A US government-funded study has provided evidence of a promising treatment for people struggling with methamphetamine. The study found that people who were given a combination of drugs were more likely to avoid the drug and report improvements in their lives than those who were given standard and placebo care. The findings are all the more encouraging because methamphetamine use disorder is particularly difficult to treat.
In recent years, the crisis of drug overdose has worsened. There have been over 70,000 overdose-related deaths in 2019and strongly expects 2020 to be worse, in part due to the covid-19 pandemic. Much of the focus on the crisis has been on opioids, but it has become clear that the abuse of other drugs – including stimulants such as methamphetamine – is also on the rise.
Although it is difficult for many people struggling with drug addiction to find help, there are treatments available for opiate use and alcohol use disorder, as well as for smoking cessation. These include cravings that reduce cravings and withdrawal symptoms that may be associated with counseling and therapy. However, to date there are no known drugs to reduce these symptoms specifically for the use of methamphetamine.
This new study, published A combination of two drugs was tested in the New England Journal of Medicine on Wednesday: bupropion, an antidepressant and smoking cessation aid, and naltrexone, used to help treat opioid and alcohol disorders.
The study involved 403 volunteers with moderate to severe methamphetamine use who were randomized to the treatment group or placebo. A second round of the study, which involved people in the placebo group who did not respond to treatment, was conducted with 225 volunteers. Those in the treatment group received an injection of naltrexone every three weeks and a daily bupropion pill, then were monitored for six weeks. Participants in both groups met weekly with clinicians and received counseling; their urine was also tested for methamphetamine.
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In both studies, the percentage of people who responded to treatment (defined as a negative test for methamphetamine at least three out of four times) was low for both groups. But it was significantly higher for people who took the combination of medications. On average, 13.6% of those taking bupropion and naltrexone responded to treatment, compared with 2.5% of those taking placebo. In the surveys conducted by volunteers, those in the experimental group appeared to report fewer cravings and a greater improvement in quality of life over the course of the study, although the researchers warn that these findings are less certain. There were no serious treatment-related side effects, but users had a higher risk of nausea, vomiting and constipation compared to the placebo group.
The benefits of this combination therapy are probably at least modest. But the authors note that the level of improvement seen in this study is roughly similar to other treatments established for some mental health disorders and substance use, including an unhealthy alcohol dependence. If nothing else, it could be the first evidence-based medicine to disrupt methamphetamine use, a serious disease that can lead to health complications such as injuries to the heart and brain, as well as hallucinations, paranoia and severe tooth decay and loss.
“This advance demonstrates that medical treatment for methamphetamine use can help improve patient outcomes,” said Nora Volkow, director of the National Institute on Drug Abuse, who helped conduct the study. statement issued by the federal agency.
Although the study paves the way for this combination therapy to be widely used for these patients, future studies will need to test how effective it can be in more real conditions and for longer periods of time, the authors wrote.