KAP Keys Based on TIP 33

Treatment for Stimulant Use 

Disorders

CSAT’s 

Knowledge Application Program

KAP Keys

For Clinicians

Based on TIP 33 

Treatment for Stimulant 

Use Disorders

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration

Center for Substance Abuse Treatment

www.samhsa.gov
KAP Keys Based on TIP 33

Treatment for Stimulant Use Disorders

Introduction

These KAP Keys were developed to accompany the Treatment 

Improvement Protocol (TIP) Series published by the Center for 

Substance Abuse Treatment (CSAT), Substance Abuse and 

Mental Health Services Administration. These KAP Keys are 

based entirely on TIP 33 and are designed to meet the needs 

of the busy clinician for concise, easily accessed “how-to” 

information.

For more information on the topics in these KAP Keys, see TIP 33.

Other Treatment Improvement Protocols that 

are relevant to these KAP Keys:

TIP 9, Assessment and Treatment of Patients With Coexisting 

Mental Illness and Alcohol and Other Drug Abuse (1994, 

Reprinted 1999) BKD134

TIP 10, Assessment and Treatment of Cocaine-Abusing 

Methadone-Maintained Patients (1994) BKD157

TIP 27, Comprehensive Case Management for Substance 

Abuse Treatment (1998) BKD251

TIP 29, Substance Use Disorder Treatment for People With 

Physical and Cognitive Disabilities (1998) BKD288
Ways To Reduce the Risk of 

Violence by Stimulant Users

Stimulant users can become violent. Reduce the risk of 

violence by:

 Helping the client stay in touch with reality by identifying 

yourself, using the client’s name, and anticipating concerns.

 Placing the client in a quiet, subdued environment with little 

stimulus.

 Ensuring sufficient space so that the client does not feel 

confined.

 Having the door readily accessible to both the client and 

the interviewer, but not letting the client get between the 

interviewer and the door.

 Acknowledging the client’s agitation and the potential for an 

escalation to violence by reassuring the client that you are 

aware of his or her distress.

 Asking clear, simple questions; tolerating repetitive replies; 

and remaining nonconfrontational.

 Listening carefully, remaining nonjudgmental, and reinforcing any progress made.

 Reducing risk by removing objects from the room that could 

be used as weapons and discreetly ensuring that the client 

has no weapons.

 Being prepared to show force if necessary by having a backup plan for help and having chemical and physical restraints 

immediately available.

 Training all medical or emergency staff to work as a team 

in managing an aggressive, paranoid, and potentially 

violent client.

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KAP Keys Based on TIP 33

Treatment for Stimulant Use Disorders
KAP Keys Based on TIP 33

Treatment for Stimulant Use Disorders
Highlights of Effective Treatment

Maximizing Treatment Engagement

 Make treatment accessible.

 Provide support for treatment participation.

 Respond quickly and positively to initial telephone inquiries.

Assessing and Orienting

 Keep initial assessment brief.

 Provide clear orientations.

 Offer clients treatment options.

 Involve significant others.

 Convey empathetic concern.

Initiating Treatment

 Establish treatment schedule.

 Discontinue use of psychoactive substances, and initiate a 

urinalysis schedule.

 Assess psychiatric comorbidity.

 Assess stimulant-associated compulsive sexual behavior.

 Remediate stimulant “withdrawal” symptoms.

 Resolve any immediate crisis.

Initiating Abstinence

 Establish structure and support.

 Address secondary drug use.

 Initiate substance avoidance strategies.

 Provide client education.

 Respond to early slips.

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KAP Keys Based on TIP 33

Treatment for Stimulant Use Disorders

Continued on next card
KAP Keys Based on TIP 33

Treatment for Stimulant Use Disorders

Maintaining Abstinence

 Teach functional analysis of stimulant use.

 Teach relapse prevention techniques.

 Enhance self-efficacy regarding high-risk situations.

 Counteract euphoric recall and the desire to test control.

Preventing Relapse

 Teach clients the following:

– How to cope with substance craving

– Substance refusal assertiveness skills

– General coping and problemsolving skills

– How to apply strategies to prevent a full-blown 

relapse if an episode of substance use occurs.
Delayed Stimulant Withdrawal 3

Remember most people experience problems when they stop 

using stimulants. However, many people’s symptoms return a 

few months after last using stimulants. These symptoms are a 

type of delayed stimulant withdrawal and

 Are a normal part of recovery

 Are part of the brain’s healing process

 Are temporary

 Can be endured

 Can be lessened by participation in recovery efforts.

Delayed Withdrawal Checklist

The items below can be part of delayed stimulant withdrawal.

Ask the client if he or she

KAP Keys Based on TIP 33

Treatment for Stimulant Use Disorders

R Is sad

R Has no energy

R Craves alcohol

R Has problems remembering

R Has stopped exercising

R Spends a lot of time alone

R Feels lonely

R Is anxious

R Experiences mood swings

R Uses alcohol

R Feels hopeless

R Feels uneasy

R Experiences fuzzy thinking

R Magnifies feelings

R Is irritable

R Has cravings and urges

R Is not interested in treatment

R Is not participating in 

meetings

R Is canceling appointments

R Has relationship problems

R Expresses or experiences 

other negative thoughts/

feelings/actions.
Ordering Information

TIP 33

Treatment for Stimulant Use Disorders

Easy Ways to Obtain Free Copies of 

All TIP Products

1. Call SAMHSA’s National Clearinghouse for Alcohol and 

Drug Information (NCADI) at 800–729–6686, 

TDD (hearing impaired) 800–487–4889

2. Visit CSAT’s Web site at www.csat.samhsa.gov

Do not reproduce or distribute this publication for a fee 

without specific, written authorization from the Office of 

Communications, Substance Abuse and Mental Health 

Services Administration, U.S. Department of Health and 

Human Services.

DHHS Publication No. (SMA) 01-3599

Printed 2001

KAP Keys Based on TIP 33

Treatment for Stimulant Use Disorders