Methylphenidate for the Treatment of Cocaine Use Disorder: A Systematic Review and Meta-analysis

Methylphenidate for the Treatment of Cocaine Use Disorder: A Systematic Review and Meta-analysis

Published: September/October 2026
Journal Article

Overview

This one-hour, journal article-based activity examines the efficacy and safety of methylphenidate (MPH) for the treatment of cocaine use disorder (CUD). Learners will explore findings from a systematic review and meta-analysis evaluating the effects of MPH on cocaine craving and use, including differences in outcomes among individuals with and without co-occurring attention-deficit/hyperactivity disorder (ADHD). The article also examines factors that may influence treatment outcomes, considerations related to the safety of MPH, and limitations in the current evidence base to inform future research and clinical practice. 

The target audience for this intermediate continuing education activity includes physicians, nurse practitioners, physician assistants, and other clinicians, researchers, students, and policymakers. 

This activity addresses the following ACGME Core Competencies: Patient Care, Medical Knowledge, and Practice-Based Learning and Improvement. 

Abstract

Aims 

Cocaine Use Disorder (CUD) is a chronic condition, often associated with Attention Deficit Hyperactivity Disorder (ADHD). No medications have been approved for the treatment of CUD, but methylphenidate (MPH) has been explored as a potential candidate. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of MPH in patients with CUD with and without ADHD.

Methods

Following PRISMA guidelines, we developed a search string for PubMed, ISI Web of Science, and Scopus databases. We included randomized and nonrandomized clinical studies that used MPH in CUD treatment.

Results

Twenty studies were included in the systematic review, 6 of them were included in the meta-analysis. In the meta-analysis, MPH did not reduce craving (ES: -0.33, 95%CI: 1.69 to 1.03) (Z = -0.473; P = 0.636) or cocaine use (ES: -0.01, 95% CI: -0.35 to 0.33) (Z= -0.084; P = 0.933) compared to placebo. However, the route of administration and the presence of ADHD in association with CUD influenced the outcomes on cocaine craving measures. Similarly, although the results were inconclusive, a trend toward the reduction of cocaine consumption was observed in patients with ADHD treated with MPH. Regarding safety, MPH can be used in patients with CUD up to 90 mg/d and monitoring the cardiovascular parameters is strictly required.

Conclusion

Evidence on the efficacy of MPH for the treatment of CUD is still limited and inconclusive. However, there might be a rationale for its use in patients with both CUD and ADHD, therefore, further clinical studies are needed in this particular category.

Learning Objectives

Upon completion of this activity, learners will be able to:

1. Evaluate the efficacy of MPH for reducing cocaine craving and use in individuals with CUD.
2. Compare MPH treatment outcomes among individuals with CUD with and without co-occurring ADHD.
3. Apply evidence regarding the efficacy and safety of MPH to clinical considerations for individuals with CUD.

Registration Rates

*Residents, Fellows-in-training, Interns, and Students must join ASAM to receive a discounted registration rate. Click here to become an ASAM member. National and Chapter membership dues apply. There is no charge for Students to become a Member, but verification of student status is required.

Membership Question?  Call ASAM at 1.301.656.3920, email us, or view the ASAM website for more information.

Refunds & Cancellations

All ASAM eLearning Center refund requests must be made in writing to [email protected] within 90 days of purchase. Those requesting refunds for courses that are in progress will receive partial refunds or eLearning Center credit. Automatic full refunds will be made for any course with a live-course component that has been canceled.

Open Registration: 10/01/2026 - 02/10/2029

Close Access Date: 02/10/2029

Course Instructions

1. Click on the Contents tab to begin this activity.
2. Click Download Journal Article in the box titled Journal Article and read the journal article in its entirety. 
3. Click Complete Post-Test to answer multiple-choice questions. You will have 10 attempts to pass and must answer 2 out of 3 questions correctly.
4. Click Complete Evaluation to provide valuable activity feedback. Scroll down on all questions, as there may be answer options that expand past the size of the window.
5. Click the button Claim Medical Credits in the box titled Claim Credits & Certificate. Choose the type of credit and click submit. Click the button View/Print Certificate to save or print your certificate. You can view/print your certificate at any time by visiting the ASAM eLearning Center, clicking Dashboard, and clicking Transcript/Achievements.

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Accreditation & Credits

Joint Accreditation Statement

In support of improving patient care, the American Society of Addiction Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Credits Available

• Physicians: 1.00 Credit
• Nurses & NPs: 1.00 Nursing Contact Hour
• PAs: 1.00 Credit
• Pharmacology Hour: 1 Hour
• Interprofessional Continuing Education: 1.00 Credit
• Certified Counselors: NBCC Contact Hours Not Offered
   American Society of Addiction Medicine has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7062. Programs that do not qualify for NBCC credit are clearly identified. American Society of Addiction Medicine is solely responsible for all aspects of the programs.

Maintenance of Certification (MOC)/Continuing Certification Program (CCP)

This activity is designed to meet the requirements for MOC/CCP for several primary physician boards and for state licensing CME requirements. MOC Credit is only reported and designated for ABA, ABP, ABIM, and ABS. By completing the online credit application and evaluation, the learner permits ASAM to report credits to the appropriate Board. Learn more.

• ABIM MOC Points: 1.00 Medical Knowledge
• ABP MOC: 1.00 Lifelong Learning & Self-Assessment
• ABS Continuing Certification: 1.00 Accredited CME
• ABA MOCA 2.0®*: 1.00 Lifelong Learning MOCA 2.0® is a trademark of the American Board of Anesthesiology®. This activity contributes to the CME requirement for Part II: Lifelong Learning and Self-Assessment of the American Board of Anesthesiology's (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, https://www.theaba.org/, for a list of all MOCA 2.0 requirements.

Additionally, this activity has been designed to satisfy the requirements of the following primary physician board certification requirements. Please confirm with your individual Board.

• American Board of Preventive Medicine (ABPM)
• American Board of Psychiatry and Neurology (ABPN)
• Royal College of Physicians and Surgeons of Canada (RCPSC)

Certificates for other professions

All participants may request a certificate of participation upon completion of the activity and an online evaluation confirming their participation. Learners are strongly advised to contact their professional licensing board or professional association to confirm this certificate will be accepted as evidence supporting continuing education requirements.

Disclosure Information

In accordance with the disclosure policies of ASAM and Joint Accreditation, the effort is made to ensure balance, independence, objectivity, and scientific rigor in all accredited continuing education activities. These policies include identifying and mitigating all relevant financial relationships with ineligible companies for those involved in the creation and dissemination of accredited continuing education. 

See the attached article and pdf for a list of disclosures