New Medication-Assisted Treatment Options For Meth Addiction

Methamphetamine is a synthetic psychostimulant that causes the release of monoamine neurotransmitters while blocking their future reuptake. Monoamine neurotransmitters include dopamine, norepinephrine, and serotonin, a stable regulation of which is crucial to mental and physical health. In 2020, 2.6 million people ages 12 or older reported using meth in a time span of 12 months; furthermore, an estimated 1.5 million people ages 12 or older exhibited methamphetamine use disorder. Generally, meth addiction is treated via behavioral therapies such as cognitive-behavioral therapy and contingency management interventions. However, new medication-assisted treatment (MAT) options have recently emerged for methamphetamine use.

What Is Methamphetamine Use Disorder?

Methamphetamine, also known as amphetamine-type substance disorder, use disorder refers to the illicit use of methamphetamine as a drug of abuse. Amphetamine is the parent substance to methamphetamine and can have medical usage. For example, methamphetamine hydrochloride (Deoxsyn) is a drug pharmaceutically available to treat attention deficit hyperactivity disorder (ADHD). The abuse of methamphetamines is an increasing problem in the United States, with an estimated 2% of Americans reporting meth use. Use varies geographically, but meth use is one of the fastest-rising substances of abuse worldwide.

What Are The Effects Of Meth Use?

Methamphetamines act as neurotoxins that can cause a severe decline in cognitive function, and brain damage after prolonged use. On top of this, meth can have many other negative side effects on the body.

Symptoms shortly after meth use include:

• Increased alertness and physical activity
• Loss of appetite
• Faster breathing
• Cardiac arrhythmias (irregular heartbeat)
• Tachycardia (rapid heartbeat)
• Hypertension (high blood pressure)
• Hyperthermia (high body temperature)

Long-term, chronic symptoms of meth use include:

• Extreme weight loss
• Addiction
• Severe tooth decay and gum disease
• Excess itching and skin sores due to scratching
• Anxiety
• Neurological changes
• Disorientation or confusion
• Memory loss
• Violent behavior
• Paranoia
• Hallucinations

Aside from such an extensive list, prenatal methamphetamine use (using meth during pregnancy) can cause dire pregnancy complications and extremely harmful effects on a baby in the womb. Some of these can include:

Effects On The Baby

• Low Birth Weight
• Birth Defects
• Malformations
• Brain Development

Pregnancy Complications

• Placental Abruption
• Preeclampsia
• Preterm Birth

Meth use also brings forth many more harmful effects that are not as often considered. For example, meth use is also linked to child neglect, endangerment, and abuse. In addition, meth use is known to cause drastically increased libido, commonly to the point of sexual aggression. With this can come a propensity to sexual assault crimes and susceptibility to sexually transmitted diseases.

Signs Of Meth Addiction

Meth addiction is not very difficult to spot, considering its long list of side effects and consequences. However, drug addiction may not be noticeable for those who haven’t been around it, or who don’t have any experience with it.

Here are some signs that you or someone you know are on meth.

• Hyperactivity
• Twitching, facial tics, jerky movements
• Paranoia
• Dilated pupils
• Noticeable and sudden weight loss
• Skin sores
• Rapid eye movement
• Reduced appetite
• Agitation
• Burns (particularly on the lips or fingers)
• Erratic sleeping patterns
• Rotting teeth
• Outbursts or mood swings
• Extreme weight loss
• Financial troubles

If you or a loved one exhibit a few or more of these symptoms, there is a likelihood of meth use disorder.

Current Treatments For Meth Addiction

As mentioned, the current treatment options for methamphetamine use disorder are limited. Until recently, treatment providers have primarily offered cognitive behavioral therapy (CBT), contingency management, and the matrix model. We will discuss these methods briefly, as they are good tools for overcoming meth addiction.

