CBT and the Matrix Model for Amphetamine Addiction
This literature review examines whether cognitive behavioral therapy (CBT) is the most effective treatment approach for amphetamine addiction. The paper begins by outlining the effects of amphetamine use — both acute and chronic — and the scope of the global addiction problem, particularly among adolescents. It then analyzes a large-scale multisite study comparing the matrix model, a 16-week manualized CBT-based protocol, against treatment as usual (TAU) across multiple outpatient settings. Key outcome indicators — including retention rates, session attendance, and methamphetamine-free urine tests — are evaluated. Finally, the review identifies practical limitations of the matrix model, including its length, cost, and intensive staff training requirements.
- Introduction: Scope, background, and three research questions
- Effects of Amphetamine Use: Acute and chronic effects of amphetamine
- Behavioral Therapy for Amphetamine Addiction in Adolescents: CBT and the matrix model overview
- Matrix Model vs. Treatment as Usual: Key Outcomes: Multisite study outcome indicators compared
- Limitations of the Matrix Model: Cost, length, and dropout challenges
- Conclusion: Recommendations for improving matrix model access
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What makes this paper effective
- The paper uses a focused research question structure, clearly stating three guiding questions and then systematically answering each one in turn, which makes the argument easy to follow.
- It grounds claims in specific empirical data — percentages, site-level means, and statistical tests — rather than relying solely on general assertions, lending credibility to the analysis.
- The review acknowledges the limitations of its primary intervention (the matrix model), demonstrating critical thinking rather than uncritical advocacy.
Key academic technique demonstrated
This paper demonstrates effective use of comparative analysis in a literature review context. By systematically presenting outcome indicators — retention rates, session attendance, MA-free urine, and abstinence periods — side by side for the matrix model and TAU, the author builds a cumulative, evidence-based argument rather than relying on a single study finding.
Structure breakdown
The paper opens with a broad contextual introduction establishing scope and research questions. It then addresses each question in a dedicated section: the pharmacological and behavioral effects of amphetamine, the effectiveness of CBT and the matrix model (supported by the Rawson et al. multisite study), and the practical limitations of the matrix model drawn from a secondary study. A brief applied conclusion closes the review with policy-relevant recommendations.
Introduction
Amphetamine is a stimulant drug primarily used in the treatment of ADHD and narcolepsy. The Drug Enforcement Administration (DEA) has classified amphetamine as a Schedule II drug, meaning it has accepted medical uses but a high potential for abuse (Drug Enforcement Administration, n.d.). Common prescription drugs include Ritalin, Adderall, and Dexedrine. Amphetamine is also used for recreational purposes; popular street names include Crank, Black Beauties, Uppers, Bennies, Ice, and Speed (Drug Enforcement Administration, n.d.).
In 2016, approximately 34.2 million people had used amphetamine and its derivatives — MDMA (ecstasy) and methamphetamine hydrochloride — globally (United Nations Office on Drugs and Crime, 2019). Amphetamines are mostly taken orally as capsules or tablets, which can also be crushed and injected. Crystal methamphetamine hydrochloride is smoked or inhaled, while methamphetamine powder can be dissolved in water and injected intravenously (Drug Enforcement Administration, n.d.). Studies indicate that amphetamine addiction is a global problem and that adolescents are the most affected population. The stimulant is also easily accessible. The devastating consequences of amphetamine addiction have renewed interest among healthcare professionals in identifying the most effective treatment interventions.
This literature review explores whether cognitive behavioral therapy (CBT) is the best approach for treating amphetamine addiction. The following questions are addressed:
1. What are the effects of amphetamine use?
2. Is behavioral therapy effective at treating amphetamine addiction in adolescents?
3. What are the limitations of the matrix model?
Effects of Amphetamine Use
Amphetamine use is not a new phenomenon. Its usage can be traced back to the 1930s, when it was used to treat asthma and narcolepsy (Drug Enforcement Administration, n.d.). During World War II, soldiers on both sides used amphetamine to stay alert and perform more efficiently. Today, adolescents are using illicit amphetamines to boost their academic performance, resulting in high addiction rates among teens. Amphetamine addiction affects both the individual user and society at large: users can no longer live productive lives, and society incurs rising healthcare costs in treating stimulant-related disorders.
The effects of amphetamine use range from acute to chronic. Acute effects include increased alertness, decreased fatigue, heightened confidence, exhilaration, improved performance on tasks requiring sustained attention, and impaired performance on tasks requiring smooth, accurate muscle movements. Chronic effects include psychosis resembling paranoid schizophrenia, paranoia, hallucinations, violent behavior, skin picking, and preoccupation with one's own thought processes (Drug Enforcement Administration, n.d.).
Behavioral Therapy for Amphetamine Addiction in Adolescents
In 2016, only one in six people with stimulant use disorders globally sought treatment (United Nations Office on Drugs and Crime, 2019). Low treatment rates have been attributed to the absence of a well-established medical model for addiction treatment. Treating amphetamine addiction in adolescents is particularly challenging because no proven effective medications exist. Compounding the problem are high relapse rates, severe cravings, and episodes of hallucinations and psychosis among users.
Currently, the cognitive behavioral therapy (CBT) approach is the primary method used to treat amphetamine addiction. CBT is a type of psychotherapy that focuses on the relationship between thoughts, feelings, and actions related to psychoactive substance use and recovery (United Nations Office on Drugs and Crime, 2019).
The most common program under CBT for stimulant addiction is the matrix model. The matrix model is a proven, evidence-based protocol used to treat psychostimulant use disorders. It is a manualized 16-week treatment that incorporates cognitive behavioral techniques, 12-step meetings (self-help programs), weekly urine monitoring, individual counseling, family education groups, and social support groups (Rawson et al., 2004).
Rawson et al. (2004) carried out a large-scale multisite study comparing treatment outcomes between the manualized 16-week matrix model and treatment as usual (TAU). The study was conducted by seven investigative teams across eight outpatient settings in California, Montana, and Hawaii between 1999 and 2001. Six outpatient sites were located in California, and one each in Montana and Hawaii. Each site aimed to recruit 150 individuals in methamphetamine treatment, with half randomly assigned to TAU and the other half to the matrix model. All participants were 18 years of age or older. A total of 978 treatment-seeking individuals participated in the study.
Conclusion
This study is relevant to amphetamine addiction treatment because it highlights practical limitations of the matrix model. To reduce the high dropout rates associated with the matrix model, amphetamine patients should be informed that the duration of treatment, despite being long, is important for their recovery. Amphetamine treatment clinics should also consider offering financial discounts or assistance for patients who are unable to afford the full cost of treatment.
Drug Enforcement Administration. (n.d.). Drugs of Abuse. Retrieved from https://www.dea.gov/sites/default/files/sites/getsmartaboutdrugs.com/files/publications/DoA_2017Ed_Updated_6.16.17.pdf#page=50
Massah, O., Effatpanah, M., & Shishehgar, S. (2017). Matrix model for methamphetamine dependence among Iranian female methadone patients: The first report from the most populated Persian Gulf country. Iranian Rehabilitation Journal, 15(3), 193–198. doi:10.29252/nrip.irj.15.3.193
Rawson, R. A., Marinelli-Casey, P., Anglin, M. D., Dickow, A., Frazier, Y., & Gallagher, C. (2004). A multi-site comparison of psychosocial approaches for the treatment of methamphetamine dependence. Addiction, 99(6), 708–717. doi:10.1111/j.1360-0443.2004.00707.x
United Nations Office on Drugs and Crime. (2019). Treatment of stimulant use disorders: Current practices and promising perspectives. Retrieved from
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