Current and Emerging Treatments for Methamphetamine Use Disorder PMC

Four authors (FDC, GLD, MC, RDG) independently screened the references retrieved by the search, selected the studies, and extracted the data, using a predefined data-extraction sheet. The same reviewers discussed any uncertainty regarding study eligibility and data extraction until consensus was reached; conflicts of opinion were resolved with another member of the review team (AC). No study we reviewed directly compared outcomes between outpatient- and inpatient-treated participants.

Mental Illness Awareness Week

• Almost two decades have passed since the last methamphetamine (METH) abuse epidemic.
• However, there were positive signals from several agents that warrant further investigation in larger scale studies; agonist therapies show promise.
• In addition to epigenetics and transcription, alterations of alternative splicing might contribute to the neurobiological changes in the CUD brain, as shown in other SUDs.

They receive advice from a trained therapist on how to avoid relapse and how to socialize in a drug-free environment. As part of the Matrix Model therapy, families are encouraged to actively participate in the recovery of their loved one. The Matrix model therapy has been effective in reducing METH use and craving during treatment and has shown somewhat better retention and abstinence rates than other behavioral interventions 74.

• C. Blinding of participants, personnel, and outcome assessor was considered separately for objective outcomes (discontinuation rates) and subjective outcomes (global state, craving, and withdrawal symptoms).
• Other substance use and social environments will also feature when determining the best setting for clinical care 75.
• The effects of chronic and regular high-dose AMPH/MA use are more complex than occasional use, and may involve the development of a substance use disorder—characterised by social and physiological (e.g. tolerance, withdrawal) manifestations 5.
• Various non-pharmacological approaches have effectively reduced METH use in study participants, with CM producing the strongest effect.

Treatment and Recovery

Future research must address the heterogeneity of AMPH/MA dependence (e.g. coexisting conditions, severity of disorder, differences between MA and AMPH dependence) and the role of psychosocial Amphetamine Addiction intervention. The severity of withdrawal symptoms is greater in amphetamine dependent individuals who are older and who have more extensive amphetamine use disorders (McGregor 2005). Withdrawal symptoms typically present within 24 hours of the last use of amphetamine, with a withdrawal syndrome involving two general phases that can last 3 weeks or more. The first phase of this syndrome is the initial “crash” that resolves within about a week (Gossop 1982; McGregor 2005). A subacute, protracted set of withdrawal symptoms that generally resolve in 3 weeks and that are not as well defined, include continued sleep disturbances (mild hypersomnia or insomnia and continued increased appetite (McGregor 2005;Gossop 1982). Although the most severe symptoms occurring during amphetamine withdrawal resolve in a week or less, some symptoms may continue for weeks or months (Watson 1972; Hofmann 1983).

S1 Data. Open data extraction.

GABAergic (blue) interneurons within the ventral tegmental area regulate the activity of dopaminergic neurons projecting to the nucleus accumbens. METH enters the dopaminergic terminal via the dopamine transporter (DAT) where it subsequently enters dopamine storage vesicles via vesicular monoamine transporter 2 (VMAT2) (black arrows). Dopamine is released from the storage vesicles to the cytoplasm and subsequently to the synaptic cleft via METH-induced reversal of the DAT and activates postsynaptic dopamine D1 and D2 receptors. (A higher resolution/colour version of this figure is available in the electronic copy of the article).

Treatment programs

In this review, a valid scale means a scale that has been published in a scientific journal. All searches included non‐English language literature and studies with English abstracts were assessed for inclusion. Although there are a variety of amphetamines and amphetamine derivatives, the word “amphetamines” in this review stands for amphetamine, dextroamphetamine, and methamphetamine. It may help to get an independent perspective from someone you trust and who knows you well.

• This document is prepared and intended for use in the context of the Canadian health care system.
• In the previous version of the DSM (DSM-IV) 7, the classification listed ‘dependence’ rather than ‘use disorder’; with ‘moderate to severe’ SUD being regarded as equivalent to ‘dependence’.
• Among adults aged 26 or older, the percentage with a past-year MUD increased from 0.3% (or 539,000 people) in 2016 to 0.4% (or 904,000 people) in 2019 (Fig.1B) 8.
• None of the six studies achieved a statistically significant difference in abstinence or reduction in use between the bupropion and placebo arm in planned primary outcome analyses.