Understanding Stimulant Use Disorder

What Are Stimulants?
Stimulants act on the central nervous system, increasing dopamine and norepinephrine activity. This includes:
- Illegal stimulants such as cocaine and methamphetamine
- Prescription stimulants used to treat ADHD, binge‑eating disorder, and narcolepsy
Misuse of prescription stimulants or use of illegal stimulants can progress to stimulant use disorder, which is associated with psychiatric symptoms, seizures, cardiovascular complications, and overdose.
A Growing Public Health Crisis
Stimulant‑related harm has risen sharply in recent years:
- Cocaine‑involved deaths increased 54% from 2019–2021, exceeding 24,000 deaths
- Methamphetamine‑involved deaths rose to nearly 33,000 deaths in 2021
- In 2023, almost 60,000 overdose deaths involved cocaine and/or psychostimulants, representing over half of all U.S. overdose deaths
Many stimulant‑related overdoses also involve fentanyl, significantly increasing lethality.
ADHD, Prescription Stimulants, and Risk
A common concern is whether treating ADHD with stimulant medications increases later risk of cocaine or methamphetamine use. High‑quality longitudinal data provide reassurance:
- Prescribed stimulant therapy for ADHD was not associated with increased risk of later cocaine or methamphetamine use in young adulthood
- Misuse of prescription stimulants, however, was a strong signal for later illicit stimulant use and warrants close monitoring and screening
This distinction is critical: appropriate ADHD treatment is not the problem—misuse is.
Treatment Challenges and Current Gaps
At present:
- There are no FDA‑approved medications for cocaine or methamphetamine use disorder
- Treatment relies on behavioral interventions, contingency management, and psychosocial support
- The FDA has issued guidance to encourage development of effective treatments, recognizing the urgent need and complexity of stimulant use disorder
Research is ongoing, but stimulant use disorder remains a condition where early identification, harm‑reduction strategies, and sustained support are essential.
A Holistic, Compassionate Approach
Stimulant use disorder is a medical condition, not a moral failure. Recovery is possible, especially when care is nonjudgmental, trauma‑informed, and individualized. Screening, education, and early intervention—particularly for adolescents and young adults—can change trajectories and save lives.
At Fox’s Holistic Care, we prioritize understanding the whole person, reducing stigma, and supporting long‑term wellness through evidence‑based, compassionate care.