Due to the significant stress and trauma caused by the ongoing COVID pandemic, substance misuse, including methamphetamine and opioids, is on the rise in the United States.
While treatment of opioid addiction can be assisted with several FDA-approved medications such as buprenorphine (Suboxone) and methadone, no comparable drugs are currently available for methamphetamine use disorder. This may change soon.
A recent study conducted by the National Institutes of Health (NIH) indicated that “a combination of two medications, injectable naltrexone, and oral bupropion, was safe and effective in treating adults with moderate or severe methamphetamine use disorder in a double-blind, placebo-controlled Phase III clinical trial.”
According to the NIH, the findings suggest that “this combination therapy may be a promising addition to current approaches to treatment, such as cognitive behavioral therapy and contingency management interventions, for a very serious condition that remains difficult to treat and overcome.”
The research, published in The New England Journal of Medicine in January, was conducted at multiple sites within the National Institute on Drug Abuse Clinical Trials Network (NIDA CTN). NIDA is part of the National Institutes of Health.
“The opioid crisis and resulting overdose deaths in the United States are now well known, but what is less recognized is that there is a growing crisis of overdose deaths involving methamphetamine and other stimulants. However, unlike for opioids, there are currently no approved medications for treating methamphetamine use disorder,” said NIDA Director Nora Volkow, M.D. “This advance demonstrates that medical treatment for methamphetamine use disorder can help improve patient outcomes.”
The Accelerated Development of Additive Pharmacotherapy Treatment for Methamphetamine Use Disorder study, or ADAPT-2, was conducted from 2017 to 2019 at clinics in multiple community treatment programs nationwide and enrolled 403 adult volunteers ages 18 to 65 years with moderate to severe methamphetamine use disorder.
In each of two six-week stages, volunteers in the treatment group were given an injection of extended-release naltrexone, a drug used to treat opioid and alcohol use disorders, every three weeks and took daily extended-release tablets of bupropion, an antidepressant also used as a treatment to aid nicotine cessation. Those in the control group were given matched injectable and oral placebos over the same time periods.
Overall, participants responded at a significantly higher rate in the treatment group. Participants in the treatment group were assessed to have fewer cravings than those in the placebo group and reported greater improvements in their lives as measured by a questionnaire called the Treatment Effectiveness Assessment. Importantly, there were no significant adverse effects associated with the dual medication treatment.
“Long-term methamphetamine misuse has been shown to cause diffuse changes to the brain, which can contribute to severe health consequences beyond addiction itself,” said Madhukar H. Trivedi, M.D., of the University of Texas Southwestern Medical Center, Dallas, who led the trial. “The good news is that some of the structural and neurochemical brain changes are reversed in people who recover, underscoring the importance of identifying new and more effective treatment strategies.”
Methamphetamine use disorder is a serious illness often associated with severe medical and mental health complications and a risk of fatal overdose. Methamphetamine is a potent stimulant with a significant potential for addiction.
Like other addictions, severe methamphetamine use disorder is frequently driven by co-occurring psychiatric disorders. These include depression, anxiety, mood and personality disorders, eating disorders, unaddressed trauma, and other mental health conditions. It is worth noting that medications that suppress cravings should not be regarded as a cure per se but may be used to complement a comprehensive treatment approach addressing all underlying conditions.
The Farley Center at Williamsburg Place is a 12-Step and medication-assisted program, offering flexible treatment services that contribute to a continuum of care that helps patients achieve long-term sobriety. During their stay, Farley patients receive psychotherapy—individually and in a group setting—experiential therapeutic interventions, integration into a 12-Step recovery program, education, and sober life skills training.
The Farley Center has seen a steady rise in the need for treatment since the beginning of the COVID pandemic. Many families have been witnessing loved ones engage in progressively unhealthy behaviors but feel unsure what options are available to them. The Farley Center has taken significant steps to be able to continue serving patients at this challenging time and is available to answer questions you may have. If you or someone you know is struggling with substance use and could benefit from addiction treatment services, please contact the Farley Center at 800.582.6066 to find out how we can help.