Stimulants intensify salience and effort signals, then crash them—driving binges, sleep loss, paranoia, and dysphoria that sabotage relationships and work. Stimulant Use Disorder translates rapidly evolving science into care that’s both safe and doable. We clarify patterns—intermittent party use, daily productivity use, and high-dose binges—and how each maps to risk (cardiac strain, hyperthermia, psychosis, vascular complications). Assessment integrates route of use, contamination risk, sexual health, sleep, nutrition, and co-occurring ADHD, PTSD, or bipolar disorder. Core treatment rests on behavior: contingency management remains the most consistently effective approach; we show how to implement it ethically and affordably with clear targets, escalating schedules, and digital verification. Pharmacologic adjuncts can support specific phenotypes (e.g., bupropion + naltrexone for some methamphetamine users, modafinil/aripiprazole data in limited contexts), but we emphasize transparent consent about mixed evidence. Safety is non-negotiable: overdose education even without opioids; counseling on xylazine injury patterns; hydration, temperature management, and sleep restoration; and structured responses to stimulant-induced psychosis. We outline clinic playbooks—same-day engagement post-ED visit, brief daily check-ins during acute risk, and rapid transitions to housing, nutrition, and infectious-disease services. For youth and young adults, we differentiate experimentation from emerging dependence and build family-inclusive plans. Digital tools help: craving prompts, geofence reminders for high-risk zones, and short skills videos. Equity considerations include transportation, phone access, and stigma in employment screening. When teams lead with evidence-based incentives, empathic structure, and honest risk communication, Stimulant Use Disorder, sessions at a stimulant addiction conference, and proven tools like contingency management can turn chaotic cycles into gradual, lasting stability.