Study identifies first potential treatment for meth addiction

Researchers think they may have found the first medication treatment for meth addiction, a significant step toward stemming the increase in overdose deaths seen in recent years.

A study published Wednesday in The New England Journal of Medicine found that a combination of two medications may be a safe and effective treatment for adults with moderate or severe methamphetamine use disorder.

The phase three clinical trial studied the effects of the combination of Naltrexone, which is approved to treat alcohol and opioid use disorder, and Wellbutrin, an antidepressant, on adults with moderate or severe methamphetamine use disorder. It compared the effects to a control group of patients receiving placebos.

Patients receiving the drug combination responded at a significantly higher rate than those in the control group and reported fewer cravings and improvements in their lives.

Unlike with other substance use disorders, there is no approved medication treatment for methamphetamine use disorder.

“We’re very excited about the results because until now, despite a lot of research that has gone into the field, there has not been any successful trials for the treatment of methamphetamine addiction that involve medications,” said Nora Volkow, director of the National Institute on Drug Abuse, which conducted the trial.

“More and more, we’re seeing people dying from methamphetamine,” Volkow added. “There’s a deep concern of not being able to have medication treatment like we have for the opioid use disorder that could help prevent people from dying from the use of methamphetamine.”

Drug overdoses have been increasing for decades, with public attention mostly focusing on opioid deaths. But experts have become increasingly concerned about the recent spikes in deaths from stimulant drugs including meth and cocaine. More than 16,000 people died from meth-related overdoses in 2019, a tenfold increase from 2009. The increase in deaths is likely in part due to a more potent meth coming from Mexico and laced with fentanyl, a synthetic opioid 50 to 100 times more powerful than morphine.

Experts have worried the pandemic has worsened the problem, with more people turning to meth, relapsing in treatment and overdosing.

“We know that from researchers in the field and patient groups there has been on the one hand an increase in drug consumption associated with the COVID pandemic and then on the other hand, an increase in people relapsing, and an increase in mortality during the pandemic from overdoses,” Volkow said. 

The results of the new study are a sign of hope, Volkow said.

The study showed 16.5 percent of patients receiving the drug combination responded to treatment compared to the 3.4 percent of patients in the control group, which received placebos.

When screened a few weeks later, 11.4 percent of the treatment group had responded to treatment, compared to 1.8 percent of the control group.

While those numbers seem low, addiction is notoriously hard to treat, and the medication combination is as effective at treating meth use disorder as other medications are at treating other addictions like alcoholism.

Volkow said the next step will be to ask the Food and Drug Administration to approve the drugs for treatment of methamphetamine use disorder so it is covered by insurance plans. Doctors can already prescribe the drug combination to patients with meth use disorder, but insurance plans may not cover it if it isn’t approved by the FDA for that purpose.

“Finally, a meditation that can help improve the outcomes and help people achieve sobriety and recovering,” Volkow said.