Methamphetamine is a powerful and highly addictive stimulant that acts on the central nervous system. The drug may produce euphoria and stimulant effects similar to those of cocaine use. Medically speaking, methamphetamine is used as a part of a treatment program to control the symptoms of attention deficit hyperactivity disorder (ADHD).
But illegal use of the drug has expanded across the globe. However, medication-assisted treatment for methamphetamine addiction doesn’t really exist as it does for opioid use disorder.
A study published in January 2021 could change that.
The research answers the question, are there any medications to treat meth addiction, and in this post, we’re going to discuss its findings.
Quick Facts About Methamphetamine Use
Methamphetamine use expanded across the globe. Numbers show that over 30 million people use methamphetamine worldwide. The main regions for methamphetamine trafficking are North America and East and Southeast Asia.
According to the National Institute on Drug Abuse, in 2017, about 1.6 million people reported using methamphetamine in the last 12 months. Additionally, 774,000 people reported using the drug in the past month.
In 2016, the average age of new meth users in the United States was 23.3 years old. Moreover, in 2017, approximately 964,000 people aged 12 or older had a methamphetamine use disorder. For the sake of comparison, that number a year earlier (in 2016) was 684,000.
Important News For Methamphetamine Addiction Treatment
Although the use of methamphetamine keeps increasing, the medication protocol for the treatment of methamphetamine use disorder still doesn’t exist. It has become paramount to find and define an effective treatment protocol for this problem. A team of scientists at the University of Texas carried out a study whose main objective was to assess the effectiveness of the combination of naltrexone and extended-release bupropion in treating methamphetamine use disorder.
The randomized and double-blind 12-week trial was conducted on eight sites in a period between May 23, 2017, and July 25, 2019. The trial evaluated the efficacy and safety of 380mg of extended-release injectable naltrexone administered every three weeks combined with once-daily oral extended-release bupropion taken 450mg per day. Some subjects received a placebo.
Participants were adults 18 to 65 years of age who wanted to quit or reduce methamphetamine use. A total of 403 subjects underwent randomization in stage one. Of these, 109 participants received the drug combination, while 294 were assigned to a placebo group. Of 225 placebo-group subjects who didn’t have a response in stage one and underwent randomization again in stage two, 114 were assigned to a drug combination group while 111 received placebo.
The average age of participants was 41, and a majority (68.7%) was male. On average, subjects used methamphetamine 27 of the 30 days before consent was provided.
The trial consisted of two stages, each lasting six weeks. Participants visited the clinic twice a week for drug screening of urine samples.
Results of the study were published in the New England Journal of Medicine, and they showed adherence to the assigned regimen in stage one was 75.1% for the naltrexone-bupropion group and 83.5% for the placebo group. In the second stage, adherence in the naltrexone-bupropion group was 77.4%, and for placebo, 82.0%.
A team of researchers measured primary and secondary outcomes of the combination of drugs in the treatment of methamphetamine use disorder. The primary outcome is a response, i.e., at least three negative drug tests out of four samples obtained in stage one or the end of stage two. In the first phase, 16.5% of subjects from the naltrexone-bupropion group and 3.4% from the placebo group had a response.
In other words, they had negative drug tests. As you can see, a combination of two drugs was far more effective in this aspect. Response at the end of the second stage was 11.4% for the naltrexone-bupropion group and 1.8% for the placebo group.
Upon the analysis of data, scientists found the overall weighted response was 13.6% in the drug combination group and 2.5% for the placebo counterpart.
Secondary outcomes revealed the percentage of subjects with methamphetamine-negative urine samples was 20.4% in the drug combination group and 12.3% in placebo during stage one. In the second stage, these outcomes were 19.2% and 13.4%, respectively. Secondary outcomes also included analyses and assessment of craving for methamphetamine and social functioning. These parameters were also in the same direction as primary outcomes.
Even though the percentage of participants who had a response in each stage was relatively low, a significant difference was observed in the weighted response between the two groups.
Scientists concluded the study confirming in persons with moderate or severe methamphetamine use disorder, treatment with a combination of naltrexone and bupropion over 12 weeks led to a higher response than placebo.
Significance of The Study
The significance of the above-mentioned study is immense because it’s the first time a medication therapy proved to be effective for the treatment of methamphetamine use disorder. It gives a glimpse of hope and a massive motivation boost to scientists and treatment centers alike to work together and find the best possible approach to help persons with disorder recover successfully.
Even though the success rate from the study doesn’t seem too high, it still demonstrates major progress in this field. Scientists note other medications used to tackle brain disorders, including addiction and mental illness, have similar response rates in patients. Naltrexone-bupropion therapy provides another tool for doctors to try with their patients.
Additionally, the authors of the study explain persons with methamphetamine use disorders could use these findings to consult their physicians and see whether this option is something they should try. Keep in mind the scientists do not claim the combination of two drugs would work for everyone, and it’s not something individuals can or should use on their own.
Yet another importance of this study is that it actually worked on people, and many of them had negative drug tests. This is particularly important if we bear in mind that many trials have failed before. Positive findings are a step in the right direction.
The success rate of the treatment could improve in time as doctors combine it with other treatment approaches, including behavioral therapy. What happens next is that the research team may move toward securing FDA approval.
How Do These drugs work?
Based on these findings, the exact mechanism of action is not entirely clear. A lot more research on this subject is necessary. One theory is that naltrexone works to decrease physiological cravings for meth.