Cognitive Behavioral Therapy

Cognitive behavioral therapy, or CBT, is a type of psychotherapy that is particularly useful in treating a wide range of mental health issues, such as mood disorders, anxiety disorders, and substance use disorders. CBT involves changing a patient’s negative thought patterns, subsequently improving their behaviors, as well as providing healthy coping mechanisms that a patient can implement into daily life. CBT, in conjunction with other treatments, is often recommended to treat anxiety, depression, bipolar disorder, schizophrenia, substance use disorders, and eating disorders. CBT has proven effective for a wide range of disorders; however, evidence to show that CBT can have any profound impact on meth addiction is sparse.

Contingency Management

Contingency Management involves offering some sort of incentive for a patient to cease the use of their drug of choice. Most commonly, patients are given a monetary reward for abstinence from a substance. Contingency Management often works because it provides a tangible reinforcement to alter a patient’s behaviors. Of course, contingency management is paired with rehab of some sort and must be closely monitored to ensure honesty from a patient. Contingency Management came around in the 1960s, initially for the intervention of alcohol addiction. Now, contingency management is used in rehabs across the country for several substances. In fact, several clinical studies found that contingency management, in conjunction with a typical rehab facility, is very effective for treating patients addicted to cocaine and methamphetamine.

The Matrix Model

The Matrix model is a well-structured, multi-component behavioral treatment model. The Matrix model involves using multiple evidence-based practices in a sequential, clinical manner. The evidence-based methods included in the Matrix model are cognitive behavioral therapy, contingency management, 12-step facilitation therapy, relapse prevention, family therapy, group therapy, psycho-education, and self-help. Several studies have found the matrix model to be highly effective for treating substance abuse disorders. In 1985, a study found that drug users who chose the Matrix model, instead of a 28-day inpatient hospital program or a typical 12-step program, showed lower rates of substance use 8 months later. Another study, focused specifically on methamphetamine users, showed that patients significantly reduced drug use two to five years after the study. A majority of these patients could also stay out of jail and become gainfully employed, regardless of drug use results. Furthermore, a 48-session alternative Matrix model was used for gay and bisexual men who were abusing meth and engaging in sexual acts risky to their health. This study showed that participants were less inclined to engage in risky sexual behavior, resulting in less HIV and AIDS.

New Medication-Assisted Treatment (MAT) Options For Methamphetamine

Historically, MAT has not been an option for methamphetamine addicts. However, this is now changing, as two medications — naltrexone and bupropion — are in discussion as potential tools for substance use disorder treatment administrators. There are many benefits to medication-assisted treatments, and if used with previously mentioned treatments, MAT could be a huge factor in improving available treatment plans for methamphetamine addicts.

What Is Medication-Assisted Treatment?

MAT stands for Medication-Assisted Treatment. MAT is a treatment used for substance abuse problems, specifically for addiction to drugs like heroin and opiates, as well as alcohol and nicotine. Now, we are seeing the emergence of medications useful in the treatment of methamphetamine use disorder. Medication-assisted treatment involves taking pharmacological medications to curb the withdrawal process. Typically, MAT takes place as a specialized treatment to monitor patients and aid recovery. However, it is also common for MAT to be used in primary care practices, meaning it doesn’t have to be done at a specialty facility. An American Society of Addiction Medicine (ASAM) study discovered that Medication-Assisted Treatment is widely underutilized, perhaps because of misconceptions about how the treatment works, its benefits, and how to get started.

Some argue that the addition of a new drug, even when used to treat the abuse of another drug, is simply replacing one addiction with a new one. This however is entirely inaccurate. Drugs used during MAT are drastically less addictive than substances like fentanyl or oxycontin. The FDA has approved 4 drugs for opioid addiction recovery, 3 drugs for tobacco addiction, and 3 drugs for alcohol addiction. However, as of right now, there are unfortunately no drugs approved by the FDA for methamphetamine use.

Benefits of Medication-Assisted Treatment

Medication-assisted treatment has proven successful for a wide range of substances, such as heroin, alcohol, nicotine, and — now, it seems — methamphetamines. Here are some reasons MAT plans are so effective.

