Treatment for Methamphetamine Use

"Methamphetamine is a highly addictive psychostimulant with evidence of neurotoxic properties (1–3) and is consistently ranked as one of the most harmful illicit substances—both to the person using and to society (4, 5). Methamphetamine use disorder is a chronic relapsing condition increasingly associated with harms that include mental and physical illness, intimate partner violence, family disruption, health care system pressures, homelessness, crime, and mortality (6–10). At present, there are no approved medications to treat methamphetamine use disorder, despite a large body of research investigating potential pharmacological interventions (10–12). The most effective non-pharmacological evidence-based intervention for the management of methamphetamine use disorder is contingency management, a non-psychotherapy behavioral approach that most often involves monetary-based reinforcement for drug-negative urine specimens (13, 14). In practice, psychotherapy is often the standard of care given resource limitations in real world settings, including cognitive behavioral therapy and motivational interviewing. Multiple barriers to treatment exist, such as stigmatizing experiences within the health care system and existing treatment options not meeting patient needs (15). Moreover, people who use methamphetamine consistently demonstrate more challenges in treatment and recovery compared to those using other substances (16, 17). A recent systematic review estimated methamphetamine treatment drop-out rates to be 53.5% (95% CI: 16.5, 87.0), the highest compared to other substances, including the psychostimulant cocaine, with the average drop-out across all substances being 30.4% (95% CI: 27.2-33.8) (18)."