What they are
- Stimulant Use Disorder: problematic use of cocaine, methamphetamine, or prescription stimulants (nonmedical). Risks include heart issues, anxiety, psychosis, dental problems, and infections (if injecting/smoking).
- Cannabis Use Disorder: persistent use causing impairment (memory/motivation issues, anxiety/panic, sleep problems, cyclic vomiting in some). Potency has increased, raising risk of dependence and psychosis in vulnerable individuals.
Both are treatable. Plans focus on reducing harm, building skills, and addressing co-occurring conditions.
Common signs and symptoms
- Stimulants: binges, intense cravings, insomnia, agitation or anxiety, chest pain, paranoia/psychosis during/after use, “crash” with fatigue and low mood
- Cannabis: tolerance, withdrawal (irritability, insomnia, decreased appetite), difficulty cutting down, using despite anxiety/memory issues, amotivation
- Impact: relationship conflict, job/school problems, financial/legal issues, risky behaviors
Why they happen
- Drugs amplify dopamine and stress circuits; conditioning links cues with cravings
- Sleep loss, loneliness, trauma, and mood/anxiety disorders increase risk
- For cannabis: high-THC products and daily vaping/”dabbing” intensify dependence risk
What helps
- Evidence-based treatments
- Contingency Management (CM): rewards for negative drug screens—strongest evidence for stimulants
- CBT and Motivational Interviewing: trigger management, coping skills, relapse prevention
- Community support: SMART Recovery, 12-step (NA/CA), recovery coaching
- Medications
- No FDA-approved meds for stimulants; promising options include bupropion + naltrexone, mirtazapine (meth), and topiramate (cocaine)—discuss with a clinician
- For cannabis: no approved meds; consider sleep supports, treat anxiety/depression; N-acetylcysteine may help some
- Harm reduction
- Stimulants: avoid mixing with opioids/alcohol/benzos; carry naloxone due to fentanyl contamination; use with others; hydration and nutrition; test strips when available
- Cannabis: reduce THC concentration, limit frequency, consider breaks, avoid driving high; if cyclic vomiting (CHS), avoid hot showers as sole “treatment”—seek care and stop cannabis
- Sleep and mood
- Rebuild sleep after stimulant use; exercise and daylight exposure
- Treat co-occurring ADHD, anxiety, depression, PTSD, and psychosis
When to seek help now
- Chest pain, severe headache, high fever, or signs of stroke—call 911
- Severe paranoia or hallucinations; suicidal thoughts
- Cyclic vomiting, dehydration, or inability to keep fluids down (possible CHS)
How to talk to a clinician
- “I want to cut down/stop [stimulants/cannabis]. I’d like contingency management or CBT and to discuss medication options that may help with cravings, sleep, and mood.”
Outlook
Many people reduce or stop use with CM, skills, and support. Expect some withdrawal and sleep changes early; energy and mood usually improve within weeks.
Resources for readers in the USA
- Immediate help: 988 Suicide & Crisis Lifeline; SAMHSA National Helpline 1-800-662-HELP (4357)
- Find care: FindTreatment.gov (filter for CM/CBT); Psychology Today (addiction-focused); NAMI HelpLine
- Community: SMART Recovery (smartrecovery.org); Cocaine Anonymous (ca.org); Crystal Meth Anonymous (crystalmeth.org); Marijuana Anonymous (marijuana-anonymous.org)
- Harm reduction: NEXT Distro (naloxone/test strip access varies by state); local syringe service programs
- Insurance tips: Verify coverage for outpatient therapy, IOP/PHP, CM programs; prior authorization; copay/coinsurance, deductible, out-of-pocket max
- Work/school supports: EAP; ADA accommodations where applicable; campus counseling
Disclaimer: Educational information, not a diagnosis. If in crisis, use the resources above.