• Cravings. Anyone who’s ever tried to quit a substance or bad habit likely knows how strong cravings for said addiction can truly be. The medication used to assist detox treatments is effective at minimizing these cravings. These drugs act to block opioid receptors, which tricks the brain into thinking it has already received the drug of choice. As you could imagine, this drastically reduces the experience of cravings during the detox treatment process.
• Withdrawal Symptoms. The primary goal of substance abuse treatment medications is to minimize withdrawal symptoms. Withdrawing from a substance can take a toll on your mind and body, which prevents many people from getting the help they need. MAT effectively combats this aspect of detoxing by changing the brain’s relationship to pain. Simply, it makes withdrawal symptoms significantly more manageable.
• High Patient Retention Rate. The success rate of MAT is tremendous, and therefore, it leads to fewer relapses. Because withdrawals and cravings are less intense, people are more likely to stick with treatments. Studies show a high treatment retention rate for patients partaking in medication-assisted treatment.
• Customizable Treatment Plans. Medication-assisted treatment is the use of medications, combined with counseling and therapy, to provide a “whole-patient” approach to substance abuse disorders. Therefore, no one treatment plan is exactly the same, meaning they are customizable to what a patient needs. Just like with therapy, one can take the lead in their recovery with MAT, which helps solidify their healing.
• Extended Medical Support. As mentioned, MAT takes place with trained professionals to make sure you get the right plan for you to beat your addictions. Withdrawal from opiates, as well as from heavy alcohol use, can have dire unexpected consequences for your body. Withdrawing from a substance without proper care and support can cause serious bodily harm and even fatality. With MAT, patients will receive the medical support they need to deal with inevitable discomfort and potential complications.

MAT Specifics For Methamphetamine

As mentioned, medication-assisted treatment has been unavailable to use for patients with methamphetamine addiction, or amphetamine-type substance use disorder. This is simply because there are no FDA-approved drugs specifically for meth addiction. However, recent studies have come to light, showing that certain drugs can help meth addicts get clean and manage withdrawal symptoms. The research for these drugs shows strong efficacy and potential for medication-assisted treatment of meth users.

A notable study funded by the U.S. National Institute on Drug Abuse, and published in The New England Journal of Medicine, showed that patients who used naltrexone and bupropion had better treatment outcomes than those who did not. It showed also that the combined use of naltrexone and bupropion had lots of strong benefits for patients. Specifically, these drugs reduce meth cravings, improved social functioning, improved quality of life, and prevented relapse to meth use.

Some more drugs that are being considered for methamphetamine medication-assisted treatment include:

• Bupropion, an antidepressant that has similar effects to meth. Research shows that it could aid meth withdrawal, as well as mend the brain-damaging effects of meth use.
• Modafinil, which also has a similar effect to meth, could help manage withdrawal symptoms and brain functioning in addicts.
• Naltrexone which is already used in MAT programs for alcohol and opioids. It could also potentially be used to minimize withdrawal cravings.
• Topiramate. This drug serves to increase the neurotransmitter, GABA, in the brain. For this reason, Topiramate helps people feel more relaxed and therefore could curb cravings for meth or amphetamine-type substances.
• Ibudilast. This drug attenuates the inflammatory effects of meth in methamphetamine users. It follows that Ibudilast could help to make the transition away from meth easier for patients.

We Can Help You Overcome

Although these medications, or any drugs for meth MAT, are currently unavailable, the research is showing that potential is there. This is good news for those struggling with and suffering because of methamphetamine addiction or amphetamine-type substance use disorder. Furthermore, the current options that are available, namely cognitive behavioral therapy, contingency management, and the matrix model, or a mix thereof, can be incredibly useful to help people get clean from a range of substances, including methamphetamine. If you or a loved one is using meth or amphetamine-type substances, please reach out to us to discuss ways we can help.