On the other hand, bupropion exhibits antidepressant effects, thus easing anxiety people experience when they stop taking the drug. Emotional stress could trigger a relapse if not treated properly.
A combination of these two drugs (naltrexone and bupropion) could work to resolve that.
What is Naltrexone?
Naltrexone is one of two drugs involved in the study, so it’s important to learn a thing or two about it. In a nutshell, naltrexone is an FDA-approved medication for the treatment of opioid use disorder (OUD) and alcohol use disorder (AUD).
The drug is available in a pill form for alcohol use disorder treatment. But for opioid addiction, the extended-release intramuscular injectable form is used. The injectable form can also work for the treatment of AUD. Remember, that’s how naltrexone was administered in this study as well.
Naltrexone isn’t an opioid, and it doesn’t induce addiction. Also, naltrexone doesn’t cause withdrawal symptoms once a patient stops using it. The drug works to block the sedative and euphoric effects of opioids by binding and blocking opioid receptors. These actions may reduce and suppress cravings for the drug.
What is Bupropion?
Bupropion is a second drug explored in this study. Known by the brand name Wellbutrin, bupropion is an antidepressant medication that works in the brain. The drug acts on neurotransmitters, brain chemicals through which nerve cells communicate with one another. The imbalance of levels of neurotransmitters could contribute to depression.
In the process called reuptake, nerve cells may recycle released neurotransmitters. That’s where bupropion works. It functions to inhibit the reuptake of serotonin, dopamine, and norepinephrine. As a result, there are more of these neurotransmitters to transmit messages to other nerve cells.
In a combination of these two drugs, bupropion works to support the mental and emotional health of an individual.
Previous Research On This Subject
The latest study was the first to demonstrate significant progress in the treatment of methamphetamine use disorder, but it wasn’t the only one that attempted to find a solution. March 2020 issue of the CNS Drugs published a review of the research literature on pharmacotherapy for dependence on amphetamines or methamphetamine.
The review included 43 studies with a total of 4065 subjects and 23 individual pharmacotherapies used alone or in combination to treat methamphetamine use disorder. Their results showed no pharmacotherapy yielded convincing results for the treatment of dependence on methamphetamine or amphetamines.
Most studies were underpowered and had low treatment completion rates. The biggest drawback of most studies on this subject is a small sample size in a fairly defined, homogeneous population.
A different study from the British Journal of Clinical Pharmacology revealed that although there’s no specific medication treatment for methamphetamine use disorder, significant progress has been made in this field. The research showed various medications have failed to show efficacy in clinical trials.
But three double-blind placebo-controlled trials using modafinil, bupropion, and naltrexone have demonstrated positive results in decreasing methamphetamine or amphetamine use. That research was published ten years ago, and these drugs were used separately and were focused on other amphetamines.
The journal Addiction and Health published a study that also explored treatments for methamphetamine use disorder. The study confirmed that currently, there are no medications that have shown efficacy in the treatment of methamphetamine dependence.
Behavioral treatments could decrease the use of the drug, but additional treatments are necessary to provide enough clinical tools for healthcare professionals to treat the majority of individuals dependent on methamphetamine. The study highlighted the importance of developing new therapies to treat both dependences on methamphetamine and psychiatric comorbidities that may arise in this population.
Effects of Methamphetamine Misuse
The use of methamphetamine has spread across the planet, thus putting an increasing number of people at risk of jeopardizing their health. People with methamphetamine use disorder, or those whose loved ones experience this problem, need to be proactive and get much-needed help at the best methamphetamine rehab center for men in Texas.
Long-term abuse of methamphetamine has a number of consequences, including the development of addiction.
Let’s talk about the short-term effects of meth use first. They include:
- Faster breathing
- Rapid or irregular heartbeat
- Higher blood pressure and elevated body temperature
- Loss of appetite
- Disturbed sleep patterns
- Behavioral problems such as aggressiveness, irritability, violent behavior
Long-term effects of methamphetamine misuse are far more serious and include, but aren’t limited to, the following:
- Dental problems, known as “meth mouth”
- Permanent damage of heart or brain
- High blood pressure leading to stroke, heart attack, and/or death
- Damage to the lungs, kidney, and liver
- Mood-related problems
- Paranoia and hallucinations
- Skin sores caused by persistent itching and scratching
Methamphetamine use, when not managed properly, can induce structural changes in the brain. As a result, it may impair the emotional state and memory as well as other cognitive functions of the affected individuals. For that reason, it’s crucial to undergo medical detox for meth addiction near Dallas-Fort Worth.
The use of methamphetamine keeps increasing across the world, especially in the United States. Both short- and long-term effects of methamphetamine use disorder are serious and may even lead to death. At this point, there is no approved medication treatment for methamphetamine addiction.
Thanks to the latest study, that might change.
The study found that a combination of naltrexone and bupropion could help decrease meth use. While the success rate was low, the research is incredibly important as it paves the way to creating new approaches to tackle this serious problem. A combination of these drugs and behavioral therapies could also be useful, but more research is necessary.
John Eckelbarger is a Business Development Representative for Stonegate Center. With a BSA in Chemistry from the University of Texas at Austin, he has an interest in the neurobiology of addiction & pharmacology of drugs. He hopes to bolster Stonegate Center to the forefront of addiction medicine through bold, innovative content. He is currently pursuing his MBA in Finance from Texas Christian University.