With meth related deaths on the rise and no FDA-approved treatments, researchers are finding repurposed drugs that may help addicts stay clean.
While the opioid addiction crisis has garnered much-needed national attention, deaths due to another highly-addictive drug have also been on the rise across America.
Overdose deaths from the highly-addicted stimulant drug methamphetamine increased 10-fold from 2009 to 2019, to over 16,500 a year. Amidst the global pandemic, meth overdoses surged even higher by roughly a third, with 19,600 deaths over a 12-month period ending in June 2020.
There are currently no FDA-approved treatments for deadly meth addiction, but a study published this week by the New England Journal of Medicine hopes to change that.
In the study, researchers found that a combination of two existing drugs can help some addicts cut back on their use. In a double-blind, placebo-controlled clinical trial of more than 400 regular meth users, 13.6% of participants had repeated clean urine tests, compared to just 2.5% of those given the placebo.
“This is a very serious illness with fatal consequences for which there are no available treatments,” said Madhukar Trivedi, the chief of the mood disorders division at the University of Texas Southwestern Medical Center and the lead author of the paper. “There is hope now for methamphetamine use disorder.”
The two drugs used in the trial were injectable naltrexone – a common treatment for opioid use disorder – and oral bupropion – an antidepressant and smoking cessation medication.
“Methamphetamine use disorder is a really difficult disorder to treat, and a really devastating illness,” said Miriam Komaromy, the medical director of Boston Medical Center’s Grayken Center for Addiction. “This study provides one of the very few medication tools that we have reason to believe is helpful for treating methamphetamine use disorder, so I’m actually quite excited.”
According to 2015 data, around 6% of Americans 12 and older have tried this highly addictive stimulant at least once. That number is likely higher now with depression rates tripling in 2020 and desperation on the rise in a time of job loss and isolation.
Methamphetamine use floods dopamine into the brain, heightening not only the user’s pleasure emotions but also increasing motivation, movement, memory and learning. A meth high makes a person alert, energized and feeling great until the significant “crash” as the drug wears off. No high is as intense as the very first experience, causing individuals to increase their use, “chasing” that level of high.
With repeated use, the brain builds up a tolerance to the drug that requires higher doses more often to achieve the effects they’ve felt before. These characteristics of the drug coupled with the lack of approved treatments make meth addiction dangerous and in grave need of better help.
“More and more, we’re seeing people dying from methamphetamine. 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.
The next step will be obtaining FDA approval for repurposing the drugs to treat methamphetamine use disorder. Doctors would already be able to prescribe the combination to patients, but without FDA approval for that purpose, it likely wouldn’t be covered by insurance.
Naltrexone is sold under the brand names ReVia and Vivitrol among others. The oral medication bupropion is manufactured by GlaxoSmithKline under four different drug names, the most well-known likely being the antidepressant Wellbutrin.
