oct;30(5):507-513. (PMID: 33844568) AIDS Behav. 2018 Jan;22(1):146-153. (PMID: 28916898) Evid Based Complement Alternat Med. 2017;2017:7217619. (PMID: 29234424) Subst Use Misuse. 2019;54(4):592-600. (PMID: 30654689) Int J Drug Policy. 2022 Jan;99:103464. (PMID: 34619447) Health Soc Care Community. 2022 Jul;30(4):e1325-e1334. (PMID: 34534399) Exp Clin Psychopharmacol. 2017 Dec;25(6):466-472. (PMID: 29251975) Front Pharmacol. 2018 Oct 23;9:1198. (PMID: 30405414) J Clin Psychiatry. 2014 Jul;75(7):757-64. (PMID: 24911028) Addict Behav. 2017 Sep;72:138-143. (PMID: 28399488) Int J Neuropsychopharmacol. 2015 Jun 10;18(12):. (PMID: 26065432) Cochrane Database Syst Rev. 2024 Feb 15;2:CD011866. (PMID: 38357958) Front Psychiatry. 2023 May 25;14:1146492. (PMID: 37304434) Harm Reduct J. 2021 May 20;18(1):57. (PMID: 34016137) BMJ Open. 2020 Dec 15;10(12):e036491. (PMID: 33323428) |
| Contributed Indexing: | Keywords: Adjunct treatments; Contingency management; Crack use disorder; Outcome; Treatment |
| Substance Nomenclature: | 0 (Crack Cocaine) |
| Entry Date(s): | Date Created: 20260323 Date Completed: 20260709 Latest Revision: 20260922 |
| Update Code: | 20260922 |
| PubMed Central ID: | PMC13233060 |
| DOI: | 10.1159/000551660 |
| PMID: | 41871216 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1421-9891 |
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| DOI: | 10.1159/000551660 |