A US government-funded study has shown hopeful treatment for people struggling with methamphetamine use. The study found that people who receive a combination therapy of medication tend to avoid the drug and report improvements in their lives. The findings are all the more encouraging because it is especially difficult to use methamphetamine.
In recent years, the drug overdose crisis has only worsened. There were more than 70,000 overdose deaths in 2019, and 2020 is strongly expected to be worse, thanks in part to the covid-19 pandemic. Much of the focus on the crisis has been on opioids, but it has been shown 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 get help, there are treatments for opioid use and alcohol use, as well as quitting smoking. These include medications that reduce urge and withdrawal symptoms that may accompany counseling and therapy. To date, however, no medication is known to specifically reduce these symptoms.
This new study, published Wednesday in the New England Journal of Medicine tested a combination of two medications: bupropion, an antidepressant and smoking cessation, as well as naltrexone, which is used to treat opioids and alcohol disorder.
The trial involved 403 volunteers with moderate to severe use of methamphetamine, randomized to the treatment group or placebo. A second round of trial, involving people in the placebo group who did not respond to treatment, was done with 225 volunteers. Those in the treatment group received an injection of naltrexone and a daily pill bupropion every three weeks, after which they were monitored for six weeks. Participants in both groups met clinicians weekly and received counseling; they also had their urine tested on meth.
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During the two trials, the percentage of people who responded to the treatment (at least three out of four times tested negative for meth) was low for both groups. But it was noticeably higher for people using the medication combination. 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 the volunteers, those in the experimental group appeared to report fewer urges and a greater improvement in quality of life over the length of the trial, although the researchers note that these findings are less certain. There were no serious adverse effects associated with the treatment, but users did show a higher risk of nausea, vomiting and constipation compared to the placebo group.
The benefits of this combination therapy are probably modest at best. However, the authors note that the level of improvement seen in this study is approximately the same as other established treatments for mental health and drug use disorders, including an unhealthy dependence on alcohol. If nothing else, it could be the first evidence-based medication for the use of methamphetamine, a serious illness that can lead to long-term. health complications such as heart and brain damage, as well as hallucinations, paranoia and severe tooth decay and loss.
“This advance shows that medical treatment for the use of disorders methamphetamine can help improve the patient’s outcomes,” said Nora Volkow, director of the National Institute on Drug Abuse, who helped manage the study. statement released 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-world conditions and for longer periods of time, the authors wrote.